Physician and Payer Receptivity to Novel Oral and Biologic Agents vs. Biosimilars – A Survey of Dermatologists and Managed Care Organization Pharmacy and Medical Directors
For many years, dermatologists have relied upon tumor necrosis factor-alpha (TNF-α) inhibitors and conventional systemic treatments to treat patients with moderate to severe forms of the inflammatory skin disease psoriasis. Dermatologists now also have considerable experience with the IL-12/23 inhibitor Stelara, which threatens the position of TNF-α inhibitors as the mainstay of biologic treatment in psoriasis. The end of 2014 and beginning of 2015 saw the launch of two new agents, further altering the landscape of psoriasis treatment: Cosentyx (Novartis’s secukinumab) features a novel mechanism of action, with demonstrated superiority over both Stelara and the TNF-α inhibitor Enbrel (Amgen/Pfizer’s etanercept), and Otezla (Celgene’s apremilast) is the first new class of oral treatment approved for psoriasis in nearly 20 years. The next three years will bring further change, with the likely approval of an additional oral therapy, Xeljanz (Pfizer’s tofacitinib), two new IL-17 inhibitors (Eli Lilly’s ixekizumab and AstraZeneca’s brodalumab), and the introduction of biosimilar adalimumab to the U.S. market. This report examines the current practice and preferences of prescribing physicians and payers, and their attitudes and expectations about how these events will shape the treatment and reimbursement landscape for moderate to severe psoriasis.