The Majority of Surveyed MCOs Will Consider Reimbursing Novel OPAT Agents Either For Their FDA-Approved Indications or For Infections With Susceptible Pathogens, According to a New Report from Decision Resources
BURLINGTON, Mass.--(BUSINESS WIRE)-- Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that, according to surveyed physicians in the United States, the use of outpatient parenteral antibiotic therapy (OPAT) will largely remain stable over the next 12 months, but Cubist’s Cubicin, Theravance/Astellas's Vibativ and Merck's Invanz will benefit from physicians’ plans to increase usage. Nearly two-thirds of hospital-based physicians and almost half of office-based physicians expect to increase their use of Cubicin as OPAT while Vibativ and Invanz will also see increased OPAT usage, particularly by hospital-based physicians, albeit to a lesser degree than Cubicin.
The new U.S. Physician & Payer Forum report entitled Antibiotic Market Opportunities Beyond the Hospital: Market Trends, Medical Practice, and Reimbursement of Outpatient Parenteral Antibiotic Therapy finds that, regarding the prescribing of antibiotics, office-based physicians will maintain the status quo to a larger degree than will their hospital-based peers. For every OPAT antibiotic included in the survey, a larger percentage of office-based physicians anticipate stable usage while a smaller percentage plan to increase or decrease use.
Forest’s Teflaro will experience a large increase in first-time use for OPAT. While 17 percent of hospital-based physicians and 23 percent of office-based physicians are currently prescribing Teflaro as OPAT, 65 percent of hospital-based physicians and 54 percent of office-based physicians indicate that they will prescribe Teflaro for OPAT in the next 12 months.
The findings also reveal that surveyed infectious disease specialists see OPAT as a logical fit for indications requiring long-duration antibiotic treatment.
“More than 80 percent of surveyed physicians ranked a patient’s clinical stability and the need for long IV treatment duration among the key drivers to initiate OPAT,” said Decision Resources Therapeutic Area Director Irene Koulinska, M.D., Sc.D. “Additionally, discharge to OPAT is most common for patients hospitalized with endocarditis or osteomyelitis.”
The report also finds that although surveyed managed care organizations’ (MCO) medical directors (MDs) indicate that no single drug attribute emerges as the most important for reimbursement decisions for OPAT, convenience and efficacy factors are deemed more important than cost. Those associated with convenience or lower risk of complications are ranked similarly to efficacy attributes—such as bactericidal activity, activity against MDR pathogens—indicating the complexity in assessing the value of antibiotics in reimbursement decisions for OPAT.
Additionally, the majority of surveyed MCO MDs will consider reimbursing novel OPAT agents either for their FDA-approved indications or for infections with susceptible pathogens. Only 14 percent of surveyed MDs indicate that they do not expect to reimburse each of the four emerging agents featured in the survey – Durata’s Dalbavancin, Achaogen’s ACHN-490, Cubist’s CXA-201 and AstraZeneca’s CAZ-104.
About Decision Resources
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Christopher Comfort, 781-993-2597
KEYWORDS: United States North America Massachusetts
INDUSTRY KEYWORDS: Practice Management Health Hospitals Infectious Diseases Pharmaceutical Managed Care