Survey Of Payers And Gastroenterologists Finds Excitement Over The Prospect Of JAK Inhibitors To Treat Inflammatory Bowel Disease

Burlington, MA /PRNewswire/ - Decision Resources Group finds that surveyed health insurance medical and pharmacy directors as well as gastroenterologists look favorably on Janus kinase (JAK) inhibitors for use in Inflammatory Bowel Disease (IBD). A majority of surveyed payers regarded Pfizer's Xeljanz (tofacitinib) and Gilead/Galapagos' filgotinib as the emerging therapies that will have the greatest impact in ulcerative colitis and Crohn's disease, respectively, and a sizable majority of gastroenterologists expect to prescribe these agents within their first year on the market. An additional finding was that Johnsons and Johnson's Remicade (infliximab) continues to enjoy favorable market access despite the launch of the infliximab biosimilar, Pfizer's Inflectra. Indeed, at the time the survey was fielded, Inflectra had experienced little uptake according to surveyed gastroenterologists. Still, physicians expect that over time, payers will push them to use the biosimilar, and some payers report that they implement utilization management approaches to encourage its use.

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Other key findings from the Access and Reimbursement report entitled Access and Reimbursement| Ulcerative Colitis and Crohn's Disease| US:

• Johnson and Johnson's Stelara (ustekinumab) appears to be off to a strong start in Crohn's disease, with a level of market access comparable to that of Takeda's Entyvio (vedolizumab).
• Manufacturers of biologics used to treat IBD seek to improve their formulary positioning using a number of contracting strategies, including: tier exclusivity, rebates, and risk-based contracting. These risk-based contracts are increasing as drugmakers seek novel ways to partner with payers.
• Both physicians and payers expect that TNF-α inhibitors will remain the standard first-line biologics of choice for IBD, despite the emergence of novel biologics and oral therapies.
• There is a sizable discrepancy between the percentage of patients physicians believe are eligible for biologics, and the percentage who actually take them. A number of market access-related factors drive this discrepancy, including: high out of pocket expenses, payer restrictions, and patient preference.

Comments from Decision Resources Group Analyst (Brian Nasipak):

• "Drugmakers looking to compete in the IBD market need to overcome the entrenched favorable reimbursement status of the long-marketed TNF inhibitors. That said, gastroenterologists are excited about the JAK inhibitors' potential in a market where many patients are refractory to treatments already available although use may be relegated to later lines."
• "At this time there is little evidence to suggest that Remicade's market access position has suffered with the launch of biosimilar infliximab. J&J has had time to prepare for the biosimilar's launch and, at least for now, appears to have protected its place in the IBD market. We will be watching carefully to see how long they can maintain their position and to see what levels of discounting and rebates are needed to do so."

About Decision Resources Group
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