Rheumatoid Arthritis – Access & Reimbursement – Detailed, Expanded Analysis (US)
The availability of multiple targeted therapies with diverse mechanisms of action, including biologics / biosimilars and oral agents, along with conventional treatments, makes the rheumatoid arthritis (RA) market increasingly crowded. The expected launch of R-Pharm’s IL-6 inhibitor olokizumab, Celltrion’s subcutaneous (SC) version of infliximab biosimilar Remsima, and multiple adalimumab biosimilars in 2023 will further fragment the market. Drug developers will undoubtedly face increasing challenges to gain favorable formulary positioning and physician uptake. In such scenarios, market access decisions for these therapies will play a key role in influencing rheumatologists’ prescribing behaviors in RA.
Questions answered
- 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 are / will be the most compelling to rheumatologists and payers of new therapies for RA?
- Do physicians expect to prescribe key emerging therapies, including olokizumab and Remsima SC, to their RA patients? How do payers intend to reimburse these emerging agents, and how will those decisions affect prescribing?
- How will the entry of multiple adalimumab biosimilars affect brand’s uptake? What factors will likely impact / influence the uptake of these biosimilars?
Content highlights
Geography: United States.
Primary research: Survey of 101 U.S. rheumatologists and 31 U.S. managed care organization (MCO) pharmacy and medical directors (PDs/MDs).
Key drugs covered: Enbrel, infliximab, Humira, Simponi, Cimzia, Orencia, Rituxan, Actemra, Kevzara, Xeljanz, Olumiant, Rinvoq, olokizumab, Remsima SC.
Reimbursement and contracting.
Access and prescribing.
Special topics.
Opportunities and challenges for emerging therapies.
Product description
U.S. Access & Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of U.S. payer policy on physician prescribing behavior in the market access environment, including up-to-date analysis of drug coverage and restriction policies and payer and prescriber perspectives on key marketed drugs and receptivity to emerging therapies.
Sheema Kher, M.Pharm., Associate Healthcare Research & Data Analyst, Immune and Inflammation. Ms. Kher has much experience in the U.S. market access and payer landscape and has analyzed formulary and payer restrictions in multiple therapy areas for diverse lines of business, including commercial, HIX, managed Medicaid, state Medicaid, and Medicare. She holds a master’s degree in drug regulatory affairs from Amity University in Noida.