Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that 30 percent of surveyed rheumatologists have altered their prescription patterns for juvenile idiopathic arthritis and more than 10 percent have altered their prescription patterns for adult rheumatoid arthritis in response to the Food and Drug Administration's (FDA) investigation into the malignancy risk associated with TNF-alpha inhibitors.
In June 2008, the FDA launched an investigation into the malignancy risk associated with TNF-alpha inhibitors in pediatric and juvenile populations being treated for autoimmune diseases. Concerns were raised when 30 cases of cancer in pediatric and juvenile patients being treated for rheumatoid arthritis and Crohn's disease were reported between 1998 and 2008.
The new Physician & Payer Forum report entitled TNF-alpha Inhibitors in Pediatric Crohn's Disease and Juvenile Idiopathic Arthritis: How Will Physicians and Payers Balance Effective Treatments and Serious Safety Concerns? finds that, of the rheumatologists that have altered their prescription patterns for juvenile idiopathic arthritis, 71 percent say that they prescribe conventional disease-modifying antirheumatic drugs more frequently than they had in the past. Nearly 60 percent of surveyed gastroenterologists say they have altered their prescription patterns for pediatric Crohn's disease -- of these gastroenterologists, 42 percent indicate that they restrict TNF-alpha inhibitors to patients with more severe disease. Furthermore, 45 percent of gastroenterologists say that they have altered their prescribing habits in adult Crohn's disease patients.
The report also finds that one out of five surveyed managed care organization (MCO) pharmacy directors indicate that they will alter their reimbursement of TNF-alpha inhibitors for the treatment of juvenile idiopathic arthritis and pediatric Crohn's disease.
"Twenty percent of surveyed MCO pharmacy directors will alter their reimbursement of TNF-alpha inhibitors for juvenile idiopathic arthritis or pediatric Crohn's disease in the light of the FDA investigation," said Decision Resources Analyst Dancella Fernandes, Ph.D. "MCOs that plan to alter the reimbursement of TNF-alpha inhibitors expect to be more cautious in granting approval, but none cite the intention of routinely refusing reimbursement for autoimmune indications."
TNF-alpha Inhibitors in Pediatric Crohn's Disease and Juvenile Idiopathic Arthritis: How Will Physicians and Payers Balance Effective Treatments and Serious Safety Concerns? is based on a U.S. survey of 71 rheumatologists, 71 gastroenterologists, and 20 managed care organization (MCO) pharmacy directors. Their responses were compared to assess similarities and differences of opinion regarding clinical, economic and scientific factors.
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