Emerging Therapies Will Need to Demonstrate Improvements Over Standard-of-Care to Justify Premium Pricing, According to Findings from Decision Resources Group
May 6, 2014 – Burlington, Mass. –
Decision Resources Group finds that overall, infectious disease (ID) specialists and non-ID physicians (critical care and internal medicine specialists) prefer the branded agents Cubist’s Cubicin (daptomycin) and Pfizer’s Zyvox (linezolid), respectively, when treating methicillin-resistant Staphylococcus aureus
(MRSA) infections in the hospital. Nearly half of surveyed ID specialists indicate they prefer Cubicin for treatment of bloodstream infections and/or endocarditis due to MRSA, whereas less than 20 percent of non-ID specialists indicate preference for Cubicin in these indications. However, both physician groups prefer Zyvox for nosocomial pneumonia due to MRSA, likely driven by post-marketing studies demonstrating its clinical superiority over vancomycin. Despite varying drug preferences between the two physician groups, vancomycin remains their most prescribed antibiotic for MRSA infections by both ID specialists and non-ID physicians, driven by physician familiarity, unrestricted formulary access and lower cost.
Other key findings from the U.S. Physician and Payer Forum report entitled MRSA Infections: How Will U.S. Physician and Payer Receptivity to Novel Therapies Influence the Hospital-Treated Infections Market?
Increasing competition in the MRSA market: The MRSA market, particularly the complicated skin and skin structure infection (cSSSI) segment, will become increasingly crowded as three new antibiotics may launch in the United States in 2014. Cubist, Durata Therapeutics and The Medicines Company have all filed new drug applications and marketing authorization applications for tedizolid, dalbavancin (Dalvance) and oritavancin, respectively.
Impact of generic linezolid on uptake of Cubist’s Sivextro (tedizolid): Among the majority of hospital pharmacy directors who indicated they would include tedizolid on formulary, only 15 percent indicated they would not include it if generic linezolid (priced at a 25 percent discount to branded Zyvox) were available, suggesting that pharmacy directors consider tedizolid sufficiently differentiated from linezolid to merit formulary inclusion of both agents.
Benefits of interchangeable IV and oral formulations: According to surveyed physicians, one-half of hospital-treated MRSA patients requiring further antibiotic therapy are discharged on oral agents, a practice which will favor therapies available in interchangeable IV and oral formulations. Such therapies promote IV-oral step-down and early hospital discharge and can reduce the length of hospital stays and lower the overall cost of care.
Comments from Decision Resources Group Analyst Maria Ascano, Ph.D.:
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“Because of the availability of multiple effective therapies for cSSSIs due to MRSA, it has been difficult for branded therapies to be clearly differentiated from current standard-of-care. By targeting patient populations for whom few efficacious therapies are available, drug developers will help their products stand out in this crowded market.”
“Dalbavancin and oritavancin have long systemic half-lives allowing for infrequent dosing. Therefore, the value proposition for these two agents will be their ability to reduce the healthcare cost by promoting early discharge and outpatient therapy. However, once-weekly or one-time dosing is a drastic departure from current standard-of-care, so physicians and pharmacy directors may be hesitant to widely prescribe these agents without further assessment of their efficacy and safety.”
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