Changes Within the Reimbursement Landscape Will Not Significantly Constrain or Promote the Use of Maintenance Therapies for NSCLC Over the Next 12 Months, According to a New Report from Decision Resources
BURLINGTON, Mass.--(BUSINESS WIRE)-- Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that surveyed U.S. oncologists estimate that 67 percent of patients with advanced non-small-cell lung cancer (NSCLC) who complete first-line induction therapy receive maintenance therapy. Currently, continuation maintenance therapies such as Eli Lilly’s Alimta, Genentech/Roche/Chugai’s Avastin, off-label use of ImClone Systems/Merck Serono/Bristol-Myers Squibb’s Erbitux and Eli Lilly’s Gemzar receive more use compared with switch maintenance therapies such as Genentech/OSI Pharmaceuticals/Roche/Chugai’s Tarceva and Sanofi-Aventis’s Taxotere among NSCLC patients. This is likely due to the fact that oncologists want to suppress disease progression after first-line induction therapy but do not wish to exhaust a patient’s treatment options prematurely.
Additionally, only one-fifth of surveyed oncologists prescribe switch maintenance therapy preferentially to continuation maintenance therapy. Most of these oncologists indicate a desire to switch a patient to a drug with a different mechanism of action from what the patient received as first-line induction therapy.
The new U.S. Physician & Payer Forum report entitled Maintenance Treatment of Non-Small-Cell Lung Cancer (NSCLC) in the United States: Will Payers and Prescribers Support a Paradigm Shift? finds that the percentage of patients who receive maintenance therapy will not increase dramatically within the next 12 months. However, surveyed oncologists expect the percentage of patients receiving switch maintenance therapy to grow slightly over the next 12 months, an increase that is likely associated with an increased uptake of Tarceva. Additionally, because most managed care organizations’ (MCO) pharmacy directors reimburse maintenance therapies at a clinician’s discretion regardless of approval, it is unlikely that changes within the reimbursement landscape will significantly constrain or promote the use of maintenance therapies over the next 12 months.
Although maintenance therapies have not historically been widely accepted as the standard of care treatment for NSCLC, two types of maintenance treatment may be prescribed (continuation or switch) in an effort to delay disease progression and/or to extend overall survival in patients with advanced NSCLC. According to the report, surveyed oncologists are divided on whether continuation or switch maintenance treatment achieves superior overall survival outcomes.
“Even though many clinical trials have demonstrated an overall survival benefit for maintenance therapies, the design of many trials has led some oncologists to question the apparent survival advantages of these treatments,” said Decision Resources Analyst Regina Jammen. “Furthermore, over a third of surveyed oncologists indicate that maintenance therapy is better with regard to safety and tolerability than observation alone, thus suggesting that some oncologists view treatment with maintenance therapy as having fewer risks when compared with the risk of untreated disease.”
The report also finds that the U.S. Food and Drug Administration’s approval and labeling of Alimta as maintenance therapy has likely helped to boost the use of the drug in this setting. According to surveyed oncologists, Alimta remains the patient share leader for continuation and switch maintenance treatment even though it is only prescribed to patients with non-squamous cell tumors.
Maintenance Treatment of Non-Small-Cell Lung Cancer (NSCLC) in the United States: Will Payers and Prescribers Support a Paradigm Shift? is based on a U.S. survey of 102 U.S. oncologists and 20 MCO pharmacy directors.
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INDUSTRY KEYWORDS: Health Clinical Trials Oncology Pharmaceutical
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