LaunchTrends: Keytruda Wave 3 (US) is the third in a series of syndicated reports designed to track physician perception, uptake, and competitive environment regarding the malignant melanoma drug Keytruda (Merck & Co.’s pembrolizumab).

LaunchTrends: Keytruda measures the impact of this novel agent on the unresectable or metastatic malignant melanoma therapy market following launch, based on a blend of quantitative and qualitative primary research with US medical oncologists. The report evaluates physicians’ current awareness and perception of Keytruda relative to other currently available therapies for unresectable or metastatic malignant melanoma, current and anticipated use of Keytruda, and promotional activity for Keytruda. LaunchTrends: Keytruda Wave 2 and 3 also assess surveyed medical oncologists’ perceptions of Opdivo (Bristol-Myers Squibb’s nivolumab), and Opdivo in combination with Yervoy (Bristol-Myers Squibb’s ipilimumab) following their approval for the treatment of malignant melanoma in December 2014 and October 2015, respectively. Surveyed and interviewed medical oncologists were questioned on their awareness, perception, and prescription of Opdivo with respect to treating malignant melanoma patients.

Questions Answered:

  • What is the awareness of and familiarity with Keytruda and Opdivo among medical oncologists?
  • What are the perceived clinical advantages and disadvantages of Keytruda compared with other marketed agents (including Opdivo) used for treating unresectable or metastatic malignant melanoma?
  •  To what extent are Keytruda, Opdivo, and Opdivo/Yervoy currently being used by surveyed medical oncologists? Where do they fit in the treatment algorithm? What reasons do nonprescribers give for not having prescribed Keytruda?
  •  What promotional messages are being employed by Merck & Co. for Keytruda?

Scope: 

Markets covered: United States.

Primary research: 76 medical oncologists; qualitative interviews with 10 respondents.

Indication coverage: unresectable or metastatic malignant melanoma.

Table of contents

  • Malignant Melanoma - Emerging Therapies - Keytruda Launch Tracking (US) Wave 3
    • Key Findings
      • Executive Summary: Awareness and Perceptions of Keytruda and Opdivo
      • Executive Summary: Keytruda and Opdivo Trial and Use
      • Executive Summary: Competitive Landscape and Promotion of Keytruda and Opdivo
    • Benchmarking Keytruda Launch Success vs. Malignant Melanoma and NSCLC Analogues
      • Prescriber and Nonprescriber Profiles
        • Keytruda: Differences Between Prescriber and Nonprescriber Profiles
      • Keytruda Awareness and Perceptions
        • Unaided and Aided Awareness of Keytruda
          • Unaided Awareness of Therapies for Unresectable or Metastatic Melanoma
          • Aided Awareness of Opdivo
          • Familiarity with Opdivo
          • Level of Familiarity: Prescribers vs. Nonprescribers
          • Aided Awareness of Keytruda
          • Familiarity with Keytruda
          • Level of Familiarity: Prescribers vs. Nonprescribers
          • Awareness of Keytruda’s FDA Indication
          • Awareness of Keytruda’s Approved Setting
          • Aware of Keytruda’s Price?
          • Average Price of Keytruda per Month
        • Familiarity with Keytruda
          • Aided Familiarity with Therapies for Unresectable or Metastatic Melanoma
          • Existence of Keytruda Attributes That Medical Oncologists Were Not Aware Of
          • Existence of Opdivo Attributes That Medical Oncologists Were Not Aware Of
        • Sources of Familiarity with Keytruda
          • Initial Reaction to and Interest in Keytruda
            • Keytruda Profile Summary
            • Opdivo Profile Summary
            • Initial Reaction to Keytruda
            • Interest Level in Keytruda
            • Initial Reaction to Opdivo
            • Interest Level in Opdivo
            • Interviewed Medical Oncologists’ Opinions of Keytruda
          • Impressions of Keytruda
            • Risk-Benefit of Keytruda
            • Uniqueness of Keytruda
            • Risk-Benefit Profile of Opdivo
            • Uniqueness of Opdivo
            • Keytruda Advantages
            • Keytruda Disadvantages
          • Prescriber and Nonprescriber Profiles
            • Keytruda: Differences Between Prescriber and Nonprescriber Profiles
        • Keytruda Trial and Use
          • Willingness to Prescribe
            • Willingness to Prescribe Keytruda for…
            • Willingness to Prescribe Opdivo for…
          • Reasons for Not Yet Prescribing
            • Reasons for Choosing Another Agent Over Keytruda for Keytruda-Eligible Patients
          • Number of Patients Currently Receiving
            • First-, Second-, and Third-Line Treatments for BRAF-Mutation-Positive, Unresectable or Metastatic Patients
            • Keytruda Prescriber vs. Nonprescriber
            • Mean Number of Keytruda-Treated Patients (Among Prescribers)
            • First-, Second-, and Third-Line Treatments for BRAF Wild-Type Unresectable or Metastatic Patients
            • Opdivo Prescriber vs. Nonprescriber
            • Mean Number of Opdivo-Treated Patients (Among Prescribers)
            • Current Treatment of Unresectable or Metastatic Melanoma
            • Keytruda Prescribers
            • Patients Still on Keytruda
            • Patients with Dose Withheld
            • Percentage of Patients Discontinued Keytruda
            • Keytruda-Treated Patient Populations
            • Qualitative Quotes
            • Opdivo-Treated Patient Populations
            • Qualitative Quotes
          • Anticipated Keytruda and Opdivo Use
            • Agents Most Likely to Be Prescribed to Unresectable or Metastatic Melanoma Patients
            • Physician Willingness to Prescribe Keytruda for Treatment-Naive, Unresectable or Metastatic Patients Regardless of BRAF-Mutation Status
            • Physician Willingness to Prescribe Opdivo for Treatment-Naive, Unresectable or Metastatic Patients Regardless of BRAF Mutation Status
            • Patient Inquires About Keytruda in Past Month
            • Qualitative Quotes
            • Medical Oncologists’ Action Based on Specific Keytruda Patient Inquiries
            • Timeline for Prescribing Keytruda Among Nonprescribers Willing to Prescribe
            • Timeline for Prescribing Opdivo Among Nonprescribers Willing to Prescribe
            • Qualitative Quotes
          • Keytruda and Opdivo Performance on Key Attributes
            • Performance of Keytruda in Terms of Important Attributes
            • Performance of Keytruda and Opdivo in Terms of Important Attributes
            • Factors Holding Back the Prescription of Keytruda
            • Factors Holding Back the Prescription of Opdivo
        • Effectiveness of Face-to-Face Detailing for Keytruda
          • Keytruda Sales Representative Frequency and Reach
            • Keytruda Sales Rep Detailing Frequency
            • Percentage of Medical Oncologists
            • Qualitative Quotes
          • Satisfaction with Keytruda Sales Representative
            • Keytruda Message Recall
              • Topics Discussed with the Keytruda Sales Rep
          • Methodology
            • Practice Sample
            • Significance Testing in This Study
          • Appendix
            • Primary Market Research
              • Aided Familiarity with Therapies for Unresectable or Metastatic Melanoma
              • US Region of Practice
              • Practice Size: Number of Medical Oncologists per Practice
              • Years in Clinical Practice
              • Number of Patients Treated per Month
              • Percentage of Patients Managed per Month
              • Percentage of Patients with Unresectable or Metastatic Melanoma
              • Medical Oncologists’ Practice Location
              • Medical Oncologists’ Practice Setting
              • First-, Second-, and Third-Line Treatments for BRAF-Mutation-Positive, Unresectable or Metastatic Patients
              • First-, Second-, and Third-Line Treatments for BRAF-Mutation-Positive, Unresectable or Metastatic Patients
              • First-, Second-, and Third-Line Treatments for BRAF-Mutation-Negative (Wild-Type), Unresectable or Metastatic Patients
              • First-, Second-, and Third-Line Treatments for BRAF-Mutation-Negative (Wild-Type), Unresectable or Metastatic Patients
              • First-, Second-, and Third-Line Treatments for BRAF Wild-Type Unresectable or Metastatic Patients
              • Impact of Keytruda on Prescription of Other Agents for BRAF-Mutation-Positive Unresectable or Metastatic Patients Who Received Prior Yervoy and a BRAF Inhibitor
              • Impact of Keytruda and Opdivo on Prescription of Other Agents for BRAF-Mutation-Positive, Unresectable or Metastatic Patients Who Received Prior Yervoy and a BRAF Inhibitor
              • Impact of Keytruda on Prescription of Other Agents for BRAF-Mutation-Negative (Wild-Type) Unresectable or Metastatic Patients who Received Prior Yervoy
              • Reasons for Not Coordinating Dosing Schedules to Minimize Drug Wastage (n = 4)
              • Qualitative Quotes
              • Reasons for Not Coordinating Dosing Schedules to Minimize Drug Wastage (n = 18)
              • Qualitative Quotes
            • Additional Information
              • Reasons for Not Coordinating Dosing Schedules to Minimize Drug Wastage (n = 18)
              • Qualitative Quotes
              • Melanoma Market Background
              • US Development Milestones for Keytruda
              • Melanoma Market News
              • Report Abbreviations
              • Study Objectives
              • Patient History
              • Preferred Therapy Choices for a BRAF-V600E-Mutation-Positive Patient with Aggressive and Symptomatic Disease, Previously Treated with Yervoy
              • Prescribe Keytruda
              • Drivers for Starting Patient on Keytruda
              • Barriers for Starting Patient on Keytruda
              • Difficult and Time Consuming
              • Qualitative Quotes
              • Patient History
              • Preferred Therapy Choices for BRAF-V600E-Mutation-Positive Patient with Brain Metastases, Previously Treated with Yervoy
              • Prescribe Keytruda
              • Drivers for Starting Patient on Keytruda
              • Barriers for Starting Patient on Keytruda
              • Managed Care Requirements for Prescribing Keytruda
              • Qualitative Quotes
              • Impact of Managed Care on Prescribing Keytruda
              • Reasons for Denial by Managed Care
              • Restrictions Imposed on the Duration of Keytruda Treatment by Insurance Plans

        Author(s): Paul Wilcock, PhD

        Since October 2015, Dr. Wilcock has been a Business Insights Analyst in the oncology team at Decision Resources Group. He has experience in various indications including metastatic malignant melanoma and renal cell carcinoma, and will have a major focus on gastric cancer going forward.

        Previously, Dr. Wilcock was a Research Funding Manager at Cancer Research UK, where he developed a deep understanding of drug discovery, predominantly in the academic setting. He gained his doctorate from the University of Manchester where he utilized Systems Biology to explore the role of cell signaling and hypoxia in oral cancer.


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