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U.S. Payers Intend to Limit Preferred Coverage to Only One Immune Biologic
Date:8/6/2009

NASHVILLE, Tenn. and GLEN ROCK, N.J., Aug. 6 /PRNewswire/ -- HealthLeaders-InterStudy and Fingertip Formulary find that 76 percent of surveyed pharmacy directors say that by 2014 they expect their managed care organization will have only one preferred biologic for all immune conditions, such as rheumatoid arthritis, psoriasis, Crohn's disease and ulcerative colitis. According to the new Formulary Forum report entitled Formulary Advantages in Immune Biologics: Tightening Payer Control Offers Opportunities for Differentiation, Centocor Ortho Biotech's Remicade and Abbott's Humira stand to most directly benefit from this strategy as these drugs are currently marketed and/or in development for multiple indications.

However, therapeutic area tenders, which are closed bids that pharmaceutical companies submit to payers that would give preferred access to patients at a set price, may present an opportunity for drug makers to compete with agents that are approved for multiple indications. More than half (58 percent) of surveyed pharmacy directors say they currently use therapeutic area tenders or are likely to adopt them within five years.

"While pharmacy directors are telling us they will offer preferred coverage to only one immune biologic, therapeutic area tenders may help some brands remain competitive with Remicade and Humira," said Michael Malecki, Ph.D., product manager for Formulary Forum. "For instance, UCB's Cimzia received U.S. approval for rheumatoid arthritis in May, so with this additional indication, UCB now has greater flexibility in being able to use tenders as a contracting strategy to get a stronger foothold in the marketplace."

The new Formulary Forum report is based on a survey of 50 pharmacy directors who control national, regional and state-level managed care organizations, as well as historical formulary data from Fingertip Formulary.


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SOURCE HealthLeaders-InterStudy
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