How are we going to sell Tofacitinib if MCOs require failure of 2 TNFs?

[Anonymous]

How are we going to sell this drug if you have to fail 2 TNFs before MCOs will pay for it?


http://www.fiercepharma.com/press-r...acitinib-be-positioned-after-anti-tnfs-say-pa

Reimbursement Intelligence: Tofacitinib to be positioned after anti-TNFs say payers based on FDA panel review

MADISON, N.J., May 15, 2012 – Reimbursement Intelligence (RI), the New Jersey-based market research firm helping biopharma, medical device and diagnostics firms succeed in the managed care environment, today announced the results of a survey of 30 payers, representing more than 100 million covered lives, about their reactions to the FDA advisory panel meeting regarding tofacitinib, Pfizer's much anticipated oral small molecule for the treatment of rheumatoid arthritis (RA). The survey was fielded on May 10-11, 2 days after the FDA advisory committee meeting on May 9.

"Payers clearly have some concerns about tofacitinib," said Rhonda Greenapple, CEO of RI. "After reviewing the panel recommendations, a substantial number of payers changed their responses when we asked them how they thought their plan would manage access to tofacitinib. All told, more than three-quarters of payers (77.4%) said that tofacitinib would have a step-edit that would require failure of one or more anti-TNFs. What we found interesting was that after they read the panel recommendations, substantially more payers that said they would require failure of 2 anti-TNFs before allowing access to tofacitinib."

Overall, payers were cautious in their assessments of the efficacy and safety profiles of tofacitinib, with more than 40% rating their perceptions as "neutral". Said Greenapple, "When we asked payers to project the market share the oral compound would have in their plan at 6 months and 1 year after launch, the average uptake was only 6% and 13%, respectively. That's surprisingly low – roughly in line with what they told us is the current share of Remicade, which has been on the market since the late 1990s."

Greenapple continued, "One factor that clearly had an impact on payers was the FDA panel's opinion that, based on the data presented, it was not possible to draw conclusions about the effect of tofacitinib on the progression of structural damage in RA. When we probed payers about their reactions to the panel's opinion, respondent's views of tofacitinib changed substantially for the worse. The proportion of payers that rated their perception as "unfavorable" jumped to 39% from 0% before this panel opinion was discussed."

For more information about RI's survey of payers, and our parallel survey of rheumatologists, contact Rhonda Greenapple at rgreenapple@reimbursementintelligence.com or at 973.805.2300.

This survey was conducted as an update for subscribers to the RI 2012 Rheumatology Insights Service. Please click here for more information about this report and other reimbursement-related information available from Reimbursement Intelligence.

Read more: Reimbursement Intelligence: Tofacitinib to be positioned after anti-TNFs say payers based on FDA panel review - FiercePharma http://www.fiercepharma.com/press-r...sitioned-after-anti-tnfs-say-pa#ixzz1wGb4EBXs
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[Anonymous]

Define failure? For some it maybe as early as one month when you really need 6 to 12 months for all TNF'S. Doc and insurance will tell when and where to use it. Price it correctlyand you will get you usage.

 

[Anonymous]

This is what you get paid for. Help the MD understand what pt population they can get the product. Will seem small at first, but if results are good it will spread. Earn your money no one ever said it would be easy. We sold clelbrex, lyrica, detrol with step edits and did pretty well.

 

[Anonymous]

Define failure? For some it maybe as early as one month when you really need 6 to 12 months for all TNF'S. Doc and insurance will tell when and where to use it. Price it correctlyand you will get you usage.

Okay, but even if failure is 1 month, that means that you have to wait at least 2 months for each patient to fail 2 TNFs! And that is minimum - depending on how failure is defined, the patient could have to wait 2 years to try our drug. And that is a long time when you have a quota to meet.

 

[Anonymous]

Okay, but even if failure is 1 month, that means that you have to wait at least 2 months for each patient to fail 2 TNFs! And that is minimum - depending on how failure is defined, the patient could have to wait 2 years to try our drug. And that is a long time when you have a quota to meet.

Quota? What quota? We don't sell copy machines and pencils. You have goals---and last time I checked, meeting goals or not has nothing to do with your evaluation. This is the problem with this industry---too many people think this is sales and are too aggresive trying to meet their "quota." Build your relationships and credibility and a solid drug will get used. Quota?

 

[Anonymous]

Quota? What quota? We don't sell copy machines and pencils. You have goals---and last time I checked, meeting goals or not has nothing to do with your evaluation. This is the problem with this industry---too many people think this is sales and are too aggresive trying to meet their "quota." Build your relationships and credibility and a solid drug will get used. Quota?

Your whole post is crap. Goal or quota call it what you want. Either way the company will give you a number to hit and it's your job to hit it. Don't be obtuse, you seem intelligent, you can't understand what the pp was saying?

Also, don't hit your goals and you get a partially mets or lower on your appraisal. Lower raise, lower career pathways points earned, and no promotion. If you don't think your job is to "sell" you are mistaken. It's your responsibility to get scripts for your product using starters, CUE, slides, and relationships.

Unless you prove Tofacitinib is better and safe, you should only get failures. With the costs associated with this medicine (I can only imagine how high vs. non-oral peers) I'm sure most insurers will establish rigourus failure requirements.

 

[Anonymous]

Quit crying like a pussy. Greenapple has a known ax to grind with Pfizer. Go look at the methodology in her study. Like political polls, everything depends on how you ask the questions. The MCOs will quickly change their responses if PFE prices tofa at $1000 a month. They will suddenly require all patients to fail tofa BEFORE they can get the anti-TNFs or monoclonals.

Pull your head out of your pussy and go to work bitch.

 

[Anonymous]

Quit crying like a pussy. Greenapple has a known ax to grind with Pfizer. Go look at the methodology in her study. Like political polls, everything depends on how you ask the questions. The MCOs will quickly change their responses if PFE prices tofa at $1000 a month. They will suddenly require all patients to fail tofa BEFORE they can get the anti-TNFs or monoclonals.

Pull your head out of your pussy and go to work bitch.

It's a little more complicated than coming up with the right price. TNF companies pay rebates and have long standing contracts with the MCOs. There is more stuff they consider too, but I am too tired tonight to type it all out for you.

 

[Anonymous]

Look, TNF's are the the end all. 50% of the patients do not see the 1/2 of their symptoms of RA go away. Once they fail on one TNF, the chances to get relief from another TNF is less than from the first. There are a lot of patients that did not work on a TNF anf they alone will more than enough to meet any goal you will get for years to come. Then just price it lower than TNF's and the plans will jump on it knowing they could always go back to a TNF. Stop acting defeated until you understand the market.

 

[Anonymous]

You guys are idiots; good luck