Colorectal Cancer | Access & Reimbursement | US | 2020

Seven premium-priced therapies (Avastin, Erbitux, Vectibix, Zaltrap, Stivarga, Lonsurf, and Cyramza) and three immune checkpoint inhibitors (Keytruda, Opdivo, and Yervoy) are FDA-approved to treat metastatic colorectal cancer, giving oncologists many treatment options and payers the leverage to control pricing through tiering and restrictions policies. Oncologists are seeking to optimize the sequencing of these therapies in a way that leads to the best outcome for patients while working within the constraints of their patients’ commercial and Medicare insurance policies. Label expansions of current therapies are expected to introduce more high-priced therapies to this market. Therefore, understanding the market access drivers that are important to payers and oncologists will be essential to maximize the uptake of these therapies.

QUESTIONS ANSWERED

• What role do key branded drugs play in the treatment of metastatic colorectal cancer, and how do payer restrictions affect oncologists’ prescribing practices?
• How widespread is the use of clinical pathways among MCOs and oncologists, and what determines a drug’s inclusion in these detailed treatment protocols?
• How do MCOs’ largest fully insured commercial plans and Medicare Advantage plans cover drugs for metastatic colorectal cancer, and what factors encourage favorable positioning of a drug on formulary?
• What are physicians’ and payers’ views on the future of novel, premium-priced therapies for metastatic colorectal cancer? How would they affect the uptake of current agents, and what measures are likely to control the rising cost of treatment?

PRODUCT DESCRIPTION

U.S. Access & Reimbursement provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of U.S. payer policy on physician prescribing behavior in the market access environment, including up-to-date analysis of drug coverage and restriction policies and payer and prescriber perspectives on key marketed drugs and receptivity to emerging therapies.

Primary Research Survey of 93 medical oncologists in the United States. Survey of 30 U.S. managed care organization (MCO) pharmacy and medical directors (PDs / MDs).

Fingertip Formulary coverage and restrictions data for colorectal cancer therapies by commercial plans covering approximately 166 million lives nationally and Medicare Advantage Part D plans covering 14 million lives.

Key Drugs Covered: Keytruda, Opdivo, Yervoy, Erbitux, Avastin, Zaltrap, Vectibix, Stivarga, Cyramza, Lonsurf