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Hepatitis C Virus | Access & Reimbursement | Detailed, Expanded Analysis (Mexico & Argentina)

Hepatitis C Virus | Access & Reimbursement | Detailed, Expanded Analysis (Mexico & Argentina)

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Hepatitis C virus (HCV) affects thousands of individuals in Mexico and Argentina. The launch of innovative therapies in recent years has brought new, highly effective options to the market, but reimbursement constraints tied to payers’ ability to fund these treatments sharply affect access to some of these medicines. Moreover, the type of payer—private versus public—requires companies operating in these markets to understand how the differences in economic capacity will affect their agent’s uptake. This A&R analysis provides key insights into navigating the HCV therapy market in Mexico and Argentina 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 HCV in Argentina and Mexico explores the prescribing patterns for current therapies, the potential impact of the anticipated arrival of new agents, and key national and regional market access factors that will shape the use of HCV therapies over the next two to three years. This content draws on insights from 101 surveyed physicians and from interviews with six payers in Argentina and Mexico, all of whom have influence at the regional, institutional, or national level.

Markets covered: Argentina and Mexico

Primary research:

  • 100 hepatologists/gastroenterologists/infectious disease physicians
  • 6 payers:
    • Argentina:
      • Head of the liver transplantation department at a major hospital in Buenos Aires; member of the Argentine Association for the Study of Liver Diseases.​​​​​​
      • Hepatologist KOL at the Alexander Fleming Specialist Institute dedicated to SUR patients, a member of the Argentine Society of Gastroenterology, and a member of the American and European Associations of Diseases of the Liver.
      • Specialist in hepatology; consultant for the the MoH for the National Program for Control of Viral Hepatitis; member of the National Program for the Control of Immunopreventable Diseases (ProNaCEI); member of the Secretary and Board of the Argentine Association for the Study of Liver Diseases.​​​​​​
    • Mexico:
      • Head of the Medical Supplies Planning Department of the Infrastructure Branch of the ISSSTE’s Administration Directorate.
      • Chief of the gastroenterology, hepatology, and liver transplantation department at a major public hospital; member of the Mexican Association of Hepatology and the Mexican Association of Gastroenterology.
      • Coordinator of the clinical guidelines at CENETEC.​​​​​​​​​​​​

Questions answered in this report:

  • ​​​​​​​​​​​What is the public and private healthcare coverage for targeted therapies for HCV by gentotype, 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 Olysio, Daklinza, or Harvoni, and how does it compare with therapies that have been on the market for longer periods of time?
  • How does treatment vary by payer type and how can marketers of HCV therapies overcome hurdles in specific payer channels?
  • What clinical benefits are physicians and payers looking for in emerging therapies such as Epclusa and Zepatier, and what kind of savings in direct and indirect costs are payers seeking?

Table of contents

  • Detailed, Expanded Analysis (Mexico & Argentina)
    • Key Updates
      • November 2017
      • September 2017
    • Market Access Overview
    • Actionable Recommendations to Optimize Market Access
      • Optimizing Market Access Opportunity for New HCV Therapies in Argentina and Mexico
    • Successes and Stumbles
      • Successes Among HCV Therapies in Argentina and Mexico
      • Stumbles Among HCV Therapies in Argentina and Mexico
      • Argentina: Coverage Successes & Stumbles of DAAs
      • Mexico: Coverage Successes & Stumbles of DAAs
    • Key Stakeholders in the Road to Market Access
      • Argentina
      • Mexico
    • Key Market Access Roadblocks
      • Key Market Access Roadblocks for HCV Therapies in Argentina and Mexico
      • Argentina: Key Market Access Roadblocks
      • Mexico: Key Market Access Roadblocks
    • Reimbursement Dynamics
      • Argentina: Coverage Dynamics for HCV
        • Argentina: HTA Details and Implications in Drug Coverage
        • Argentina: Drivers of Formulary Coverage
        • Argentina: Coverage & HTA Details
        • Argentina: Lessons Learned and Key Takeaways
        • Argentina: Reimbursement Background
      • Mexico: Coverage Dynamics for HCV
        • Mexico: HTA Details and Implications in Drug Coverage
        • Mexico: Drivers of Formulary Coverage
        • Mexico: Coverage & HTA Details
        • Mexico: Lessons Learned and Key Takeaways
        • Mexico: Reimbursement Background
    • Pricing and Reimbursement, Policy, and Coverage: Impact on Prescribing
      • Prescriber Preferences for Genotype-1-Infected Patients
      • Prescriber Preferences for Genotype-2- and Genotype-3-Infected Patients
      • Impact of Payer Policy on Prescribing for Chronic HCV
      • Top Prescribing Drivers: Chronic Hepatitis C Virus
      • Key Levers and Constraints on Current Therapies
    • Market Access Landscape for Emerging Therapies
      • Likely Impact of Emerging Therapies for Chronic HCV
      • Market Access Challenges for Emerging Therapies for Chronic HCV
      • Payer Opinion on Emerging Therapies for Chronic HCV
    • Methodology
      • Primary Research Design
      • Physician Demographics and Practice Setting
      • Pricing Methodology
    • Appendix
      • Commercial Context
        • Epidemiology: Total Prevalence of HCV in Argentina and Mexico
        • Treatment Guidelines for HCV in Argentina and Mexico
        • Key Drugs for Chronic HCV in Argentina and Mexico
        • Price per Day of Treatment for Chronic HCV Drugs
        • Timeline of Approvals of Key Drugs for Chronic HCV
        • Emerging Therapy Profiles
      • Physician Survey Data
      • About Decision Resources Group
        • Author(s) Biography

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  • Pub Date: November 2017
  • Author(s): Susana Ribeiro da Silva; Roy Moore, MBA
  • Roy manages global market access content for DRG, including US Access & Reimbursement (legacy PPF) and the Global Market Access Solution. He has 10 years of experience writing/managing in market access content, including nearly two years on the global front. For nearly five years, he has managed/directed what had been Physician & Payer Forum. Previously, he spent five years as an analyst for legacy HealthLeader-InterStudy’s health plan analysis team, focusing on Florida, Illinois, and the national Medicare market. He also had 5 years business reporting experience with a focus on healthcare.

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