Uptake of Vivus's Qsymia and Arena/Eisai's Belviq Will Be Hampered by Widespread Managed Care Formulary Exclusion

Novo Nordisk's Victoza Will Emerge as the New Market Share Leader in Obesity, According to a New Report from Decision Resources

April 16, 2013—Burlington, Mass. —Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that nearly one half of surveyed managed care organization (MCO) pharmacy and medical directors in the United States currently exclude or block access to all weight-loss drugs, and one-third will not cover an obesity drug without demonstration of long-term benefit. These market access hurdles are significant barriers for uptake of new drugs such as Vivus's Qsymia (phentermine and topiramate) and Arena/Eisai's Belviq, despite the high level of unmet need for safe and effective obesity drugs. Surveyed prescribers estimate that approximately 40 percent of their patients do not receive a weight-loss drug due to formulary tiering or MCO restrictions.

The new U.S. Physician & Payer Forum report entitled The Emerging Obesity Market: What U.S. Market-Access Hurdles Will Weight-Loss Drugs Face? finds that nearly two-thirds of surveyed endocrinologists and primary care physicians (PCPs) expect to increase their prescribing of Vivus' Qsymia over the next year. However, Novo Nordisk's Victoza will likely become the market-share leader in the obesity market, owing to physician familiarity with the drug's use in type 2 diabetes and current experience with off-label prescribing of the drug for obesity. Survey results show that endocrinologists expect to prescribe Victoza to 20 percent of their obese and overweight patients in 2015.

The report also finds that Qsymia and Orexigen/Takeda's Phase III drug Contrave (bupropion and naltrexone) are vulnerable in the obesity market due to surveyed physicians' willingness to prescribe generic components instead of the branded fixed-dose combinations. Additionally, surveyed PCPs continue to view phentermine (Teva's Adipex-P, generics) as the most efficacious weight-loss drug; 59 percent of PCPs anticipate prescribing phentermine first line in 2015.

"Surveyed endocrinologists and PCPs estimate that fewer than 26 percent of their overweight and obese patients request a specific weight-loss drug," said Decision Resources Senior Director Donny Wong, Ph.D. "As a result, despite Qsymia's status as the newest obesity drug to launch in the United States since Roche's Xenical and Abbott's Meridia, phentermine remains the most commonly prescribed obesity drug. However, the heavy use of phentermine in the United States may provide an opportunity for patients to be 'upgraded' to Qsymia, or to try combination therapy with Belviq once that option becomes available."

About Decision Resources
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.

About Decision Resources Group
Decision Resources Group is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources Group at www.DecisionResourcesGroup.com.

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