How to assess, not guess, the potential of global markets.

In the past few years, an extended hot streak of groundbreaking approvals has turned the Hepatitis C Virus (HCV) landscape on its head. The emergence of direct-acting anti-viral (DAA) therapies signaled a major paradigm shift that has now yielded effective cures for HCV – and minimizing many of the harshest side effects associated with the conventional, lower-efficacy treatment combinations.

DAAs have changed the epidemiologic projections, too; namely, that the prevalence of HCV within a given population is essentially now a function of the availability of the new drugs. However, the high costs of these cures, even as prices continue to come down, will prohibit their widespread use in many global markets. Treatment policies regarding HCV and the availability of DAAs are sure to differ from one country to the next.

For biopharmaceutical companies developing new products, or looking to expand into new territories, this presents a problem. HCV is a large global market and manufacturers are making important decisions that are going to impact the viability of their assets in each of these given countries. But it’s hard to quantify market opportunities in a meaningful way when the size of the patient pool can fluctuate widely with policy changes. It’s just not the sort of gamble pharma companies are used to taking.

But as any seasoned gambler will tell you, it’s all about watching the cards and hedging your bets. The problem is that manufacturers often don’t have enough reliable information with which to assess these opportunities and bet on them with confidence, especially in such an uncertain market. Fortunately, a new product, the HCV Interactive Patient Flow Model offers companies a lifeline.

Underpinned by gold-standard epidemiology data, the model can generate 15-year forecasts of HCV patient landscapes for 45 countries, based on five different treatment scenarios – each broken down by genotype and viremic status, and depicted by interactive patient flow diagrams and extensive data sets.

The first scenario is DRG’s own forecast, which details the most likely outcome within each market. An in-house team of infectious diseases epidemiology experts predicts how each country is likely to act, based on historical behavior and comparable proxy diseases, such as HIV, and uses those key assumptions as a basis for the projections.

Users can generate four additional forecasts for each country, based on alternative treatment scenarios: one, assuming no DAAs will enter the market; two, assuming countries have resource constraints and choose to treat only high-risk patients (i.e. those with liver cirrhosis); three, assuming countries have no resource constraints and can treat patients at the same levels as high-income European countries; and four, assuming countries are able to meet WHO goals for diagnosis and treatment by 2030.

These insights enable companies to understand how different treatment scenarios impact the HCV epidemic over a 15-year forecast, empowering them to make reasonable assumptions about the viability of their HCV assets within 45 different countries. The comparison scenarios also allow companies to assess the potential impact of any unanticipated reimbursement and policy shifts among payers.

Effect of different scenarios on the HCV population in Mexico

The “DRG Forecast” shows that the number of incident cases in each year of the forecast will fall through 2030. The “No Resource Constraints” scenario follows a similar pattern. However, both the “No DAAs” and “High-Risk Only” scenarios project that the number of new cases of viremic HCV each year will continue to increase through 2030, with a similar narrative for the viremic population. The results indicate that the size of the patient pool could vary significantly over time, depending on how Mexico chooses to treat HCV.

By exploring alternative treatment scenarios and comparing outcomes, users will gain a richer understanding of the dynamics and the forces shaping the HCV landscape. While it won’t offer total immunity from the unexpected perils of the marketplace, it should eliminate enough of the guesswork to dramatically increase the chances of commercial success.

For more information on HCV Interactive Patient Flow Model, click here.

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