Biomarkers in Oncology | Access & Reimbursement | US | Non-Small-Cell Lung Cancer, Breast Cancer, and Colorectal Cancer | 2022

Biomarker-driven prescribing is paramount in key oncology indications. The use of biomarkers is entrenched in non-small-cell lung cancer (NSCLC), breast cancer, and colorectal cancer. Biomarker-associated therapies cater to both large and niche patient subpopulations within these common oncology indications. Although these therapies offer the advantage of selecting the patients who are most likely to respond to targeted therapy, typically they are premium-priced and subject to payer restrictions and cost-containment strategies.


  • What factors largely influence payers’ reimbursement decisions about biomarker-driven therapies in NSCLC, breast cancer, and colorectal cancer?
  • Do access and reimbursement challenges differ by indication, and how well established are biomarkers in each indication?
  • Which managed care organization (MCO) utilization management controls most restrict oncologists’ prescribing of biomarker-driven therapies?
  • What are payers’ opinions about emerging agents, and how will oncologists’ prescribing patterns change with the launch of new therapies?
  • What factors influence reimbursement and access to companion biomarker tests?

GEOGRAPHY: United States.

PRIMARY RESEARCH: Survey of 101 U.S. medical oncologists and 30 U.S. MCO pharmacy directors and medical directors (PDs/MDs).

KEY DRUGS COVERED: Keytruda, Opdivo, Yervoy, Tecentriq, Enhertu, Perjeta, Kadcyla, Margenza, Nerlynx, Tukysa, Lynparza, Erbitux, Vectibix, Braftovi, and Stivarga.


  • Reimbursement and contracting.
  • Access and prescribing.
  • Opportunities and challenges for emerging therapies.
  • Disease-specific special topic.


​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.

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