How Will U.S. Payer and Prescriber Attitudes Shape This Competitive Market?

The treatment of non-Hodgkin’s lymphoma (NHL) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) in the United States is centered on the use of Roche/Genentech’s Rituxan. This monoclonal antibody (MAb) has demonstrated clear improvements in clinical practice, and is still enjoying significant commercial success nearly two decades after its launch. Recent approvals of small-molecule inhibitors Imbruvica and Zydelig are becoming increasingly entrenched in the NHL and CLL/SLL treatment algorithms, while MAbs developed to challenge Rituxan—Novartis’s Arzerra and Roche/Genentech’s Gazyva—face considerable competition from Rituxan’s dominance in the marketplace.

Questions Answered in This Report:

  • Obtain hematological oncologists’ perspectives on current and future management of NHL and CLL/SLL. How do MAbs fit into the NHL and CLL/SLL treatment algorithms? For what treatment settings/lines of therapy do hematological oncologists prescribe them? What factors influence prescribing of these agents?

  • Reimbursement for NHL and CLL/SLL therapies is relatively uniform across all lines of therapy and patient subpopulations. How do payers restrict access to these therapies? What has been the uptake of relatively new-to-market therapies Imbruvica and Zydelig?

  • There are three anti-CD20 MAbs approved for use in first-line CLL/SLL patients. What are surveyed hematological oncologists’ perceptions of anti-CD20 MAbs Rituxan, Gazyva, and Arzerra in this setting? What factors influence hematological oncologists’ choice of CD20-targeting agents in this patient population?

  • Kinase inhibitors Imbruvica and Zydelig are competing within the relapsed/refractory CLL space. What are surveyed hematological oncologists’ perceptions of kinase inhibitors Imbruvica and Zydelig in this setting? Which agent has the strongest profile across key clinical and non-clinical attributes?

  • Understand how payers view and value novel agents for NHL and CLL/SLL. What factors influence MCO formulary decisions of agents for NHL and CLL/SLL? What factors will carry the most influence on formulary inclusion of emerging therapies for NHL and CLL/SLL? What will the tier placement be for these emerging therapies? How will surveyed hematological oncologists’ embrace new market entrants: venetoclax, duvelisib, Afinitor, and Revlimid?

Scope:

This U.S. Physician & Payer Forum report contains insights from a survey of 101 hematological oncologists and 31 MCO pharmacy/medical directors to capture their views on anticipated prescribing and reimbursement barriers in relation to current and emerging agents for NHL and CLL/SLL.

Markets covered: United States.

Primary research: Online survey of 101 oncologists and 31 MCO pharmacy/medical directors.

Author(s): Dana Gheorghe, Ph.D.

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