Surveyed U.S. Payers Are Most Receptive to Therapies Offering a Significant Median Overall Survival Benefit over Currently Available Therapies, According to a New Report from Decision Resources
June 5, 2013—Burlington, Mass. —Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that symptom control and quality of life is one of the factors the most influences surveyed U.S. and European oncologists’ treatment decisions for second- and subsequent-line metastatic castrate-resistant prostate cancer (mCRPC), and that improved symptom control and quality of life is one of the greatest unmet needs in this indication. Interviewed thought leaders expressed optimism that cabozantinib (Exelixis’s Cometriq) and radium-223 (Algeta/Bayer HealthCare’s Xofigo) will have an advantage over sales-leading abiraterone (Johnson & Johnson/Janssen Biotech/Janssen-Cilag’s Zytiga) on this attribute and will help to partially fulfill the large unmet need.
The DecisionBase 2013 report entitled Prostate Cancer (Second- and Subsequent-Line Metastatic Castrate-Resistant): What Advantages Do Surveyed Oncologists and Payers Believe Emerging Therapies Have to Offer in Order to Gain Traction in This Crowded and Competitive Market finds that surveyed U.S. managed care organization pharmacy directors are most willing to grant favorable formulary status to new second- and subsequent-line mCRPC therapies offering increased median overall survival (MOS) over currently available treatment options. Nevertheless, nearly half of the surveyed payers indicated that they would not reimburse a new therapy priced the same as enzalutamide (Medivation/Astellas Pharma’s Xtandi) or higher that offered a three-month improvement in median overall survival over enzalutamide, most commonly stating insufficient clinical benefit to grant reimbursement.
The report also finds that surveyed U.S. oncologists would prescribe the emerging hormonal agent orteronel (Takeda/Millennium) to 25 percent of their second- and subsequent-line mCRPC patients—however, Decision Resources forecasts that orteronel will earn a more conservative patient share owing primarily to its late launch compared with its main competitors—abiraterone and enzalutamide— in the United States.
“Early-stage clinical data for orteronel are encouraging,” said Decision Resources Senior Business Insight Analyst Dr. Karen Pomeranz. “Thought leaders are enthusiastic about hormonal therapies, in particular CYP17 inhibitors and state that they offer high efficacy and a more manageable safety and tolerability profile compared with that associated with standard chemotherapy. However, by the time orteronel will reach the market, the current hormonal therapies, abiraterone and enzalutamide, will have become well entrenched in the treatment algorithm for second- and subsequent-line mCRPC.”
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