Tyrosine kinase inhibitors (TKIs) have revolutionized the management of chronic myelogenous leukemia (CML) over the last decade. However, as 2013-approved second-generation TKIs Bosulif (Pfizer’s bosutinib) and Iclusig (Ariad Pharmaceuticals’ ponatinib) join Glivec (Novartis’s imatinib), Sprycel (Bristol-Myers Squibb’s dasatinib), and Tasigna (Novartis’s nilotinib), treatment decisions are becoming increasingly challenging—especially in later lines of CML therapy—with each TKI agent offering a unique blend of benefits and risks, on top of a premium price tag.
Decision Resources Group’s European Physician & Payer Forum report “Chronic Myelogenous Leukemia: EU5 Prescribing Decisions and Payer Landscape in a Crowded and Dynamic Market” explores reimbursement and additional payer policies that influence prescribing trends for approved targeted agents in CML. The report assesses levers and barriers that will promote or restrict market access for premium-priced novel agents across the cost-constrained EU5 (France, Germany, Italy, Spain, and the United Kingdom). It draws on insights from 251 surveyed hematological oncologists in the EU5 and from interviews with 15 European payers, all of whom have influence at a national or regional level. Interviewed payers include the following:
- France: Hospital pharmacy directors, members of the local formulary committee, and advisors to the Haute Autorité de Santé (HAS; National Health Authority) from northern and southeastern France; hospital pharmacy director and member of the local formulary committee from northern France.
- Germany: Ex-Krankenkassen (health insurance funds) member; GBA (Joint Federal Committee of Physicians, Dentists, Hospitals, and Health Insurance Funds) member; member of national boards and ex-GBA member.
- Italy: Advisor to the Agenzia Italiana del Farmaco (Italian Medicines Agency) and member of the Prontuario Terapeutico Ospedaliero Regionale (PTO/PTOR; [regional] hospital pharmaceutical formulary) committee in southern Italy; AIFA member from northern Italy; PTO/PTOR member from central Italy.
- Spain: Hospital/regional formulary committee members from central, eastern, and southwestern Spain.
- United Kingdom: Clinical Commissioning Group (CCG) advisor and formulary committee member; CCG advisor and ex-CCG commissioner; CCG advisor and ex-advisor to the National Institute for Health and Care Excellence (NICE).