According to Surveyed Specialists in China and South Korea, the Uptake of Peg-IFN Agents for Hepatitis C Virus (HCV) is Hindered by Their Relatively High Cost and Their Partial Reimbursement Status in Both Countries
Christopher Comfort, 781-993-2597
Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that although peg-IFN (Roche’s Pegasys, Merck’s PegIntron) combined with ribavirin is recommended as first-line therapy by the Chinese HCV (hepatitis C virus) Prevention and Treatment Guidelines as well as the National Health Insurance (NHI) of South Korea, the uptake of peg-IFN agents is hindered by their relatively high cost and their partial reimbursement status in both countries. The peg-IFNs are included on China’s National Reimbursement Drug List (NRDL), but with type B status. All interviewed payers believe that these agents are unlikely to achieve Type A status (which equates to 100 percent reimbursement) because the associated cost burden is beyond the affordability of the state healthcare budget. In South Korea, peg-IFN is reimbursed at 50 percent, the standard reimbursement rate for hospital-administered therapies. Among surveyed specialists in both China and South Korea, unaffordable copay is noted prominently as the reason why some virus-diagnosed patients do not, or no longer, receive treatment.
The new Emerging Markets Physician & Payer Forum report entitled also finds that surveyed physicians in both China and South Korea report a preference for Pegasys/ribavirin over PegIntron/ribavirin therapy. In both China and South Korea, the estimated patient shares for Pegasys/ribavirin in treatment-naive patients across all genotypes are about twice those for PegIntron/ribavirin. The difference in patient share estimates is less prominent in non-responder populations, although Pegasys maintains a slight advantage.
“Interviewed payers in China, especially, and in South Korea, report that some smaller hospitals can only afford to include one Peg-IFN on their formularies,” said Decision Resources Director Janie Cox, Ph.D. “According to these payers, the factor that most influences a hospital’s choice of which brand to stock is price, followed by relationship with the manufacturer and physician familiarity with the therapies.”
The report also finds that interviewed payers in both China and South Korea report that the increasing prevalence of HCV means that there’s a growing demand for improved reimbursement of existing treatments as well as an increasing need for more effective novel agents. To this end, South Korean payers express unanimous confidence that the novel HCV protease inhibitors Incivek (Vertex/Johnson & Johnson/Mitsubishi Tanabe Pharma) and Victrelis (Merck/Roche) will be added to the positive list, although they expect restrictions to be applied due to likely high price. Payers in China believe that Incivek and Victrelis are likely to be included in the NRDL, although the drugs must have been marketed for at least one year to be eligible, and they will likely miss the next NRDL update, which is expected to occur by 2014. The two agents have a similar probability of gaining state reimbursement and the cost of these therapies will be the main differentiator in reimbursement considerations, according to these payers.
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