What Are the U.S. Market Access Levers and Hurdles Facing Orally Administered, Small-Molecule Targeted Oncology Drugs for Renal Cell Carcinoma and Hepatocellular Carcinoma? | Physician & Payer Forum | US| 2015

A Survey of Medical Oncologists and Managed Care Organization Pharmacy and Medical Directors

The hepatocellular carcinoma (HCC) and renal cell carcinoma (RCC) markets differ with respect to small-molecule targeted therapies. Nexavar (Bayer/Amgen/Onyx’s sorafenib) is the only approved agent for HCC and, as a consequence, enjoys widespread uptake. However, challenges in the ability of HCC patients, who are frequently severely compromised by comorbidities, to tolerate Nexavar mean that substantial unmet need in this market remains. In contrast, the treatment of RCC is highly competitive as six small-molecule targeted therapies vie for patient share and strive to differentiate themselves on efficacy, tolerability, and delivery attributes. In this competitive environment, market access factors such as tier placement, preferred brand status, and levels of copayment and coinsurance are important factors in therapy selection. Although surveyed medical oncologists rank immune checkpoint inhibitors highly as showing promise in both HCC and RCC, they also express interest in emerging novel small-molecule targeted therapies directed at C-MET and MEK. We investigate surveyed physician perceptions and their prescribing of these agents in both first-line and pretreated settings and explore their receptivity to introducing biomarker testing to these indications. We also explore payer receptivity to price points of emerging novel small-molecule agents and their tier positioning.

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