How Much? Payers and the New Pfizer Inc. RA Pill

Published: Jan 04, 2013

Two months ago, the FDA approved a pill from Pfizer called Xeljanz that is being used to treat adults with moderately to severely rheumatoid arthritis who did not respond to, or cannot tolerate, methotrexate, a standard of care. Some Wall Streeters expect the drug, which competes with such biologics as Humira, to become a blockbuster. The drug is the first in a class of medications known as JAK inhibitors for RA and data has indicated the pill would offer similar efficacy to such widely used injectables that, collectively, generate some $13 billion in annual sales for treating rheumatoid arthritis. As noted previously, Xeljanz will also be the first new oral disease-modifying antirheumatic drug, or DMARD, for treating the affliction in more than a decade. But first, Pfizer (PFE) must satisfy payers. So what do they think of this newest drug? A new survey finds that payers would like to see less use of intravenous and injectable meds, such as Humira, and 64 percent believe patient compliance is very important, but dosing and administration routes are not priorities. At the same time, Xeljanz will be treated the same as other biologics in the RA category, with 77 percent of payers saying they will manage the drug regardless of mechanism of action or administration route. And two-thirds will position Xeljanz as a non-preferred drug under a pharmacy benefit with specialty pharmacy. The survey was conducted late last month by Reimbursement Intelligence, a market research and consulting firm, which queried 22 medical and pharmacy directors at national and regional health plans, as well as six medical directors, 15 pharmacy directors, and one clinical pharmacist.

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