 Physician & Payer Forum --
February 2008
 In This Issue...
Until 2007, Centocor/Schering-Plough/Tanabe’s Remicade
(infliximab) dominated the Crohn’s disease (CD) and ulcerative colitis (UC)
markets as the only biological agent approved for either indication. The
January 2007 approval of Abbott/Eisai’s Humira (adalimumab) for CD heralded a
new, competitive era for biological agents in inflammatory bowel disease.
Several more biological agents are in late-phase clinical development for CD
and UC. While gastroenterologists welcome new treatments for often underserved patients,
MCOs will closely scrutinize these agents for cost-effectiveness and
improvement over existing treatments as they establish restrictions on biological
therapy and assign new agents to formulary tiers.
Decision Resources’ Physician & Payer Forum
report "The Emergence of New
Biologic Treatment Options for Crohn’s Disease and Ulcerative Colitis:
Physician and Payer Attitudes" explores the future of biological
therapy in the treatment of CD and UC, based on the view of prescribers and managed
care organization pharmacy directors (PDs).
We surveyed 101 gastroenterologists and 20 MCO PDs, and
compared their responses to assess similarities and differences. This survey
enabled Decision Resources to accomplish the following:
- Assess how gastroenterologists currently use marketed
biologics for CD and UC: To what extent have biologics penetrated the
markets for patients with moderate CD and moderate UC? After how many
lines of therapy with conventional agents (and which ones) do clinicians
turn to Remicade versus Humira? Is treatment of an acute episode still a
critical point of entry for biological therapy? How many patients who
achieve remission with biologics are transitioned away from them for long-term
treatment with conventional therapies?
- Evaluate the gastroenterologists’ and MCO PDs’ perceptions
of Remicade and Humira in terms of their relative performance in key
measures.
- Understand the extent to which gastroenterologists are
turning to off-label biological solutions to treat CD or UC.
- Understand how many patients fail to receive biologics or
first-choice biologics for cost or formulary-inclusion reasons.
- Measure the extent to which gastroenterologists plan to
use novel biological agents such as Biogen Idec/Elan’s Tysabri (natalizumab)
and UCB’s Cimzia (certolizumab pegol) in their clinical practice, and
which patients will receive these agents.
- Measure the cost-control strategies MCOs apply to Remicade
and Humira, learn how these will change during 2008, and evaluate how MCO
PDs perceive the cost-effectiveness of biologics.
- Understand the drivers of formulary inclusion and
reimbursement controls and offer insight on how companies need to
differentiate their brands to gain favorable placement.
- Determine the number of biologics that MCOs will reimburse
for UC prior to colectomy.
- Evaluate the dollar impact of key prescribing shifts
identified by the survey.
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