Reimbursement Intelligence: Tofacitinib to be positioned after anti-TNFs say payers based on FDA panel review

Reimbursement Intelligence: Tofacitinib to be positioned after anti-TNFs say payers based on FDA panel review

MADISON, N.J., May 15, 2012 – Reimbursement Intelligence (RI), the New Jersey-based market research firm helping biopharma, medical device and diagnostics firms succeed in the managed care environment, today announced the results of a survey of 30 payers, representing more than 100 million covered lives, about their reactions to the FDA advisory panel meeting regarding tofacitinib, Pfizer's much anticipated oral small molecule for the treatment of rheumatoid arthritis (RA). The survey was fielded on May 10-11, 2 days after the FDA advisory committee meeting on May 9.

"Payers clearly have some concerns about tofacitinib," said Rhonda Greenapple, CEO of RI. "After reviewing the panel recommendations, a substantial number of payers changed their responses when we asked them how they thought their plan would manage access to tofacitinib. All told, more than three-quarters of payers (77.4%) said that tofacitinib would have a step-edit that would require failure of one or more anti-TNFs. What we found interesting was that after they read the panel recommendations, substantially more payers that said they would require failure of 2 anti-TNFs before allowing access to tofacitinib."

Overall, payers were cautious in their assessments of the efficacy and safety profiles of tofacitinib, with more than 40% rating their perceptions as "neutral". Said Greenapple, "When we asked payers to project the market share the oral compound would have in their plan at 6 months and 1 year after launch, the average uptake was only 6% and 13%, respectively. That's surprisingly low – roughly in line with what they told us is the current share of Remicade, which has been on the market since the late 1990s."

Greenapple continued, "One factor that clearly had an impact on payers was the FDA panel's opinion that, based on the data presented, it was not possible to draw conclusions about the effect of tofacitinib on the progression of structural damage in RA. When we probed payers about their reactions to the panel's opinion, respondent's views of tofacitinib changed substantially for the worse. The proportion of payers that rated their perception as "unfavorable" jumped to 39% from 0% before this panel opinion was discussed."

For more information about RI's survey of payers, and our parallel survey of rheumatologists, contact Rhonda Greenapple at [email protected] or at 973.805.2300.

This survey was conducted as an update for subscribers to the RI 2012 Rheumatology Insights Service. Please click here for more information about this report and other reimbursement-related information available from Reimbursement Intelligence.

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