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Improved Quality of Life Is Major Unmet Need in COPD Treatment, Survey Finds

Indacaterol/glycopyrronium has advantages over current therapies (May 20)

In a survey conducted by Decision Resources, a research and advisory firm located in Burlington, Massachusetts, U.S. and European pulmonologists agree that therapies offering a greater effect on quality of life (QOL) are among the areas of highest unmet need in the treatment of chronic obstructive pulmonary disease (COPD).

Given the high level of subjectivity and variability of tests used to measure QOL, interviewed thought leaders state that it is difficult to differentiate therapies based on these measures. However, available clinical data and thought-leader opinion indicate that the two sales-leading COPD therapies, Spiriva (tiotropium bromide; Pfizer/Boehringer Ingelheim) and Advair (fluticasone propionate/salmeterol; GlaxoSmithKline), offer comparable efficacy on this attribute. Phase III data indicate that indacaterol/glycopyrronium (Novartis) may offer greater improvement in QOL compared with these market leaders.

The survey also finds that U.S. pulmonologists would prescribe indacaterol/glycopyrronium to 25% of their COPD patients, driven by the positive phase III efficacy data. However, indacaterol/glycopyrronium is expected to earn a more conservative patient share, constrained in part by a late launch relative to its competitors in the U.S.

“Phase III data indicate that indacaterol/glycopyrronium has a strong efficacy profile,” said analyst Amanda Puffer. “Thought leaders are enthusiastic about the LABA/LAMA products and expect them to provide greater efficacy compared with individual current therapies. Based on lung function data and improvements in quality of life, indacaterol/glycopyrronium has advantages over both Spiriva and Advair. But the market is expected to be crowded, so we are conservative in our expected uptake of indacaterol/glycopyrronium.”

The report also finds that surveyed pharmacy directors at U.S. managed care organizations (MCOs) are not likely to reimburse premium-priced therapies that offer improvements only in the dosing burden over current treatment regimens. Pharmacy directors are highly willing to grant favorable formulary status to therapies that provide advantages for lung function or the frequency of exacerbations over currently available therapies. However, they also indicate that if the drugs are priced at a premium to Spiriva, gains in efficacy will need to be substantial to secure reimbursement.

Source: Decision Resources; May 20, 2013.

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