The autoimmune therapy class boasts one of the broadest arrays of options within specialty drug classes. And while many physicians in general may tend to prescribe older medications that they have more familiarity with, a recent study shows that this may not necessarily be the case within this therapeutic class, AIS Health reported. The study, led by AllianceRx Walgreens Prime, found that among 5,547 analyzed psoriasis patients, providers may be comfortable with prescribing a newer type of autoimmune biologic as a first-line treatment.
The study assessed the use of two third-generation biologics, Novartis Pharmaceuticals Corp.’s Cosentyx (secukinumab) and Eli Lilly and Co.’s Taltz (ixekizumab), in the treatment of psoriasis. The FDA approved Cosentyx in January 2015, with Taltz’s approval coming about a year later, in March 2016.
Most of the patients on one of those two IL-17 inhibitors — 4,301 — were on Cosentyx, with 1,246 on Taltz, the study found. Of those on one of the two drugs, 1,696 switched from another biologic: AbbVie Inc.’s Humira (adalimumab), Bausch Health’s Ortho Dermatologics’ Siliq (brodalumab) or Stelara (ustekinumab) from the Janssen Pharmaceutical Companies of Johnson & Johnson.
Based on patients’ reporting, the main reason for switching was that the prior biologic was ineffective, cited by 68.9%. Slightly more than 10% were uncertain of the reason for the switch, and 8.6% reported it was due to side effects.
“Psoriasis and disorders within the inflammatory disease category comprise a large portion of patients on specialty medications — in particular, biologic medications,” Rick Miller, R.Ph., vice president, clinical services, professional practice and accreditation, AllianceRx Walgreens Prime, who was one of the study’s co-authors, explained to AIS Health. “Little is known about the rates and reasons for patients switching prescribed biologic medications utilized to treat psoriasis.”
“Based on patient reporting, the majority of the patients were started on one of the study IL-17 medications instead of switching biologics,” wrote the study authors. “This may indicate that prescribers are becoming comfortable with prescribing IL-17 biologics as first-line agents for psoriasis.”
The study’s findings indicate that payers, Miller said, “should expect, and not be surprised, to see prescribers initiate patients on these newer, third-generation biologic medications for psoriasis — which may impact benefit design and prior-authorization/utilization management criteria.”