BURLINGTON, Mass., Nov. 14, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that surveyed rheumatologists across the EU5 (France, Germany, Italy, Spain and the United Kingdom) currently prescribe biologics—largely Pfizer's Enbrel or AbbVie's Humira— to approximately half of their psoriatic arthritis (PsA) patients who are treated with a disease-modifying antirheumatic drug (DMARD). By the end of 2016, 58 to 86 percent of respondents in each EU5 market expect to prescribe the fifth TNF-alpha inhibitor approved for PsA—UCB's Cimzia—compared with 30 to 58 percent who expect to prescribe Janssen's first-in-class IL-12/23 inhibitor Stelara. Notably fewer surveyed physicians expect to prescribe other emerging therapies by this time point, including Celgene's oral phosphodiesterase-4 inhibitor apremilast and Novartis's IL-17 inhibitor secukinumab.
The European Physician and Payer Forum report entitled Moving Beyond the TNF-Alpha Inhibitor Class in Psoriatic Arthritis in Europe: How Will Payers and Prescribers React to an Expanding Array of Treatment Options? also finds that while a novel mechanism of action may be a pricing lever, given the limited treatment options for TNF-alpha-refractory patients in PsA, manufacturers must strive to show evidence that sets their new brand apart from currently available TNF-alpha inhibitors in order to optimize market access opportunity for emerging brands. The rising health technology assessment (HTA) bar is illustrated by a lack of comparative data which contributed to Simponi's (Merck) ASMR of V (i.e. no added benefit versus marketed comparators) in France, stringent benefit assessments in Germany and the upcoming requirement for a therapeutic positioning report in Spain that will consider clinical benefit and degree of innovation when evaluating emerging drugs. As the cost constrained EU5 markets strive to draw out value for money, increasingly demanding HTA and increasingly complex pricing and reimbursement negotiations are evident in all markets.
The report also finds that the majority of surveyed rheumatologists expect the earliest reimbursed treatment line for Stelara will be as a second- or third-line therapy for conventional DMARD-refractory patients, and surveyed physicians do not foresee apremilast achieving a more favorable reimbursed treatment line, despite the drug's oral delivery and favorable safety profile.
"By the end of 2016, surveyed physicians across the EU5 report they will more likely position emerging therapies Stelara and apremilast in the third- or later-lines than in earlier lines of therapy for their PsA patients," said Decision Resources Analyst Kathryn Beane. "Surveyed physicians cite multiple reasons, including efficacy and a lack of a postmarketing efficacy and safety record (for apremilast) as factors constraining their prescribing."
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