Crohn's disease: Remicade prescription to decrease, while Humira's increases

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Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that surveyed gastroenterologists estimate that (assuming no new data on adverse events emerge) they will treat fewer Crohn's disease patients with Centocor Ortho Biotech/Merck/Mitsubishi Tanabe's Remicade by the end of 2010, while the percentage of biologics-treated patients receiving Abbott/Eisai's Humira will increase to 36 percent. Surveyed gastroenterologists also indicate that the percentage of patients treated with a biologic who receive UCB/Otsuka's Cimzia will rise from 9 percent to 12 percent within the next year.

The new Physician & Payer Forum report entitled The Expanding Biologics Landscape in CD and UC: Clinician and Payer Perspective on the Role of Premium-Priced Biologics in CD and UC Treatment also finds that, on average, surveyed gastroenterologists report prescribing Remicade to 31 percent of their ulcerative colitis patients. Fifty-three percent of surveyed gastroenterologists prescribe Remicade to between 1 percent and 20 percent of their ulcerative colitis patients, while 13 percent of surveyed gastroenterologists prescribe Remicade to between 91 percent and 100 percent of patients.

Additionally, the report finds that 8 percent of gastroenterologists report that they are not currently treating any of their ulcerative colitis patients with Remicade.

"Gastroenterologists' reservation of Remicade for later-line use reflects the effectiveness of nonbiological therapies for ulcerative colitis such as aminosalicylates and corticosteroids as well as the fact that Remicade became available somewhat recently as the only approved biologic for ulcerative colitis," said Decision Resources Analyst Kathryn Benton.

The report also finds that, according to surveyed MCO pharmacy directors, Humira has achieved the most favorable tier placement among biologics for Crohn's disease and ulcerative colitis, with the majority of plans assigning the drug to tier one or tier two. Among surveyed brands, Humira has achieved tier one or two status in the largest proportion of plans (70 percent). However, tier placement of Remicade varies widely between plans, with 35 percent of plans placing Remicade on tier two and the same proportion on tier three. Surveyed pharmacy directors also indicate that they place Biogen Idec/Elan's Tysabri on tier three or higher, indicating that the drug is generally classified as a non-preferred brand that carries a high copay.

The Expanding Biologics Landscape in CD and UC: Clinician and Payer Perspective on the Role of Premium-Priced Biologics in CD and UC Treatment is based on a U.S. survey of 103 gastroenterologists and 20 MCO pharmacy directors. Their responses were compared to assess similarities and differences of opinion regarding clinical, economic and scientific factors.

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