Xeljanz, Other New RA Treatments Might Not be Worth Hefty Price Tag

Published on October 2, 2019 by Sandy Liebhard

A new report suggests Xeljanz and other new treatments for rheumatoid arthritis (RA) aren’t as cost effective as their older competitors.

Xeljanz Only Marginally Better than Humira

The analysis, which was conducted by the Institute for Clinical and Economic Review (ICER), focused on the cost effectiveness of JAK inhibitors, a medication class that includes Pfizer’s Xeljanz, Eli Lilly and Incyte’s Olumiant, and AbbVie’s Rinvoq.  ICER looked at pricing, as well as the drugs’ ability to achieve either RA remission or “low disease activity” at three months

The review did indicate that substantially more JAK inhibitor patients achieved remission or low disease activity at 12 weeks compared to those taking older drugs like methotrexate alone. However, ICER was unable to reach the same conclusion when comparing combinations of methotrexate with either JAK inhibitors or Humira.

Therefore, the group concluded that Rinvoq provided only “marginal clinical benefit” over Humira, noting that even with discounts, its yearly cost exceeded $150,000. Xeljanz also appeared only marginally better, with ICER concluding that “prices for this drug much higher than the price of [Humira] may not be justified.”

ICER was unable to reach a firm conclusion on Olumiant, as it’s only indicated for RA patients who already failed to respond to Humira or another TNF blocker.

FDA Orders Xeljanz Blood Clot Warning

The ICER review marks the second Xeljanz-related setback for Pfizer in recent months.

Earlier this year, the drug maker was forced to shut down part of a clinical trial after early findings suggested RA patients on a twice-daily 10mg Xeljanz regimen were more likely to experience pulmonary embolism, a life-threatening blood clot that travels to the lungs.

In July, the U.S. Food & Drug Administration (FDA) ordered Pfizer to update the Xeljanz Black Box Warning to reflect these findings. The agency also restricted the medication as a second-line treatment status for ulcerative colitis patients “who are not treated effectively or who experience severe side effects with certain other medicines.”

According to an FDA Drug Safety Communication published on July 26th, doctors should use the lowest effective Xeljanz dose when treating these patients and limit use of the 10mg twice-daily regimen to the shortest duration possible. They should also avoid prescribing the medication to patients already at risk for blood clots.