Payers are Most Receptive to Reimbursing Premium-Priced Novel Therapies that Offer Clinical Improvements in the Rate of Severe Exacerbations, According to a New Report from Decision Resources
July 1, 2013—Burlington, Mass. —Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that surveyed pulmonologists in the United States and Europe agree that a drug’s effect on reducing the exacerbation rate is one of the attributes that most influences their prescribing for persistent asthma. Clinical data and the opinions of interviewed thought leaders indicate that no current or emerging therapy is currently positioned to surpass the market-leading therapy, GlaxoSmithKline’s Advair/Seretide/Adoair, on this measure.
The DecisionBase report entitled Asthma: Where do Pulmonologists and Payers Signal the Greatest Need—and Greatest Opportunity for Differentiation—for Novel Therapies for Persistent Disease? finds that surveyed U.S. and European pulmonologists and U.S. managed care organization (MCO) pharmacy directors consider therapies with improvements on measures of exacerbation rate to be one of the greatest unmet needs for persistent asthma. Therapies that offer an improvement on these end points would have the most opportunity for differentiation.
In line with identifying improvement on measures of exacerbation as the highest unmet need, the report also finds that surveyed U.S. MCO pharmacy directors are most receptive to new therapies for persistent asthma that offer a reduced rate of severe exacerbations over currently available therapies. These payers are more willing to accept higher price premiums on this measure than for improvements in lung function, reduced hospitalization rate or dosing burden improvements.
“Both surveyed payers and pulmonologists are tolerant of higher prices for therapies that offer a substantial reduction in the exacerbation rate compared with Advair/Seretide/Adoair,” said Decision Resources Analyst Colleen Albacker, Ph.D. “Payers and physicians will be looking for novel therapies to decrease exacerbations for the more-severe patients, offering disease control and preventing unexpected physician and hospital visits. However, while some hold promise, current clinical trial results for emerging therapies do not demonstrate the levels of efficacy needed to secure a premium price with the majority of payers.”
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