LaunchTrends: Zarxio (Wave 2) is the second in a series of syndicated reports designed to track physician perception and uptake of Sandoz’s Zarxio (filgrastim-sndz), a biosimilar of Amgen’s Neupogen and the first biosimilar to launch in the United States.

The study surveys medical oncologists and hematology-oncologists in the United States and assesses the formulary coverage and restrictions associated with Zarxio and other products in the granulocyte colony-stimulating factor (G-CSF) class. These reports evaluate physicians’ awareness and perception of Zarxio, uptake of the biosimilar over time, Zarxio's effect on other G-CSFs, and promotional activity related to Zarxio and other G-CSF products.

Questions Answered:

  • Zarxio launched in the United States in September 2015. Are U.S. oncologists aware of the biosimilar and of how it was tested during clinical development?
  • Biosimilars are intended to share the clinical profile of the reference brand; therefore, a clinical benefit over the brand is not expected to be associated with their use. Why have physicians chosen to prescribe Zarxio or an alternative G-CSF?
  • Pharmacists in the United States are not permitted to substitute the reference brand Neupogen for Zarxio, because Zarxio was approved as a biosimilar, not an interchangeable biological product; thus, physicians must directly prescribe Zarxio for their patients to receive it. What promotional messages are sales representatives using for Zarxio and other G-CSF brands to influence physician prescribing?
  • Zarxio is the first biosimilar to launch in the United States. As such, the industry has no prior experience of how managed care organizations will incorporate Zarxio into formularies. Which formulary tier and what restrictions, if any, are being applied to Zarxio, and how does it compare with other G-CSFs?

Table of contents

  • Oncology: Zarxio Launch Tracking (US) Wave 2
    • Key Findings
      • Zarxio Awareness and Promotional Activity for G-CSFs
      • Who Is the Zarxio Prescriber?
      • Who Is the Zarxio Patient?
      • Trends in Zarxio Uptake
    • Benchmarking Zarxio Launch Success versus Other New Products
      • Key Findings
    • Formulary Analysis
      • Introduction
      • Zarxio Formulary Coverage Compared with Neupogen
      • Granix Formulary Coverage Compared with Neupogen
      • Changes in Formulary Status of G-CSFs
    • Zarxio Awareness and Perceptions
      • Unaided Awareness of Biologics for Treatment/Prevention of Chemotherapy-Induced Neutropenia
      • Level of Familiarity with Biosimilars and Zarxio
      • Physician Perception of Indications in Which Zarxio Was Studied
      • Physician Perception of Zarxio's Approved Indications
      • Information on Zarxio's Development
      • Physician Perception of Indications Zarxio Should Be Approved to Treat
    • Zarxio Trial and Use
      • Patients Prescribed Zarxio
        • Prescription of Zarxio: Patients Receiving Myelosuppressive Chemotherapy
        • Prescription of Zarxio: Other Hematology-Oncology Patients
        • Healthcare Coverage of Zarxio-Treated Patients
        • Healthcare Coverage for Neutropenia Patients
        • Prevalence of Treatment Switching to Zarxio or Use of Zarxio in Treatment-Naive Patients
        • Current Patient Share of G-CSFs
      • Prescribers' Experience of Zarxio
        • Prescription of Zarxio: Any Indication
        • Reasons for Prescribing Zarxio
        • Perceived Similarity Between Zarxio and Neupogen
        • Satisfaction with Zarxio
        • Perceived Cost of Zarxio
        • Filgrastim Pricing and Medicare Part B Reimbursement
      • Reasons for Not Prescribing Zarxio
    • External Factors Affecting Use
      • Factors That Could Increase Use of Zarxio
      • Sources of Pressure or Recommendations to Use Zarxio
      • Predicted Uptake of Zarxio by Healthcare Coverage
      • Rate of Acceptance of Zarxio by Patients
      • Opinions on Nonproprietary Names for Biosimilars
    • Promotional Activity
      • Most Recent Contact with Sales Representatives
      • Topics of Discussion with Medical Representatives
    • Future Use of Biosimilars
      • Zarxio's Influence on Willingness to Use Other Biosimilars
        • Likelihood of Prescribing Other Biosimilars: Medical Oncologists
        • Likelihood of Prescribing Other Biosimilars: Hematology Oncologists
      • Likelihood of Prescribing Different Filgrastim Biosimilars
      • Future Patient Share Expectations for G-CSFs
        • Future Patient Share of G-CSFs: Pegfilgrastim Biosimilars Unavailable
        • Future Patient Share of G-CSFs: Pegfilgrastim Biosimilars Available
        • Future Patient Share of G-CSFs Among Zarxio Prescribers and Nonprescribers
        • Future Patient Share of G-CSF Biosimilars Among Zarxio Prescribers and Nonprescribers
    • Appendix
      • Background on the U.S. G-CSF Market
        • Overview
        • Short-Acting G-CSFs
        • Long-Acting G-CSFs
        • G-CSF Market News
        • Assumptions Supporting Launch Date Estimates for Future G-CSF Biosimilars
      • Methodology and Objectives
        • Objectives
        • Methodology
        • Significance Testing
      • Respondent Demographics
        • Practice Location of Oncologists
        • Regional Location of Oncologists
        • Years in Clinical Practice and Practice Type
        • Patients Under Management: Medical Oncologists
        • Patients Under Management: Hematology-Oncologists
        • Prescribed Drugs: Medical Oncologists
        • Prescribed Drugs: Hematology-Oncologists

Author(s): Marta Delgado, PhD

Marta Delgado, is a Business Insight Analyst in the Biosimilars Research team, responsible for the analysis of the biosimilars market across four main therapeutic areas – oncology, endocrinology, immunology and nephrology. Marta holds a in Molecular Neuroscience from University College of London (UCL) and a in Biomedicine from University Pompeu Fabra (UPF), Barcelona. Prior to joining the Biosimilars Research team, Marta worked as a Research Analyst at SKIM, specialising in advanced quantitative studies assessing the potential market opportunities to support life sciences companies in their business decision making.


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