Biomarker-driven prescribing continues to play an increasingly prominent role in key oncology indications. Biomarkers play an important role and are well-entrenched in indications such as non-small-cell lung cancer, malignant melanoma, and colorectal cancer. While biomarker-associated therapies offer the advantage of selecting the patients most likely to respond to treatment, these therapies are premium-priced and often subject to payer restrictions. We explore the drivers and barriers to use of these agents and report on how reimbursement impacts drug selection and prescribing. We also evaluate surveyed medical oncologists’ and surveyed payers’ perceptions of emerging biomarker-driven therapies in select solid-tumor indications.
- What factors most greatly influence payers’ reimbursement decisions for biomarker-driven therapies in NSCLC, malignant melanoma, and colorectal cancer? What restrictions do they impose?
- Do access and reimbursement challenges differ by indication and/or how well established is the biomarker in each indication?
- What role do reimbursement, cost, and clinical factors play in oncologists’ decisions to prescribe biomarker-driven therapies.
- What are payer opinions of emerging agents, and how will oncologists’ prescribing patterns change with the launch of new therapies?
- What factors influence reimbursement and access for companion biomarker tests?
Access & Reimbursement provides in-depth insight regarding the impact of payer policy on physician prescribing behavior so you can build your market access strategy and optimize your brand positioning.
Scope of Report:
- Geography: United States.
- Primary research: Survey of 101 medical oncologists in the United States and survey of 30 U.S. managed care organizations (MCO) pharmacy and medical directors (PDs/MDs).
- Key drugs covered: Keytruda, Xalkori , Zykadia, Gilotrif, Tagrisso, Portrazza, Zelboraf, Tafinlar, Cotellic, Mekinist, Avastin, Erbitux, Vectibix.
- Biomarkers In Oncology - Access & Reimbursement - Detailed, Expanded Analysis: Biomarker-Targeted Therapies For NSCLC, Malignant Melanoma, And Colorectal Cancer (US)
Author(s): Laura Vinuesa, DVM, MSc
Laura Vinuesa, DVM, M.Sc., is a Senior Business Insights Analyst in the Oncology Division at Decision Resources Group, with expertise in thyroid carcinoma and bladder cancer. Previously, Dr. Vinuesa was an EU Market Access Analyst in the Global Market Access Insights Team at Decision Resources Group. She has expertise in market access, pricing and reimbursement, health technology assessment, and health policy.
Prior to joining Decision Resources, she worked as Market Access & Institutional Relations Analyst at Pfizer in Spain, providing support for the successful market launch of drugs for different areas: cardiovascular, oncology, mental disorder and rare disease. She is a Doctor of Veterinary Medicine from the Complutense University of Madrid, and holds a M.Sc. in Clinical Research and Pharmaceutical Medicine from EPHOS - School of PharmaStudies.