The Majority of Surveyed Physicians Expect to Prescribe Late-Stage Disease-Modifying Therapies and the Majority of Payers Expect to Reimburse Them, 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, in the United States, surprisingly few surveyed neurologists are familiar with key emerging therapies for Alzheimer’s disease on which they were surveyed. Additionally, the majority of surveyed primary care physicians (PCPs) are unfamiliar with any such emerging therapy for Alzheimer’s disease. Surveyed neurologists and PCPs were most familiar with Baxter’s Gammagard, presently in Phase III clinical trials for Alzheimer’s disease, which likely reflects the fact that the agent is currently marketed for other indications. Less than one-quarter of surveyed neurologists were familiar with the anti-beta-amyloid monoclonal antibodies solanezumab (Eli Lilly) and bapineuzumab (Janssen Alzheimer Immunotherapy/Pfizer) and less than 10 percent of PCPs were familiar with these emerging disease-modifying drugs. However, despite physicians’ high level of unfamiliarity with these agents, when presented with available clinical trial data for each drug, 47 to 61 percent of surveyed physicians said they expect to prescribe these drugs to their Alzheimer’s disease patients.
The new U.S. Physician & Payer Forum report entitled Physician and Payer Insights on the Impact of Emerging Therapies and Generic Donepezil on the U.S. Alzheimer’s Disease Market also finds that most managed care organizations’ (MCOs) pharmacy directors were unfamiliar with any of the key emerging Alzheimer’s disease therapies on which they were surveyed. An unexpectedly low percentage of MCO pharmacy directors indicated that they were familiar with solanezumab (5 percent) and bapineuzumab (0 percent). This finding is surprising given the fact that these potential disease-modifying therapies, as high-priced biologics, could create a paradigm shift in the treatment of Alzheimer’s disease, resulting in a parallel, and presumably substantial, change in the reimbursement costs associated with the disease.
Similar to surveyed physicians, despite low levels of familiarity with late-stage emerging therapies, surveyed MCO pharmacy directors are receptive to adding these drugs to their formularies. Among the disease-modifying therapies profiled in the report, Gammagard is expected to be covered by the fewest surveyed commercial and Medicare Advantage plans. However, bapineuzumab is expected to be covered by the fewest Medicare Part D plans, possibly due to the higher risk of serious side effects (compared with solanezumab and Gammagard) associated with the drug in clinical trials to date.
“These expectations bode well for the late-stage emerging disease-modifying therapies for Alzheimer’s disease,” said Decision Resources Analyst Georgiana Kuhlmann, S.M. “Even with the limited clinical data available for these agents, Decision Resources forecasts that they will see fairly widespread reimbursement, which will be crucial for their uptake among Alzheimer’s disease patients, who are largely elderly and on a fixed income.”
The report also finds that Eisai/Pfizer’s Aricept (donepezil) suffered substantial loss of prescriptions to generic donepezil, following the latter agent’s launch in November 2010. Aricept has historically been the preferred acetylcholinesterase inhibitor (AChEI), as evidenced by its status as the patient and market-share leader, and the availability of the lower-cost generic donepezil will result in donepezil—branded and generic formulations combined—retaining its status as the patient-share leader. While generic donepezil eroded sales of branded Aricept upon its launch, other AChEIs—including both branded and generic formulations—saw little to no change in patient share following the launch of generic donepezil, consistent with their status as less-widely prescribed AChEIs.
“Once Alzheimer’s disease patients are stabilized on a medication, or combination of medications, physicians are reluctant to change their treatment regimen owing to the fear of inducing a worsening of the disease,” Ms. Kuhlmann said. “As a result, few patients receiving a therapy other than Aricept were switched to generic donepezil upon its launch.”
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