Dermatologists have many years of experience with the tumor necrosis factor-alpha (TNF-α) inhibitors Humira (AbbVie) and Enbrel (Pfizer) as first-line biologics for the treatment of psoriasis. Janssen’s interleukin (IL)-12/23 inhibitor Stelara has also gained traction in early lines of therapy. However, the market penetration of more-effective biologics, such as IL-17 inhibitors Cosentyx (Novartis) and Taltz (Eli Lilly), is now threatening the first-line dominance of TNF-α inhibitors, and further competition is expected, with the highly efficacious IL-23 inhibitors, led by Janssen’s guselkumab, set to enter the fray in 2017. With the added availability of biosimilars, EU5 payers and prescribers must carefully balance clinical superiority with cost-effectiveness, and drug marketers must be well equipped to navigate a complex road to reimbursement.

Questions Answered in This Report:

  • The EU5 psoriasis market will see continued uptake of the six approved biologics and targeted oral agent Otezla. How do reimbursement terms for psoriasis biologics and oral agent Otezla vary across the EU5? How do payers regulate use of these premium-priced agents? How do prescribing patterns for key psoriasis therapies differ between and within EU5 countries, and to what extent does payer policy impact uptake?
  • As biologics use in psoriasis continues to grow, EU5 payers increasingly emphasize the importance of biosimilars for curbing healthcare expenditures; the first two biosimilars in psoriasis, biosimilar infliximab and biosimilar etanercept, entered the European markets in early 2015 and 2016, respectively. How has the launch of biosimilar versions of infliximab and etanercept altered payer preferences and mandates, and what has the actual impact of biosimilar availability been on physician prescribing?
  • The psoriasis market will become increasingly crowded with the anticipated entry of five additional biologics by 2020. What key market access challenges do emerging psoriasis agents face? What lessons have been learned, and what market access levers can drug developers take advantage of to optimize the positioning of their products?


  • Markets covered: France, Germany, Italy, Spain, United Kingdom.
  • Methodology: Surveys of 250 dermatologists and 10 country-specific interviews with European payers.
  • Indication coverage: Psoriasis.
  • Key drugs covered: Humira, Enbrel, Remicade, Stelara, Otezla, Cosentyx, Taltz, brodalumab, guselkumab, tildrakizumab, risankizumab, Cimzia.
  • Key companies mentioned: AbbVie, Pfizer, Merck, Janssen, Celgene, Novartis, Eli Lilly, Leo Pharma, Amirall, Sun Pharmaceutical, Boehringer Ingelheim, UCB, Dermira.

Table of contents

  • Psoriasis - Access & Reimbursement - Detailed, Expanded Analysis (EU)

Author(s): Yulia Privolnev, MA; Ronnie Yoo

Yulia Privolnev is a manager on the Global Market Access Insights team at Decision Resources Group, primarily focusing on European market access. She is responsible for monitoring, analyzing, and reporting on global market access through the production of DRG’s Global Market Access Solution (GMAS) and Access & Reimbursement products. Yulia’s specific focus is on all aspects of market access in Western and Eastern Europe, as well as external reference pricing (ERP) and managed entry agreements (MEAs) on a global scale. Yulia holds a bachelor’s degree from the University of Toronto and a master’s degree from the London School of Economics.

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