Introduction:
The entry of biologics with
mechanisms of action that are novel to tumor necrosis factor-alpha (TNF-α)
inhibition has intensified competition in the rheumatoid arthritis (RA) market
and segmented the market for disease-modifying agents into the TNF-α
inhibitor and the TNF-refractory markets. Both markets have multiple biological
competitors, recent entrants, and late-stage agents vying for share of the
total $4.9 billion opportunity (2008 U.S. sales for RA).
Scope:
Decision Resources’ Physician
& Payer Forum report "The Rheumatoid Arthritis Biologics Landscape:
Differentiation and Reimbursement in a Crowded Market" explores the
current treatment of RA in the United States and the incremental improvements
that differentiate biological competitors. We surveyed 100 rheumatologists and
20 managed care organization (MCO) pharmacy directors (PDs) to achieve the
following:
- Determine what
patient share novel agents, particularly Pfizer’s CP-690550, can expect to
achieve within the disease-modifying antirheumatic drug (DMARD) market. Will
the TNF-α inhibitor market continue to be the primary growth engine of the
overall market? Will the biological DMARD market continue to expand?
- Explore physician
and payer expectations for the price of novel oral agents. When given different
price scenarios, what tier will payers assign these agents? What is the
critical price threshold that will result in preferred brand status in most
formularies?
- Understand
whether Roche’s Actemra will primarily serve the TNF-refractory market or be
prescribed ahead of the TNF-α inhibitors. How will this novel biologic
impact Bristol-Myers Squibb’s Orencia and Biogen Idec/Roche’s Rituxan?
- Understand how
the launches of Centocor Ortho Biotech’s Simponi and UCB’s Cimzia will impact
sales of Amgen/Pfizer’s Enbrel, Abbott’s Humira, and Centocor Ortho Biotech’s
Remicade.
- Explore why
clinicians will or will not prescribe emerging biological agents. Will
next-in-class biologics cannibalize their predecessors?
- Understand the
extent to which medical versus pharmacy benefit coverage drives prescribing
decisions.
- Glean clinicians’
and MCO PDs’ insights into the effect copay assistance programs are having on
prescribing for RA. What plans do MCOs have to respond to such programs?