Survey Results Suggest Payers, Gastroenterologists Favor JAK Inhibitors to Treat IBD

Gastroenterologists favorably view Janus kinase (JAK) inhibitors for utilization in treating inflammatory bowel disease (IBD), according to a recent survey conducted by Decision Resources Group.

The results of the “Ulcerative Colitis/Crohn’s Disease: US Access & Reimbursement” survey also suggested that a majority of payers recognize Pfizer’s Xeljanz (tofacitinib) and Gilead/Galapagos’ filgotinib as upcoming therapies for treating ulcerative colitis and Crohn’s disease, according to the report. Gastroenterologists predict that these therapies will be prescribed within their first year on the market.

Johnson & Johnson’s Remicade (infliximab) was also found to be prevalent in the market despite the introduction of the infliximab biosimilar, Pfizer’s Inflectra, to the market. However, it is predicted that payers will push biosimilars to encourage their use through implementing utilization management approaches.

Additional key findings from the survey include:

• Johnson & Johnson’s Stelara (ustekinumab) appears to be successful in treating Crohn’s disease has market access comparable to Takeda's Entyvio (vedolizumab).
• Biologics manufacturers are looking to improve their formulary positioning through contracting strategies.
• Physicians and payers predict TNF-α inhibitors will remain the standard of biologics of choice for IBD, regardless of new novel biologics and oral therapies.
• There is a significant discrepancy between the percentage of patients that physicians think are eligible for biologics and the percentage who actually take them.

"Drug makers looking to compete in the IBD market need to overcome the entrenched favorable reimbursement status of the long-marketed TNF inhibitors,” Brian Nasipak, an analyst with Decision Resources Group, said in a statement. “That said, gastroenterologists are excited about the JAK inhibitors' potential in a market where many patients are refractory to treatments already available although use may be relegated to later lines."

The report was intended to bring insight into the impact of payer policy on physician prescribing behavior. Overall, the results reveal how gastroenterologists ultimately favor JAK inhibitors to treat IBD.

"At this time there is little evidence to suggest that Remicade's market access position has suffered with the launch of biosimilar infliximab. J&J has had time to prepare for the biosimilar's launch and, at least for now, appears to have protected its place in the IBD market,” Nasipak concluded. “We will be watching carefully to see how long they can maintain their position and to see what levels of discounting and rebates are needed to do so."