Market Access Obstructs Newer Biologic And JAK Adoption In Rheumatoid Arthritis

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Despite frequent involvement with payers for the approval of biologics/JAKs in RA, rheumatologists report that their use is heavily impacted by the negative reimbursement and access environment, according to a recent report from Spherix Global Insights.(http://bit.ly/2bJfbtN)

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“Xeljanz really could be a first-line treatment after methotrexate if there were not so many insurance barriers.”

While the majority of surveyed rheumatologists (n=100) report that access to the traditional TNFs – Janssen’s Remicade, Amgen/Pfizer’s Enbrel and AbbVie’s Humira – is generally more favorable than that of other brands, cost and access issues still represent the greatest obstacle to expanded use of these agents.

Pfizer’s Xeljanz and Roche’s Actemra may feel the greatest pinch from a payer perspective. In fact, nearly half of the surveyed rheumatologists report that if insurance and cost were not an issue for prescribing Xeljanz they would increase their use of the JAK inhibitor and nearly one-quarter stated they would use Xeljanz earlier in their treatment algorithm, after methotrexate failure or prior to a TNF-inhibitor.

Indeed, one rheumatologist reports, “Xeljanz really could be a first-line treatment after methotrexate if there were not so many insurance barriers.”

The tense reimbursement environment coupled with rheumatologists’ high familiarity and excitement for baricitinib, Eli Lilly and Incyte’s phase 3 JAK inhibitor, will make its entry price point and formulary status all the more important. Rheumatologists report higher familiarity with baricitinib, than with the late-stage IL-6 inhibitors (Regeneron/Sanofi’s sarilumab and Janssen/GSK’s sirukumab) and 41% expect to use baricitinib routinely once it is approved. How routine the use of baricitinib will be and to what extent it will compete with Xeljanz will be strongly dependent upon a successful market access strategy.

RealTime Dynamix™: Rheumatoid Arthritis is an independent report issued on a quarterly basis that provides highly granular brand insights on the rheumatoid arthritis market. The next survey will field in September and will continue to track the RA market dynamics.

About Spherix Global Insights
Spherix Global Insights is a business intelligence and market research company specializing in renal, autoimmune, neurologic and rare disease markets. Our aim is to apply our commercial experience and unique relationships within core specialty markets to translate data into insight, enabling our clients to make smarter business decisions.

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Lynn Price, Franchise Head Immunology
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