Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that, despite its dominance in early lines of metastatic colorectal cancer treatment, Roche/Chugai's Avastin will face increasing competition from Bristol-Myers Squibb/Eli Lilly/Merck KGaA's Erbitux in Germany, France and Spain.
The new Special European Physician & Payer Forum report entitled Metastatic Colorectal Cancer in Europe: Changing Dynamics in Light of Increasing Segmentation and New Therapeutic Options finds that more than half of surveyed oncologists in Germany, France and Spain indicate that the existence of a validated biomarker for Erbitux has decreased their prescribing of Avastin in a subpopulation of patients with metastatic colorectal cancer. Sales of Erbitux in these countries will be driven by its use to treat patients with wild-type KRAS (Kirsten rat sarcoma 2 viral oncogene) metastatic colorectal cancer. However, the existence of a validated biomarker for Erbitux has not had a significant impact on the prescribing of Avastin in Italy, which is likely due to the currently low levels of KRAS testing in this country.
"More than half of oncologists in France and Italy say they use Avastin-containing regimens as first-line treatment in patients known to have wild-type KRAS metastatic colorectal cancer, despite a valid biomarker proving the efficacy of Erbitux in this population," said Decision Resources Analyst Marcus Hoyle, B.Sc. "However, in Spain, the majority of oncologists say they use Erbitux-containing regimens in this setting, which is most likely due to the high levels of KRAS testing in Spain as compared to other countries."
The report finds that reimbursement of KRAS testing varies between the European countries surveyed. In France and Spain, KRAS testing is reimbursed but in Germany KRAS testing is not covered by all health insurance systems. As a result, the proportion of patients tested for KRAS status in Germany is substantially lower than the proportion tested in France and Spain. The proportion of patients tested for KRAS status in the United Kingdom, which is currently low, will increase significantly over the next 12 months.
Metastatic Colorectal Cancer in Europe: Changing Dynamics in Light of Increasing Segmentation and New Therapeutic Options is based on surveys with 224 oncologists and interviews with 20 hospital-based payers in Germany, France, Italy, Spain and the United Kingdom. Their responses were compared to assess similarities and differences of opinion regarding clinical, economic and scientific factors.
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