Decision Resources, Inc., one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that physicians report use of Centocor/Schering-Plough/Tanabe Seiyaku's Remicade among Medicare beneficiary rheumatoid arthritis (RA) patients has decreased since the Medicare Modernization Act (MMA) went into effect in January, 2006. According to the new PhysicianForum report entitled The Impact of Medicare Reform and the Launch of Novel Biologics on the Rheumatoid Arthritis Market, the number of physicians who choose Remicade as their first-line biologic for Medicare beneficiary RA patients has also decreased. Not surprisingly, the drop in use of Remicade coincides with a rise in use of Amgen/Wyeth's Enbrel and Abbott's Humira as first-line biologics among Medicare beneficiary RA patients.
"The impact of MMA on Enbrel, Humira, and Remicade use among Medicare beneficiary RA patients has not yet reached its full effect," said Melissa Stolper, therapeutic area director at Decision Resources. "Approximately 40% of surveyed rheumatologists say they expect their use of Enbrel and Humira among Medicare beneficiary RA patients to increase further in the coming year, compared with only 9% of physicians who report that their use of the two drugs will decrease during this time."
The report also finds that surveyed HMO pharmacy directors report that RA biologics covered as a pharmacy benefit in their private drug plans and Medicare Advantage plans or as Part D drugs in their Medicare PDPs have copayments between $0 and $50. More notable, however, is the fact that a majority of surveyed pharmacy directors reports that coinsurance is required for RA biologics covered as a pharmacy benefit or as a Part D drug and that typically, the level of coinsurance required is 20% of the drug's price or less.
"With the cost of therapy for all rheumatoid arthritis biologics typically exceeding $11,000 per year, patients treated with such agents face thousands of dollars in out-of-pocket expenses to cover the coinsurance requirements of various health plans," continued Ms. Stolper. "Thus, it is not surprising that copayment and coinsurance requirements are often an obstacle to more widespread prescribing of such drugs among Medicare and non-Medicare beneficiary RA patients."
PhysicianForum is a primary research service from Decision Resources that offers access to high volume-prescribing physicians, specialists, and managed care organization representatives in the United States; analysis of events and survey participants' responses to them; insight into prescribing patterns; and an examination of the implications of events and issues for the pharmaceutical market.
The Impact of Medicare Reform and the Launch of Novel Biologics on the Rheumatoid Arthritis Market is based on a U.S. survey of 20 HMO pharmacy directors and 101 rheumatologists. Their responses were compared to assess similarities and differences of opinion regarding clinical, economic, and scientific factors.
About Decision Resources
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