Is There a Disconnect Between Physician and Payer Perceptions of Therapies Across Key Indications?
The treatment of both solid and hematological cancers is associated with a wide range of serious side effects, including febrile neutropenia, anemia, nausea and vomiting, and oral mucositis. In addition to being life threatening, these side effects have significant detrimental impact on patients’ quality of life and often require dose delays, dose reductions, or cessation of cancer treatment, thereby compromising outcomes. As a result, the optimal treatment of chemotherapy-related side effects using supportive care therapies is an integral part of good cancer patient care. Recently approved biosimilar filgrastim (Sandoz’s Zarxio), the first biosimilar to receive FDA approval, will drive down price, assuming that both payers and physicians are receptive to biosimilar therapies. Anemia associated with both cancer and its treatment has a huge impact on patients, but some physicians remain reluctant to prescribe erythropoiesis-stimulating agents (ESAs), because of their toxicity profile and negative effect on outcomes.
Preventative treatment of chemotherapy-induced nausea and vomiting has become a routine component of treatment for specific chemotherapy regimens; however, many patients still suffer symptoms, and agents have been costly. The arrival of generic drugs and innovative formulations should improve access and symptom control for patients if payers facilitate access to these therapies. Management of oral mucositis, especially for patients with squamous cell cancer of the head and neck undergoing radiotherapy/chemoradiotherapy, is inadequate and leaves patients with terrible symptoms and poor quality of life. Despite suboptimal treatments, access to current therapies is variable and comes with substantial patient out-of-pocket costs. Across these diverse supportive care indications run the themes of patient access, increasing costs, and restrictive measures.