Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that while United Therapeutics' Tyvaso and Adcirca--launched in 2009--are each prescribed by more than half of surveyed pulmonologists in the specialized pulmonary arterial hypertension (PAH) center setting, Adcirca is much more widely used than Tyvaso among surveyed non-PAH-center physicians.

The new Physician & Payer Forum report entitled Pulmonary Arterial Hypertension: How Will Physicians and Payers Shape an Evolving Market? finds that 53 percent of PAH-center pulmonologists and only 14 percent of non-PAH center pulmonologists have experience prescribing Tyvaso while 59 percent of PAH-center pulmonologists have used Adcirca compared with 36 percent of non-PAH center pulmonologists. The launch of Tyvaso and Adcirca bring the number of marketed drugs in the United States for PAH to eight, including Actelion's Tracleer--the blockbuster market-leading agent. All surveyed pulmonologists practicing in a specialized PAH-center have experience prescribing Tracleer and Pfizer's Revatio and 97 percent of other surveyed pulmonologists also have experience prescribing these two agents.

The report also finds that, despite Adcirca's increasing use among pulmonologists since its launch, Adcirca has the least favorable tier status of all available oral agents. According to surveyed managed care organizations' pharmacy directors, 55 percent of commercial drug plans place Adcirca on tier three or exclude the drug altogether. In contrast, among surveyed brands, Pfizer's Revatio and Tracleer have achieved tier one or two status in the largest proportion of commercial plans - 70 percent and 65 percent, respectively.

"Despite being a rare disease, pulmonary arterial hypertension offers sizeable untapped potential for drug developers and the opportunity for billion-dollar worldwide sales, as already achieved by Tracleer," said Decision Resources Therapeutic area Director Nikhil Mehta. "Although the U.S. approvals of Tyvaso, Adcirca and Gilead's Letairis in the last three years have given prescribers more choice to treat this life-threatening disease, no drug or drug combination provides a panacea and all available agents have limitations that restrict their use, which offers opportunity for new agents in this market."

Pulmonary Arterial Hypertension: How Will Physicians and Payers Shape an Evolving Market? is based on a U.S. survey of 100 pulmonologists (including 34 who practice in specialized PAH centers), 20 managed care organization pharmacy directors. Their responses were compared to assess similarities and differences of opinion regarding clinical, economic and scientific factors.

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