A Survey of Rheumatologists and Interviews with Payers in the EU5
Rheumatoid arthritis (RA) is a complex autoimmune condition characterized by chronic and progressive joint inflammation that may result in permanent, debilitating tissue damage. Early intervention with disease-modifying antirheumatic drugs (DMARDs), both conventional and biological, can effectively treat the symptoms of RA and slow joint destruction. However, high-cost biological therapy is typically initiated, with TNF-α inhibitors, in patients who have failed therapy with conventional DMARDs. The non-TNF-α inhibitor biologics (e.g., MabThera [Roche’s rituximab], Orencia [Bristol-Myers Squibb’s abatacept], RoActemra [Roche’s tocilizumab]) largely compete for use in the TNF-refractory population. The launch of biosimilar versions of Remicade (Janssen’s infliximab) in the EU5 markets in early 2015, and the anticipated arrival over the next few years of biosimilars for the leading RA biologics, Enbrel (Pfizer’s etanercept) and Humira (AbbVie’s adalimumab), will drastically change the dynamics in this high-priced market. In the increasingly crowded and intensely competitive RA market, emerging RA agents will face rigorous HTA and P&R negotiations as payers and physicians aim to balance clinical efficacy with budgetary constraints. This report analyzes European rheumatologists’ and payers’ expectations and attitudes regarding the changing RA market through year-end 2018.