Industry Reports

November 2009

Biosimilars: TNF-Alpha Inhibitors and Interferon-Alphas in Immune and Infectious Disease

Report Authors
Michael Malecki, Ph.D.
MaryEllen Klusacek, Ph.D.

Introduction:

Since the launch of the first biosimilar human growth hormone (hGH) in 2006, biosimilars have become increasingly important to pharmaceutical companies as they try to protect revenue streams from their major brands. Previously, branded biologics were protected from the type of generic erosion that eventually faces all small-molecule therapies by the absence of an abbreviated regulatory pathway for approval of biosimilars. As regulatory agencies have now established, or are in the process of establishing, pathways for approval of biosimilars, companies marketing major biologic brands need to characterize and account for impending competition.

This report forecasts the impending erosion faced by the following biologic drugs used to treat hepatitis C virus (e.g., interferon [IFN]-alphas) and immune disorders including Crohn’s disease, ulcerative colitis and rheumatoid arthritis (e.g., tumor necrosis factor-alpha [TNF-α] inhibitors).

- IFN-alphas—for example, Schering-Plough’s Intron A (IFN-alfa-2b) and Peg Intron (pegylated IFN-alfa-2b); Roche’s Pegasys (pegylated IFN-alpa-2a).

- TNF-α inhibitors—for example, Amgen’s Enbrel (etanercept), Abbott’s Humira (adalimumab), and Centocor Ortho Biotech/Schering-Plough’s (infliximab).

Biologics today are some of the most effective agents on the market, and yet many are also the most expensive agents available. Managing the costs associated with TNF-α inhibitor therapy, in particular, is a concern shared by payers, physicians, and patients. The prospect of lower cost biosimilars in gastroenterology and rheumatology has created a balancing act between payers’ desire to limit spending on chronic therapies and physicians’ demand for clinical proof of biosimilars’ equivalent efficacy versus branded reference agents. This report uses our extensive primary research with U.S. and European specialists as well as U.S. payers to highlight the key expectations of each stakeholder that will drive or constrain biosimilar adoption.

Questions Answered in This Report:

  *   Payer perspectives: We gathered survey data from 41 U.S. pharmacy and medical directors detailing their outlook on biosimilar adoption and the impact biosimilars will have on their business. Which classes of drugs most concern payers, and how will payers encourage uptake of biosimilars to reduce spending in these classes? Which reimbursement controls will payers use most often, and how do payers expect physicians to react to these controls?

  *   Physician perspectives: Our survey of 75 gastroenterologists and 78 rheumatologists across France, Germany, and the United States reveals that expected uptake of biosimilars among rheumatologists and gastroenterologists differs by drug class and indication. What clinical and commercial features of biosimilars will most strongly drive and/or constrain uptake of biosimilars among gastroenterologists and rheumatologists? Which tactics can makers of branded biologics use to encourage physicians to continue prescribing branded agents instead of biosimilars? How susceptible are gastroenterologists and rheumatologists to these tactics, compared with other physicians?

  *   Market forecast: Across the U.S. and EU5 markets, we project biosimilars of TNF-α inhibitors covered in this report will erode $9.6 billion in brand sales, saving the healthcare system $4.0 billion in the process. We forecast more modest erosion of brand sales in the hepatitis C virus market, with a loss of $500 million in brand sales attributable to biosimilar IFN-alphas. Which brands will see the most dramatic biosimilar erosion? How will biosimilar erosion of brands used in gastroenterology and rheumatology compare with that of brands used in other therapeutic areas? How will reference pricing affect biosimilar erosion of branded sales differently in Europe than in the United States?

Scope:

Markets covered: United States, France, Germany, Italy, Spain, and United Kingdom.

Primary research—Physicians: Surveys with 75 gastroenterologists and 78 rheumatologists across the United States, Germany, and France, each with at least three years experience post-residency.

Primary research—Payers: Surveys with 41 U.S. pharmacy and medical directors, each with at least three years experience on their plan’s Pricing and Therapeutic Committees and each responsible for at least 100,000 covered lives.

Market forecast features: Annualized, 11-year market forecast (2008-2018) with full transparency of forecasting assumptions. Class-level biosimilar trends to allow clients to see how biosimilar erosion of their brand compares with that of their closest competitors and to facilitate informed choices on which analogues are most appropriate for forecasting a given brand. Timeline for biosimilar entry in the major markets, with key challenges resulting from the current and anticipated regulatory environment. Custom forecasting tool with our complete forecasts that allows user modification.

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