MCO Pharmacy Directors are Very Supportive of PCPs Prescribing Currently Available and Emerging HCV Therapies to Patients Who Are Treatment-Naive or Who Have Minimal or No Fibrosis, According to a New Report from Decision Resources
November 19, 2012-Burlington, Mass. –Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that, in contrast to surveyed managed care organization (MCO) pharmacy directors’ notable support for primary care physicians (PCPs) treating patients with hepatitis C virus (HCV), the majority of surveyed specialists are wary of PCPs treating this patient population. Less than one-third of surveyed specialists are supportive of PCPs prescribing currently available HCV regimens, and slightly less than half support the idea of PCPs prescribing oral, interferon (IFN)-free regimens, underscoring specialists’ low confidence in PCPs’ ability to manage HCV patients in the current treatment environment.
The new U.S. Physician & Payer Forum report entitled PCPs in an IFN-Free World: How Will the Availability of Safer and More Effective Oral Therapies Impact the Role of PCPs in Treating HCV Patients?
finds that 35 percent of specialists maintain that HCV patients should not be treated by PCPs, but instead should be treated by specialists in all cases. Additionally, 45 percent of surveyed specialists think the “ideal” HCV patient for treatment by a PCP would be one who is newly diagnosed or treatment-naive with minimal or no fibrosis or other complications, thus requiring straightforward treatment with less monitoring, versus treatment that is required for sicker patients.
Similar to specialists’ perceptions of PCPs, the majority of surveyed PCPs report that they are not familiar with current HCV therapies and are unwilling to prescribe or uncertain about prescribing IFN-free therapy. Nearly three-quarters of surveyed PCPs say they would be uncomfortable (to varying degrees) with treating any but the most straightforward cases of HCV—such as treatment-naive patients with minimal or no fibrosis—most likely because the majority are unfamiliar with most currently available HCV antivirals. Moreover, many surveyed PCPs believe their lack of training in managing HCV patients will preclude their use of IFN-free antivirals
, even if these agents are safer and easier to use, suggesting that PCP training is a key area for marketers of new HCV antivirals to tackle if they want to gain ground in the primary care space.
The report also finds that MCO pharmacy directors are very supportive of PCPs prescribing not only currently available HCV therapies but also emerging IFN-free therapies to the most straightforward HCV patients—treatment-naive patients with minimal or no fibrosis. Their support lessens as disease severity increases, suggesting that PCPs will be best targeted by manufacturers of HCV therapies designed for patients who are new to treatment with relatively healthy livers.
“Assuming oral, IFN-free therapy is available, at least 80 percent of surveyed pharmacy directors are supportive or very supportive of PCPs prescribing such therapy to treatment-naive patients with moderate, minimal, or no fibrosis,” said Decision Resources Analyst Seamus Levine-Wilkinson, Ph.D. “Overall, surveyed pharmacy directors are less supportive of such treatment by PCPs for nonresponders or for patients with severe fibrosis.”
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