In their latest report, entitled, “Crohn’s Disease and Ulcerative Colitis: U.S. Physician and Payer Perspectives on Established and Recently Launched Biologics, Emerging Novel Agents and Biosimilars,” Decision Resources, a Decision Resources Group company, surveyed gastroenterologists and payers about the current use of biologics and their perception on the future role of biosimilar versions in patients’ treatments.

Biologics constitute the newest treatment for Crohn’s Disease (CD) and Ulcerative Colitis (UC). Unlike corticosteroids, which suppress the entire immune system, biologics have specific antibodies binding selectively to CD triggering factors. Biologic treatments for CD and UC include TNF inhibitors and Integrin receptor antagonists. The report focused on the available TNF inhibitors for CD, REMICADE® (infliximab), HUMIRA® (adalimumab), SIMPONI® (golimumab) and UCB’s CIMZIA® (certolizumab pegol); anti-integrins TYSABRI® (natalizumab) and ENTYVIO (Vedolizumab); new therapies include STELARA® (ustekinumab) and XELJANZ® (tofacitinibcitrate); and the new biosimilars for REMICADE® (infliximab) and HUMIRA® (adalimumab).

The key findings from the report were:

Current treatment for CD and UC: gastroenterologists reported that among those in the CD/UC patient population who can actually receive a biologic, approximately 20 percent reported treatment failure and ultimately discontinued it; these patients are thus eager to try new treatments with a different mode of action.

Emerging therapies in CD and UC: Emerging therapies are likely to have a favorable outlook. However, to be able to be implemented with efficacy, managed care organizations (MCOs) highlight the need for cost incentives (such as, lower list price and the possibility of discounts).

Biosimilars in CD and UC: Biosimilars that prove the same efficacy with lesser costs constitute thereby a notable threat to the present established drugs.

Adi Reske Ph.D., an Analyst from Decision Resources Group noted, “No cases of progressive multifocal leukoencephalopathy (PML) have been reported with Entyvio to date yet the risk of PML is the greatest concern in prescribing the agent. Among surveyed gastroenterologists who expect to use Entyvio for CD and UC the majority will prescribe the agent following failure with at least one TNF-alpha inhibitor. By the end of 2017 biosimilars will account for at least one-quarter of the patient share currently captured by Remicade and Humira. The availability of biosimilars on formularies will depend on their price discount to the brand with savings of at least 20 percent likely needed to merit widespread formulary inclusion. At these discounts MCOs will encourage use of the biosimilar before the brand through lower copays.”