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A handful of classes makes up more than three fourths of prescriptions filled through specialty pharmacies. Additional indications for existing medications within these classes — primarily therapies for inflammatory conditions and oncology — play a large part in increased utilization.
According to Express Scripts’ Drug Trend Report, released earlier this year, new indications were largely responsible for a nearly 18 percent increase in utilization of biologic therapies marketed for treatment of inflammatory conditions. In 2006, for instance, use of etanercept (Enbrel) and adalimumab (Humira) — previously approved for rheumatoid arthritis — increased, a year after the U.S. Food and Drug Administration granted the products indications for psoriatic arthritis.
This phenomenon may continue. Eculizumab (Soliris), approved last March for the treatment of a rare blood disorder, is considered a potential RA therapy, and several new products in the pipeline undergoing study for RA may eventually prove useful for other inflammatory conditions.