Introduction:
Breast cancer is the first solid tumor indication in which a
targeted agent (Roche/Chugai’s Herceptin) has broken through into the lucrative
adjuvant setting. In the metastatic setting, Herceptin, and GlaxoSmithKline’s Tyverb/Tykerb
compete for share of the HER2 overexpressing population, and Genentech/Roche/Chugai’s
Avastin has achieved approval. Decision Resources expects six novel targeted
agents to enter this dynamic market over the next ten years. This report
explores the impact of two agents that will launch within the next two years (Eli
Lilly/BioPar’s BSI-201, and Roche’s Herceptin-DM1), and one later launch (Eli
Lilly’s Ramucirumab) on treatment of breast cancer in the EU5.
Decision Resources’ Physician and Payer Forum report "European
Trends in Targeted Therapies in Breast Cancer: A Clinician and Payer
Perspective on the Current and Future Uptake" explores dynamics that affect
sales of current and emerging targeted agents used to treat breast cancer in
Germany, France, Italy, Spain, and the UK. The report is based on surveys with
224 oncologists from the EU5, and interviews with 20 European payers.
Scope:
These primary sources enabled Decision
Resources to achieve the following:
- Understand what limits the use of Avastin in CaB in the EU5.
How have negative overall survival data affected prescribing? What would drive
oncologists to prescribe a competing VEGF inhibitor ahead of Avastin? Which of
Avastin’s side effects cause oncologists most concern? How, and to what extent,
does cost prevent access to Avastin in the EU5?
- Understand how European oncologists select CaB patients for
Avastin. How does HER2 status impact Avastin prescribing in Europe, where
Avastin’s label is not restricted to HER2-negative patients? How do hormone
receptor status, patient age, and performance status affect prescribing?
- Explore oncologists’ regimens of choice for CaB, by line of
therapy, and country. What share of the CaB market does Avastin command, by
line of therapy (first-line, second-line, third-line, Avastin-pretreated),
stage of disease, and country. What roles do Herceptin and Tyverb play?
- Determine the mechanisms by which targeted therapies are
reimbursed in the EU5. What steps have national health authorities taken to
regulate the prescribing of these high-cost therapies? Do European oncologists
operate under a financial incentive to favor oral therapies? IV therapies?
- Explore clinician attitudes to Sanofi-Aventis’s BSI-201, Eli
Lilly’s Ramucirumab, and Roche’s Herceptin-DM1 in the EU5. How do surveyed
oncologists expect to use BSI-201 in patients with triple negative CaB? How
will uptake vary by country?