BURLINGTON, Mass., Sept. 25, 2014 /PRNewswire/ -- Decision Resources Group finds that the majority of surveyed infectious diseases (ID) specialists and internists are willing to prescribe Actavis/ AstraZeneca's ceftazidime/avibactam (CAZ-AVI), Cubist's ceftolozane/tazobactam and Tetraphase's eravacycline for the treatment of Gram-negative infections (GNI) in the hospital setting. Comparison of anticipated prescribing for the emerging cephalosporin/beta-lactamase inhibitor combinations indicates that ID specialists are more likely to prescribe CAZ-AVI than ceftolozane/tazobactam, suggesting that CAZ-AVI's clinical profile and mainly its spectrum of activity resonates with ID specialists. However, hospital pharmacy directors (PDs) indicate that drug pricing will be central to formulary positioning of these new GNI agents; cost-conscious PDs expect to impose a variety of prescribing restrictions and even exclude CAZ-AVI, ceftolozane/tazobactam and eravacycline from the formulary if these agents are priced at a premium to current brands.
Other key findings from the U.S. Physician and Payer Forum report entitled Gram-Negative Infections: How Will U.S. Payer and Prescriber Receptivity to Novel Antibiotics Shape the Market for These Therapies?
- Current treatment of GNIs: Inexpensive, generically available therapies, namely piperacillin/tazobactam and the fluoroquinolones, remain the mainstay therapies for hospital-treated GNIs. However, the rising rates of drug resistance in GNIs is resulting in first-line use of more potent antibiotics and in earlier treatment with traditional later-line agents, such as the carbapenems.
- Formulary status of key antibiotics: Surveyed physicians and hospital PDs report the current formulary status and associated prescribing restrictions for key GNI agents; approximately 60% of represented hospitals do not impose any prescribing restrictions for meropenem, underscoring overall uptake of carbapenem prescribing.
- Premium-pricing for LPAD drugs: Although less than half of surveyed physicians and PDs report awareness of the proposed Limited Population Antibacterial Drugs (LPAD) regulatory pathway, PDs and physicians alike are willing to accept highly priced LPAD therapies if these agents can demonstrate benefits in select efficacy and outcomes-based parameters.
Comments from Decision Resources Group Director Brenda Perez-Cheeks, Ph.D.:
- "While entrenched prescribing loyalties and generic competition in the hospital GNI market remains an important barrier to entry, drug resistance is reshaping the treatment landscape; follow-on therapies will need to differentiate themselves from current options on efficacy attributes, particularly in infections due to multi-drug resistant GNPs."
- "Hospitals continue to look for ways to contain spend, including their pharmacy expenditures. With increasing emphasis on health outcomes and hospital reimbursement rates tied to quality of care and rates of hospital-related complications, novel agents that demonstrate improvements in efficacy outcomes, reduce readmission rates for key HTIs and decrease length of hospitalization could see elevated uptake despite premium pricing."
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