The Majority of Surveyed Oncologists Prescribe Avastin Off-label to Their Ovarian Cancer Patients; However Approximately Half Encounter Access and Reimbursement Hurdles

Treatment Rates with Avastin in Endometrial Cancer are Low but Most Surveyed Oncologists Believe that Angiogenesis Inhibitors Can Play a Role in Treatment of Endometrial Cancer, According to a New Report from Decision Resources

August 14, 2013—Burlington, Mass. —Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that Roche/Genentech/Chugai’s Avastin, although currently not FDA-approved for treatment of ovarian cancer, is prescribed by approximately 70 percent of surveyed oncologists in first-line advanced ovarian cancer. Avastin is most frequently prescribed in first-line advanced ovarian cancer as an add-on agent to doublet platinum-based chemotherapy followed by continued administration of Avastin as a maintenance monotherapy. Approximately half of the surveyed oncologists who prescribe Avastin in first-line advanced ovarian cancer indicate that they encounter reimbursement barriers (such as prior authorization) when prescribing Avastin in this setting.

The U.S. Physician and Payer Forum report entitled Ovarian and Endometrial Cancer: How Will U.S. Prescriber and Payer Attitudes Toward Emerging Antiangiogenics and Other Targeted Anticancer Agents Shape the Treatment Landscape? finds that current treatment of ovarian and endometrial cancers relies heavily on generically available chemotherapies and that carboplatin/paclitaxel is very frequently prescribed in early-stage ovarian cancer, first-line advanced ovarian cancer and in early-stage and advanced endometrial cancer. However, the use of Avastin for treatment of ovarian cancer in all disease settings is common amongst surveyed oncologists and more than 65 percent of surveyed oncologists think that treatment rates with Avastin will increase in the next five years—primarily because they believe Avastin will gain regulatory approval for ovarian cancer. Avastin is rarely used by surveyed oncologists for treatment of endometrial cancer; however, surveyed oncologists believe that angiogenesis inhibitors can play a role in its treatment with 70 percent of surveyed oncologists responding that targeting the vascular endothelial growth factor (VEGF) pathway will likely be a promising treatment approach in this disease.

The report also finds that demonstrating a survival advantage over currently available therapies is of paramount importance to most surveyed managed care organizations’ (MCOs) pharmacy directors (PDs) for formulary inclusion and favorable tier status for ovarian cancer therapies. Surveyed MCO PDs indicate that the cost of treatment has a smaller impact on these decisions.

“The high use of off-label Avastin in ovarian cancer means that novel therapies for ovarian cancer, such as Amgen/Takeda Pharmaceutical’s trebananib, Merck/Endocyte’s vintafolide and GlaxoSmithKline’s Votrient (pazopanib), will not only face strong competition from generically available chemotherapies, but also from premium-priced Avastin,” said Decision Resources Senior Business Insights Analyst Karen Pomeranz, Ph.D. “Strong efficacy data and competitive pricing of emerging therapies compared with Avastin will encourage a high proportion of surveyed MCO PDs to offer reimbursement to novel ovarian cancer therapies and physicians to incorporate these agents into the treatment algorithm.”

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Decision Resources (www.decisionresources.com) is a world leader in market research publications, advisory services and consulting designed to help clients shape strategy, allocate resources and master their chosen markets. Decision Resources is a Decision Resources Group company.

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