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Access Infinity
DZP SLE quantitative payer research, follow-on to H2 2025 qual, May 2026
Proposal · UCB and Biogen · May 2026 · Confidential

Quantifying the pricing corridor, access outcomes, and launch sequence for dapirolizumab pegol in SLE.

A follow-on to the H2 2025 qualitative payer research. Eight markets, five stakeholder groups, one integrated price-volume model per market. Designed to inform launch sequencing, pricing corridor, positioning, and evidence investment decisions for DZP.

Prepared for
Thomas Schleret, UCB · Nasreen Vadachia, UCB · Sharon Chen, Biogen
Project window
June 2026, kickoff. End-2026, delivery.
Markets
The opportunity

The H2 2025 P&MA and PVP qualitative phase laid the foundation. This phase quantifies the price-volume trade-off to inform decision making.

The H2 2025 P&MA and PVP qualitative research surfaced the key value drivers to leverage for P&MA success and gave you the structural picture: which evidence payers value and how access plays out in each market.

This phase builds on that foundation. It produces a defensible pricing opportunity per market with credible intervals, quantifies the impact of WoCBA on access and pricing, and ranks the eight markets by pricing potential and reimbursement likelihood for launch sequence planning. The design is calibrated to the H2 2025 findings so the two phases work as one programme.

We have designed a methodology specific to your business challenge: a shared survey design with five instrument types matched to the five stakeholder groups, integrated into one price-volume model per market. Pricing is anchored to the forecast 2029 to 2030 SLE pricing opportunity, not to today's prices. UCB and Biogen's own assumptions and target product value profiles (TPVP) inform and guide the DCE levels and the simulator inputs; the work is designed to refine and de-risk those forecasts rather than rely on them as fixed inputs. Pipeline competitor pricing carries inherent uncertainty, handled in the simulator's competitor-price flex post-delivery.

Carry-forward from H2 2025

What we learned in qual that we now quantify

  • Increasing SLE competition leveraged by payers to erode net pricing opportunity. Without robust value differentiation claims at launch, payers will be reluctant to grant a premium price to DZP.
  • Incremental value across heterogenous subgroups supports broad access. If price does not reflect payer expectations, they may look to restrict access to subgroups where clinical value is greatest.
  • Fatigue can / may be a supportive driver in payer decision making. Improvements in fatigue support value perception but are not a substitute for comparative efficacy data in P&MA negotiations.
  • WoCBA is a share lever, not a whole-population price lever. Best used to win access / share via targeted pathways, especially in the US.
  • IV formulation applies additional pressure when most entrants are SC or oral. If not proactively reframed, IV becomes a negotiation lever for discounts and / or access friction.
  • US policy dynamics directly influence global P&MA opportunity. Ongoing policy changes from the current administration will materially impact strategy within the US and beyond, requiring close monitoring.

The 2029 to 2030 competitive landscape

DZP is expected to be approximately the 10th FDA-approved treatment to market in SLE, after currently approved biologics and several products launching ahead. Most pipeline trials carry placebo-controlled designs, meaning current treatments are the key benchmarks rather than future head-to-head comparators. The chart below shows trial start dates and primary completion dates from clinicaltrials.gov, with estimated FDA and EMA approval windows extending from each primary completion.

Solid bar = actual trial period (study start to primary completion). Vertical tick = primary completion date (PCD). Flag markers = estimated approval (US flag for FDA = PCD + 15 months; EU flag for EMA = PCD + 24 months).

Gazyva (obinutuzumab)Roche / Genentechanti-CD20 mAb
FDA
EMA
Sotyktu (deucravacitinib)Bristol Myers SquibbTYK2 inhibitor
FDA
EMA
LitifilimabBiogenanti-BDCA2 mAb
FDA
EMA
Rinvoq (upadacitinib)AbbVieselective JAK1
FDA
EMA
CenerimodIdorsiaS1P1 modulator
FDA
EMA
IanalumabNovartisanti-BAFF-R mAb
FDA
EMA
Imaavy (nipocalimab)Johnson & JohnsonFcRn antagonist
FDA
EMA
DZP (dapirolizumab pegol)UCB / Biogenanti-CD40L IV
FDA
EMA
DZP launch window
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
Dec 2030
Approved (Gazyva approved in LN; SLE submission April 2026) In development, mid-pipeline In development, later-stage pipeline DZP trial period Estimated FDA approval (PCD + 15 months) Estimated EMA approval (PCD + 24 months)
How the 2029 to 2030 anchor works

Pricing is anchored to the forecast 2029 to 2030 SLE pricing opportunity, not to today's prices. UCB and Biogen's own assumptions and target product value profiles (TPVP) inform and guide the DCE attribute levels and the simulator inputs; the work is designed to refine and de-risk those forecasts rather than rely on them as fixed inputs. Pipeline competitor pricing carries inherent uncertainty, handled in the simulator via a competitor-price flex toggle.

Sources: clinicaltrials.gov NCT records (Obinutuzumab NCT04963296, study start 26 Oct 2021, PCD 15 Sep 2025; Deucravacitinib NCT05617677, study start Dec 2022, PCD Jun 2025; Litifilimab NCT04895241, start 25 May 2021, PCD 30 Sep 2026; Upadacitinib NCT05843643, start 25 Jul 2023, PCD Mar 2027; Cenerimod NCT05672576, start Jun 2023, PCD May 2027; Ianalumab NCT05624749, start 21 Apr 2023, PCD 12 Apr 2027; Nipocalimab NCT07438496, start 5 Mar 2026, PCD 6 Dec 2028; DZP NCT06617325, start 21 Nov 2024, PCD 31 May 2028) supplemented with Access Infinity internal assumptions and expertise. Approval estimates: FDA = primary completion date + 15 months; EMA = primary completion date + 24 months. PHOENYCS-GO has read out; PHOENYCS-FLY primary completion is 31 May 2028.

Three strategic questions

Three questions, mapped from your RFP. Each one tied to a specific output and decision.

Question 1

What attribute combinations and evidence thresholds unlock a price premium for DZP, and which payer trade-offs make that premium accessible?

The HCP survey produces a 7-attribute willingness-to-prescribe (WTRx) hierarchy per market. The payer surveys quantify the price-by-restriction trade-off at each plausible attribute combination. Together they isolate the evidence levels (e.g. BICLA, fatigue, steroid-sparing onset, WoCBA placental transfer, LupusQOL) that move payers from non-preferred to preferred placement, and the restriction depths payers will accept for a given premium.

Strategic priority
Question 2

Does demonstrating value in WoCBA / high-risk pregnancy materially shift willingness-to-pay and access conditions, and which evidence unlocks it?

WoCBA is tested two ways. (1) Embedded as a DCE attribute level with three evidence states (none, pharmacokinetic placental-transfer study, full prospective WoCBA evidence). This gives the marginal lift in HCP willingness-to-prescribe and payer access at each evidence threshold. (2) Dedicated scenario module in the simulator that flexes the size of the WoCBA-eligible subgroup and how it interacts with country-specific access routes. Together they answer: how much does WoCBA shift access overall, and how much does it shift access in the patients it actually applies to. The hypothesis carried forward from qualitative findings is that WoCBA is a share lever for the eligible subgroup rather than a population-wide price lever.

Strategic priority
Question 3

How should the eight markets be prioritised and sequenced for launch, balancing pricing potential, reimbursement likelihood, access conditions, MFN reference-basket dynamics and IRP risk?

The integrated price-volume curve per market produces a rank-ordered view of pricing potential. Overlaid with payer access-state probability and HCP demand realisation, this yields a defensible launch sequence. Crucially, the sequence must also hedge risk against basket countries for the US IRP and address MFN exposure: launching first in a high-reference-priced market locks in a benchmark price that downstream IRP-basket markets will reference, so MFN / IRP is a core sequencing input, not a side scenario. We model this directly into the sequencing logic.

Strategic priority
Why us

A trusted partner to UCB and Biogen. Strong SLE expertise, deep pricing heritage, established stakeholder network.

Six dimensions of why our heritage with the UCB / Biogen alliance makes us well placed to deliver this study quickly and efficiently. Click through to see the detail on each.

Strong lupus expertise developed over the last 3 years

  • Completed over 15 projects informing clinical development programmes for SLE and other lupus assets across North America, EU, LatAm and APAC in the last 3 years
  • Experience spans 1-to-1 payer research, KOL clinical research, advisory boards
  • Nuanced understanding of payer expectations on SLE outcome measures and trial design
  • Market-specific dynamics of current clinical landscape and treatment paradigms for SLE across the 8 markets in scope
Recent SLE engagements

Value assessment for a potential SLE asset

Markets: EU4, UK, LATAM. Conducted primary research to understand evidence expectations on comparator, outcome measures, value drivers and price potential. Reviewed clinical landscape to understand unmet need within subgroups. Obtained recommendations on evidence generation strategy satisfying EU payer requirements.

Recent SLE engagements

Price and access strategy for an SLE asset

Markets: DE, CN. Analysed current and future SLE treatment landscape, including patient journey and clinical guidelines. Assessed unmet need particularly in sub-populations. Evaluated payer expectations focused on evidence, pricing and access strategies, including appropriate comparator therapy (ACT) considerations and key benefit-rating drivers.

Quantitative research at scale, with an internal centre of excellence for recruitment

  • Bespoke survey design. Custom questionnaire architecture so the data we collect maps directly to the strategic question
  • Modelling. Extensive experience modelling complex research outputs (DCE, conjoint, MaxDiff, hierarchical Bayes)
  • Quality assurance. Academically-validated approaches throughout, ensuring reliable and robust outputs
  • Vast experience. Over 100 quantitative projects completed with a variety of stakeholders including patients and HCPs
Expert network

3.6 million verified physicians worldwide

Differentiated into 747 sub-specialties. Strong coverage in North America (250k+ physicians) and across all 8 markets in scope.

In-house patient recruitment experience for large-sample studies across geographies while maintaining respondent quality.

Experts in both qualitative and quantitative pricing studies

Access Infinity incorporates a range of established and proprietary techniques across the pricing lifecycle, with strong global pricing expertise. We bring comprehensive understanding of the US healthcare system (including a US-based partner) alongside extensive EU experience with the evolving landscape, including JCA readiness.

Early pricing strategy

In-licensing and willingness-to-pay

Methodologies: analogue analysis. Typical questions: which viable assets have the greatest commercial potential, what is the price potential under different TPVP scenarios, how should we position to achieve optimal revenue.

Qualitative pricing

Global price policy, contracting, launch sequencing

Methodologies: qualitative stakeholder research (1-1 IDIs, focus groups, advisory boards). Typical questions: impact of follow-on competitors, strategies to extend patent and maintain pricing, subsequent indication impact on existing pricing.

Quantitative pricing

Gross-to-net, contracting, revenue optimisation

Methodologies: quantitative research (conjoint / DCE, Gabor-Granger, MaxDiff). Typical questions: how share changes with new entrants, HCP prescribing influence on price optimisation, payer-imposed restriction impact on revenue.

Established payer and KOL network spanning more than 40 countries

  • In-house consultants fluent in EU languages and Mandarin; native-speaking moderators contracted for Japanese as required
  • Up-to-date knowledge on recent policy changes and expected evolution
  • Frequent project cadence keeps the network current
  • Payers for this study can be selected based on prior experience with therapies in SLE

Relevant institutions per market

US
National + regional MCOs, PBMs, IDN P&T leads
China
NHSA, HE unit of NDRC; private payers (Tai Kang, Ping An); Huiminbao active cities
Japan
MHLW, Chuikyo
UK
NICE, SMC; ICBs
France
TC, CEPS, CEESP; hospital pharmacists
Spain
DGFPS, CIPM; CCAA (Mad, And, Val, Cat)
Germany
G-BA, GKV-SV, IQWiG, KV, KK
Italy
AIFA; regional payers and hospital authorities (ASLs)

Extensive experience supporting pharma through evolving policy landscapes

Strong expertise across the policy environments that matter most for SLE launch in the 8 markets in scope: IRA (US Inflation Reduction Act and Medicare negotiation), MFN (US Most-Favoured-Nation reference pricing), JCA (EU Joint Clinical Assessment, preparing for impact from 2025 onwards), and the BStabG reform in Germany (the Drug Stabilisation Law coming into effect from 2027, which abolishes the AMNOG guardrails for products with no or weak added benefit ratings).

  • Continuously monitoring the BStabG and its implications for pharma clients launching from 2027 onwards; preparing AMNOG-outcome scenarios for clients with active immunology pipelines
  • JCA readiness work conducted in 2024 to 2026 covering multiple immunology assets
  • IRA-related work supporting pharma clients impacted by the Inflation Reduction Act in the US, including HE / health economics and pricing strategy
  • MFN scenario modelling via our internal Price Risk Predictor calculator tool
Tooling

MFN Price Risk Predictor

An internal tool we run alongside delivery so UCB and Biogen can model exposure to MFN reference pricing under a range of CMS guidance scenarios. Not asked of payers in the survey.

A trusted UCB partner for over 6 years, with an active MSA in place

Our Consulting and Digital teams have worked with UCB across numerous therapy areas at both global and regional levels, on launch brands and pipeline products. We currently have an active MSA in place. The H2 2025 DZP SLE qualitative payer research was delivered by our team and the leadership for this quantitative phase carries through directly. That continuity is the single biggest reason we are well placed to deliver this study quickly and efficiently for the UCB / Biogen alliance.

Therapy area experience with UCB: atopic dermatitis, axSpA / nr-axSpA / AS-r-axSpA, COPD, hidradenitis suppurativa, NCFB, psoriatic arthritis, psoriasis, rheumatoid arthritis, SLE; rare disease and neurology including ITP, MG, CDD, CIDP, MOGAD, APS, epilepsy, COVID ARDS, DS, LGS, POI, osteoporosis, SSc-PAH, IMM, TED.

UCB launch brands and pipeline products supported

Bimzelx (bimekizumab)
5 years
Fintepla (fenfluramine)
3 years
Rystiggo / Zilbrysq
2 years
Evenity, Cimzia, Galvokimig
6 to 12 months

Project types delivered with UCB

BD and due diligence · Market access landscaping · Evidence reviews · Analogue analysis and HTA reviews · Value proposition development · GVD and objection handlers · Strategic pricing and revenue optimisation · P&MA assessments · MEA / VBP planning · Lifecycle management planning · Value and evidence generation planning

Sustainability alignment with UCB's commitments

Access Infinity is committed to operating sustainably and aligned to UCB's sustainability priorities. We hold validated SBTi (Science-Based Targets initiative) emissions-reduction targets, a current EcoVadis sustainability rating, and a strong rating on the Indigo supplier ESG assessment. Our carbon-maturity programme covers operations and procurement, and we report on our progress at each annual review with UCB procurement.

The H2 2025 connection

The H2 2025 qualitative payer research for UCB and Biogen on DZP in SLE was led by Access Infinity. The methodology in this proposal is calibrated against the priors developed during that qualitative phase. Those qualitative outputs (WoCBA hypothesis, Saphnelo SC dynamics, biologic-experienced as a key gating attribute) feed directly into the hierarchical Bayes estimation as informative priors. The quantitative phase builds on the qualitative phase rather than starting cold.

Our approach

Our approach, in plain language. Phases first. Then where the methodology varies by market, why, and what the survey looks like.

This section walks through how the study runs end to end and what each output looks like. We start with the phase plan, then introduce the five stakeholder groups we are recruiting and explain why we segment them this way, then size the eligible patient populations, then show what the survey looks like at each stakeholder type, then describe how the data come together into one integrated price-volume curve per market, and close with the four deliverables that come out of the engagement and how each ties back to your RFP.

Double-blinded throughout

All references to DZP and the PHOENYCS trials will be blinded throughout the survey instruments and respondent-facing stimuli. The survey describes "a new biologic for patients with active moderate-to-severe SLE who require add-on therapy to standard treatment" with attribute profiles; respondents are not told the asset is DZP. This protects the integrity of the trade-off measurements and avoids respondent bias linked to UCB, Biogen, or the PHOENYCS programme.

Phase plan, end to end click any phase to expand; open as many as you need

Eight phases, June to December 2026. Each phase ends with a named deliverable that UCB / Biogen sign off before the next phase opens. Two review cycles (draft and final), with only the US conducting country-level reviews of stimuli.

Phase
Deliverable signed off at end of phase

What we do, and why. Cross-functional kickoff with the UCB / Biogen core team, then a longer working session with the core team to lock the survey attributes and the scenarios we will model.

How we do it

  • Cross-functional kickoff call to align scope, success criteria, contacts
  • Workshop with core team (Access Infinity team + UCB / Biogen core team) to align on the strategic scenarios to test
  • Finalise the DCE attribute list with you, balanced against survey fatigue and number of screens
  • Confirm forecasted 2029 to 2030 comparator prices that anchor the DCE

What we do, and why. Access Infinity team designs the survey instruments based on agreed attributes and scenarios. Country-specific items layered in where they matter.

How we do it

  • Draft full survey instruments for each respondent type (HCP, US MCO, US IDN, ex-US national, ex-US subnational)
  • Embed key differentiation areas: fatigue (FATIGUE PRO tool), WoCBA placental-transfer PK evidence, earlier onset of steroid tapering, LupusQOL
  • One draft review cycle with UCB / Biogen before pilot

What we do, and why. The survey is built online, translated into local languages, and link-checked before any respondent sees it.

How we do it

  • Programme the survey on our DCE platform
  • Translation plus independent back-translation across 6 ex-US languages
  • Live-link checking and language-overlay testing per market
  • Internal QA pass before pilot

What we do, and why. Every piece of respondent-facing material is reviewed and approved by UCB / Biogen compliance before it touches an external respondent. Nothing goes into pilot or fielding without sign-off.

How we do it

  • Submit full stimulus pack (survey scripts, scenarios, comparator profiles, screeners) for compliance review
  • Standard 2-week review window for global / US materials
  • Japan runs longer in parallel based on prior qualitative-engagement experience; we kick off the JP submission earlier so it lands in the same window
  • Address any compliance feedback; locked compliance-cleared materials handed to pilot

What we do, and why. A small number of live interviews check that respondents understand the questions, the survey runs cleanly, and the design produces useable data.

How we do it

  • 5 pilot interviews total: 1 MCO + 1 rheumatologist + 1 IDN provider in the US, plus 1 rheumatologist + 1 subnational payer in the UK (English-speaking markets first so non-English translations begin in parallel)
  • Capture comprehension issues, timing, drop-off
  • Apply changes to the survey (final round of revisions)

What we do, and why. We collect the data across all 8 markets in parallel, with a mid-fielding check halfway through.

How we do it

  • Online HCP fielding across all 8 markets in parallel
  • Online payer surveys for US MCO, US IDN, and ex-US subnational
  • Ex-US national 90-minute moderated interviews with structured quantitative components
  • Mid-fielding flag check at 50% sample to surface issues early

What we do, and why. Two parallel tracks: the analysis track cleans data and runs the statistical models that turn respondent answers into willingness-to-prescribe estimates and access curves per market. The simulator build track populates the interactive tool with the fitted utilities, so UCB / Biogen can flex pricing, evidence, and competitive scenarios live.

How we do it (Analysis)

  • Data cleaning (multi-criterion checks for inattention, speeding, contradictions)
  • Hierarchical Bayes modelling that produces utility estimates even for small markets
  • Lives-weighting (US MCO) and patient-pool weighting (ex-US subnational)
  • Hold-out validation and model fit checks reported in delivery

How we do it (Simulator build, in parallel)

  • Simulator architecture finalised early in fielding so the build runs in parallel
  • Scenario modules populated; for example, Saphnelo SC adoption, France access route, BStabG reform in Germany, China CHIIDL versus NRDL, US cross-benefit management, IRA selection, pipeline density, TPVP readout
  • Validation against H2 2025 qual point estimates
  • Wireframe demoed at mid-project review

What we do, and why. One PowerPoint deliverable covering all markets, plus the simulator with training. Two core-team review cycles (draft and final) before the final hand-off.

How we do it

  • Per-market chapters plus cross-market synthesis
  • Strategic recommendations with launch sequencing logic
  • Two core-team review cycles (draft and final); US conducts country-level reviews of stimuli, other markets review at the global level
  • 90-minute simulator training session at handoff

For week-by-week sequencing and the full Gantt with monthly tickers, see the Timeline section ↓ at the end of this proposal.

Who we are talking to and why

We are recruiting five stakeholder groups. Each one makes a different access decision, so each one answers a different question in a different way. The mix is driven by where the access decision is actually taken in each market, not by a one-size template.

1
Rheumatologists
Where: all 8 markets
What they decide: which biologic to prescribe, and at what point in the treatment journey.
How we ask: 7-attribute discrete choice experiment online, c. 45 min. Quota mix tailored per market (community vs academic, regional spread, biologic-experience).
Sample (Plus tier): US n=100, ex-US n=60 per market. Standard / Premium variants in table below.
2
US MCO coverage owners
Where: US only
What they decide: the national coverage policy on DZP (Open / Prior auth / step-edit / restricted), weighted by lives across commercial / Medicare Advantage / Medicaid plan archetypes.
How we ask: online price-access DCE with a restriction-depth follow-up that probes utilisation-management depth conditional on each coverage state.
Sample: 22 to 25
3
US IDN institutional contracting leads
Where: US only
What they decide: institutional formulary placement against SC alternatives; how 340B economics and cross-benefit management shift the choice.
How we ask: online institutional contracting DCE. Includes office-based J-code / buy-and-bill attribute for IDNs delivering in outpatient infusion settings.
Sample: 15 to 18
4
Ex-US national decision-makers
Where: all 7 ex-US markets
What they decide: the national pricing corridor and access outcome. HTA where it applies (Germany AMNOG, UK NICE, France SMR / ASMR, Italy AIFA, Spain CCAA); national payer / formulary where it does not (US, Japan Chuikyo, China CHIIDL / NRDL).
How we ask: 90-minute moderated interview at n=5 per market with three quantitative techniques embedded (scenario-based pricing, adaptive paired-profile, analogue-anchored calibration). A standard online survey cannot estimate at this sample size; the moderated format does, and the content is still quant.
Sample: 5 per market
5
Ex-US subnational payers
Where: markets where access is meaningfully shaped below national level
What they decide: regional / institutional access and country-specific contracting. UK ICBs run managed access schemes; Italy regional payers (post-AIFA) implement the national listing locally; Spain CCAA set the regional budget and can introduce additional subnational access controls; China tier-3 (Class III) hospital P&T leads in tier-1 cities (the highest-tier hospitals), plus Huiminbao city-supplementary commercial coverage in active cities, plus private payer bodies (Tai Kang, Ping An).
How we ask: online subnational payer DCE with one to two country-specific items per market.
Sample: 12 to 15 per market

Note on China: at the national level the Ex-US national group covers both public (NRDL / CHIIDL) and private payers; in the public sector there is no provincial payer access for DZP-class therapies (decisions are made centrally), so the subnational layer is hospital and commercial-channel. Tier-driven totals: Standard c. 815 respondents, Plus (recommended) c. 985, Premium c. 1,165. See the Investment section for tier definitions.

Sample sizes by stakeholder and tier

Tier choice (Standard / Plus / Premium) drives the N per cell; the instrument set and market coverage are identical across tiers.

Stakeholder group Markets Standard Plus (recommended) Premium
Rheumatologists USUS80100120
Rheumatologists ex-US, per market 7 markets506070
US MCO Part B coverage ownersUS182228
US IDN institutional contracting leadsUS121520
Ex-US national decision-makers per market 7 markets555
Ex-US subnational payers per market 4 markets81215
Total respondents across all 8 markets~815~985~1,165

Mint highlight = Plus tier (recommended default). Ex-US national n=5 across all tiers (small-sample IDIs; depth-of-instrument is the lever, not N). Quotas per stakeholder group: rheumatologists by community vs academic mix, regional spread and biologic-experience; US MCOs by plan archetype (commercial / MA / Medicaid) and lives-weighted with a 15% single-respondent cap; US IDNs by SLE infusion volume; subnational respondents by region or hospital tier as appropriate. The interactive cost model in the Investment section flexes per-market scope and tier together.

The 90-minute interviews are quantitative

The moderated interviews in every market except the US are not the same as the H2 2025 qualitative phase. They embed three structured quantitative techniques (scenario-based pricing, adaptive paired-profile, analogue-anchored calibration); each one produces numbers we pool with the rest of the data. The moderated format exists because a standalone online survey is not estimable at a sample of 5; the quant content is still there.

Why we use hypothetical comparator profiles

Different markets have different relevant competitors and many lack published data at the time we are designing the survey. We use hypothetical comparator profiles, built from archetypes, that work market-agnostically and cover the plausible minimum and maximum evidence outcomes for each attribute. The simulator then lets UCB and Biogen flex named-product scenarios post-delivery as new data emerge.

Pilot interviews before fielding

Five pilot interviews to confirm comprehension, timing and drop-off before the live survey opens. We test the English-speaking markets (US, UK) first so translations into the six ex-US languages can begin in parallel.

PilotRespondentMarketWhat we check
1MCO coverage policy ownerUSComprehension of price-access scenarios, restriction-depth follow-up
2Community rheumatologistUSChoice-task clarity, attribute level interpretation
3IDN P&T leadUSInstitutional contracting attribute clarity, bridge wording
4RheumatologistUKClinical attribute interpretation in ex-US context
5Subnational payer (ICB lead)UKCountry-specific managed access scheme item

Population sizing, who is eligible and how many

The price-volume model needs sized populations for every subgroup we are testing in the survey. That includes moderate-to-severe SLE patients requiring add-on therapy in each of the eight markets, plus splits for severe-only SLE, biologic-experienced vs biologic-naive, and WoCBA. It also needs to be flexible: as the design lands at the kick-off workshop, we may test further subgroups (e.g. by previous biologic class, age band, contraception use); the sizing model is built to extend to whatever subgroup the final survey design touches. We anchor on the UCB / Biogen 2025 SLE Epidemiology Package wherever possible and only generate new data where the package leaves gaps.

Sizing funnel, from total SLE to addressable sub-segments

Stage 1
Total SLE prevalence per market
Country-level rates per 100,000 from the UCB / Biogen epi package, applied to UN / Eurostat adult denominators.
UCB / Biogen epi pkg
Stage 2
Moderate-to-severe split
EULAR 2024 severity definitions in the package, calibrated to Speyer et al. (37 / 34 / 29% mild / mod / severe), then refined per market.
Epi pkg + HCP refinement
Stage 3
Requires add-on therapy
EULAR treatment positioning plus MarketScan biologic-use signals (PRR 15.8 in SLE post-index); refresh requested from UCB / Biogen at kick-off.
UCB internal + HCP
Stage 4
Bio-experienced / naive cut
UCB / Biogen MarketScan stratification where available; HCP estimates fill the gap by market.
UCB internal + HCP
Stage 5
WoCBA share lever
Female SLE counts from the package (e.g. US 343 per 100,000 in women); WoCBA definition aligned with UCB / Biogen at kick-off (4 options proposed).
Epi pkg + HCP

Source legend: pink = UCB / Biogen epi package primary anchor; green = HCP-validated. Each cell in the final model carries a source tag and a confidence level (high / medium / low).

Stage 1 baseline prevalence, per market

MarketAdult SLE prevalence (per 100,000)Primary source in the packageConfidence
US74.2 (Cerner EHR, age-adjusted); claims-based up to 167.1 (MarketScan)UCB / Biogen epi package, US sectionHigh
Germany55.8Schwarting et al. 2021High
France47.0 (crude); 40.8 (WHO age-standardised)Arnaud et al. 2014 (data from 2010)Med
Italy60.57Ferrara et al. 2024High
UK107.1 (2020); 97.04 in 2012Ellis et al. 2024 (CPRD 1990 to 2020)High
Spain17.5 (Lugo region, age ≥15) to 210 (cross-sectional, small sample n=12)Alonso et al. 2011 / Cortés Verdú et al. 2020Low
Japan60.0 (overall, range 47.0 Tottori to 101.7 Tokyo)Yokogawa et al. 2025 (nationwide claims, 74,277 cases 2019 to 2020)High
China47.6 (2017 nationwide); 36.0 (2009 to 2010 Anhui rural)Li et al. 2024 (nationwide cohort, ~300m residents) / Zou et al. 2014High

Confidence rule: 2020+ studies and large nationally representative samples = High; older studies (2015 to 2019) or single-region estimates = Medium; pre-2015 small samples = Low. UN and Eurostat adult denominators applied to convert rates to patient counts. Triangulated against Appendix Table 1 of the package (SLE Incidence and Prevalence Estimates 2000 to 2025). Spain is the weakest cell: we will request a UCB / Biogen-led refresh at kick-off and flag for HCP validation.

How each stage is built

2
Severity splits using the EULAR 2024 framework
Anchor on the EULAR severity definitions cited in the package (mild: SLEDAI ≤6, BILAG C or ≤1 BILAG B; moderate: SLEDAI 7 to 12, ≥2 BILAG B; severe: SLEDAI >12, ≥1 BILAG A). Use the Speyer et al. US validation study referenced in the package (37% mild, 34% moderate, 29% severe) as the starting split, acknowledged as a small US-only sample and refined via UCB / Biogen internal data and HCP validation in each market.
Epi pkgUCB internalHCP validate
3
Add-on therapy eligibility
EULAR treatment positioning in the package (biologics for inadequate disease control on standard therapy, or where steroid tapering fails) sets the eligibility frame. Combined with MarketScan signals already in the package (biological response modifiers PRR 15.8 post-index, a ratio that needs further work to become a percentage). At kick-off we ask UCB / Biogen for a MarketScan refresh providing actual percentages by drug class (biologic-experienced %, % on belimumab, % on anifrolumab) stratified by severity proxy.
Epi pkgUCB internal refreshHCP fill gaps
4
WoCBA sizing with an aligned definition
Anchor on the package's female-to-male ratios (9:1 during reproductive years, up to 15:1 in some studies), peak incidence at 15 to 44 years and peak prevalence at 45 to 64 years, and country-level female prevalence (e.g. US 343 per 100,000 in women). We align with UCB / Biogen at kick-off on the WoCBA definition most relevant for the price-volume model. Options to discuss:
  • All women aged 15-49 (WHO definition, broadest)
  • Women aged 15-49 not actively on contraception
  • Women aged 15-49 actively planning pregnancy in the next 12 months
  • Women currently pregnant
  • Cascading sub-segments (combination of the above)
Validate definition and splits with HCPs in primary research; capture contraception and pregnancy-intent breakdowns where the segment is defined more narrowly.
Epi pkg female countsHCP validation
5
Remaining sub-segment splits from primary research
Where the package does not size a sub-segment, generate it from HCP interviews and average across HCPs per market:
  • % biologic-experienced vs biologic-naive in moderate-to-severe SLE
  • % on standard therapy but inadequately controlled
  • % WoCBA by sub-definition (on contraception, planning pregnancy, pregnant)
HCP primary
6
Triangulate, document confidence, and validate with payers
Every cell in the model carries three pieces of metadata: the value, the source (UCB / Biogen epi package / UCB / Biogen internal / secondary research / HCP primary), and a confidence level (high / medium / low). During payer IDIs we present the derived sub-segment sizes for that payer's market and ask whether the splits match their understanding of the treated population, capturing any disagreement as a flag for follow-up.
Epi pkgUCB internalSecondaryHCP primary
Trade-offs we are accepting

The UCB / Biogen epi package gives a robust prevalence denominator but does not size treated sub-populations or country-specific severity splits. UCB / Biogen-sourced data is high confidence but limited to what is already done. HCP-sourced data is fast and flexible but carries higher uncertainty (small sample per market, recall-based estimates). The hybrid approach grounds the model in the package wherever possible and uses HCP data only to fill specific gaps.

Asks for UCB / Biogen at kick-off

1. Can UCB / Biogen run additional MarketScan analyses to provide actual biologic-experienced percentages, severity stratification, and WoCBA cross-cuts?
2. How should we define WoCBA for the price-volume model (all 15-49, those not on contraception, those planning pregnancy, those currently pregnant, or cascading sub-segments)?
3. Are there country-specific claims or registry analyses UCB / Biogen has done for ex-US markets that supplement the epi package?
4. Do you have internal estimates of % requiring add-on therapy by market?
5. Are there any planned epi analyses we should align with?

Deliverable, population sizing model

Excel workbook with one tab per market plus a cross-market summary tab. Every cell shows value, source (with specific reference to the UCB / Biogen epi package where applicable), and confidence level. The model feeds directly into the price-volume convolution shown in the Analysis section.

Survey design, illustrative mockups by respondent group Illustrative

These are illustrative mockups, not the final survey, intended to show the draft format and question style. The final survey content will be iterated with the UCB / Biogen team at the Phase 1 alignment workshop and validated through the Phase 4 pilot interviews.

HCP DCE for rheumatologists (Discrete Choice Experiment)

A 7-attribute discrete choice experiment (illustrative), 12 choice tasks plus 1 hold-out for validation, c. 45 minutes total. Embeds the four differentiation areas UCB / Biogen flagged as priorities: fatigue (FATIGUE PRO), WoCBA placental-transfer evidence, earlier onset of steroid tapering, LupusQOL response.

HCP DCE · Choice task 6 of 12
Imagine you are choosing a new biologic for a 38-year-old female SLE patient, biologic-naïve, on hydroxychloroquine plus low-dose prednisone, with active disease. Which option would you select? Option A is DZP (the new biologic in this study). Options B and C are competitor biologics with different attribute mixes; B and C are NOT alternative DZP profiles, they are real / archetypal competitors.
Option A
(DZP)
Option B
(competitor)
Option C
(competitor)
BICLA Wk 24
+17% vs placebo
+12% vs placebo
+20% vs placebo
Onset of steroid tapering
Wk 8
Wk 12
Wk 12
Fatigue improvement
-2.4 pts (FATIGUE PRO, multidimensional)
-1.4 pts (FACIT-F)
-1.8 pts (FACIT-F)
LupusQOL response
+15 pts
Not measured
+10 pts
WoCBA evidence
PK study, limited placental transfer
None at launch
None at launch
Safety vs BEL
No new signal
No new signal
Hepatic AE
Access conditions
A2 (PA only)
A1 (Open)
A3 (Step edit)
12 choice tasks total. 1 hold-out task for validation.

What the survey measures: the relative value HCPs place on each attribute, expressed as willingness-to-prescribe (WTRx) shares. Captures the differentiation areas UCB / Biogen flagged: fatigue via the FATIGUE PRO multidimensional tool, WoCBA placental-transfer evidence, earlier onset of steroid tapering (week 8 vs comparators week 12), and LupusQOL response.

Who answers: rheumatologists in all 8 markets. At the Plus (recommended) tier, n=100 in the US and n=60 per ex-US market. Standard tier scales down to n=80 US / n=50 ex-US; Premium scales up to n=120 US / n=70 ex-US (full table in the Approach section). Quotas adjusted per market: community vs academic mix, regional spread, biologic-experience proportion.

What it produces: a ranked hierarchy of value drivers per market with 80% credible intervals, plus a cross-market view that shows which drivers matter most where.

A note on the attribute list

The 7 attributes shown above are our illustrative starting point. Adding an attribute has real implications: it grows the number of choice screens (12 today; 14 to 16 at 8 attributes) and respondent fatigue starts to push response quality down past 45 minutes. We will run a long working session with the UCB / Biogen core team at the Phase 1 kickoff to lock the final attribute set, balancing strategic importance against survey burden.

Bridge questions, HCP · Convert WTRx choice to simulator share inputs
Q1 of 2 · Share of treated patients
For your eligible moderate-to-severe SLE patients on add-on therapy in the next 12 months, what share would you start on Option A (DZP) vs the available competitor biologics if the products on the market matched the profiles you just saw?
Q2 of 2 · Sequencing intent
In which line of therapy would you typically prescribe Option A (DZP)?

US MCO Price-Access DCE, lives-weighted

US MCO · Scenario 7 of 12
A new biologic for SLE is launching with these characteristics. How would your plan cover it?
Net price (annual, post-rebate)
$48,200
Efficacy vs Benlysta
BICLA +5%, BILAG flare -10%
Safety
No new signal vs Benlysta
Evidence type
RCT plus open-label extension
Route + setting
IV in-office, q4w
WoCBA evidence
Pregnancy registry, 200+ exposures
Coverage decision: A1 Open / A2 PA only / A3 Step-edit through SC biologic / A4 Restricted to biologic-experienced / A5 Restricted refractory / A6 Not covered
12 scenarios. Restriction-Depth 6-task follow-up.

Purpose: Captures coverage and utilisation-management (UM) decisions across plan archetypes (commercial, MA, Medicaid MCO; national vs regional). The Restriction-Depth follow-up is a short second exercise that asks given the coverage choice you just made, how strict would the prior authorisation, step therapy and population restrictions be at each price level? It produces price-by-restriction-depth trade-offs, not just price-by-coverage.

Sample: 25 MCO Part B coverage policy owners. Senior Medical Director or VP Medical Affairs (MD), or Specialty Drug Director (PharmD).

Analytical output: Lives-weighted price-access curve. Each respondent contributes weighted by reported covered lives. Capping rule: no single respondent contributes more than 15% of total sample-weighted lives.

Bridge questions, US MCO · Convert coverage choice to simulator inputs
Q1 of 3 · Covered share
At the access state you selected, what share of your covered SLE patient population would gain DZP coverage within 12 months?
Q2 of 3 · Rebate threshold
At what additional rebate level off WAC would your plan move from A3 step-edit to A2 PA only?
Q3 of 3 · Cross-benefit reference
Would you cross-reference DZP against lower-cost SC alternatives when setting UM criteria? If yes, which one carries the strongest pull?

US IDN Institutional Contracting DCE

US IDN · Scenario 5 of 10
A new biologic for SLE is being considered for your IDN's formulary. What formulary placement would you give it?
Net acquisition price after contracting
$46,800 per patient per year
Efficacy vs Benlysta and Saphnelo
BICLA +5% vs BEL, +2% vs ANI; BILAG flare -10% vs BEL
Rebate / discount structure
Outcomes-based rebate tied to BICLA Wk 24
340B applicability
Eligible site; sub-ceiling discount applies
Comparators on your formulary
Benlysta IV + SC; Saphnelo IV + SC; Gazyva expected within 12 months
Infusion capacity / chair burden
Moderate; IV q4w fits current capacity
Evidence package
RCT + OLE; pregnancy-PK study; LupusQOL data
Formulary placement decision: Preferred / Non-preferred / Restricted (PA criteria) / Not on formulary
10 scenarios with varying SC competitor + payer mix combinations.

Purpose: IDN formulary inclusion is the strategically novel question for an IV product launching against approved SC alternatives. We model the decision against varying SC-competitor availability, payer mix, and contracting terms.

Sample: 15 to 18 IDN institutional contracting leads (P&T chairs or pharmacy directors at academic and community IDN systems).

Analytical output: Formulary placement probability against each SC-competitor scenario, weighted by SLE infusion volume in the IDN.

Bridge questions, US IDN · From placement choice to share-of-prescription
Q1 of 3 · Share shift
At preferred placement, what share of SLE biologic prescriptions in your IDN would shift to DZP within 12 months?
Q2 of 3 · Biologic displacement
Would adding DZP at preferred placement push any current SLE biologic off your formulary? If yes, which one is most likely?
Q3 of 3 · Contracting lever
What contracting feature would most influence your move from Non-preferred to Preferred?

Ex-US Subnational payer DCE (UK example shown)

Subnational payer · Scenario 6 of 10
A new biologic for SLE has received NICE recommendation. How would your ICB / region handle implementation?
National HTA rating (fixed context)
NICE Recommended with Managed Access Scheme (UK example)
Net price (national-negotiated)
£5,800 per patient per year
Coverage / formulary inclusion
In-scope for biologics line; standard inclusion criteria
Restriction depth
Prior auth + bio-naive line-of-therapy restriction
Country-specific item
UK: ICB managed access scheme + data-collection requirement
Expected % eligible patients
Estimated 40 to 60% of regional eligible pool
Clinical evidence summary
BICLA +17%; BILAG flare reduction; no new safety; LupusQOL +12
Regional access decision: Open / Restricted (line-of-therapy or population) / Not included
10 scenarios. One to two country-specific items per market.

Purpose: Captures subnational payer access decisions. Shared core attributes plus one to two country-specific items: UK ICB managed access, Italy regional payers (post-AIFA), Spain CCAA budget, China NRDL list-A / list-B / Huiminbao / CHIIDL listing.

Sample: 12 to 15 per market across UK, Italy, Spain, China. Regional payers, ICB clinical leads, autonomous community pharmacy directors, tier-3 (Class III) hospital P&T leads in tier-1 cities.

Analytical output: Regional access state probability, weighted by eligible SLE patient pool. Combined with the national survey to produce per-market access curves.

Bridge questions, Subnational payer · From access state to regional rollout
Q1 of 3 · Patient reach
At the access state you selected, what share of eligible SLE patients in your region would gain DZP within 12 months?
Q2 of 3 · Country-specific lever
If your country offered a risk-share / MAS / innovation status, would your access state move?
Q3 of 3 · Implementation lag
From national HTA recommendation, how long does your region typically take to implement?

Bridge questions, HCP · From choice task to prescribing share

After the 12 choice tasks, HCPs answer three bridge questions that turn the option they chose into a prescribing share the simulator can use.

HCP bridge questions · Convert DCE choice to prescribing share-of-voice
Q1 of 3 · Switch share
For the option you chose most often, what percentage of your active SLE patients would you switch to DZP within 12 months of availability?
Q2 of 3 · Access tier sensitivity
How would your prescribing share change if the access state moved one tier in either direction (A2 PA to A3 Step-edit)?
Q3 of 3 · Patient subgroup
Within the WoCBA / pregnancy-planning subgroup, what share would you switch to DZP if placental-transfer PK evidence is available at launch?

Cross-instrument attribute map

Which attribute appears in which instrument. The shared clinical core appears in every survey so respondents are reacting to the same DZP profile; stakeholder-specific attributes layer on top.

Attribute
HCP
all 8 markets
US MCO
US only
US IDN
US only
Ex-US National
7 ex-US markets
Sub-national
UK, IT, ES, CN
Shared clinical core (every respondent reacts to the same DZP profile)
BICLA Wk 24 response
Primary efficacy endpoint, in the DCE
SRI-4 response
Paired readout, reported alongside BICLA · not a separate DCE attribute
BILAG flare reduction
Onset of steroid tapering (Wk 8 vs Wk 12)
Fatigue (FATIGUE PRO)
LupusQOL response
WoCBA evidence (placental-transfer PK)
Safety profile vs comparators
Stakeholder-specific attributes
Net price (post-rebate)
·
Access conditions / coverage tier
·
·
Restriction depth / UM (US-specific)
·
·
·
·
SC competitor availability (BEL SC / ANI SC on market)
·
340B / payer mix / outcomes-rebate
·
·
·
·
National HTA outcome (e.g. AMNOG benefit)
·
·
·
Country-specific items (PAS, regional payers, CCAA, NRDL / CHIIDL)
·
·
·

Read: mint ✓ = shared clinical core, magenta ✓ = stakeholder-specific attribute, dot = not in this instrument. Sample counts and instrument lengths trade off the number of stakeholder-specific attributes per cell.

Ex-US national n=5 per market: moderated quantitative interview

A 90-minute moderated interview, run in every market except the US (all 7 ex-US markets), with three integrated techniques. Each component addresses a different failure mode of standard small-n pricing methods.

Component 1

Structured scenario-based pricing

Respondents see 6 to 10 versions of DZP (different TPVP scenarios, evidence levels, comparator landscapes) and indicate the price and access conditions each would receive. Free-text price entry separately for broad and restricted population. Defensible at n=5 because each scenario is its own data point.

Component 2

Adaptive paired-profile

Algorithm narrows the WTP band over 3 to 5 paired comparisons: pick the more acceptable version. Each task halves the uncertainty interval. Typical convergence: from a €1,600 starting band to a €200 final band in 4 tasks.

Component 3

Analogue-anchored calibration

Respondents rate DZP price relative to documented prior decisions on Benlysta, Saphnelo, and recent biologics in their market. Within-respondent ratio rather than absolute price, dramatically reducing noise floor at n=5.

Pooled hierarchical Bayes

The three components are pooled together, with the larger neighbouring samples and the H2 2025 qualitative findings informing the estimates. Each component's result is consistent with the others; the final corridor combines all three with a credible interval band. If recruitment shortfalls drop the sample below 5, we fall back to qualitative depth plus analogue calibration only.

Worked example, France national payer interview

What the moderator and respondent see at each component

Four screens shown sequentially during the structured portion of the 90-minute interview. Layout is illustrative; final stimulus locked in Phase 1 alignment with UCB / Biogen.

Screen 1, Component 1 · Structured scenario-based pricing
France · SSBP · Scenario 3 of 6 · TPVP FLY Base + WoCBA partial
A new biologic for SLE is launching in France. Anchor: BEL France 2030 forecast €4.2k net, ANI France 2030 forecast €7.4k net. What net price corridor would CEPS accept, separately for broad label and WoCBA-restricted subgroup?
BICLA Wk 24
+17% vs placebo
Severe BILAG flare
-45% (Wk 48)
Onset of steroid tapering
Wk 8
Safety vs BEL
No new signal
Route + frequency
IV q4w
WoCBA evidence
PK study, limited placental transfer (partial)
LupusQOL
+12 pt vs comparators
Price corridor entry, net post mandatory discount
Low
Point
High
Broad label
€ __,___
€ __,___
€ __,___
WoCBA subgroup
€ 4,400
€ 4,700
€ 4,900

Respondent declined broad label (SMR Insufficient most likely). ASMR V in a subgroup where there is no appropriate comparator, corridor €4,400 to €4,900 net.

Free-text entry. Moderator probes the rationale before moving to scenario 4.
Screen 2, Component 2 · Adaptive paired-profile · Step 2 of 4
France · Paired · Step 2 · band narrowed €1,600 to €600
Step 1 told us your price sensitivity is moderate. Pick the more acceptable option: a +3% BICLA gain with ITC for an extra €800, vs the lower-cost profile.
Profile A*
Profile B*
BICLA Wk 24
+17% vs placebo
+20% vs placebo
Severe BILAG flare
-45%
-45%
Route + freq
IV q4w
IV q4w
ITC vs ANI
None
Yes, favourable
Net price (WoCBA subgroup)
€4,500
€5,300

Respondent picked B*. Algorithm infers ITC + Δ3% BICLA worth ~€500 to this respondent. Next step tests against a different attribute trade-off (safety vs price).

4 steps planned. Band collapses €1,600 to €200 by step 4.
Screen 3, Component 3 · Analogue-anchored calibration · Probe 1 of 2
France · Analogue calibration · ANI reference
Reference launch: Anifrolumab (Saphnelo IV) launched in France at €11,600 list (2022), CEPS-negotiated to €7,700 net (33% rebate after mandatory 7.5%), ASMR V in broad label.
Question: Where would DZP at FLY Best + ITC + Full WoCBA evidence land relative to ANI's France launch corridor of €7,700 net?
Calibrated point: at FLY Best + ITC + Full WoCBA, DZP estimated at ~€8,470 net under ASMR V subgroup. Within-respondent ratio × ANI anchor × subgroup adjustment.

Probe 2 repeats the exercise vs Benlysta IV France 2030 forecast (€4,200 net). Two anchors disciplined by within-respondent ratios; small-sample noise floor reduced.

Within-respondent ratio. 2 probes total.
Screen 4, Bridge questions · Convert to simulator inputs
France · Bridge · 3 questions to anchor the integrated curve
Q1 of 3 · Access
At your point-estimate corridor (€4,700 net, WoCBA subgroup), what share of eligible French SLE patients would gain access within 12 months?
Q2 of 3 · Subgroup access route
Under SMR Insufficient broad label, would you support an ASMR V route in a subgroup where there is no appropriate comparator?
Q3 of 3 · Evidence threshold
At what additional evidence threshold would your ASMR rating shift from V to IV?
Open text + multi-select: Full WoCBA pregnancy registry (500+ exposures, prospective); head-to-head vs ANI; sustained Wk 52 BILAG flare reduction; corticosteroid taper data > 12 months.
Bridge answers feed the simulator directly. Continuous inputs replace discrete DCE outputs.

Source: screens derived from the H2 2025 qualitative interview structure with UCB / Biogen, refined for the small-sample. Each screen is an illustrative mockup; final stimulus locked in Phase 1.

Analysis, turning many respondents into one curve per market

Up to here, each respondent group has answered different questions in different ways. The analysis brings three input streams together: DCE utilities, bridge-derived demand shares, and scenario flexes. They converge in one convolution that produces the integrated price-volume curve per market.

Input 1 · Choice tasks
DCE utilities

Every choice task across every instrument feeds a hierarchical Bayes model. Output: utility weight per attribute per respondent group, with 80% credible interval. Pools across cells so small samples borrow strength from larger ones.

Input 2 · Bridge battery
Bridge-derived demand shares

The 2 to 4 bridge questions after each choice task convert discrete utilities into continuous probabilities (covered share, prescribing share-of-voice, restriction tier sensitivity). These are the simulator's continuous inputs.

Input 3 · Scenario library
Scenario flex inputs

Post-estimation flexes captured in the scenario library: Saphnelo SC adoption, France access route, TPVP readout, CBM intensity, China CHIIDL vs NRDL, pipeline density, IRA selection, MFN reference-basket. Not asked of respondents. See each scenario in detail ↓

P(access) × demand × scenarios
Simulator convolution

For each market and price point we convolve payer access-state probability with HCP demand at that access state, weighted by patient pool, then apply the scenario flexes the user has selected. The curve re-renders live.

Integrated price-volume curve

One curve per market with 80% credible interval. X: DZP price index. Y: percent eligible reached with positive access (A1 + A2 + A3). All three input streams visible behind the curve at any selected toggle state.

Worked example, US: how the bridge ties three respondent groups into one curve

Three US respondent groups answer three different decisions. The bridge questions convert each respondent's discrete choice into a continuous unit (a share, a probability, a percentage) that combines cleanly with the others. That is why we do not need to test every attribute and every scenario inside each instrument: each group's answer translates into the same currency, the simulator multiplies them, and scenarios flex the inputs after estimation.

US HCP Rheumatologists, 60-70 Picks DZP vs comparators at the patient level US MCO Coverage owners, 25 Assigns access state (A1 to A6) at plan level US IDN Institutional leads, 15-18 Chooses formulary placement vs SC alternatives HCP BRIDGE "What % of your active SLE patients would you switch to DZP at A2 access?" → prescribing share-of-voice MCO BRIDGE "At this access state, what share of covered lives gain DZP in 12 months?" → lives-weighted P(A) over A1-A6 IDN BRIDGE "At preferred placement, what share of SLE biologics shift to DZP?" → formulary share-shift % COMMON CURRENCY: probabilities the simulator can multiply P(HCP demand | A) per state P(A) lives-weighted P(IDN preferred) × prescription shift Simulator convolution P(A) × demand × scenarios → US integrated curve US integrated price-volume curve
Why this works

Three respondents, one shared vocabulary

All three groups answer questions about the same six access states (A1 to A6) and the same DZP clinical profile (the shared clinical core in the attribute map). The bridge converts each group's specific decision into a probability that occupies the same probability space.

Why we do not need to test everything

Scenarios flex inputs after estimation

Once each group's utility is estimated, scenarios like Saphnelo SC adoption, cross-benefit management or IRA-selected Benlysta act as multipliers on the convolved output. We do not need to ask payers "how would you change if Benlysta were IRA-selected?" because that flex sits in the simulator, not in the survey.

Read across markets

Same architecture, different respondents

In ex-US national markets the moderated interview replaces the online survey but the bridge still converts the answer into the same probability currency. The architecture is identical; only the data-collection mechanism varies by market.

The analytical detail, on demand

Tab through the four mechanisms that connect respondent answers to the integrated curve. Read in order, or skip to the part you care about.

A1 through A6 are not labels we invented for this study. They are the access-state taxonomy validated in the H2 2025 qualitative phase, mapped against documented payer language across the 8 markets. Each state has a fixed meaning at the payer (decision label) and at the HCP (prescribing reality).

State
Name
Payer meaning
HCP / patient impact
A1
Open access
Broad indication, no PA, no UM
Full indication eligible
A2
PA only
PA required, criteria align with indication
75 to 85% of indication eligible
A3
Step-edit
Trial of SC biologic required first
45 to 60% eligible after step
A4
Bio-experienced
Restricted to biologic-failed patients
25 to 40% eligible
A5
Refractory
Restricted to severe / refractory disease
10 to 20% eligible
A6
Not covered
Not on formulary; out-of-pocket only
0% covered

2 to 4 bridge questions per stakeholder, asked after the DCE. They convert discrete choices into continuous probability inputs the simulator can convolve. Wording fielded verbatim after pilot interview.

US MCO"At the access state you selected, what percentage of your covered SLE patient population would gain DZP coverage within 12 months?""At what additional rebate level (% off WAC) would your plan move from A3 step-edit to A2 PA only?"
US IDN"At preferred formulary placement, what share of SLE biologic prescriptions in your system would shift to DZP within 12 months?""Would adding DZP at preferred placement push any current SLE biologic off your formulary; which?"
HCP"For the option you chose, what percentage of your active SLE patients would you switch to DZP within 12 months of access?""How would your prescribing share change if access state moved one tier in either direction (A2 to A3)?"
Ex-US national IDI"At your point-estimate corridor, what share of eligible SLE patients in your market would gain access within 12 months?""At what additional evidence threshold would your HTA rating shift by one tier?"

Standard MNL needs a substantial sample per cell. With our smallest cells at n=5 (ex-US national) and n=12 to 15 (subnational, US institutional), standard MNL fails to converge or produces wildly uncertain estimates.

A hierarchical Bayes model uses information from markets with more data to inform estimates in markets with less data. H2 2025 qualitative findings enter as prior expectations. Plainly: estimates are produced at every sample size; precision still scales with how much data we have.

Diagnostics reported at delivery
  • R-hat < 1.05 per parameter
  • Effective sample size > 400
  • Hold-out hit-rate > 70%
  • Posterior predictive check vs analogue launches
  • Sensitivity to prior strength

If a cell fails to converge: simplify model, exclude flagged respondents, or re-estimate with revised priors. Reserve held for re-analysis cycle.

Each cell's contribution to the population-level output is weighted by what it represents, with caps to prevent outlier dominance.

US MCO

Lives-weighted, 15% cap

Weighted by reported covered lives. National MCO at 30M lives contributes more than regional at 500k. No single respondent > 15% of total weighted lives.

US HCP

Volume-weighted, 5% cap

Weighted by annual SLE biologic infusions. 5% single-respondent cap (tighter than MCO because HCP populations are larger).

Ex-US subnational

Patient-pool where available

UK ICB, Italy regions, Spain CCAA weighted by eligible SLE pool. China falls back to channel-stratified unweighted with sensitivity check.

Scenarios that feed the simulator convolution Illustrative

These are the "Scenario flex inputs" from the analysis flow above, in detail. Each one acts as a multiplier on the convolved output. Each card below shows: how much the integrated curve shifts when the lever moves, which instrument's data captures the underlying signal, and what the simulator flexes post-delivery. Where comparator data is limited by publicly available publications, we cover plausible minimum and maximum likelihood outcomes rather than a single point.

Saphnelo SC adoption

Share of franchise that shifts to SC in the 2027 to 2030 window. Determines US institutional formulary alignment and step-edit propensity.
% eligible reached, US, at parity to BEL 2030f net
10% adoption
68%
25% (base case)
60%
50% adoption
49%
75% adoption
36%

Dominant Saphnelo SC adoption (>50% of franchise) drops US co-preferred zone by ~5 to 8 percentage points.

Captured in: HCP DCE comparator archetypes; US MCO step-edit attribute; US IDN comparator-on-formulary attribute. Simulator flexes: share of franchise on SC + corresponding IDN preference.
Example survey item (US MCO): "Assuming Saphnelo SC is available to your members and currently used by [X]% of your eligible SLE population, would you place DZP at step-edit through Saphnelo SC, step-edit through Benlysta SC, or open access?" Repeated across three SC-adoption levels (10% / 25% / 50%). The resulting choice probabilities populate the simulator's "SC adoption %" toggle.

France access route

If SMR Insufficient is the broad-label outcome (likely), the realistic reimbursed route is ASMR V in a subgroup where there is no appropriate comparator. Outside that, direct hospital purchasing under hospital pharmacist guidance is an alternative, very low-volume route.
France: % eligible patients reached
Broad label only
8%
WoCBA subgroup
32%
Both in parallel
38%

The ASMR V subgroup route is conditional on the placental-transfer PK evidence package being available at launch.

Captured in: Ex-US national IDI Component 1 (SSBP) + Bridge Q2; Ex-US subnational France-specific item. Simulator flexes: WoCBA-subgroup-only vs broad-label routing.
Example survey item (FR national, in the 90-min moderated interview): "Under DZP's expected PHOENYCS-FLY label, what is the most likely SMR outcome? If SMR Insufficient, what reimbursed route remains: Option A: ASMR V in a subgroup where there is no appropriate comparator; Option B: direct hospital purchasing only; Option C: no reimbursed access?" Probe for each: Option A asks what net-price corridor CEPS would accept; Option B notes hospitals negotiate individually so there is no CEPS-agreed price (corridor reflects what hospital pharmacy directors would pay); Option C confirms no reimbursed price. Combined with bridge Q2 to translate the route into eligible-patient share.

Pipeline density pre-DZP launch

How many new novel-MoA competitors land in SLE before DZP. We test slow, base and fast scenarios to cover the plausible range; the survey itself uses hypothetical comparator profiles so the analysis is robust to specific named-competitor uncertainty.
% eligible reached at parity-to-BEL 2030f, US
Slow (few competitors)
66%
Base case
60%
Fast (many novel MoAs)
50%

A denser competitive landscape shifts the curve modestly downward for DZP, particularly where novel-MoA differentiation drives WTRx.

Captured in: HCP DCE archetype profiles; Ex-US national SSBP comparator landscape. Simulator flexes: number of novel-MoA competitors in the 2030 set.
Example survey item (HCP): the HCP DCE includes choice tasks where Option B and Option C are hypothetical comparators built from archetypes (anti-IFN, BAFF-blocker, novel-MoA biologic, oral, etc.). By running with different mixes of competitor archetypes in the choice set, we measure how DZP's preferred-product share shifts when the landscape is denser. No direct "how many novel MoAs will launch" question is asked of HCPs.

Cross-benefit management (US)

MCOs and providers that cover both SC and IV products push to use lower-cost SC alternatives. Payer movement between Medicare and commercial coverage (and PA criteria across benefit types) further tightens DZP access even at parity pricing.
% eligible reached, US, at parity to BEL 2030f
No CBM impact
60%
Moderate CBM
50%
High CBM (PB-anchored)
40%

H2 2025 qual flagged cross-benefit management as a key US payer concern.

Captured in: US MCO restriction-depth follow-up; US IDN formulary placement DCE. Simulator flexes: CBM intensity (none / moderate / high).
Example survey item (US MCO restriction-depth follow-up): "Given the coverage state you selected for DZP, would your plan apply a cross-benefit reference against Benlysta SC or Saphnelo SC when setting UM criteria? If yes, which one is the strongest pull, and what is the rebate-equivalent threshold that would move DZP from step-edit to open access?" The answer combines with the restriction-depth distribution to feed CBM-intensity scenarios.

China CHIIDL versus NRDL price triangulation

NRDL covers a much larger population but with deeper discount; CHIIDL listing supports a higher price ceiling at launch with smaller volume. The scenario triangulates which pathway DZP optimises for in launch year 1, and how a pathway switch shifts the net-price corridor over time.
Illustrative net-price ceiling in China (indexed vs CN BEL 2030f net)
NRDL Yr 1
55%
CHIIDL Yr 1
95%
CHIIDL Yr 1 → NRDL Yr 2
70%

CHIIDL listing at launch defends a higher price; NRDL list-B at subsequent annual review adds NRDL volume at a deeper but defensible discount, anchored against the CHIIDL price point.

Captured in: China subnational survey CHIIDL listing item; China NRDL listing item; ex-US national China interview. Simulator flexes: CHIIDL-only / NRDL-only / CHIIDL-first-then-NRDL pathway choice.
Example survey item (CN national / subnational): "What is the highest net-price ceiling DZP could achieve via the CHIIDL route in launch year 1?" and "What is the deepest discount DZP would need to take to be accepted on NRDL List B at the next annual review?" The triangulation between the two answers anchors the CHIIDL versus NRDL pathway choice in the simulator.

MFN price risk (calculator tool, not payer survey)

US Most-Favoured-Nation pricing risk handled as an external calculator output, not asked of payers. Access Infinity's MFN Price Risk Predictor models DZP's exposure based on declared ex-US prices.
Tooling
Access Infinity MFN Price Risk Predictor
Predicts MFN reference-basket impact on US price under multiple scenarios. Calibrated to CMS guidance evolution.

We will not test MFN scenarios in the payer survey: it would inflate respondent burden without producing reliable answers.

Captured in: Calculator tool only · no survey input. Simulator flexes: reference-basket impact on US net price.
No survey question: this scenario is computed externally by the MFN Price Risk Predictor (it takes ex-US declared prices and CMS guidance inputs, returns a US-net adjustment). The simulator applies that adjustment as a post-estimation flex on the US curve.

Hypothetical comparator profiles, not named products

Different markets have different relevant competitors and many of them lack published data at the time of survey design. We therefore use hypothetical comparator profiles built from archetypes (anti-IFN, BAFF blocker, novel MoA, etc.) that work market-agnostically and cover the plausible minimum and maximum evidence outcomes for each attribute. The full competitive landscape sits in the Opportunity section above.
In-survey archetypeAnchors the design against
anti-IFN biologicSaphnelo IV / SC (approved)
BAFF-targeted biologicBenlysta IV / SC (approved); ianalumab
B-cell depleterGazyva (LN approved; SLE submission April 2026)
novel signalling / oralSotyktu, Rinvoq, cenerimod (in development)
novel-MoA biologiclitifilimab, nipocalimab (in development)

Hypothetical profiles let us cover the plausible evidence range without forcing respondents to react to a specific company or trial. The simulator flexes named-product scenarios post-estimation; see the full pipeline table in the Opportunity section.

TPVP readout (PHOENYCS GO vs FLY Base vs FLY Best)

How DZP's clinical profile shifts under the three TPVP scenarios. PHOENYCS-GO has read out; PHOENYCS-FLY reads in 2028. The simulator lets the team flex the assumed DZP profile across these scenarios.
% eligible reached, US, at parity to BEL 2030f
FLY Best
70%
FLY Base
60%
PHOENYCS GO
48%

FLY Best (best-case PHOENYCS-FLY readout) shifts the curve up materially; FLY Base is the central scenario; PHOENYCS-GO alone (no FLY data at launch) drags access down.

Captured in: clinical attribute levels in every DCE; Ex-US national IDI uses TPVP scenarios as the stimulus profile (SSBP Component 1). Simulator flexes: DZP profile assumption across all three TPVPs.
Example survey item (Ex-US national, SSBP Component 1): the respondent sees three DZP product profiles in turn (PHOENYCS-GO, FLY Base, FLY Best) and answers the same pricing question for each: "Under this clinical profile, what net price would the local price-negotiation body accept (CEPS in France, GKV-Spitzenverband in Germany, Chuikyo in Japan, AIFA in Italy, the NHS pricing route in the UK, etc.), and what access route?" The within-respondent comparison disciplines the TPVP effect estimate.

IRA-Benlysta / IRA-Rinvoq selection

US Inflation Reduction Act Medicare negotiation: Benlysta and Rinvoq are the two SLE-relevant comparators most likely to be selected in coming rounds. If either is selected, its Medicare D net price drops materially and the US comparator anchor shifts.
% eligible reached, US, at parity to today's BEL net
No IRA selection
60%
BEL selected
49%
Rinvoq selected
53%
Both selected
41%

IRA selection drops the US comparator anchor, which compresses the WTRx corridor for DZP. The MFN calculator tool runs alongside to score the downstream international reference effect.

Captured in: US MCO comparator-pricing context; US IDN comparator-on-formulary attribute (with selected-comparator net price). Simulator flexes: Medicare D net price drop applied to the selected comparator (BEL, Rinvoq, or both).
Example survey item (US MCO): two of the 12 MCO scenarios are run with a "BEL net price reduced by Y%" overlay (representing IRA negotiation outcome). The respondent answers the same coverage and restriction-depth question for each. This produces a paired-comparison estimate of how DZP's preferred-share shifts when the BEL anchor drops.

BStabG reform in Germany (from 2027)

Germany's Drug Stabilisation Law (BStabG) comes into effect from 2027. It abolishes the AMNOG guardrails for products with no or weak added benefit ratings (no anerkennter Zusatznutzen / geringer Zusatznutzen), removing the price ceiling that currently caps these products at the cheapest comparable therapy. The scenario tests DZP's German net price under three plausible AMNOG outcomes given the BStabG framework.
Germany net price indexed to 2030f Benlysta = 100, under each AMNOG outcome
Considerable added benefit
120
Minor added benefit (post-BStabG)
95
Non-quantifiable / no added benefit (post-BStabG)
70

Pre-BStabG, a no/weak added benefit rating would have forced DZP to a price at or below the cheapest comparator. The BStabG removes that ceiling, leaving GKV-Spitzenverband negotiation as the primary lever, and creates new degrees of freedom for DZP's German pricing strategy.

Captured in: Ex-US national German interview (SSBP Component 1 + Component 2); included as a Germany-specific scenario layer in the simulator. Simulator flexes: pre-BStabG (current AMNOG) vs post-BStabG behaviour at each added-benefit outcome.
Example survey item (DE national, in the 90-min moderated interview): "Under DZP's expected PHOENYCS-FLY profile, what is the most likely G-BA added benefit rating? Now compare the negotiated net price under the current AMNOG framework versus under the BStabG framework that comes into force in 2027: what is the realistic GKV-Spitzenverband-negotiated corridor in each case?" Combined with bridge questions to translate the framework choice into a German net-price corridor.
Why these scenarios sit in the simulator and not in the DCE

Putting six to seven competitive and policy uncertainties into the survey itself would inflate respondent burden well past the 45-minute cap and shrink design integrity. The simulator handles them post-delivery so UCB and Biogen can flex landscapes as new data emerges. Try the toggles in the Live simulator section below.

Deliverables, and how they tie back to your RFP

Four deliverables come out of this study, each fed by a specific part of the work. Below: what each is, what feeds it, and which RFP ask it answers.

D1

Final PowerPoint report

Per-market chapters (one chapter per market, c. 25 to 35 slides each) plus a cross-market synthesis. Strategic recommendations for pricing corridors, evidence prioritisation, and launch sequencing. Decision-grade.

Fed by
  • HCP DCE outputs (WTRx hierarchy per market)
  • US MCO DCE (lives-weighted price-access curves)
  • US IDN DCE (formulary placement under SC competitor scenarios)
  • Ex-US national moderated interviews (price corridor + access outcome)
  • Ex-US subnational DCE (regional access spread)
  • Hierarchical Bayes analysis layer; lives + patient-pool weighting
  • Population sizing model (D3) for absolute volume context
Answers RFP asks: pricing corridor per market, payer access conditions, launch sequencing logic, evidence prioritisation, WoCBA value driver, market-by-market access outcomes.
D2

Interactive simulator

The web-based interactive tool with 20+ user-flexible toggles. Convolves payer access-state probability with HCP demand, weighted by patient pool, and applies the scenario flexes the user selects. Re-renders the price-volume curve live.

Fed by
  • Hierarchical Bayes utility estimates from all five DCE / IDI instruments
  • Bridge questions (HCP, MCO, IDN, Subnational) that translate DCE choices into shares
  • Population sizing model (D3) for patient-pool weighting
  • Scenario library (Saphnelo SC, France route, TPVP, CHIIDL vs NRDL, CBM intensity, pipeline density, IRA, MFN)
  • MFN Price Risk Predictor (external tool, runs alongside)
Answers RFP asks: scenario flex post-delivery, sensitivity testing, ongoing decision support through 2027 to 2029, launch-sequence stress-testing.
D3

Population sizing model (Excel)

One tab per market plus cross-market summary. Each cell shows value, source, and confidence (high / medium / low). Feeds the patient-pool weighting in the simulator and the volume estimates in D1.

Fed by
  • UCB / Biogen 2025 SLE Epidemiology Package (primary anchor)
  • UCB / Biogen MarketScan refresh (requested at kick-off)
  • HCP primary research (severity splits, biologic-experience, WoCBA sub-definitions)
  • Payer validation in IDIs (do the sub-segment sizes match what payers see?)
Answers RFP asks: moderate-to-severe SLE population sizing, add-on therapy eligibility, biologic-experienced vs naive split, WoCBA sub-segment sizing per market.
D4

Simulator training session

90-minute live training on the simulator at handoff. Walks through every toggle, common analytical questions UCB / Biogen will want to answer, and how to read the price-volume curve under different scenarios. Recording shared so it can be replayed.

Fed by
  • Final simulator build (D2)
  • Cross-market synthesis from D1 used as worked examples
  • Documentation pack covering every toggle and scenario
Answers RFP asks: internal team enablement, simulator self-service, post-delivery decision support.
How the four deliverables work together

D3 (population sizing) and the analysis layer feed D1 (PPT report) and D2 (simulator). D2 is built in parallel with the analysis so it ships at the same time as D1. D4 (training) hands D2 to the UCB / Biogen team so they can run their own scenarios after delivery without needing Access Infinity in the loop.

Live simulator Illustrative

Try it now. Toggle pricing, evidence, competitive scenarios; watch the curve update.

Below is a live working version of the interactive simulator that ships at end-2026. The embedded version uses illustrative utilities calibrated to H2 2025 qual point estimates. The production version, delivered at the end of the engagement, uses estimated utilities from this study's fielded data.

Embedded simulator uses illustrative utilities. Production simulator delivered at end-2026 with estimated utilities from this study.

Integrated price-volume curve for United States
DZP price index vs eligible patient pool reached with positive access (A1 to A3). Shaded band shows credible interval. Illustrative
60 95 130 165 200 DZP price index (forecasted 2030 Benlysta net = 100) 0 25 50 75 100 % eligible reached
% eligible reached
0%
At current price index
Access state
A2
PA only (most likely)
Relative premium
+0%
vs forecasted 2030 BEL net
Access state probability distribution
Where the DZP coverage decision sits under current toggle state
A1 Open
10%
A2 PA only
30%
A3 Step-edit
35%
A4 Bio-exp
15%
A5 Refractory
7%
A6 Not covered
3%

Source: Illustrative utilities calibrated to H2 2025 qualitative payer research (UCB / Biogen DZP SLE) and analogue launches (Benlysta IV, Saphnelo IV per market). Methodology: hierarchical Bayes model stub function. Production version uses estimated utilities from fielded data.

Premium simulator features Premium tier

The interactive simulator built at Plus tier already includes 20+ toggles, scenario library, CrI band, and 90-min training. Premium adds the four features below to make the simulator a self-service decision tool the team can run unaided through 2027.

Multi-scenario side-by-side compare

Save current toggle state as Scenario A or B; both render together on the curve so you see the delta live.

80% credible-interval band on the curve

Already rendered as the shaded band around the curve above. Premium widens the band by sub-population (HCP, payer, IDN) and lets you toggle which uncertainty source to visualise.

Point estimate ± 80% CrI Toggle source: combined · HCP only · payer only · IDN only
Sensitivity tornado

Which toggle moves the integrated curve the most? Sorted from largest to smallest impact at the current price point.

Saphnelo SC adoption (10% to 75%)
−19 pp
TPVP scenario (GO to FLY Best)
+15 pp
DZP price index (100 to 140)
−13 pp
CBM intensity (none to high)
−10 pp
WoCBA evidence (none to full)
+8 pp
IRA selection (none to both)
−7 pp
Pipeline density (slow to fast)
−5 pp
Stakeholder share decomposition

For the curve point at the selected price, decompose the integrated share into the three inputs: HCP demand, payer access state, population pool.

HCP WTRx
62%
Payer P(access)
48%
Eligible pool reached
38%
Integrated (HCP × Access × Pool)
30% eligible reached
Sample outputs

What you will receive at end-2026. A preview of the deliverable formats.

Mockups below preview the format and depth of the deliverable so you can see the shape of the outputs. Actual data points are filled in during the engagement. Approximately 280 to 320 charts and tables across the full deliverable; representative examples shown here.

01Cross-market strategic viewDecision-grade comparison across the 8 markets
Price corridor per market with credible interval Illustrative
Net price corridor indexed to forecasted 2029 to 2030 corridor, with reference index = 100. 80% credible interval shown as the band; point estimate as the magenta marker. Comparator anchor agreed with UCB / Biogen at kickoff to ensure cross-market consistency given competitor differences by market.
60 100 (reference) 140 180 220
US
170 to 210
$72 to 89k
JP
110 to 130
¥9.2 to 10.9k
UK
100 to 122
£5.9 to 7.3k
DE
100 to 118
€7.5 to 8.9k
IT
92 to 112
€5.2 to 6.4k
ES
88 to 108
€4.0 to 4.9k
FR
75 to 95
€3.4 to 4.3k
CN
60 to 80
¥1.8 to 2.6k
80% CrI (band) Point estimate Below-parity markets (FR / CN)

Source: hierarchical Bayes model output, lives-weighted (US) / patient-pool-weighted (ex-US). Comparator anchor: forecasted 2029 to 2030 net price of an agreed comparator per market (UCB / Biogen internal forecast; comparator agreed at kickoff to ensure cross-market consistency where the relevant competitor differs by market) = 100. Index reflects 80% credible interval per market. Local-currency equivalents alongside reflect those forecasted values.

Access outcomes matrix, 8 markets Illustrative
Predicted access outcome and utilisation management per market under FLY Base TPVP (HTA decision in markets where HTA applies; payer / formulary outcome in non-HTA markets like US and Japan). Green = broad reimbursement, amber = reimbursed with restrictions or utilisation management, red = not reimbursed or out-of-pocket only.
Broad label
WoCBA subgroup
Refractory only
US
Tier 2/3, step-editStep through SC; commercial-lives weighted
Tier 2, PA onlyIf WoCBA full evidence
Tier 3/4Bio-experienced restriction common
DE
Reimbursed, minor added benefitG-BA; reimbursement is broad in DE. NAB rule constrains price, not access
Reimbursed, considerable added benefit possibleConditional on full WoCBA evidence; would unlock price headroom
Reimbursed, no added benefitStill reimbursed but capped at NAB; price pressure highest in this branch
FR
SMR InsufficientNot reimbursed; HAS Transparency Commission
ASMR V (subgroup)Restricted reimbursement, price floor 5 to 10% below cheapest comparator
SMR InsufficientRefractory not differentiating enough
IT
Class H reimbursed (hospital)AIFA Class H; regional variability post-CTS
Class H + innovationInnovation status if WoCBA evidence sufficient
Class H restrictedRefractory may face hospital P&T friction
ES
Reimbursed restrictedCCAA budget impact varies
Reimbursed broadRisk-share viable; clinical pathways favourable
Restricted refractoryRegional restrictions likely
UK
Recommended with PASNICE; patient access scheme (PAS) likely
RecommendedIf ICER < £30k QALY in WoCBA subgroup
Not recommendedICER unlikely to clear in refractory
JP
Std reimb, no premiumChuikyo; analogue pricing dominates
Std reimb with premiumUsefulness premium if WoCBA evidence available
Std reimb, discountSignificant discount likely
CN
CHIIDL at launch · NRDL List B next cyclePrice negotiation at central level; commercial channel pre-NRDL
NRDL List B + HuiminbaoHuiminbao adds commercial reach in tier-1 / tier-2 cities (Beijing, Shanghai)
NRDL restricted to refractory + CHIIDL fallbackNRDL restricts to HCQ + multiple-immunosuppressant failure; CHIIDL with deep discount if NRDL not achieved; hospital DTC concentrates in tier-1 specialist centres

Source: hierarchical Bayes model projection of access-state probability mapped to access outcomes per Access Infinity rubric. France SMR Insufficient under broad label is the structural finding; ASMR V in the subgroup where there is no appropriate comparator is the realistic alternative route.

02Country deep-divesPer-market chapter with corridor and access

Each per-market chapter follows the same structure. Worked example below: Spain.

Spain pricing trajectory Illustrative
Net price corridor, EUR per pt per year, post-mandatory 7.5% discount.
€4k€6k€8k€11k ANI 2030f €7.4k BEL 2030f €4.2k Broad €7.1 to 9.2k WoCBA €8.5 to 11k Refract. €8.5 to 11k

Anchors: forecast 2030 SLE pricing opportunity, BEL Spain €4,200 (post-biosimilar pressure); ANI Spain €7,400 (CEPS price-erosion trajectory). UCB / Biogen TPVP and own assumptions inform the DCE attribute levels and these reference lines.

Spain HCP WTP hierarchy Illustrative
Top attributes, WTP-equivalent (EUR / pt / yr) with 80% credible interval.
Severe BILAG flare
€1,820
Steroid taper
€1,490
BICLA Wk 24
€1,210
Safety vs BEL
€950
Route + freq
€660
WoCBA evid.
€520
Access state
€380

Source: hierarchical Bayes model on HCP DCE, n = 60 Spanish rheumatologists. Magenta = top-2 drivers; mint = mid and lower drivers. Whisker = 80% credible interval.

Spain access scenario at each price point Illustrative
Distribution of access states across the 6-state vocabulary. Stacked across A1 to A6.
Low €7.2k
22
32
28
12
Point €8.0k
14
26
32
18
7
High €9.7k
16
28
28
14
8
High €11k
10
22
32
18
16
A1 Open A2 PA A3 Step A4 Bio-exp A5 Refract. A6 None

Same chart produced per market and per TPVP scenario; cross-market access overlay in the cross-market chapter.

03TPVP and value frameworkAttribute-level outputs
TPVP value framework Illustrative
Attributes grouped by WTP-magnitude × cross-market consistency. Top-left quadrant: invest aggressively. Top-right: invest selectively. Bottom rows: deprioritise.
High WTP · Consistent across markets
  • Severe BILAG flare reduction
  • Steroid taper rate (sustained < 7.5mg)
High WTP · Market-specific
  • BICLA Wk 24 (highest in )
  • WoCBA evidence (highest in )
  • Safety vs BEL (US payer-side)
Moderate WTP · Consistent
  • Route + frequency (mid-tier across all 8)
  • Fatigue / QoL response
Low WTP · Variable
  • Mucocutaneous-only response
  • Open-label extension data alone
  • Time-to-first-flare beyond 24 weeks

Source: cross-market hierarchical Bayes model on HCP DCE, weighted aggregate of all 8 markets. Quadrant cutoffs at median WTP and 25% cross-market variance.

MaxDiff value-message ranking Illustrative
Best-worst scaling, hierarchical Bayes model utility scale centred at 0, scaled -100 to +100. Pooled HCP + payer respondents, 16 messages.
-100-500+50+100
Severe flare reduction without steroid burden
+76
Steroid taper with maintained efficacy
+62
Mucocutaneous + articular response
+54
WoCBA / pregnancy-planning safety
+44
Fatigue improvement, FACIT-F / LupusQOL
+34
No hepatic safety signal
+22
Novel CD40L MoA, no B-cell depletion
+12
IV q4w, in-office administration
-12
Open-label extension data only
-28
Single-trial confirmatory evidence
-46

Source: MaxDiff hierarchical Bayes model utility scores, pooled HCP + payer respondents weighted 60 / 40. Top-5 messages used in launch positioning brief; bottom-5 deprioritised or reframed.

04US deep-diveLives-weighted, plan-stratified, institutional contracting
Lives-weighted price-access curve Illustrative
% eligible reached vs DZP WAC, stratified by commercial / MA / Medicaid MCO. Lives-weighted at analysis layer.
DZP $48k (point) $30k$45k$60k$75k WAC, annual % eligible 100 50 0 Commercial MA Medicaid MCO

Source: hierarchical Bayes model on US MCO DCE, n = 25 MCO Part B coverage policy owners, lives-weighted with 15% single-respondent cap. Plan archetype curves with 80% credible interval band shown for commercial.

DZP IDN formulary placement under competitor scenarios Illustrative
What this chart shows: the share of US IDNs that would place DZP in each formulary tier (Preferred / Non-preferred / Restricted) under different competitor scenarios at DZP launch. Each row stacks to 100% of IDNs surveyed.
Why it matters: SC reformulations of established biologics change the institutional contracting maths for an IV-only DZP. As more SC options are available, more IDNs push DZP down the formulary; this quantifies the magnitude.
Scenario 1
IV-only competitive set (Benlysta IV, Saphnelo IV only)
52%
38%
10%
Scenario 2
Saphnelo SC available (live since 2026)
34%
44%
22%
Scenario 3
Both SC biologics available (Benlysta SC + Saphnelo SC)
22%
48%
30%
Scenario 4
SC biologics + Gazyva LN extension + oral entrant (Sotyktu)
16%
42%
42%
Preferred (DZP listed without restriction or with light UM) Non-preferred (DZP listed but with step-edit or PA) Restricted or off-formulary (DZP only for narrow population, or not on formulary)

Source: hierarchical Bayes model on US Institutional Contracting DCE, n = 15 to 18 IDN P&T leads, weighted by reported SLE infusion volume. Scenarios drawn from the competitive landscape chart in the Opportunity section.

05Strategic optionsLaunch sequencing and contracting
Recommended launch sequence, guided by MFN / IRP dynamics Illustrative
The launch order is built first to protect US net price from MFN / IRP exposure, then layered with pricing potential and reimbursement likelihood. Low-reference markets are sequenced later so they do not anchor downstream IRP-basket prices. Composite score on 100 scale.
Wave 1
US, Q1 2029
MFN / IRP rationale: launch first in the US to set the highest reference anchor before any low-reference market lands. Layered: highest absolute pricing potential; lives-weighted access viable from launch.
94
Wave 2
Japan + Germany, Q2 to Q3 2029
MFN / IRP rationale: both are high-reference markets in major IRP baskets; their net price feeds back into US MFN and ex-US IRP if launched late. Sequence them after the US anchor. Layered: predictable reimbursement; Chuikyo premium scenario is the upside in Japan.
81
Wave 3
Italy + UK, Q4 2029
MFN / IRP rationale: mid-reference markets, manageable IRP exposure after Wave 1 and Wave 2 anchors are in place. Layered: subnational variability; UK patient access scheme / AIFA innovation tools available.
72
Wave 4
Spain + China, Q1 2030
MFN / IRP rationale: low-reference markets that would drag the US MFN basket if launched early. Sequenced late on purpose. Layered: subnational complexity; CHIIDL listing at China launch with NRDL List B targeted in a subsequent review cycle.
63
Wave 5
France, Q2 2030 if at all
MFN / IRP rationale: France's low net-price ceiling is the single most damaging anchor for the US IRP basket. Defer until US, JP, DE are settled. Layered: ASMR V subgroup pathway is the realistic reimbursed route; direct hospital purchasing as low-volume fallback.
38

Composite score weights: 50% MFN / IRP impact on US net price, 30% pricing potential, 20% reimbursement likelihood. Sequencing rationale tested against the MFN Price Risk Predictor scenario library.

Ex-US contracting options, ranked by access uplift Illustrative
Per-market contracting lever menu. Each option's estimated +pp access at point-estimate price.
FR
PV agreement
+18 pp
UK
ICB-level patient access scheme (PAS)
+12 pp
CN
Huiminbao commercial addition (active cities)
+9 pp
IT
Payment-by-results (PbR)
+8 pp
JP
Usefulness premium (Chuikyo)
+7 pp
ES
Risk-share agreement with CCAA
+6 pp
DE
PV agreement
+5 pp
US
Outcomes-based rebate (IDN)
+5 pp

Per-market contracting lever menu; each option estimated to move eligible access by the indicated percentage points at the point-estimate price corridor. Lever choice agreed with UCB / Biogen at delivery; modelled in the simulator post-delivery.

Risks we would flag

Risks we have anticipated. Each with a documented mitigation.

The methodology has been designed to degrade gracefully under each anticipated risk. The proposal includes this register explicitly to demonstrate risk discipline before execution begins.

RiskSeverityMitigation
Recruiting 15 high-quality subnational respondents per market (UK / IT / ES / CN)HighPre-booking the curated subnational network from kickoff. Screening criteria emphasise direct decision-making experience for SLE biologics. Fallback to ICB / regional payer (UK) and tier-1 hospital P&T (CN) where named subnational payers are not available.
Hierarchical Bayes model fails to produce stable estimates in any respondent groupMediumStandard diagnostics reported at delivery. Documented fallbacks: simplify the model, exclude flagged respondents, re-estimate with revised assumptions. Reserve held for late-cycle re-analysis.
Pilot interviews reveal attribute count too high or comprehension issuesMediumPre-fielding gate. Drop attributes if needed; revise stimulus; re-confirm with UCB / Biogen. Reserve held for revisions.
Competitor data drops mid-fielding (e.g. cenerimod, litifilimab top-lines)MediumSimulator sensitivity layer for top-line-only readouts. Stimulus refresh budget held for material full-data publications. Decision gate at fielding mid-point to assess whether refresh is needed.
Translation issues delay ex-US fieldingMediumTranslation vendor selected at kickoff with qualification check. Translation plus independent back-translation across 6 ex-US languages, with link-checking and language-overlay testing before pilot.
Timeline

Eight phases. Kickoff in June.

Compliance review sits ahead of pilot interviews (we approve before anything goes external). Analysis and simulator build run in parallel. Weekly working calls with the UCB / Biogen core team run from kickoff to hand-off. The detailed phase plan and deliverables for each phase live in the Approach section above.

June
July
August
September
October
November
December
W1
W5
W9
W13
W17
W21
W25
W30
01Kickoff + alignment
02Survey design
03Programming + translation
04Compliance review
05Pilot interviews
06Fielding
07Analysis + simulator (parallel)
08Synthesis + 2 reviews + final
Sequential phase Parallel track (simulator build, runs alongside analysis)
Reviews, cycles, and cadence

Two review cycles on the main deliverables: draft and final. Within each cycle, only the US conducts country-level reviews of stimuli (other markets review at the global level). The compliance hold (Phase 4) is the gate before anything goes external, so we never field unapproved materials. Weekly working calls with the UCB / Biogen core team run from kickoff to final hand-off, with ad-hoc working sessions added when decisions are needed faster.

Your team

A senior-led team with deep heritage on the UCB / Biogen alliance. Continuity from H2 2025 qualitative to the quantitative phase.

The same project leadership that ran the H2 2025 qualitative phase. Brett and George co-lead end-to-end (George also served as qualitative project co-lead in H2 2025). Emily was interim project manager on the qualitative phase and continues as project manager. Leigh Ann brings US market access and policy expertise as a partner-level advisor.

Brett Gardiner
Senior Partner · Project Co-lead
University of Cambridge graduate with a clinical and academic background in immunology and genetics. Track record of leading and contributing to pricing and market access strategies for over 200 biopharmaceuticals, vaccines and medical devices across the full lifecycle. Specialism in DCE, value-based pricing, US managed markets and contracting strategy, payer / KOL moderation. Has led multiple UCB strategic studies including DZP, Bimzelx, Evenity, Cimzia, Rystiggo and Zilbrysq. SLE experience dating back to the early launch of Benlysta in the 2010s.
George Forsyth
Associate Director · Project Co-lead
UCL Pharmacology (1st class honours), full-time consulting since 2016. Has contributed to pricing and market access strategies for over 65 early- and late-stage assets across oncology, rare disease, chronic disease and vaccines. Highly proficient moderator with over 2,500 IDIs, duos, focus groups and advisory boards delivered. Was project co-lead for the DZP H2 2025 qualitative workstream, providing direct continuity into this phase.
Emily Hall
Senior Consultant · Project Manager
BSc Biomedical Sciences and MSc Health Economics and Decision Science from UCL. Pricing and access strategy across oncology, haematology, respiratory, immunology, cardiovascular and reproductive health, with multi-region delivery in EUCAN, UK and APAC (including Japan and China). Multi-stakeholder primary and quantitative research specialism. Interim project manager on the DZP H2 2025 qualitative workstream, continuing as project manager here.
Leigh Ann Bruhn
Partner (US) · Project Advisor
US-based partner with extensive US market access expertise and global experience. Healthcare career spanning brand marketing at Pfizer, US market access leadership at AbbVie (Humira Market Access Director), then consulting at Avalere (access + policy) and Syneos Health (drug pricing risk and reputation). Advisor to over 125 biopharma clients of all sizes. Product and portfolio access experience across oncology, rare, cell & gene, immunology and neurology. Duke MBA, B.S. Finance (University of Illinois). Has served on the Duke Healthcare Alumni Advisory Board and AMCP / NASP committees.
Investment

Plus tier cost breakdown. Eight markets, five deliverables, full transparency.

All costs net in EUR, exclusive of VAT. The Plus (recommended) tier is fully costed below across the five deliverables (D1 Kickoff and PM, D2 Quantitative survey, D3 External validation, D4 Analysis and simulator, D5 Report and hand-off). Professional fees (Access Infinity labour) and third-party / honoraria are shown separately. The 5% UCB / Biogen alliance rebate applies to professional fees only.

Standard
Minimum N for defensible direction
  • US HCP n=80; ex-US HCP n=50 per market
  • US MCO n=18; US IDN n=12; ex-US subnational n=8 per active market
  • Ex-US national n=5 per market (same across all tiers)
  • No interactive simulator (Excel scenario table only, c. 40 pre-computed scenarios)
  • MaxDiff with Likert (not full HB on messages)
Pricing available on request
Premium
Optimal N + simulator with new features
  • US HCP n=120; ex-US HCP n=70 per market
  • US MCO n=28; US IDN n=20; ex-US subnational n=15 per active market
  • Ex-US national n=5 per market
  • Simulator with CrI band, sensitivity tornado, multi-scenario compare, stakeholder share decomposition
  • Mid-fielding interim readout + extended maintenance through 2027
Pricing available on request

The Plus tier is costed in the matrix below at full 8-market scope. Standard and Premium are available as alternative scopes; pricing for those tiers will be provided on request once the preferred tier, market mix and any custom scope adjustments are confirmed with your team.

Deliverable Scope Professional fees
Access Infinity in-house (k€)
Honoraria
pass-through to respondents (k€)
D1 · Kickoff, alignment & project management
Kickoff + alignment workshopCross-functional kickoff plus working session with the UCB / Biogen core team to prioritise and lock attributes and scenarios for testing15.5
Ongoing project managementWeekly UCB / Biogen working calls, financial & resource management, escalation handling, governance43.0
D1 sub-total58.50
D2 · Quantitative survey
Survey design (5 instruments, 1 draft cycle)5 instrument types tailored per market; embed differentiation areas (BICLA / SRI-4, fatigue, steroid taper, WoCBA, LupusQOL); country-specific items53.2
Internal QAVendor programming sign-off, link testing across 8 markets, language-overlay review, pilot link UAT45.4
Survey programming & set-upDCE scripting, hosting & link generation across 5 instruments · in-house50.0
Translation (forward)Forward translation across the 6 ex-US languages, all five instrument types (HCP DCE, US MCO DCE, US IDN DCE, ex-US subnational DCE, ex-US national IDI guides) · in-house33.9
Translation QA & in-country reviewBack-translation reconciliation, native-speaker review per market, pilot-driven revisions · in-house9.0
D2 sub-total191.50
D3 · External validation, fielding & honoraria
Pilot interviews5 IDIs (3 US, 2 UK) to confirm comprehension, timing & drop-off; revise & lock survey10.7
Rheumatologist DCE fielding8 markets, n=520 total · internal hours = quota management, recruiter liaison, data QA11.5
US MCO Part B coverage DCE fieldingn=22 · in-house recruitment by Fieldwork Manager · quota management (commercial / MA / Medicaid / national vs regional Blues)10.5
US Hospital / IDN DCE fieldingn=15 · in-house recruitment; SLE infusion volume quota verification7.0
Ex-US national 90-min IDIsn=5 × 7 ex-US markets = 35 IDIs · in-house recruitment AND moderation; Fieldwork Manager handles recruitment logistics37.0
Ex-US subnational payer DCE fieldingIT / ES / UK + CN sub-cells, n=54 total · in-house recruitment; country-specific item review; data QA24.5
Recruitment fees (Rheumatologist DCE)520 respondents × specialist fieldwork agency recruitment fee · in-house, managed by our Fieldwork Manager104.0
Honoraria: RheumatologistsPer-respondent fee (MAX-of-vendor + 25% KOL buffer) · pass-through to respondents110.8
Honoraria: US payers (MCO + IDN)Per-respondent fee, US Part B coverage and institutional contracting · pass-through to respondents14.4
Honoraria: IT / ES / UK subnationalPer-respondent fee, regional payer / ICB / CCAA · pass-through to respondents7.3
Honoraria: CN subnationalPer-respondent fee, hospital P&T / Huiminbao / CHI insurer · pass-through to respondents2.3
Honoraria: Ex-US national payersFMV-based per-respondent fee, 90-min IDI format · pass-through to respondents13.4
D3 sub-total205.2148.2
D4 · Analysis, simulator & population sizing
Hierarchical Bayes analysisData cleaning, HB modelling across all instruments, lives + patient-pool weighting, hold-out validation, model diagnostics, sensitivity testing · in-house15.0
Simulator buildArchitecture, scenario library, 20+ toggles, validation against H2 2025 qual findings, wireframe demo at mid-project, final UAT with UCB core team · in-house45.0
Population sizing modelExcel workbook with 1 tab per market + cross-market roll-up; sources & confidence tags for each data point; feeds simulator weighting20.8
D4 sub-total80.80
D5 · Final report, hand-off & training
Final PPT deliverablePer-market chapters covering rheum + payer findings; cross-market synthesis identifying differentiation opportunities; pricing & access recommendations linked to simulator outputs; 2 core-team review cycles66.0
Final presentation + simulator hand-off + 90-min training sessionLive walk-through with UCB / Biogen core team; recorded session for re-watching8.9
D5 sub-total74.90
Sub-totals across D1 to D5610.9148.2
Sub-total, all deliverables759.1
5% UCB / Biogen alliance rebate (per cost-sheet terms)−20.7
Grand total, Plus tier · 8 markets · net of rebate738.4 k€

All prices net in k€. Professional fees are all Access Infinity in-house work, including programming, translation, recruitment, hierarchical Bayes analysis, and simulator build — none of these are outsourced. Honoraria are the only pass-through cost: per-respondent fees paid to the respondents themselves. The 5% UCB / Biogen alliance rebate applies as agreed per the cost-sheet terms (calculated on the labour-hour base from the rate-card sheet). Invoicing schedule: 25% kickoff, 25% instrument lock, 25% fielding complete, 25% final delivery. Honoraria calibrated on MAX-of-vendor (M3 / Sermo) per-respondent rates with a 25% KOL buffer for rheumatologists; ex-US national IDIs are FMV-based. Grand total in full EUR: €738,395 (sub-total €759,090; rebate €20,695).

Next steps

Let's talk. One follow-on conversation.

A single 90-minute working session to walk the UCB / Biogen team through everything. Brett and George co-lead the discussion together; the wider Access Infinity team is on standby for any specific methodology or content question.

Working session

Methodology and proposal walkthrough

90 minutes, joint review of the proposal end to end. Walks through the strategic questions, the five-instrument design, the analysis approach, the simulator, deliverables and the costing. Decision points flagged for your input.

Co-led by: Brett Gardiner and George Forsyth.

Contact

Reach out any time

Brett Gardiner, Senior Partner and Project Lead.
brett@access-infinity.com

Specific methodology or simulator questions ahead of the session: route through Brett and we will pull in the right team member.

Meet the lead

The same lead you worked with on H2 2025.

Brett Gardiner

Senior Partner · Project Co-lead

Senior Partner at Access Infinity. Cambridge graduate with a clinical and academic background in immunology and genetics. Has led pricing and market access strategies for over 200 biopharmaceuticals across the full lifecycle, with a long-standing relationship with the UCB / Biogen alliance covering DZP, Bimzelx, Evenity, Cimzia, Rystiggo and Zilbrysq. SLE specialism dating back to the early launch of Benlysta in the 2010s, with continued work across pipeline assets in lupus and lupus nephritis.

"Continuity from the qualitative phase into the quantitative phase is how we turn payer insight into decision-grade pricing evidence quickly and credibly."

Direct contact for methodology questions, kickoff scheduling, and any item in this proposal:

brett@access-infinity.com