The lucrative HR-positive, HER2-negative breast cancer market in Europe is fast-moving and competitive. CDK4/6 inhibitors Ibrance (Pfizer), Kisqali (Novartis) and Verzenios (Eli Lilly) are creating new dynamics in the treatment of metastatic disease, while PARP inhibitor Lynparza (AstraZeneca) is poised to offer treatment for BRCA1/2-mutation-positive tumors. In addition, near-term emerging agents including PI3K inhibitor alpelisib (Novartis), look set to further strengthen the field. This research examines the market access levers and barriers for existing and emerging HR-positive, HER2-negative breast cancer therapies in the top 5 European markets (France, Germany, Italy, Spain, UK) as competition intensifies, the reimbursement environment becomes ever more complex, and healthcare budgets become increasingly constrained.


  • What role do key brands play in HR-positive, HER2-negative breast cancer treatment in the markets under study? How is their use monitored and restricted?
  • How great an uptake advantage is CDK4/6 inhibitor Ibrance’s first-to-market status? What market access strategies help Kisqali and Verzenios to compete?
  • Which treatments do surveyed oncologists think perform best on clinical and other attributes? Do interviewed payers consider the overall cost of biomarker-driven prescribing to be justified?
  • How can emerging HR+/HER2- breast cancer therapies optimize reimbursement and market access in the top European markets.


European Access & Reimbursement provides integrated brand-level and country-specific analysis of primary market research conducted with payers and prescribers, examining reimbursement dynamics and evaluating the impact of payer policy on prescribing behavior.


France, Germany, Italy, Spain, United Kingdom


  • Survey of 250 medical oncologists across the top 5 European markets (50 per country)
  • Interviews with 10 payers across the top 5 European markets (2 per country)Key Drugs Covered


Afinitor, Faslodex, Ibrance, Kisgali, Verzenios, Avastin, Anastrozole, Letrozole, Exemestane, Lynparza, alpelisib


  • Actionable recommendations to optimize market access
  • Market access success and stumbles
  • Market access roadblocks
  • Pricing and reimbursement dynamics
  • Impact of payer policy and coverage on prescribing
  • Market access outlook for emerging therapies

Table of contents

  • Detailed, Expanded Analysis - Optimizing Market Access Amid an Evolving Landscape for HR+/HER2- Therapies (EU)
    • Access & Reimbursement - HR+/HER- Breast Cancer - Top 5 European Markets - July 2019

Author(s): Henrique Duarte; Sonia Alesso, PhD

Henrique Duarte is an analyst on the Global Market Access Insights team at Decision Resources Group, primarily focusing on European market access. He is responsible for monitoring, analyzing, and reporting on global market access through the production of DRG’s Global Market Access Solution (GMAS) and Access & Reimbursement products. Henrique’s specific focus is on all aspects of market access in the EU5, as well as in select Latin American countries. Henrique holds a pharmaceutical science degree from the Universidade Lusófona and a postgraduate certificate in health economics from the University of York.

Since joining DRG Abacus as a Medical Writer, Sonia has gained experience across a variety of projects including health technology assessment (HTA) submissions, publication manuscripts, posters, advanced budgetary notification documents, value dossiers and value communications suites. Her disease areas of expertise include schizophrenia, depression, attention deficit hyperactivity disorder (ADHD), haematology, dysphagia and orphan diseases. Prior to joining DRG Abacus, Sonia was a Senior Medicinal Chemist at a biotechnology company in Oxfordshire. Over the course of her 11-year career as a Medicinal Chemist, Sonia has gained experience writing manuscripts for peer‑reviewed journals and intellectual property documents. Sonia has a Masters of Organic Chemistry from the University of Palermo, Italy, and a PhD from the University of Southampton investigating solid supported reagents for use in combinatorial organic chemistry. Sonia is bilingual (English and Italian).

Related Reports

Breast Cancer | Landscape & Forecast | Disease Landscape & Forecast

Characterized by high incidence and long treatment durations, the breast cancer market represents a great commercial opportunity for drug developers. CDK4

View Details

Breast Cancer | Geographic Focus - China | Breast Cancer | China In-Depth | China

COMING SOON Breast cancer is one of the most frequently diagnosed cancers among Chinese women. A high incidence and a prolonged treatment duration makes breast cancer a...

View Details

Breast Cancer | Disease Landscape and Forecast | G7 | 2019

Characterized by high incidence and long treatment durations, the breast cancer market represents a g...

View Details

Breast Cancer | Unmet Need | Detailed, Expanded Analysis: Advanced/Metastatic Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC) is a patient population with high unmet need given the poor outcomes associated with current treatment...

View Details