LaunchTrends: Ibrance (Wave 2) is the second in a series of syndicated reports designed to track physician perception, uptake, and competitive environment regarding the newly launched breast cancer drug Ibrance (Pfizer’s palbociclib). In this report, we measure the impact of this novel agent on the U.S. advanced/metastatic breast cancer therapy market following launch, based on a blend of quantitative and qualitative primary research with U.S. medical oncologists. We compare findings between waves of research, providing insight into changing dynamics following the launch of Ibrance. We evaluate physicians’ current awareness and perception of Ibrance relative to other currently available therapies for hormone receptor (HR)-positive/human epidermal growth factor receptor (HER2)-negative advanced/metastatic breast cancer and their current and anticipated use of Ibrance and the promotional activity surrounding Ibrance.

Questions Answered:  

  • In February 2015—more than two months ahead of schedule—the FDA awarded Pfizer’s Ibrance accelerated approval in combination with letrozole for the first-line treatment of postmenopausal women with HR+/HER2- metastatic breast cancer. What is medical oncologists’ level of awareness of and familiarity with Ibrance?
  • Ibrance is a first-in-class CDK4/6 inhibitor. What are perceived clinical advantages and disadvantages compared with other marketed agents used to treat HR-positive, HER2-negative advanced/metastatic breast cancer?
  • A common treatment for HR-positive, HER2-negative advanced/metastatic breast cancer in the first-line setting is an aromatase inhibitor. To what extent is Ibrance currently being used by surveyed medical oncologists? Where does Ibrance fit in the treatment algorithm? What reasons do nonprescribers give for not having prescribed Ibrance?
  • At one-month postlaunch, almost half of surveyed oncologists had been contacted by an Ibrance sales representative in the previous week or month. What promotional messages is Pfizer using?

Scope: 

Markets covered: United States.

Primary research: Approximately 75 medical oncologists; qualitative interviews with 10 respondents.

Indication coverage: HR-positive, HER2-negative advanced/metastatic breast cancer.

Table of contents

  • Breast Cancer - Emerging Therapies - Ibrance Launch Tracking (US) Wave 2
    • Key Findings
      • Awareness and Perceptions of Ibrance
      • Ibrance Trial and Use
      • Competitive Landscape and Ibrance Performance
    • Benchmarking Ibrance Launch Success vs. Perjeta
      • Prescriber and Nonprescriber Profiles
        • Ibrance: Differences Between Prescriber/Nonprescriber Profiles
      • Ibrance Awareness and Perceptions
        • Unaided and Aided Awareness of Ibrance
          • Aided Awareness of Ibrance
          • Familiarity with Ibrance
          • W2 Level of Familiarity: Prescribers vs. Nonprescribers
          • Awareness of Ibrance Indication
          • Awareness of Ibrance’s Dosing Schedule
          • Aware of Ibrance’s Price?
          • Average Price of Ibrance per Month
          • Qualitative Quotes
          • Unaided Awareness of Therapies for HR+/HER2- Metastatic Breast Cancer
        • Familiarity with Ibrance
          • Existence of Ibrance Attributes of Which Medical Oncologists Were Unaware
          • Aided Familiarity with Therapies for Treatment of HR+/HER2- Breast Cancer
          • Mean Aided Familiarity with Therapies for HR+/HER2- Breast Cancer
        • Sources of Familiarity with Ibrance
          • Initial Reaction to and Interest in Ibrance
            • Ibrance Product Profile
            • Interviewed Medical Oncologists’ Opinions of Ibrance
            • Initial Reaction to Ibrance
            • Interest Level in Ibrance
          • Impressions of Ibrance
            • Uniqueness of Ibrance
            • Ibrance Risk-Benefit Profile Balance
        • Ibrance Trial and Use
          • Willingness to Prescribe Ibrance
            • Number of Patients Currently Receiving Ibrance
              • Ibrance Prescriber vs. Nonprescriber
              • Mean Number of Ibrance-Treated Patients (Among Prescribers in General Practice)
              • First-, Second-, and Third-Line Treatments for High-Risk Postmenopausal HR+/HER2- Breast Cancer Patients
              • First-, Second-, and Third-Line Treatments for Low-Risk Postmenopausal HR+/HER2- Breast Cancer Patients
              • Ibrance Discontinuation Rate
              • Modification of Ibrance Dosing After an Adverse Event
              • Surveyed Oncologists Prescribing Ibrance to Patients Outside Current FDA Label
              • Percentage of Off-Label Ibrance Prescriptions
              • Off-Label Ibrance-Treated Patient Populations
              • Select Qualitative Quotes
              • Treatment of HR+/HER2- Advanced/Metastatic Breast Cancer: Select Quotes from Qualitative Interviews
              • Hormonal Therapies Prescribed with Ibrance
              • Agents Most Likely to Be Prescribed to Low-Risk HR+/HER2- Patients
            • Reasons for Not Yet Prescribing Ibrance
              • Reasons for Having Not Yet Prescribed Ibrance
            • Anticipated Ibrance Use
              • Timeline for Prescribing Ibrance Among Nonprescribers Willing to Prescribe
              • Select Qualitative Quotes
              • Surveyed Oncologists Who Would Prescribe Ibrance to All Eligible Patients
              • HR+/HER2- Postmenopausal Breast Cancer Patients Who Would Not Receive Ibrance Prescription
              • Agents Most Likely to Be Prescribed to High-Risk HR+/HER2- Patients
              • Patient Inquiries About Ibrance in Past Month
              • Medical Oncologists’ Action Based on Specific Ibrance Patient Inquiries
            • Ibrance Performance on Key Attributes
              • Performance of Ibrance in Terms of Important Attributes
          • Effectiveness of Face-to-Face Detailing for Ibrance
            • Ibrance Sales Representative Frequency and Reach
              • Sales Representatives’ Detailing Frequency for Ibrance
              • Ibrance Sales Rep Detailing Frequency
            • Satisfaction with Ibrance Sales Representative
              • Ibrance Sales Representative Performance
            • Ibrance Message Recall
              • Sales Representatives’ Detailing Frequency for Ibrance
              • Topics Discussed with the Ibrance Sales Representative
              • Messages Communicated by Ibrance Sales Representatives (Aided)
          • Methodology
            • Primary Market Research Methodology
              • Methodology
              • Significance Testing in This Study
              • Report Abbreviations
            • Physician Demographics
              • Respondent Demographics
              • U.S. Region of Practice
              • Practice Size: Number of Medical Oncologists per Practice
              • Years in Clinical Practice
              • Number of Patients Treated Per Month
              • Practice Setting* (percentage of medical oncologists)
              • Practice Location (percentage of medical oncologists)
          • Appendix
            • Primary Market Research
              • Agents Most Likely to Be Prescribed to High-Risk HR+/HER2- Patients
              • Agents Most Likely to Be Prescribed to Low-Risk HR+/HER2- Patients
            • Additional Information
              • Breast Cancer Market Background
              • Treatment of Advanced/Metastatic, HR-Positive, HER2-Negative Breast Cancer
              • Defining High-Risk Postmenopausal HR+/HER2- Metastatic Breast Cancer Patients
              • Difficult and Time-Consuming
              • Qualitative Quotes
              • Managed Care Requirements for Prescribing Ibrance
              • Qualitative Quotes
              • Impact of Managed Care on Prescribing Ibrance
              • Surveyed medical oncologists in Wave 2 report that, on average, 11% of Ibrance prescriptions have been denied by the patient’s managed care plan.
              • Restrictions Imposed on the Duration of Ibrance Treatment by Insurance Plans
              • Case Study #1: HR+/HER2- Low-Risk, Postmenopausal Metastatic Breast Cancer Patient (First-Line in the Metastatic Setting)
              • First-Line Therapy Choices for a Low-Risk Metastatic HR+/HER2- Breast Cancer Patient
              • Prescribe Ibrance
              • Drivers for Starting Patient on Ibrance
              • Barriers for Starting Patient on Ibrance
              • Case Study #2: HR+/HER2- High-Risk, Postmenopausal Metastatic Breast Cancer Patient (First-Line in the Metastatic Setting)
              • First-Line Therapy Choices for a High-Risk, Metastatic HR+/HER2- Breast Cancer Patient
              • Prescribe Ibrance
              • Drivers for Starting Patient on Ibrance
              • Barriers for Starting Patient on Ibrance1
              • Change in Therapy Choice if Positive Trial Data for Ibrance + Letrozole vs. Chemotherapy

        Author(s): Amy Duval, M Res

        Amy Duval M.Res., is a director in the oncology and biosimilars team at Decision Resources Group. Ms. Duval manages a team of analysts responsible for market research across oncology indications, and also provides client support across Decision Resources Group oncology products.

        Previously, Ms. Duval was a principal analyst in the oncology group, where she developed in-depth expertise in breast and ovarian cancer. Ms. Duval has worked on multiple oncology indications, including malignant melanoma, renal cell carcinoma, and lung cancer, and has worked on topics in both the major and emerging pharmaceutical markets. Ms. Duval earned her B.Sc. in natural sciences and M.Res. in molecular and cellular biology from the University of Birmingham, where she conducted research into the epigenetics of leukemia.


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