|By PR Newswire||
|August 20, 2014 12:00 PM EDT||
BURLINGTON, Mass., Aug. 20, 2014 /PRNewswire/ -- Decision Resources Group finds that surveyed managed care organizations (MCOs) anticipate that their costs of covering biologic treatments of autoimmune diseases will increase by double-digit rates each year the next two years. The cost trend for rheumatoid arthritis (RA), which MCOs expect to average 19 percent, is a major concern for more than two-thirds of the 40 surveyed MCO pharmacy directors/medical directors. As a result, payers have increased cost controls on biologics, which has affected prescribing by specialists. The survey, which also included 103 rheumatologists, indicates that 80 percent of the specialists encounter moderate-to-strong control by payers when prescribing biologic agents for RA and psoriatic arthritis (PsA), while 74 percent of specialists note this level of control for ankylosing spondylitis (AS).
Other key findings from the U.S. Physician & Payer Forum report High-Cost Biologics for Autoimmune Diseases: How Will Healthcare Reform and Payer-Led Cost-Taming Strategies Impact Brand Prescribing?:
- Prescribing of biologic agents: Close to 60 percent of surveyed rheumatologists said their patients treated for RA, PsA and AS are prescribed a biologic agent—typically after an initial trial and failure of conventional disease modifying antirheumatic drugs.
- Utilization management controls: Among all the restrictions and strategies to control the use of high-cost biologics, MCOs overwhelmingly apply utilization management controls, most commonly prior authorization and step therapy, to steer to preferred agents.
- Adherence to preferred drug lists: In response to increased payer controls, more than half of surveyed rheumatologists reported they adhere more closely to preferred drug lists and plan to do so in the next 12 months.
- Specialty pharmacy use: About half of MCOs reported a specialty pharmacy is commonly used to acquire biologic drugs for members with RA—a trend that may accelerate with the launch of more self-administered therapies, thus increasing the ability of payers to control costs.
- Site of care restrictions: Only 23 percent of MCO directors reported their MCO restricts the site of care of infused therapies; among the rest, 45 percent anticipate adding such restrictions in the next two years.
Comments from Decision Resources Group Analyst Chris Lewis:
- "Autoimmune diseases represent the most costly class of specialty drugs for the nation's payers, and they have responded by enacting controls that encourage prescribers to adhere to treatment protocols and prescribe MCOs' preferred agents. With blockbusters like Enbrel, Humira and Remicade enjoying first-line status, other therapies face the continual challenge of getting prescribed."
- "Considering prescribers intend to adhere more closely to preferred drug lists as a result of increased payer control on biologics, drug marketers need to find ways to obtain preferred brand coverage on MCO formularies or risk losing patient share to competitors that achieve favorable coverage."
- Media members are welcome to attend our upcoming webinar based on this report entitled Taming High-Cost Biologics: The Impact of Payer Restrictions on Prescribing of Autoimmune Therapies. This presentation will be held on Thursday, September 18, 2014. For more information, please contact Christopher Comfort at [email protected].
About Decision Resources Group
Decision Resources Group offers best-in-class, high-value information and insights on critical issues within the healthcare industry. Clients rely on this analysis and data to make informed decisions. Find out more at www.DecisionResourcesGroup.com.
All company, brand, or product names contained in this document may be trademarks or registered trademarks of their respective holders.
For more information, contact:
Decision Resources Group
SOURCE Decision Resources Group
DevOps tends to focus on the relationship between Dev and Ops, putting an emphasis on the ops and application infrastructure. But that’s changing with microservices architectures. In her session at DevOps Summit, Lori MacVittie, Evangelist for F5 Networks, will focus on how microservices are changing the underlying architectures needed to scale, secure and deliver applications based on highly distributed (micro) services and why that means an expansion into “the network” for DevOps.
Jul. 1, 2015 07:15 PM EDT Reads: 2,484
"We have a tagline - "Power in the API Economy." What that means is everything that is built in applications and connected applications is done through APIs," explained Roberto Medrano, Executive Vice President at Akana, in this SYS-CON.tv interview at 16th Cloud Expo, held June 9-11, 2015, at the Javits Center in New York City.
Jul. 1, 2015 05:00 PM EDT Reads: 778
Containers have changed the mind of IT in DevOps. They enable developers to work with dev, test, stage and production environments identically. Containers provide the right abstraction for microservices and many cloud platforms have integrated them into deployment pipelines. DevOps and Containers together help companies to achieve their business goals faster and more effectively. In his session at DevOps Summit, Ruslan Synytsky, CEO and Co-founder of Jelastic, reviewed the current landscape of...
Jul. 1, 2015 05:00 PM EDT Reads: 2,203
"AgilData is the next generation of dbShards. It just adds a whole bunch more functionality to improve the developer experience," noted Dan Lynn, CEO of AgilData, in this SYS-CON.tv interview at 16th Cloud Expo, held June 9-11, 2015, at the Javits Center in New York City.
Jul. 1, 2015 04:09 PM EDT Reads: 476
The Internet of Things is not only adding billions of sensors and billions of terabytes to the Internet. It is also forcing a fundamental change in the way we envision Information Technology. For the first time, more data is being created by devices at the edge of the Internet rather than from centralized systems. What does this mean for today's IT professional? In this Power Panel at @ThingsExpo, moderated by Conference Chair Roger Strukhoff, panelists addressed this very serious issue of pro...
Jul. 1, 2015 03:30 PM EDT Reads: 1,037
The cloud has transformed how we think about software quality. Instead of preventing failures, we must focus on automatic recovery from failure. In other words, resilience trumps traditional quality measures. Continuous delivery models further squeeze traditional notions of quality. Remember the venerable project management Iron Triangle? Among time, scope, and cost, you can only fix two or quality will suffer. Only in today's DevOps world, continuous testing, integration, and deployment upend...
Jul. 1, 2015 03:00 PM EDT Reads: 1,919
"We provide a web application framework for building really sophisticated web applications that run on a browser without any installation need so we get used for biotech, defense, and banking applications," noted Charles Kendrick, CTO and Chief Architect at Isomorphic Software, in this SYS-CON.tv interview at @DevOpsSummit (http://DevOpsSummit.SYS-CON.com), held June 9-11, 2015, at the Javits Center in New York
Jul. 1, 2015 02:45 PM EDT Reads: 1,052
Discussions about cloud computing are evolving into discussions about enterprise IT in general. As enterprises increasingly migrate toward their own unique clouds, new issues such as the use of containers and microservices emerge to keep things interesting. In this Power Panel at 16th Cloud Expo, moderated by Conference Chair Roger Strukhoff, panelists addressed the state of cloud computing today, and what enterprise IT professionals need to know about how the latest topics and trends affect t...
Jul. 1, 2015 02:30 PM EDT Reads: 1,176
Explosive growth in connected devices. Enormous amounts of data for collection and analysis. Critical use of data for split-second decision making and actionable information. All three are factors in making the Internet of Things a reality. Yet, any one factor would have an IT organization pondering its infrastructure strategy. How should your organization enhance its IT framework to enable an Internet of Things implementation? In his session at @ThingsExpo, James Kirkland, Red Hat's Chief Arch...
Jul. 1, 2015 02:21 PM EDT Reads: 547
In the midst of the widespread popularity and adoption of cloud computing, it seems like everything is being offered “as a Service” these days: Infrastructure? Check. Platform? You bet. Software? Absolutely. Toaster? It’s only a matter of time. With service providers positioning vastly differing offerings under a generic “cloud” umbrella, it’s all too easy to get confused about what’s actually being offered. In his session at 16th Cloud Expo, Kevin Hazard, Director of Digital Content for SoftL...
Jul. 1, 2015 01:15 PM EDT Reads: 2,150
"A lot of the enterprises that have been using our systems for many years are reaching out to the cloud - the public cloud, the private cloud and hybrid," stated Reuven Harrison, CTO and Co-Founder of Tufin, in this SYS-CON.tv interview at 16th Cloud Expo, held June 9-11, 2015, at the Javits Center in New York City.
Jul. 1, 2015 12:54 PM EDT Reads: 564
One of the hottest areas in cloud right now is DRaaS and related offerings. In his session at 16th Cloud Expo, Dale Levesque, Disaster Recovery Product Manager with Windstream's Cloud and Data Center Marketing team, will discuss the benefits of the cloud model, which far outweigh the traditional approach, and how enterprises need to ensure that their needs are properly being met.
Jul. 1, 2015 12:15 PM EDT Reads: 2,044
The time is ripe for high speed resilient software defined storage solutions with unlimited scalability. ISS has been working with the leading open source projects and developed a commercial high performance solution that is able to grow forever without performance limitations. In his session at Cloud Expo, Alex Gorbachev, President of Intelligent Systems Services Inc., shared foundation principles of Ceph architecture, as well as the design to deliver this storage to traditional SAN storage co...
Jul. 1, 2015 12:00 PM EDT Reads: 1,997
"Plutora provides release and testing environment capabilities to the enterprise," explained Dalibor Siroky, Director and Co-founder of Plutora, in this SYS-CON.tv interview at @DevOpsSummit, held June 9-11, 2015, at the Javits Center in New York City.
Jul. 1, 2015 11:45 AM EDT Reads: 1,014
It is one thing to build single industrial IoT applications, but what will it take to build the Smart Cities and truly society-changing applications of the future? The technology won’t be the problem, it will be the number of parties that need to work together and be aligned in their motivation to succeed. In his session at @ThingsExpo, Jason Mondanaro, Director, Product Management at Metanga, discussed how you can plan to cooperate, partner, and form lasting all-star teams to change the world...
Jul. 1, 2015 11:30 AM EDT Reads: 2,241