Prostate Cancer | Access and Reimbursement | Physician Dispensing of Oral Oncolytics in Prostate Cancer | US | 2018


The increase in oral oncolytics has fueled an increase in physician dispensing of drugs either from the office or from a pharmacy owned by the practice or hospital, as allowed by state laws. Direct dispensing enables physicians to more comprehensively manage their patients’ medical and therapeutic needs and provides an extra revenue stream. However, some managed care organizations (MCOs) are concerned that physician dispensing diverts prescriptions from their specialty pharmacy or from their pharmacy benefit manager’s contracted specialty pharmacy. Understanding physician dispensing and its effect on payer reimbursement and on oncologists’ and urologists’ prescribing habits is essential to creating a sound market-access strategy for drugs to treat prostate cancer and other cancers with oral options.


  • How common is it for oncologists and urologists to dispense oral prostate cancer drugs─ such as Janssen’s Erleada and Zytiga and Pfizer’s Xtandi─from within their practices or in-house dispensing pharmacies?
  • What advantages do physicians report from in-office dispensing?
  • How do MCOs view and react to in-office dispensing, and how does its affect physician reimbursement?
  • What is the coverage and prescribing environment for metastatic castrate-resistant prostate cancer (mCRPC) therapies in general, including the IV agents Provenge, Xofigo, and Jevtana?
  • What is the market access outlook for emerging therapies for nonmetastatic castrate-resistant prostate cancer (nmCRPC), including Erleada and Xtandi, as well as Bayer HealthCare/Orion’s darolutamide?


Access & Reimbursement provides in-depth insight regarding the impact of payer policy on physician prescribing behavior so that clients can build their market access strategy and optimize their brand positioning.


United States


  • Survey of 50 medical oncologists and 51 urologists in the United States.
  • Survey of 40 U.S. MCO pharmacy and medical directors.


Erleada, Jevtana, Provenge, Xofigo, Xtandi, Zytiga, darolutamide


  • Reimbursement and contracting.
  • Access and prescribing.
  • Special topic: in-office dispensing of oral therapies.
  • Opportunities and challenges for emerging therapies.
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