Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that patient access to premium-priced targeted cancer treatments in Brazil and Mexico is improving, creating an opportunity for developers and marketers of epidermal growth factor receptor (EGFR) inhibitors. Interviewed Brazilian payers report that the Health Secretariat is developing measures to facilitate public patient access to the most commonly requested targeted agents, and that while private insurers have traditionally often failed to cover oral antineoplastic therapies, a number of companies are starting to change their policies to include these agents. In Mexico, inclusion of targeted therapies in national formularies has increased in recent years, and the public Seguro Popular program—which covers a vast proportion of Mexico's population—is set to expand its oncology coverage to include colorectal cancer in addition to breast cancer, which is already covered. As a result, new drugs that offer clear clinical advantages are well positioned for market access and efforts by marketers to ensure that oncologists and payers are aware of the benefits their drugs offer are expected to bear dividends.
“In practice, oncologists in many Mexican cancer centers preempt budget shortages by prioritizing cheaper chemotherapeutic agents”
Decision Resources' new Emerging Markets Physician & Payer Forum report entitled The Market Access Landscape for EGFR Inhibitors in Brazil and Mexico: Physician and Payer Perspectives also finds that most surveyed Mexican oncologists report that the number of patients to whom they can prescribe EGFR inhibitors is limited by the hospital reimbursement budget. Surveyed Brazilian oncologists point out that non-hospital-administered EGFR inhibitors are not currently widely reimbursed by private healthcare, which covers about one-quarter of the population.
Mexican payers report that in the Social Security sector which covers approximately 45 percent of the Mexican population, healthcare programs frequently run out of funds to pay for targeted agents. When this happens patients are denied treatment with EGFR inhibitors.
"In practice, oncologists in many Mexican cancer centers preempt budget shortages by prioritizing cheaper chemotherapeutic agents," said Decision Resources Analyst Niamh Buckley, Ph.D. "Furthermore, Mexican payers believe prescribing of regimens incorporating two targeted agents, such as Herceptin and Tykerb, will be severely constrained in Mexico."
Surveyed oncologists from both Brazil and Mexico consider EGFR inhibition to be a more important therapeutic option for non-small-cell lung cancer and colorectal cancer than for breast cancer. This perception is likely based on the availability of several other effective treatment options for breast cancer and due to the fact that just one-fifth of breast cancer patients are eligible for HER2-targeted therapy. Among the marketed EGFR inhibitor drugs, virtually all surveyed oncologists in Brazil and Mexico prescribe Roche/Genentech/Chugai's Herceptin and ImClone Systems (a subsidiary of Eli Lilly)/Merck Serono/Bristol-Myers Squibb's Erbitux to their cancer patients. By contrast, relatively few oncologists in Brazil and Mexico prescribe Amgen's Vectibix. Additionally, fewer oncologists in Mexico than in Brazil prescribe GlaxoSmithKline's Tykerb or Genentech/OSI Pharmaceuticals/Roche/Chugai's Tarceva.
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