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Survey: Most U.S. Payers Would Reimburse New Higher-Priced Asthma Drugs If They Reduce Exacerbations

Lower exacerbation rates remain top driver of physician prescribing choices

In a new survey conducted by Decision Resources Group, a health care research firm located in Burlington, Mass., 90% of surveyed U.S. payers indicated a willingness to pay a premium price for novel therapies that offer substantially greater improvements in reducing exacerbations than omalizumab (Xolair, Genentech/Novartis) in the treatment of patients with severe asthma.

Surveyed U.S. and European pulmonologists agreed that a reduction in the rate of exacerbations is the attribute that most influences prescribing decisions in patients with moderate-to-severe asthma. Clinical data and the opinions of interviewed thought leaders indicate that the investigational agents mepolizumab (Bosatria, GlaxoSmithKline) and lebrikizumab (Roche) have the potential to partially fulfill this unmet need.

Surveyed pulmonologists indicated that a therapy offering a greater improvement in quality of life is one of the highest unmet needs in moderate-to-severe asthma. No emerging therapies are positively differentiated from the market leader, fluticasone propionate/salmeterol (Advair, GlaxoSmithKline) on this attribute, based on clinical data and the opinions of interviewed thought leaders.

Less-frequent administration is the delivery attribute with the greatest opportunity for positively differentiating novel therapies entering the asthma market, according to the new report. This need will be fulfilled by several emerging therapies, including mepolizumab, lebrikizumab, fluticasone /vilanterol (Breo and Relvar, GlaxoSmithKline), tiotropium (Spiriva, Boehringer Ingelheim), and reslizumab (Cinquil, Cephalon). Breo, Relvar, and Spiriva are once-daily inhalers, in contrast to the twice-daily options currently available. All of the late-stage emerging biologics in development for the treatment of asthma are being dosed once every 4 weeks in their respective clinical trials, similar to omalizumab and much less frequently than oral or inhaled therapies.

U.S. pulmonologists indicated that they were willing to prescribe a new therapy with the ability to reduce exacerbations and the dose of oral corticosteroids in patients with severe asthma even if the drug costs more than omalizumab.

“Findings from our survey of physicians and payers emphasize that although current treatments are sufficient for a substantial portion of the asthma population, moderate to high unmet needs remain for many patients with moderate to severe asthma,” said analyst Eun-Jin Yang, PhD. “Particularly, emerging agents that can offer greater reductions in exacerbations and oral corticosteroid use over currently available therapies may reap the benefit as preferred choices in physician prescribing and reimbursement.”

Source: Decision Resources; May 1, 2014.

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