BURLINGTON, Mass.--(BUSINESS WIRE)--Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that 74 percent of surveyed U.S. neurologists indicate that they will prescribe Biogen Idec’s oral immunomodulator BG-12 for the treatment of relapsing-remitting multiple sclerosis (MS), and 32 percent expect to prescribe the drug to patients with clinically isolated syndrome—the highest levels of support expressed by surveyed neurologists who evaluated four late-stage emerging therapies profiled in the report. These findings likely reflect neurologists’ positive perception of BG-12’s clinical profile, which combines strong efficacy, good tolerability, convenient formulation, unique mechanism of action and a favorable safety profile to date.
The new U.S. Physician & Payer Forum report entitled Physician and Payer Attitudes Toward Gilenya and Emerging Oral and Parenteral Disease-Modifying Therapies in the U.S. Multiple Sclerosis Market also finds that, in comparison to BG-12, just over half of surveyed U.S. neurologists expect to prescribe Sanofi’s Aubagio or Teva/Active Biotech's oral laquinimod for relapsing-remitting MS, while 41 percent indicate they would prescribe Genzyme/Sanofi/Bayer HealthCare’s intravenous anti-CD52 monoclonal antibody Lemtrada for this population. Following the anticipated launch of the emerging products profiled, surveyed neurologists expect their use of current disease-modifying agents will contract. In particular, they expect that conventional early-line options such as the interferon-beta therapies (most notably Biogen Idec’s Avonex) or Teva’s Copaxone will be replaced by emerging oral agents while Lemtrada is most likely to replace Biogen Idec/Elan’s Tysabri.
If priced at a premium to currently available comparators, approximately 80 percent of surveyed managed care organizations’ (MCOs) pharmacy directors expect to cover BG-12, Aubagio, laquinimod and Lemtrada, with approximately one-quarter expecting to cover each drug on tiers one or two based on a suggested premium price scenario. At least 40 percent of surveyed MCO pharmacy directors who would reimburse the emerging therapies profiled (at some price point) indicate they will allow access to these products for any MS patient regardless of disease subtype, while between about one-third and one-half expect to impose step therapy protocols on emerging agents, generally requiring failure of conventional mainline therapies.
The report also finds that, armed with a predictive test for assessing the risk of progressive multifocal leukoencephalopathy (PML), 64 percent of surveyed neurologists expect to use Tysabri in earlier lines of therapy in patients who test negative for antibodies to the JC virus (the virus that causes PML), and three-quarters of MCO pharmacy directors anticipate reimbursing Tysabri only for seronegative patients. Additionally, while nearly 80 percent of current prescribers of Novartis/Mitsubishi Tanabe Pharma’s Gilenya expect their use of the drug to “increase substantially” in the next 12 months, only about one-third of Gilenya prescribers and one-quarter of payers believe Gilenya’s annual cost is commensurate with its clinical value.
“The near-term launches of compelling new products, in addition to the availability of Gilenya as well as tools to maximize the use of Tysabri, will help inaugurate a new era of choice in the treatment of MS,” said Decision Resources Analyst Jonathan Searles. “While treatment and reimbursement decisions are becoming more complex for physicians and payers, respectively, the heterogeneity of patients’ disease course and treatment response should inspire a role in clinical practice, and a place on payers’ formularies, for each new drug, including high risk/high-reward therapies.”
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