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Research & Reports

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Breast Cancer | Access & Reimbursement | Detailed, Expanded Analysis (Brazil and Mexico)

Breast Cancer | Access & Reimbursement | Detailed, Expanded Analysis (Brazil and Mexico)

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Breast cancer affects thousands of individuals in Brazil and Mexico, and is managed with premium-priced agents, chemotherapy, and hormone therapy. In Mexico, coverage of treatment varies across the different healthcare programs; in Brazil, Herceptin is covered, but the uniqueness of public funding for oncology drugs makes public coverage of other treatments limited. The future will bring an influx of new drugs and biosimilars, and while both countries are eager to adopt new technologies, they have limited budgets—in an increasingly competitive market, only drugs that meet the clinical and economic expectations of both countries will achieve success. This A&R analysis provides key insights for navigating the HER2-positive breast cancer market in Brazil and Mexico, while adapting brand agents’ value message to payers’ and physicians’ needs and expectations in each country.

Scope:

Decision Resources Group’s Access and Reimbursement module for Breast Cancer in Brazil and Mexico explores the prescribing patterns for current HER2-targeted therapies, the potential impact of the anticipated arrival of novel therapies, and key national and regional market access factors that will shape the use of HER2-targeted therapies over the next two to three years. This content draws on insights from 100 surveyed physicians and from interviews with six payers in Brazil and Mexico, all of whom have influence at the regional or national level.

Markets covered: Brazil and Mexico

Primary research:

  • 100 oncologists/medical oncologists
  • 6 payers:
    • Brazil:
      • Pharmacist, specializing in public health. Member of the Department of Health of the State of São Paulo. Senior member of CCTIES (Coordinator of Science, Technology and Strategic Health Supplies) of the State of São Paulo. Close collaborator to MoH and CONITEC.
      • Clinical oncologist in reference hospitals in the public and private settings. Member of the Standardization Committee of New Technologies and responsible for elaboration of new protocols in public reference hospital. Member of the American Society of Clinical Oncology (ASCO).
      • Physician, Director of major HMO of the self-management type. Member of the Advisory Committee of the International Society for Pharmacoeconomics and Outcomes Research - ISPOR Latin America.
    • Mexico:
      • Head of the Department of Programming of Assets of Medical Supplies at ISSSTE.
      • Head of the Service of Medical Oncology at Medical Center of IMSS. Opinion leader in Mexico and Latin America. Member of the Society of Medical Oncology of IMSS. Member of National Coordination for the Creation of Diagnostic Guides - Therapeutics in the Oncology area of the IMSS. Active member of the Mexican Council of Oncology.
      • Oncologist, Chief of the Oncology and Radiotherapy Service of Hospital of the Secretary of Health. Member of the Mexican Council of Oncology.

Questions Answered in This Report:

  • What is the public and private healthcare coverage for premium-priced therapies for HER2-positive breast cancer, and how do payers’ policies and infrastructure influence access to specialized healthcare and treatments?
  • What are the current drivers and barriers for prescribing established premium-priced agents such as Herceptin, or newer agents such as Perjeta?
  • What will be the impact of biosimilars of trastuzumab in the prescription of Herceptin and other premium-priced agents?
  • What clinical benefits are physicians and payers looking for in emerging therapies such as margetuximab or neratinib, and what kind of savings in direct and indirect costs are payers looking for?

Table of contents

  • Detailed, Expanded Analysis (Brazil and Mexico)
    • Key Updates
      • November 2017
      • August 2017
    • Market Access Overview
    • Actionable Recommendations to Optimize Market Access
      • Optimizing Market Access Opportunity for New Breast Cancer Therapies in Brazil and Mexico
    • Successes and Stumbles for HER2-Targeted Therapies in Breast Cancer
      • Successes Among HER2-Targeted Breast Cancer Therapies in Brazil and Mexico
      • Stumbles Among HER2-Targeted Breast Cancer Therapies in Brazil and Mexico
      • Brazil: Coverage Successes & Stumbles
      • Mexico: Coverage Successes & Stumbles
    • Key Stakeholders in the Road to Market Access
      • Brazil
      • Mexico
    • Key Market Access Roadblocks
      • Key Market Access Roadblocks for HER2-Targeted Breast Cancer Therapies in Brazil and Mexico
      • Brazil: Key Market Access Roadblocks
      • Mexico: Key Market Access Roadblocks
    • Reimbursement Dynamics
      • Brazil: Coverage Dynamics for Breast Cancer
        • Brazil: HTA Details and Implications in Drug Coverage
        • Brazil: Drivers of Formulary Coverage
        • Brazil: Coverage and HTA Details for Key Drugs in HER2-Positive Breast Cancer
        • Brazil: Lessons Learned and Key Takeaways
        • Brazil: Reimbursement Background
      • Mexico: Reimbursement/Coverage Dynamics for Breast Cancer
        • Mexico: HTA Details and Implications in Drug Coverage
        • Mexico: Drivers of Formulary Coverage
        • Mexico: Coverage Details for Key Drugs in HER2-Positive Breast Cancer
        • Mexico: Lessons Learned and Key Takeaways
        • Mexico: Reimbursement Background
    • Pricing and Reimbursement, Policy, and Coverage: Impact on Prescribing
      • Prescriber Preferences for Advanced/Metastatic 1st Line Therapy of HER2-Positive Breast Cancer
      • Prescriber Preferences for Advanced/Metastatic 2nd and 3rd Lines of Therapy of HER2-Positive Breast Cancer
      • Prescriber Preferences for Biosimilars
      • Impact of Payer Policy on Prescribing for HER2-positive Breast Cancer
        • Impact of Payer Policy on Prescribing for HER2-Positive Breast Cancer: Changes in Prescribing Without Access Barriers
      • Top Prescribing Drivers for First Line Advanced/Metastatic HER2-Positive Breast Cancer
      • Key Levers and Constraints on Current Therapies
    • Market Access Landscape for Emerging Therapies
      • Likely Impact of Emerging Therapies on HER2-Positive Breast Cancer
      • Market Access Challenges for Emerging Therapies in Recurrent HER2-Positive Breast Cancer
      • Payer Opinion on Emerging Therapies for Breast Cancer
    • Methodology
      • Primary Research Design
      • Physician Demographics and Practice Setting
      • Pricing Methodology
    • Appendix
      • Commercial Context
        • Epidemiology: Diagnosed Prevalence of HER2-Positive Breast Cancer in Brazil and Mexico
        • Treatment guidelines for HER2-Positive Breast Cancer in Brazil and Mexico
        • Key Drugs for HER2-Positive Breast Cancer
        • Price per 21 Days of Treatment with Key HER2-Targeted Breast Cancer Drugs
        • Timeline of Approvals of Key Drugs for HER2-Positive Breast Cancer
        • Emerging Therapies Profiles
        • Brazil: Productive Development Partnerships
      • Physician Survey Data

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  • Pub Date: November 2017
  • Author(s): Nuno Tiago Giao Antunes, PhD
  • Nuno T. Antunes, ,  is senior business insights analyst on the Infectious, Niche, and Rare Diseases team at Decision Resources Group, specializing in antibacterial agents. Previously, he was a Latin America Market Access senior analyst in the Global Market Access Insights Team, where he developed expertise in market access, pricing and reimbursement, health technology assessment, and health policy. Nuno holds a in animal health from the Universidad de las Palmas de Gran Canaria, Spain, and a degree from the Universidade de Trás-os-Montes e Alto Douro, Portugal. Prior to joining DRG, he conducted research in antimicrobial resistance and antimicrobial development, and worked in the medical devices industry as a scientist.

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