Nearly One-Third of Surveyed Managed Care Organizations Levy Coinsurance Charges and Other Protocols on Remicade and Humira, According to a New
Report from Decision Resources
WALTHAM, Mass., March 4 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that although gastroenterologists are increasingly prescribing Centocor/Schering-Plough/Mitsubishi Tanabe's Remicade and Abbott/Eisai's Humira for the treatment of Crohn's disease and ulcerative colitis, a high proportion of managed care organizations (MCOs) subject both drugs to multiple cost-control strategies to keep costs down and limit the use of the two biologic therapies.
The new Physician & Payer Forum primary market research report entitled The Emergence of New Biologic Treatment Options for Crohn's Disease and Ulcerative Colitis: Physician and Payer Attitudes includes forecasts on the future of biological therapy in the treatment of Crohn's disease and ulcerative colitis, based on the views of prescribers and MCO pharmacy directors. According to the report, nearly one-third of the 20 MCOs surveyed levy coinsurance charges on Remicade and Humira and most plans require prior authorization for each drug. More than half of the plans that cover both drugs also employ step-therapy protocols. The report also finds that six of the 20 MCOs surveyed plan to extend their step therapy requirements during 2008 for Remicade, and five of 19 MCOs will do the same for Humira.
"Despite prior authorization and step therapy protocols that MCOs have
put into place, both Remicade and Humira are being increasingly prescribed
to patients with Crohn's disease," said Cindy Mundy, Ph.D. director at
Decision Resources. "Humira, which was approved for Crohn's disease in
January, 2007, is rapidly gaining ground on Remicade in terms of physician
perceptions of key measures. We also found that approxima
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