Parkinson’s disease (PD) is one of the most common chronic neurodegenerative
diseases in the elderly, and its prevalence is expected to grow 20% over the
next decade as the general population ages. Despite the large and growing
presence of generics in this market, several high-cost brands remain important
to PD treatment, such as the MAO-B inhibitor Azilect (Teva’s rasagiline) and
the dopamine agonist Neupro (UCB’s rotigotine), recently relaunched in the
United States. Moreover, new premium-priced entrants from current drug classes
(such as Newron Pharmaceuticals/Zambon Pharma/Meiji Seika Pharma’s safinamide),
first-in-class agents (Acadia Pharmaceuticals’ pimavanserin), and novel
reformulations (IPX-066 [Impax Laboratories’ Rytary]) are expected to launch
over the next several years, targeting niche populations (e.g., patients
experiencing motor response complications, PD-related psychosis). The evolving
PD marketplace will make physicians’ treatment decisions more complex, while
payers’ coverage decisions will likely be increasingly strained by the need to
contain growing PD-related healthcare expenditures.
This primary-research based report presents and analyzes the
results of a survey of 101 U.S. neurologists treating PD patients and 30
managed care organization (MCO) directors. The report explores key market access
features and clinical factors impacting PD treatment today and in the future.
In particular, we assess physicians’ and payers’ attitudes, expectations,
receptivity, and reservations regarding current and emerging PD therapies.
Questions Answered in This Report:
Understand how surveyed neurologists treat PD patients across
a spectrum of symptoms and comorbidities.
How does treatment initiation
differ between patients younger or older than age 70? How common are
levodopa-sparing approaches? Have physicians incorporated the recently relaunched
dopamine agonist Neupro into their treatment algorithms? How do current
therapies compare on a collection of clinical and market access attributes?
What are the most common first-, second-, and third-line approaches to treating
patients presenting with motor response complications, psychotic symptoms, or
Explore the standing of current PD therapies in commercial
plans and Medicare PDPs and how surveyed neurologists perceive access hurdles.
percentage of commercial plans and Medicare PDPs reimburse key PD drugs and therapies
for treating nonmotor aspects of the disease? What is the formulary status of
key brands? Is coverage for PD drugs expected to change in the near future?
What reimbursement hurdles are typically imposed on key brands? What
reimbursement hurdles do surveyed neurologists find most burdensome to
Examine how surveyed neurologists and MCO directors expect to
receive emerging PD therapies.
What near-term drug development opportunities,
if realized, are surveyed neurologists most likely to prescribe? To which emerging
agents are surveyed payers most likely to grant favorable tier status? What
patient shares do surveyed neurologists estimate for the four emerging agents profiled
within the first year of launch, depending on the drugs’ tier status? What
percentage of surveyed prescribers expect to use pimavanserin first for
PD-related psychosis? On what attributes do surveyed neurologists expect
safinamide to differentiate itself from Azilect? How do MCO directors expect to
reimburse emerging PD therapies, if at all, on commercial and Medicare plans? How
will price impact formulary coverage and tier placement? What does neurologist
and payer receptivity to these emerging therapies imply for drug developers
hoping to enter the PD space?
This U.S. Physician &, Payer Forum report contains
insights from a survey of 101 neurologists and 30 MCO pharmacy/medical
directors regarding physician and payer dynamics
that affect prescribing practices for the treatment of PD in the United States.
In this report, we explore the use, reception, and formulary status of key current
PD therapies by neurologists and MCO directors and gauge surveyed physician and
payer outlook on four late-stage emerging therapies. By understanding the
attitudes and expectations of prescribers and payers toward current and
emerging PD therapies, stakeholders can gain an understanding of the complex PD
treatment algorithm and the reimbursement climate for PD.
Markets covered: United States.
Primary research: Online survey of 101 neurologists and 30
MCO pharmacy or medical directors.
Epidemiology: 2012-2022 prevalent cases of PD in the
Market analysis: 2012 U.S. market and patient share by