Oncology indications increasingly use predictive biomarkers to guide prescribing of costly therapies. However, uptake of targeted therapies in Brazil is highly dependent on incorporation into private and publically funded formularies which vary widely between treatment settings, in terms of drugs and indications covered. As multiple marketed and late-stage emerging agents seek to optimize the market access opportunities offered by targeting premium-priced treatment to those patients most likely to benefit, this report assesses how the rising cost of personalized medicine is balanced with clinical need in breast cancer, non-small-cell lung cancer (NSCLC), colorectal cancer (CRC), and malignant melanoma (MM).

Questions Answered in This Report:

  • Assess payer attitudes toward biomarker-driven prescribing: To what extent has biomarker-driven prescribing penetrated the indications under study, and how do prescribing patterns vary by treatment setting (public versus private)? What are the current drivers and barriers to biomarker-driven prescribing in oncology, and what are the main cost-related/clinical constraints to the uptake of agents with biomarkers? How do surveyed oncologists in Brazil anticipate biomarker-driven prescribing will evolve by year-end 2017?



  • Assess payer attitudes toward biomarker-driven prescribing: How do national and/or institutional healthcare authorities regulate the prescribing of these agents? What procedures must patients and providing institutions follow in order to receive drugs listed, and not listed, in these formularies? What are payers’ reactions to recently approved therapies with biomarkers? How much of a market access lever is personalized medicine as health technology assessment evolves in the wake of tightening healthcare budgets in Brazil?



  • Explore the outlook for emerging agents: What role will head-to-head and pharmacoeconomic outcomes play in differentiating the reimbursement of high-cost targeted therapies versus currently available targeted therapies? What market access levers can drug developers take advantage of to better position new targeted therapies with biomarkers in Brazil? How do payers expect access to key targeted therapies and their companion diagnostics brands to evolve in the next three years? Are government initiatives under way to expand patient access?

     

Scope:

Decision Resources Group’s Emerging Markets Physician & Payer Forum report “Biomarker-Driven Prescribing in Oncology: Stakeholder Dynamics in Brazil for Breast Cancer, NSCLC, CRC, and Malignant Melanoma” explores the evolving reimbursement and market access landscape for biomarker-driven prescribing, the dynamics affecting prescribing of key targeted drugs in the cost-controlled climate, and the primary challenges facing emerging therapies aspiring to significantly penetrate this multifarious market segment.

- Markets covered: Brazil.

- Primary research: This report draws on insights from 50 surveyed medical oncologists and 3 interviewed payers in Brazil. Interviewed payers include the following: Head of pharmaceutical assistance programs at Hospital das Clinicas (HC), São Paulo (reference to the MoH and CONITEC for development of protocols), member of the pharmacy and therapeutics (P&T) committee of HCFMUSP and representative of HC pharmacy in the therapeutic committee of the Department of Health of the São Paulo State; Pharmacist and biochemist at INCA (Instituto Nacional do Cancer), Rio de Janeiro, member of the P&T Committee of the institution, and independent advisor for public and private institutions for the development of treatment protocols; Oncologist KOL, practitioner at a major private HMO, and a member of the Drug Standardization Committee from the institution.

Author(s): Susana Silva, M.S.
Andreia Ribeiro, Ph.D.

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