Schering-Plough drug use ‘limited by payer-restrictions’

Remicade, a rheumatoid arthritis pharmaceutical from Schering-Plough, Centocor and Tanabe Seiyaku, is being used for the same percentage of first and second line treatment in patients as Enbrel from Amgen and Wyeth. This is despite its previous reimbursement advantage over other TNF-alpha inhibitors, reports state.

Until the passing of the Medicare Prescription Drug Improvement and Modernisation Act in the US, self-administered injectible drugs such as Enbrel were not reimbursable.

However, healthcare market research company Decision Resources states that Remicade has had limited market penetration, being used by less than three per cent of patients on first-line treatment and less than four per cent in patients on second-line treatment.

Dr Madhuri Borde, an analyst at Decision Resources, said: “Despite Remicade’s advantage to Medicare subscribers, Amgen/Wyeth’s Enbrel still managed to capture an equal percentage of first-and-second-line patient shares and has a greater use than Remicade in third-line patient share.”

This lack of penetration has been attributed to payer restrictions on reimbursement for the condition, whereby patients must fail methotrexate therapy before health care plans will reimburse for more expensive pharmaceuticals.

In July, Remicade received EU approval to be used as a monotherapy in the treatment of progressive psoriatic arthritis in patients with an intolerance or contraindication to methotrexate.