Increasingly, it has become clear that there is no one size fits all model for the treatment of breast cancer. Informed by better understanding of disease pathogenesis, companies have developed agents that target specific subpopulations of breast cancer patients. This report will examine the barriers facing premium-priced therapies for the treatment of breast cancer, molecular testing for targeted therapies, and hormonal agents in China and South Korea as well as strategies to circumvent these barriers. In both markets, Roche/Genentech/Chugai’s HER2-targeted monoclonal antibody Herceptin (trastuzumab) has received regulatory approval. GlaxoSmithKline’s small-molecule HER2 inhibitor Tykerb (lapatinib) is available in both markets. HER2 overexpression is a well-validated marker for increased likelihood of response to these premium-priced HER2-targeted agents; however, the use of molecular testing to identify patients who are overexpressing HER2 represents an extra cost to the healthcare systems. As novel HER2-targeted agents such as Roche/Genentech/Chugai’s Kadcyla ado-trastuzumab emtansine [T-DM1]) and Roche/Genentech/Chugai’s Perjeta (pertuzumab) continue to emerge, the financial impact of treating this population is set to put increasing cost pressures on healthcare authorities.
Targeted agents are beginning to penetrate the advanced HR+ population; Novartis’s Afinitor (everolimus) has proven efficacy when used in combination with hormonal therapy in recurrent, postmenopausal patients with advanced disease. It is well established that hormone-receptor-positive (HR+) breast cancer patients respond well to endocrine therapy. In both China and South Korea, the majority of hormonal therapies are now available as generics; however, AstraZeneca’s Faslodex (fulvestrant) remains patent-protected and commands a premium price in both markets. Premium-priced agents directed to the HR+ population are likely to be particularly burdensome to payers because a large proportion of diagnosed breast cancer cases are HR+. Understanding how to best position your brand in these key Asian markets will be essential to maximizing uptake in the region.
This Emerging Markets Physician & Payer Forum report explores how key market access drivers such as price and payer policy affect prescribing of breast cancer therapies in China and South Korea. Insights from 100 surveyed medical oncologists and 7 interviewed payers who influence reimbursement at a national or regional level will inform insights in this report.