Based on the uncertainty relating to the comparison of efficacies of Leo Pharma’s anti-IL-13, Adtralza/Adbry (tralokinumab); AbbVie’s oral Janus kinase (JAK) 1 inhibitor, Rinvoq (upadacitinib); and Pfizer’s oral JAK 1 inhibitor, Cibinqo (abrocitinib) to standard treatments, the UK’s National Institute for Health and Care Excellence (NICE) is not recommending these agents for the treatment of moderate to severe atopic dermatitis (AD). GlobalData, a leading data and analytics company, anticipates that the uptake of Adtralza, Rinvoq, and Cibinqo will be slow in the UK unless an agreement is reached, despite the clear lack of therapies for the treatment of moderate to severe AD.

Ramla Salad, Pharma Analyst at GlobalData, comments: “Despite this recommendation not affecting patients already using these treatments, these events have further highlighted that strong safety and efficacy profiles are important to justify reimbursement of such expensive medicines. As the market competition intensifies, these decisions will have more of an impact on reimbursement and treatment hierarchy.”

Adtralza was approved by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) in June 2021 and both Rinvoq and Cibinqo were approved in September 2021. Their uptake and upcoming competitors’ uptake will now be limited as the committee has requested further information to determine the cost-effectiveness of these therapies and will consider the topic again at a meeting in May 2022.

Salad adds: “This decision benefits early entrants to the market, Sanofi and Regeneron’s anti-IL-4/13, Dupixent (dupilumab), and Eli Lilly’s JAK 1/2 inhibitor, Olumiant (baricitinib), which remain part of the UK treatment hierarchy, to be used after broad systemic immunosuppressants, temporarily protecting their UK market share from the recent EU-approved therapies.”

However, both Dupixent and Olumiant were initially not recommended for use in AD due to their high costs of therapy, but these decisions were reversed in the final appraisal consultation with both Sanofi and Lilly entering a commercial agreement with NICE to provide discounted therapy. Although NICE has not recommended these therapies, Scotland’s health technology assessment (HTA) body, Scottish Medical Consortium (SMC), is reviewing their use in adults with moderate to severe AD, but with the caveat that the NHS Scotland patient access scheme (PAS) arrangement delivers cost-effectiveness results upon which the temporary decision was based.