Non-Small-Cell Lung Cancer | Access & Reimbursement | Detailed, Expanded Analysis (Brazil and Mexico)

Publish date: August 2017

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Non-small-cell lung cancer (NSCLC) affects thousands of individuals in Brazil and Mexico, and it is managed with premium-priced targeted agents and chemotherapy. In both countries, public coverage is extremely limited, compared with more robust coverage in the private setting. 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 NSCLC 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 NSCLC in Brazil and Mexico explores the prescribing patterns for current 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 targeted therapies over the next two to three years. This content draws on insights from 100 surveyed physicians and from interviews with 6payers in Brazil and Mexico, all of whom have influence at the regional, institutional, 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 targeted therapies for NSCLC, 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 Tarceva or Iressa, or newer agents such as Zykadia or Opdivo?
  • What will be the impact of biosimilars of bevacizumab in the prescription of Avastin and other premium-priced agents?
  • What clinical benefits are physicians and payers looking for in emerging therapies such as Tafinlar + Mekinist or Keytruda in Brazil, and what kind of savings in direct and indirect costs are payers seeking?

Table of contents

  • Detailed, Expanded Analysis (Brazil and Mexico)
    • Key Updates
      • September 2017
    • Market Access Overview
    • Actionable Recommendations to Optimize Market Access
      • Optimizing Market Access Opportunity for New Non-Small-Cell Lung Cancer Therapies in Brazil and Mexico
    • Successes and Stumbles
      • Successes Among Non-Small-Cell Lung Cancer Therapies in Brazil and Mexico
      • Stumbles Among Non-Small-Cell Lung Cancer Therapies in Brazil and Mexico
      • Brazil: Coverage Successes and Stumbles
      • Mexico: Coverage Successes and Stumbles
    • Key Stakeholders in the Road to Market Access
      • Brazil
      • Mexico
    • Key Market Access Roadblocks
      • Key Market Access Roadblocks for Non-Small-Cell Lung Cancer Therapies in Brazil and Mexico
      • Brazil: Key Market Access Roadblocks
      • Mexico: Key Market Access Roadblocks
    • Reimbursement Dynamics
      • Brazil: Coverage Dynamics for Non-Small-Cell Lung Cancer
        • Brazil: HTA Details and Implications in Drug Coverage
        • Brazil: Drivers of Formulary Coverage
        • Brazil: Coverage & HTA Details
        • Brazil: Lessons Learned and Key Takeaways
        • Brazil: Reimbursement Background
      • Mexico: Coverage Dynamics for Non-Small-Cell Lung Cancer
        • Mexico: HTA Details and Implications in Drug Coverage
        • Mexico: Drivers of Formulary Coverage
        • Mexico: Coverage Details
        • Mexico: Lessons Learned and Key Takeaways
        • Mexico: Reimbursement Background
    • Pricing and Reimbursement, Policy, and Coverage: Impact on Prescribing
      • Prescriber Preferences for First-Line Treatments for Nonsquamous EGFR-Wild-Type/Unknown and ALK-Translocation-Negative/Unknown Non-Small-Cell Lung Cancer
      • Prescriber Preferences for Second and Third-Line Recurrent Metastatic/Advanced Nonsquamous Non-Small-Cell Lung Cancer
      • Prescriber Preferences for First-Line EGFR-Mutated Non-Small-Cell Lung Cancer
      • Prescriber Preferences for First-Line ALK-Translocation-Positive Non-Small-Cell Lung Cancer
      • Impact of Payer Policy on Prescribing for Non-Small-Cell Lung Cancer
        • Impact of Payer Policy on Prescribing for Non-Small-Cell Lung Cancer: Changes in Prescribing Without Access Barriers
      • Top Prescribing Drivers: Non-Small-Cell Lung Cancer
      • Key Levers and Constraints on Current Therapies
    • Market Access Landscape for Emerging Therapies
      • Likely Impact of Emerging Therapies for Non-Small-Cell Lung Cancer
      • Market Access Challenges for Emerging Therapies for Non-Small-Cell Lung Cancer
      • Payer Opinion on Emerging Therapies for Non-Small-Cell Lung Cancer
    • Methodology
      • Primary Research Design
      • Physician Demographics and Practice Setting
      • Pricing Methodology
    • Appendix
      • Commercial Context
        • Epidemiology: Diagnosed Incidence of Non-Small-Cell Lung Cancer in Brazil and Mexico
        • Treatment Guidelines for Non-Small-Cell Lung Cancer in Brazil and Mexico
        • Key Drugs for Non-Small-Cell Lung Cancer
        • Price per 28 Days of Treatment with Key Non-Small-Cell Lung Cancer Drugs
        • Timeline of Approvals of Key Drugs for Non-Small-Cell Lung Cancer
        • Emerging Therapies Profiles
        • Brazil: Productive Development Partnerships
      • Physician Survey Data

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.