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Survey: Neurologists More Likely Than Payers to See Tecfidera (Dimethyl Fumarate) as MS Breakthrough

New therapies face market challenges (September 3)

Decision Resources, a research and advisory firm located in Burlington, Mass., finds that more than half of surveyed neurologists consider Tecfidera (dimethyl fumarate, Biogen Idec) to be a “breakthrough” in the treatment of multiple sclerosis (MS) — slightly greater than those who feel the same about Gilenya (fingolimod, Novartis) and nearly twice as many as for Aubagio (teriflunomide, Genzyme).

Conversely, less than one-third of surveyed pharmacy directors and medical directors (PDs/MDs) in managed care organizations (MCOs) identify Tecfidera, Gilenya, and Aubagio as breakthrough treatments, perhaps underscoring their decision to most commonly cover all three oral agents on nonpreferred tiers in their largest commercial plans. Notably, approximately one-quarter of surveyed MCO PDs/MDs did not cover Aubagio or Tecfidera at the time the survey was fielded, which was likely due to the recent launches of these agents.

The report also finds that two emerging products — Plegridy (Biogen Idec), a pegylated version of Avonex (interferon beta-1a, Biogen Idec), and Copaxone (glatiramer acetate injection, Teva) 40 mg/mL dosed three-times weekly, a reformulation of once-daily 20 mg/mL Copaxone — will experience usage patterns and market-access positioning similar to those of their respective predecessor compounds. This finding suggests that physicians and payers consider the clinical value of these new products to be sufficient to drive use and coverage, but that they lack strong differentiation from their respective predecessor compounds.

The report also finds that novel late-stage emerging disease-modifying therapies (DMTs) for the treatment of MS — Lemtrada (alemtuzumab, Genzyme/Bayer HealthCare), daclizumab (Biogen Idec/AbbVie), and ocrelizumab (Roche/Genentech) — will generally be reserved for treatment-refractory patients, likely reflecting safety concerns about each drug.

“As more DMTs enter the MS market in the U.S., uptake and coverage of each agent will depend on clear demonstration of its value to stakeholders, driven in particular by the balance of cost, advancements in efficacy and acceptable safety,” said analyst Jonathan Searles. “Moreover, MCO PDs/MDs indicate that post-marketing studies supporting the health economic benefits of a DMT will be an influential factor in determining future formulary coverage.”

Source: Decision Resources; September 3, 2013.

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