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    Ulcerative Colitis/Crohn’s Disease: U.S. Access & Reimbursement

    The U.S. ulcerative colitis (UC) and Crohn’s disease (CD) markets include the predominately entrenched TNF-α inhibitors (e.g., Janssen/Merck’s Remicade, AbbVie/Eisai’s Humira), however, recent entries that offer alternative treatment options for TNF-α refractory patients (i.e., Takeda’s Entyvio and Janssen’s Stelara), as well as the arrival of biosimilar infliximab (Pfizer’s Inflectra), continue to evolve the UC/CD treatment landscapes.

    The potential arrival of several more agents offering novel MOAs and/or formulations (e.g., Pfizer’s tofacitinib, Gilead/Galapagos’ filgotinib, Roche/Genentech’s etrolizumab), as well as increasing physician experience prescribing biosimilars will fuel competition and pricing pressure these markets. Emerging therapies looking to gain favorable uptake in UC and/or CD will face a growing number of challenges to impress physicians and payers alike, and may struggle to gain robust uptake and/or favorable formulary placement.

    This report provides answers to the following questions:

    • What is the current and expected formulary placement of key biologic agents prescribed for UC and CD, and how are utilization management strategies employed by MCOs to control costs of these agents?
    • How do MCO restrictions impact physicians’ prescribing of biologics to their UC or CD patients?
    • How do payers expect to cover emerging therapies (e.g., Pfizer’s tofacitinib, Gilead/Galapagos’ filgotinib, Roche/Genentech’s etrolizumab) on their commercial health plans at various price points and how does this align with physicians’ anticipated prescribing of these therapies?
    • What impact will biosimilar entries have on payer coverage of the originator brands and what impact will biosimilars have on physicians’ prescribing decisions?

    Access & Reimbursement Solution

    This report provides in-depth insight regarding the impact of payer policy on physician prescribing behavior so you can build your market access strategy and optimize your brand positioning. Learn more about how you can quickly identify, analyze, and act on emerging challenges with timely and accurate insights DRG’s Insights Platform.