Cost of Avastin a deterrent for non-small-cell lung cancer treatment

Dec 18 2009

Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that the cost of Roche/Chugai's Avastin, followed by concerns about its efficacy and side-effect profile, are cited most frequently by surveyed oncologists as the factors preventing their use of Avastin for non-small-cell lung cancer treatment in Germany, France, Italy, Spain and the United Kingdom.

The new Special European Physician & Payer Forum report entitled Targeted Therapies for NSCLC: How High are the Barriers to Displacing Avastin in Europe? finds that Avastin, which is not recommended for use within the United Kingdom's National Health Service, is used more often for non-small-cell lung cancer in the first and second line in France and Germany than in Italy and Spain. However, over the next 12 months, surveyed oncologists in Italy and Spain expect to increase first-line use of targeted agents such as Avastin, OSI Pharmaceuticals/Roche/Chugai's Tarceva and AstraZeneca's Iressa. According to the report, Tarceva is the second-most commonly prescribed targeted therapy in the first line after Avastin.

While Avastin, Tarceva and Iressa have shown modest efficacy in select patient populations, other agents in late-stage development have struggled to reach the non-small-cell lung cancer drug market. Three targeted therapies -- Bristol-Myers Squibb/Eli Lilly/Merck KGaA's Erbitux, AstraZeneca's Zactima and Pfizer's figitumumab -- experienced recent setbacks in ongoing Phase III clinical trials or in receiving approval from the European Medicines Agency.

"The landscape for non-small-cell lung cancer will shift over the next several years as oncologists and payers grapple with the role of maintenance/consolidation therapy, increasing uptake of targeted therapies in the first-line setting and with the potential launch of new biologic agents," said Decision Resources Director Madhuri Borde, Ph.D.

The report also finds that cost-sharing schemes for targeted therapies -- which have been negotiated by the Italian Medicines Agency for both Avastin and Tarceva -- are much more prevalent in Italy than in the other European countries surveyed. Negotiating cost-sharing schemes is one of several factors that can contribute to delayed uptake of targeted therapies in Italy. Other factors include the time the agency spends reviewing new drug applications, setting prices and the requirement that new drugs must be accepted onto both regional and hospital formularies prior to their use.

Targeted Therapies for NSCLC: How High are the Barriers to Displacing Avastin in Europe? is based on surveys with 224 oncologists and interviews with 20 hospital-based payers in Germany, France, Italy, Spain and the United Kingdom. Their responses were compared to assess similarities and differences of opinion regarding clinical, economic and scientific factors.