Rheumatoid Arthritis | Access and Reimbursement | US | 2019


The availability of multiple targeted therapies with diverse mechanisms of action, including biologics / biosimilars and oral agents, together with conventional treatments, makes the rheumatoid arthritis (RA) market increasingly crowded. The recent launch of AbbVie’s upadacitinib and the expected launch of another Jak inhibitor (Galapagos / Gilead’s filgotinib) and a third IL-6 inhibitor (R-Pharm’s olokizumab) in the next few years will further fragment the market. Drug developers will undoubtedly face ever-increasing challenges to gain favorable formulary positioning and physician uptake. In such scenarios, market access decisions for these therapies will play a key role influencing rheumatologists’ prescribing behaviors in RA.


  • How does the coverage of therapies for RA differ on MCOs’ largest commercial insurance plans? How do various cost-control measures impact the prescribing of current therapies for RA?
  • How do pharmacoeconomic / health economic outcomes data impact formulary decision making for therapies for RA?
  • What points of differentiation of new therapies for RA are/will be most compelling to rheumatologists and payers?
  • Do physicians expect to prescribe the newly launched agent upadacitinib and key emerging therapies, including filgotinib and olokizumab, to their RA patients? How do payers intend to reimburse these agents, and how will those decisions affect prescribing?


U.S. Access & Reimbursement provides in-depth insight on the impact of payer policy on prescribing behavior so that clients can build their market access strategy and optimize their brand positioning. This analysis of primary market research with physician specialists and U.S. payers helps clients stay up-to-date on restriction policies, gauge payer and prescriber attitudes toward specific therapies, identify opportunities where brands can capture patient share through market access, and maximize opportunities for emerging therapies by learning how previous brands gained favorable reimbursement or why they stumbled.

Geography: United States

Primary Research: Survey of 100 U.S. rheumatologists and 31 U.S. managed care organization (MCO) pharmacy and medical directors (PDs / MDs)

Key Drugs Covered: Actemra, Cimzia, Enbrel, filgotinib, Humira, infliximab, Kevzara, olokizumab, Olumiant, Orencia, Rituxan, Simponi, Xeljanz, upadacitinib

Content Highlights:

  • Reimbursement and contracting.
  • Access and prescribing.
  • Special topics.
  • Opportunities and challenges for emerging therapies.
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