Introduction:
The osteoporosis market is dominated by the bisphosphonates,
notably alendronate (Merck’s Fosamax, generics) and risedronate
(Sanofi-Aventis/Procter & Gamble’s Actonel), but the emerging RANKL inhibitor
denosumab (Amgen/GlaxoSmithKline’s Prolia) is set to have a significant impact
on the market when it launches in 2010. Denosumab combines good safety and
efficacy with infrequent (twice-yearly dosing) but is anticipated to be priced
as one of the most expensive drugs available for osteoporosis. Two other drugs
in late-stage development for osteoporosis are the novel selective estrogen
receptor modulators (SERMs) bazedoxifene (Pfizer’s Viviant) and
bazedoxifene/conjugated estrogen (Pfizer/Ligand Pharmaceuticals’ Aprela). These
agents will compete with the existing SERM raloxifene (Eli Lilly’s Evista).
Decision Resources’ Physician & Payer Forum survey “How
Will Clinician and Payer Attitudes Determine How Prolia Will Compete with
Established Brands in the Dynamic Osteoporosis Market?” explores the attitudes
of key players in this market. We surveyed 52 primary care physicians (PCPs),
51 endocrinologists, 51 gynecologists, and 20 managed care organization
pharmacy directors (MCO PDs) to assess their attitudes and expectations
surrounding current and emerging therapies for osteoporosis.
Scope:
This study allowed Decision Resources to determine
the following:
- Observe how PCPs, endocrinologists, and gynecologists are
using currently available drugs to treat osteoporosis and osteopenia. How do
these diverse clinician types perceive these current drugs in terms of
efficacy, safety, and delivery? What aspects of current drug therapy do these
clinician types prioritize for improvement?
- Understand how these clinicians diagnose and treat
osteoporosis and osteopenia. What are the primary goals of pharmacological
treatment for these conditions? How do these clinicians prefer to measure
disease severity and progression?
- Understand physicians’ opinions of three emerging therapies
for osteoporosis, Prolia, Viviant and Aprela. How efficacious and safe do
clinicians and payers consider these drugs to be compared with existing drugs?
What are the most important strengths and weaknesses of these drugs?
- Provide insight into how prescribing of HRT by
endocrinologists, PCPs, and gynecologists has changed since the publication of
the WHI and HERS II data in 2002.
- Gauge how MCO PDs are positioning currently available drugs
for osteoporosis on their formularies and understand how they are using cost
controls to guide prescribing. What do they consider to be the most efficacious
and safest currently available drugs for osteoporosis?
- Understand what factors are most important in persuading MCO
PDs to include novel drugs for osteoporosis on their formulary. How do MCO PDs
expect to position Prolia, Viviant and Aprela, and what cost controls do they
expect to use? What do they perceive to be the major advantages and
disadvantages of these drugs that are likely to affect formulary inclusion?