BURLINGTON, Mass., Dec. 16, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that in China, the uptake of premium-priced targeted therapies for hepatocellular carcinoma (HCC) is heavily influenced by their high cost and the unfavorable status of reimbursement both at the national and regional level. However, patient share of Bayer/Onyx's Nexavar, the first approved targeted therapies for advanced unresectable HCC, may double by 2016 if it achieves provincial formularies listing in the near future.

Decision Resources' new special report entitled Hepatocellular Carcinoma in China: The Impact of Prescriber and Payer Dynamics on Uptake of Targeted Therapies also finds that there is disparity in the healthcare environment across cities with different Tier levels. Patients in Tier 1 cities generally have better medical insurance coverage and accessibility to HCC targeted therapies than those in Tier 2 and Tier 3 cities, according to surveyed oncologists.

According to interviewed payers, the economic disparity among provinces in China means that premium-priced agents cannot be placed on the national formulary, as they would be beyond the budgets for some areas. However, they indicate that these agents possibly achieve provincial formularies (PRDLs) listing in wealthier provinces. Another key market access challenge for HCC targeted therapies is the Medicine Rate (the percent of total hospital expenditures that are spent on drugs). Each hospital must adhere to the Medicine Rate, which limits the prescription of expensive drugs. Nexavar has the patient share of only around 20 percent, though it is most preferred by surveyed oncologists when prescribing targeted therapies for their HCC patients. However, they expect it to reach 40 percent by 2016, anticipating the improvement of reimbursement environment of this drug (inclusion on several PRDLs) and patients' ability to pay.

"Manufacturers with novel HCC targeted therapies should consider several strategies for market access in China," said Decision Resources Analyst Michelle Zhou, M.B.B.S., Ph.D. "First of all, novel agents must show robust efficacy since efficacy is still the most unmet need for HCC therapy. Secondly, pricing strategies should be considered to fit in the new bargaining system implemented in several wealthier provinces, making premium-priced agents firstly included on PRDLs of these provinces. Thirdly, patient assistance programs, which help to reduce the burden of high patient co-pays, are able to optimize the uptake of the targeted therapies and are worth to be set up. Finally, since Tier 2/3 cities have much less access to HCC targeted therapies and have much room for improvement, strategies for Tier 2/3 cities penetration should be developed to further expand the market."

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