Inflectra (infliximab-dyyb), Pfizer/Celltrion’s Remicade biosimilar, became the first monoclonal antibody biosimilar to enter the U.S. market in late November 2016. In this series, we track Inflectra’s awareness and uptake since launch, to understand how its entry will shape the evolving U.S. immune biologics market. Along with awareness, familiarity, and perceptions of biosimilars in general, and Inflectra specifically, the research also explores the drivers and barriers behind uptake of biosimilars/Inflectra. Promotional efforts are explored, as well as prescriber and nonprescriber profiles, and benchmarking comparisons against other available biosimilars, to better understand the dynamics of the U.S. biosimilars market.

Questions Answered

  • Are U.S. physicians aware of Inflectra and its clinical development?
  • What are the drivers to prescribing Inflectra? What is the current level of Inflectra use, and how is that changing over time?
  • Has experience with Inflectra changed physicians’ opinions on biosimilars?
  • Have physicians experienced pressures to prescribe Inflectra to patients?
  • What promotional messages are sales representatives employing for Inflectra and Remicade?
  • How does initial formulary placement of Inflectra compare with other TNF-alpha inhibitors, and does this change over time?

Scope:

  • Markets covered: United States
  • Primary research: Survey of 91 U.S. rheumatologists, gastroenterologists, and dermatologists

Key Companies Mentioned:

  • Amgen
  • AbbVie
  • Celltrion
  • Johnson & Johnson/Janssen
  • Pfizer

Key Drugs Mentioned:

  • Remicade (infliximab)
  • Inflectra (infliximab-dyyb)
  • Enbrel (etanercept)
  • Humira (adalimumab)

Table of contents

  • Biosimilars - Emerging Biosimilars - Immunology: Inflectra Launch Tracking (US) Wave 2
    • Key Findings
      • Biosimilar Prescriber and Nonprescriber Profiles
        • Differences Between Inflectra Prescribers and Nonprescribers
        • Significant Differences Between Prescribers and Nonprescribers of Inflectra
    • Benchmarking Inflectra Launch Success vs. Other Biosimilar Launches
      • Formulary Analysis
        • Formulary Coverage of Inflectra Versus Remicade
          • Formulary Coverage of Infliximab
          • Inflectra and Remicade Coverage Among Commercial Plans
          • Inflectra and Remicade Coverage Among Medicare Plans
          • Inflectra Commercial and Medicare Coverage Compared with Remicade
          • Changes in Formulary Status Between January to June 2017
          • Explanation of Tiers and Restrictions
      • Awareness and Perceptions of Inflectra
        • Awareness and Familiarity with Inflectra
          • Biologics Recalled for Rheumatoid Arthritis
          • Biologics Recalled for Crohn's Disease
          • Biologics Recalled for Ulcerative Colitis
          • Biologics Recalled for Plaque Psoriasis
          • Familiarity with Biosimilars
          • Mean Level of Familiarity with Biosimilars
          • Level of Familiarity with Biosimilars
          • Mean Level of Familiarity with Inflectra
          • Level of Familiarity with Inflectra
        • Perceptions of Inflectra
          • Physicians' Perception of Inflectra's Tested and Approved Indications
          • Indications in Which Physicians Believe Inflectra Was Clinically Studied Prior to Approval
          • Indications in Which Physicians Believe Inflectra Is Approved to Treat
          • Indications in Which Physicians Believe Inflectra Should Be Approved to Treat
          • Physicians' Perceived Importance of Inflectra's Postmarketing Experience in Europe
          • Importance of European Postmarketing Experience for Inflectra's Approved Indications in the United States
      • Trial and Use
        • Current Use of Inflectra
          • Prescribers of Inflectra
          • Number of Patients Who Have Received Inflectra
          • Healthcare Coverage of Patients by Indication
          • Healthcare Coverage of Inflectra-Treated Patients
          • Proportion of Inflectra-Treated Patients Who Were Biologic-Naive or Switched from Another Biologic
          • Current Rheumatoid Arthritis Patient Share
          • Current Crohn's Disease Patient Share
          • Current Plaque Psoriasis Patient Share
        • Drivers and Barriers for Inflectra Use
          • Reasons for Choosing to Prescribe Inflectra
          • Percentage of Physicians Who Report That Inflectra Is Unavailable to Them
          • Reasons for Not Prescribing Inflectra
          • Percentage of Physicians Unaware of Inflectra's Net Cost Compared with Remicade
          • Mean Physician-Reported Net Cost of Inflectra Below Remicade
          • Prescriber Perception of Inflectra's Similarity to Remicade
          • Reported Differences Between Inflectra and Remicade in Wave 2
          • Reported Differences Between Inflectra and Remicade in Wave 1
          • Mean Level of Satisfaction with Inflectra
          • Overall Level of Satisfaction with Inflectra
      • External Factors Affecting Use
        • Sources of Pressure or Recommendations to Use Inflectra
          • Sources of Pressure for the Use of Inflectra Instead of Remicade
          • Sources of Pressure for the Use of Inflectra Instead of Remicade: Prescribers and Nonprescribers
          • Types of Pressure Experienced for the Use of Inflectra
        • Patients' Acceptance of Inflectra
          • Percentage of Physicians Who Have Never Proposed Inflectra to Their Patients
          • Mean Percentage of Patients Who Have Accepted Inflectra
      • Promotional Activity
        • Promotional Activity for Inflectra vs. Remicade
          • Rheumatologists' Most Recent Contact with Medical Representatives
          • Gastroenterologists' Most Recent Contact with Medical Representatives
          • Dermatologists' Most Recent Contact with Medical Representatives
          • Topics Discussed with Medical Representatives of Inflectra
          • Topics Discussed with Medical Representatives of Remicade
      • Future Use of Biosimilars
        • Willingness to Prescribe Novel Biosimilars
          • Rheumatologists' Likelihood of Prescribing Other Biosimilars as a Result of Inflectra Use
          • Gastroenterologists' Likelihood of Prescribing Other Biosimilars as a Result of Inflectra Use
          • Dermatologists' Likelihood of Prescribing Other Biosimilars as a Result of Inflectra Use
          • Mean Likelihood of Prescribing Other Infliximab Biosimilars
          • Rheumatologists' Likelihood of Prescribing Other Infliximab Biosimilars
          • Gastroenterologists' Likelihood of Prescribing Other Infliximab Biosimilars
          • Dermatologists' Likelihood of Prescribing Other Infliximab Biosimilars
          • Expected Length of Time to Start Prescribing Inflectra
          • Reasons Why Physicians Do Not Plan on Using Inflectra in Wave 2
          • Reasons Why Physicians Do Not Plan on Using Inflectra in Wave 1
          • Factors That Would Encourage Physicians to Initiate or Increase Inflectra Use
          • Factors That Would Encourage Physicians to Initiate or Increase Inflectra Use: Prescribers and Nonprescribers
        • Future Patient Share Expectations for Infliximab and Other Biologics
          • Expected Future Rheumatoid Arthritis Patient Share
          • Expected Future Crohn's Disease Patient Share
          • Expected Future Plaque Psoriasis Patient Share
          • Expected Impact of Patient Healthcare Coverage on Inflectra Uptake
          • Physicians' Expectation of Impact of Patients' Healthcare Coverage on Inflectra Uptake
          • Reasons Why Physicians Think Inflectra’s Uptake Will Be Most Rapid Among Patients on Government Plans
          • Reasons Why Physicians Think Inflectra’s Uptake Will Be Most Rapid Among Patients on Commercial Plans
      • Appendix
        • Background on the U.S. Infliximab Market
          • Product Information: Remicade and Inflectra
          • List Price for Infliximab
          • Market Background: Celltrion’s Partners for Biosimilar Infliximab
          • The Celltrion Partnership Network
          • Timeline of Milestones for Inflectra
          • Biologics Approved for Rheumatic, Inflammatory Bowel, and Psoriatic Diseases in the United States
          • Assumptions Supporting U.S. Launch Date Estimates for Future Infliximab Biosimilars
          • Clinical Trial Information in Which Inflectra Was Studied Prior to FDA Approval
        • Market News
          • Methodology and Objectives
            • Objectives
            • Methodology
            • Number of Study Participants
            • Significance Testing in This Study
          • Respondent Demographics
            • Mean Number of Years in Practice
            • Number of Years in Practice
            • Practice Type
            • Practice Location
            • Distribution of Respondents by Region
            • Number of Adult Patients Under Management per Month
            • Number of Pediatric Patients Under Management per Month
            • Available Biologics Prescribed for Rheumatoid Arthritis by Rheumatologists
            • Available Biologics Prescribed for Psoriatic Arthritis by Rheumatologists
            • Available Biologics Prescribed for Crohn's Disease by Gastroenterologists
            • Available Biologics Prescribed for Ulcerative Colitis by Gastroenterologists
            • Available Biologics Prescribed for Psoriasis by Dermatologists

      Author(s): Hamzah Aideed, M.Sc.

      Hamzah Aideed is a Principal Analyst in the biosimilars team at Decision Resources Group. Hamzah’s responsibilities include conducting primary and secondary market research, generating key insights into biosimilars and the biopharmaceutical industry, and providing client support. His work in biosimilars encompasses four key therapy areas – immunology, oncology, endocrinology, and nephrology.

      Prior to joining DRG, Hamzah was a Senior Research Executive at Consulting at McCann Health, specializing in the design and execution of advanced qualitative and quantitative research methodologies, for bespoke ad-hoc consulting projects. He holds an M.Sc. in Biotechnology & Business Management from the University of Warwick and a B.Sc. in Biological Chemistry from Aston University.