Biomarkers have become an integral component of the treatment landscape for an increasing number of oncology indications. Patients’ biomarker status often directs prescription choice in malignant melanoma, colorectal cancer, and ovarian cancer. When incorporated into standard clinical care, biomarker-driven therapies offer specific subpopulations of patients the potential for higher response rates and improved survival, albeit often at a high price. We explore the drivers of and barriers to the use of biomarker-based therapies and the impact of reimbursement policies on the use of these therapies. We also evaluate surveyed medical oncologists’ and surveyed payers’ prescriptions of emerging biomarker-driven therapies to treat these solid-tumor indications.
· What factors largely influence payers’ reimbursement decisions for biomarker-driven therapies in malignant melanoma, colorectal cancer, and ovarian cancer? What restrictions do they impose?
· Do access and reimbursement challenges differ by indication, and how well established are biomarkers in each indication?
· What impact do reimbursement and access have on oncologists’ decisions to prescribe biomarker-driven therapies?
· What are payer opinions of emerging agents, and how will oncologists’ prescribing patterns change with the launch of new therapies?
GEOGRAPHY: United States.
PRIMARY RESEARCH: Survey of 101 U.S. medical oncologists and 31 U.S. managed care organization (MCO) pharmacy directors and medical directors (PDs/MDs).
KEY DRUGS COVERED: Avastin, Erbitux, Vectibix, Opdivo, Keytruda, Yervoy, Zelboraf, Tafinlar, Mekinist, Cotellic, Braftovi, Mektovi, Lynparza, Zejula, Rubraca