BURLINGTON, Mass., Dec. 5, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that—following the approval of Janssen Biotech's Stelara for psoriatic arthritis—about one-third of surveyed dermatologists expect to at least modestly increase the prescribing of Stelara as a first-line biologic. In addition, following the FDA's approval of self-administration for Stelara, 26 percent of surveyed dermatologists report that they would at least modestly increase prescribing Stelara as a first-line biologic, suggesting that convenience of self-administration could further increase Stelara's uptake.
The new U.S. Physician & Payer Forum report entitled Will the Anticipated Approval and Reimbursement of Novel Orals Result in a Major Shift in Biologics Prescribing in Psoriasis? finds that, among available biologics for psoriasis, Stelara currently has the highest level of formulary exclusion and National Drug Code blockage. However, following Stelara's approval for the treatment of psoriatic arthritis and for self-administration, more than half of surveyed Managed Care Organization pharmacy and medical directors who currently cover Stelara predict their plans are likely to move the drug to a preferred tier. Also, among those surveyed payers who do not currently cover Stelara, 83 percent indicate a willingness to start including Stelara on their formulary.
The psoriasis market is also set to incorporate Celgene's apremilast, an oral Phosphodiesterase-4 inhibitor expected to be approved in 2014. The findings reveal that if apremilast is placed on a preferred tier, 72 percent of surveyed dermatologists expect to prescribe this therapy. Among the dermatologists who expect to prescribe apremilast, 40 percent would consider prescribing it as a first-line systemic therapy if apremilast is in a similar formulary position as Amgen/Stiefel/Pfizer's Enbrel and AbbVie/Eisai's Humira. This finding is not surprising, given the drug's benign safety profile in trials reported to date and the convenience of the drug's oral formulation. This, combined with the agent's modest efficacy profile compared with Enbrel, suggests that apremilast's best use is for patients with less severe psoriasis than those who are biologics candidates. In addition, more than 70 percent of surveyed payers who plan to cover apremilast would consider reimbursing it on a preferred tier only if the drug is priced at a substantial discount (greater than 40 percent) to Humira.
"Apremilast's oral formulation and its likely lower price compared with biologics would persuade dermatologists to prescribe apremilast," said Decision Resources Analyst Eun-Jin Yang, Ph.D. "However, surveyed dermatologists who indicate a willingness to prescribe the drug anticipate that dissatisfaction with apremilast's efficacy profile and expectation of poor formulary coverage or a high copay will constrain prescribing of the drug."
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