Colorectal Cancer – Access & Reimbursement – Detailed, Expanded Analysis (US)
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
Table of contents
- Colorectal Cancer - Access & Reimbursement - Detailed, Expanded Analysis (US)
- Access and Reimbursement Colorectal Cancer US May 2020
Snigdha Gupta, Ph.D., is a principal analyst on the Oncology team at Clarivate. She has worked on multiple oncology indications, including non-small-cell lung cancer and multiple myeloma. She holds a Ph.D. in infectious diseases from the Indian Institute of Chemical Biology at Jadavpur University in Kolkata. She pursued a postdoctoral fellowship at the Mucosal Immunology Lab of the National Institute of Immunology in New Delhi and has been published in several peer-reviewed journals.
Laura Vinuesa, D.V.M., M.Sc., is a senior business insights analyst on the Oncology team at Clarivate. She specializes in bladder cancer and head and neck cancers and in optimizing market access opportunities for new biomarker-targeted therapies in oncology. Previously, she was part of the Global Market Access Insights team, for whom she analyzed the healthcare systems and pharmaceutical markets of the EU5 and focused on evolving HTA demands, P&R processes, and stringent cost-containment strategies. She obtained her doctorate in veterinary medicine from Complutense University in Madrid and a master’s degree in clinical research and pharmaceutical medicine from EPHOS Business School in Madrid.
Snigdha Gupta, Ph.D., is a principal analyst on the Oncology team at Clarivate. She has worked on multiple oncology indications, including non-small-cell lung cancer and multiple myeloma. She holds a Ph.D. in infectious diseases from the Indian Institute of Chemical Biology at Jadavpur University in Kolkata. She pursued a postdoctoral fellowship at the Mucosal Immunology Lab of the National Institute of Immunology in New Delhi and has been published in several peer-reviewed journals.