Johnson & Johnson's Tremfya high formulary spot for psoriasis could be improved if dosing edge, real-world data proven; limited budget impact highlighted – experts

22 Aug 2017

Johnson & Johnson's Tremfya high formulary spot for psoriasis could be improved if dosing edge, real-world data proven; limited budget impact highlighted – experts

Johnson & Johnson’s (NYSE:JNJ) Tremfya (guselkumab) for moderate-to-severe psoriasis is likely to be in formulary tier 3 or 4, due to a crowded market and its potentially high price, experts said. However, Tremfya could have preferential choice in tier 3 due to its improved dosing over other tier 3 options and future real-world data, some added. It could also move to tier 2 due to clinical similarities with Johnson & Johnson’s (J&J’s) Stelara (ustekinumab) but will face major roadblocks from established competition, others said.

An analyst report says competition would dampen pricing but did not elaborate how this would affect tier placement. Some experts this news service interviewed said Tremfya could secure a price on the higher end of the USD 50-100k a year range, but overall potential limited budget impact should be spelled out to lock this in.
Risk-sharing agreements could help ease payer reservations, with step-edits and preauthorisations likely, experts said. The analyst report states rising out-of-pocket costs add uncertainty to pricing, to which some experts said patient assistance programmes would help.

Tremfya was FDA-approved on 13 July. This news service reported 8 July that Tremfya’s longer dosing interval and positive efficacy data could be attractive, but patients/clinicians might wait for real-world data before they switch. A second analyst report states Tremfya could have USD 30m sales in 2017, growing to USD 425m in 2019 then USD 885m in 2021.

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