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U.S. Payers Intend to Limit Preferred Coverage to Only One Immune Biologic

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.


Members of the media are welcome to attend our upcoming webinar entitled How Will My Brand Be Affected? An Examination of the Reimbursement and Prescribing of Immune Biologics and the Emergence of Novel Cost Control Measures. This webinar will be held on Thursday, August 13, 2009 at 12 p.m. U.S. Eastern Time. For more information, contact Lisa Osgood at 781-296-2606.

About Fingertip Formulary

Fingertip Formulary (, the leading provider of access to and insight into formulary data in the United States, offers comprehensive formulary data covering commercial, Medicaid, Medicare and PBM plans, among others. The company offers a variety of unique data and marketing solutions for the pharmaceutical industry, consultants and healthcare providers that provide access to and insight into formulary data. Fingertip Formulary is a Decision Resources, Inc. company.

About HealthLeaders-InterStudy

HealthLeaders-InterStudy, a Decision Resources, Inc. company, is the authoritative source for managed care data, analysis and news. For more information, please visit

About Decision Resources, Inc.

Decision Resources, Inc. is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Both HealthLeaders-InterStudy and Fingertip Formulary are Decision Resources, Inc. companies. Please visit Decision Resources, Inc. at

All company, brand or product names contained in this document may be trademarks or registered trademarks of their respective holders.

    For more information, contact:

    Lisa Osgood                              Elizabeth Marshall
    HealthLeaders-InterStudy                 Decision Resources, Inc.
    781-296-2606                             781-296-2563             

SOURCE HealthLeaders-InterStudy
Copyright©2009 PR Newswire.
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