TNF-α inhibitors (e.g., Janssen's Remicade, AbbVie’s Humira) are well entrenched in the U.S. ulcerative colitis (UC) and Crohn’s disease (CD) markets. Newer therapies that offer alternative treatment options (i.e., Takeda’s Entyvio, Pfizer’s Xeljanz, and Janssen’s Stelara) and the increasing penetration of biosimilar infliximab (e.g., Pfizer’s Inflectra, Merck’s Renflexis) continue to expand the UC / CD treatment landscapes and are shifting UC and CD market dynamics. Additionally, the arrival of emerging agents—some with novel MOAs—including Gilead / Galápagos’ Jyseleca, AbbVie’s Rinvoq and Skyrizi, Janssen’s Tremfya, Eli Lilly’s mirikizumab, Takeda’s darvadstrocel, and BMS’s Zeposia, and physicians’ increasing prescribing of biosimilars will fuel competition and add to pricing pressure. Emerging therapies seeking favorable uptake in UC and/or CD will face an increasing number of market-access challenges.
- How do MCO restrictions impact physicians’ prescribing of biologics / oral targeted agents to their UC or CD patients?
- What is the current and expected formulary placement of key biologics / oral targeted agents (e.g., Zeposia, Skyrizi, Rinvoq), and how are utilization management strategies used by MCOs to control costs of these agents?
- How do payers expect to cover emerging therapies in their commercial health plans, and how does this coverage align with physicians’ anticipated prescribing of these agents?
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.
Key drugs: Remicade, Humira, biosimilar infliximab, Simponi, Cimzia, Entyvio, Stelara, Xeljanz, Rinvoq, Zeposia, Skyrizi, Tremfya, mirikizumab
Key Companies: AbbVie, Bristol-Myers Squibb, Eli Lilly, Janssen, Merck, Pfizer, Takeda, UCB, Celltrion Healthcare, Gilead, Galápagos.
- Ulcerative Colitis - Access & Reimbursement - Detailed, Expanded Analysis (US)
- Access & Reimbursement UC & CD US September 2021
Ritesh Gupta, Ph.D.
Ritesh Gupta, Ph.D., is a manager in the Immune and Inflammatory Disorders team at Clarivate. He has years of experience in competitive intelligence, scientific analysis, and market opportunity assessment and has worked in various therapeutic areas to provide strategic recommendations to pharmaceutical companies. He holds a Ph.D. in cell biology from the Max Delbrück Center for Molecular Medicine in Berlin.
Chris Lewis is a primary research manager at Clarivate. She is responsible for the coordination, content review, and content generation of U.S. Access & Reimbursement reports, including authoring select A&R reports on managed care trends. Before this position, Ms. Lewis was a senior analyst at HealthLeaders-InterStudy. She analyzed the managed care markets in California, New York, and Pennsylvania. She also launched and authored the Pharmacy Benefit Manager profile series. She received her bachelor’s degree from California State University in Sacramento.