COPD & Emphysema Support Group
COPD is a progressive disease characterized by airflow obstruction or limitation. Emphysema is characterized by loss of elasticity of the lung tissue, destruction of structures supporting the alveoli and of capillaries feeding the alveoli. Both have symptoms that include shortness of breath, among other respiratory troubles. If you are a COPD or Emphysema sufferer, join...
12 April 2012
Price and Preferred Tier main consideration of US physicians in intent to prescribe COPD drugs
Print This
ShareThis
US physicians are eager to prescribe Relovair (fluticasone furoate and vilanterol (FF/VI), being developed by GlaxoSmithKline (LSE: GSK) and Theravance (Nasdaq: THRX), which is expected to be the first and only once-daily long-acting beta2 agonist/inhaled corticosteroid (LABA/ICS) fixed-dose combination to enter the US market for the treatment of both asthma and chronic obstructive pulmonary disease (COPD).
Although surveyed physicians surveyed by advisory firm Decision Resources view once-daily dosing as Relovair most desirable attribute, access to the therapy will be an important determinant of the drugs use as over 90% of surveyed US pulmonologists and primary care physicians (PCPs) indicate that they will prescribe the drug if it is on a preferred tier (tier 1 or 2) but only about one-third of surveyed physicians will prescribe Relovair if it is on a non-preferred tier (tier 3 or higher). These findings suggest that, in the opinions of prescribers, improvements in dosing will not outweigh additional out-of-pocket costs to the patient.
Enjoying this article? Have the leading Pharma news & analysis delivered daily on email by signing up for our FREE email newsletter here.
Conditions for preferred status
The new US Physician & Payer Forum report, titled US Physician and Payer Attitudes to Novel and Me-Too Fixed Dose Combination Inhalers for Asthma and Chronic Obstructive Pulmonary Disease, also finds that surveyed managed care organization (MCO) pharmacy directors would be persuaded to grant Relovair preferred brand status if the drug demonstrates improvements in efficacy relative to currently marketed LABA/ICS fixed-dose combinations. In the absence of any gains in efficacy, the majority of surveyed MCO pharmacy directors would place Relovair on a preferred tier if it is priced at less than a 10% premium to GlaxoSmithKlines Advair, but just 28% of MCOs would do the same if the drug is priced at a greater than 10% premium to Advair (fluticasone and salmeterol), GSKs currently marketed COPD drug.
Given that pharmacy directors do not appear to be willing to tolerate a greater than 10% price premium relative to Advair without gains in efficacy, Relovair will need to be priced competitively to achieve widespread preferred brand status, said Decision Resources analyst Amanda Puffer, adding: However, regardless of whether Relovair achieves widespread preferred tier status, physicians indicate fewer of their patients will be treated with Advair and AstraZenecasymbicort following the launch of Relovair.
Merck & Cos Dulera lacks reimbursement
The report also finds that surveyed physicians do not prescribe Merck & Cos Dulera (formoterol/mometasone) for asthma because of lack of reimbursement for the drug or the implementation of cost controls. When provided with a profile of Dulera for COPD that included key Phase III clinical trial data, physicians said they would be most inclined to prescribe Dulera if it were available at a lower cost than Advair, highlighting the fact that there is little to differentiate the drug from currently available LABA/ICS fixed-dose combinations.
40% of surveyed MCOs exclude Dulera from their largest commercial plan, while 60% of surveyed MCOs exclude Dulera from their largest Medicare prescription drug plan. Additionally, nearly one-third of surveyed MCOs expect to move Advair to a more favorable tier in the next 12 months, and 35% expect to either move Dulera to a less favorable tier or remove it from their formulary. These changes in tier placement could intensify current trends that promote access to Advair and restrict access to Dulera.
The report also finds that among the four novel LABA/long-acting muscarinic antagonist (LAMA) fixed-dose combinations included in the survey - Forest/Almirall formoterol/aclidinium, Boehringer Ingelheims olodaterol/tiotropium, Novartis indacaterol/glycopyrronium and GlaxoSmithKline/Theravance vilanterol/GSK-573719 - the greatest percentage of surveyed pulmonologists and primary care physicians selected vilanterol/GSK-5783719 as the most promising LABA/LAMA.
http://www.thepharmaletter.com/file/112533/price-and-preferred-tier-main-consideration-of-us-physicians-in-intent-to-prescribe-copd-drugs.html
Interesting....
Easy Breathing to all,
Love Holly
Price and Preferred Tier main consideration of US physicians in intent to prescribe COPD drugs
Print This
ShareThis
US physicians are eager to prescribe Relovair (fluticasone furoate and vilanterol (FF/VI), being developed by GlaxoSmithKline (LSE: GSK) and Theravance (Nasdaq: THRX), which is expected to be the first and only once-daily long-acting beta2 agonist/inhaled corticosteroid (LABA/ICS) fixed-dose combination to enter the US market for the treatment of both asthma and chronic obstructive pulmonary disease (COPD).
Although surveyed physicians surveyed by advisory firm Decision Resources view once-daily dosing as Relovair most desirable attribute, access to the therapy will be an important determinant of the drugs use as over 90% of surveyed US pulmonologists and primary care physicians (PCPs) indicate that they will prescribe the drug if it is on a preferred tier (tier 1 or 2) but only about one-third of surveyed physicians will prescribe Relovair if it is on a non-preferred tier (tier 3 or higher). These findings suggest that, in the opinions of prescribers, improvements in dosing will not outweigh additional out-of-pocket costs to the patient.
Enjoying this article? Have the leading Pharma news & analysis delivered daily on email by signing up for our FREE email newsletter here.
Conditions for preferred status
The new US Physician & Payer Forum report, titled US Physician and Payer Attitudes to Novel and Me-Too Fixed Dose Combination Inhalers for Asthma and Chronic Obstructive Pulmonary Disease, also finds that surveyed managed care organization (MCO) pharmacy directors would be persuaded to grant Relovair preferred brand status if the drug demonstrates improvements in efficacy relative to currently marketed LABA/ICS fixed-dose combinations. In the absence of any gains in efficacy, the majority of surveyed MCO pharmacy directors would place Relovair on a preferred tier if it is priced at less than a 10% premium to GlaxoSmithKlines Advair, but just 28% of MCOs would do the same if the drug is priced at a greater than 10% premium to Advair (fluticasone and salmeterol), GSKs currently marketed COPD drug.
Given that pharmacy directors do not appear to be willing to tolerate a greater than 10% price premium relative to Advair without gains in efficacy, Relovair will need to be priced competitively to achieve widespread preferred brand status, said Decision Resources analyst Amanda Puffer, adding: However, regardless of whether Relovair achieves widespread preferred tier status, physicians indicate fewer of their patients will be treated with Advair and AstraZenecasymbicort following the launch of Relovair.
Merck & Cos Dulera lacks reimbursement
The report also finds that surveyed physicians do not prescribe Merck & Cos Dulera (formoterol/mometasone) for asthma because of lack of reimbursement for the drug or the implementation of cost controls. When provided with a profile of Dulera for COPD that included key Phase III clinical trial data, physicians said they would be most inclined to prescribe Dulera if it were available at a lower cost than Advair, highlighting the fact that there is little to differentiate the drug from currently available LABA/ICS fixed-dose combinations.
40% of surveyed MCOs exclude Dulera from their largest commercial plan, while 60% of surveyed MCOs exclude Dulera from their largest Medicare prescription drug plan. Additionally, nearly one-third of surveyed MCOs expect to move Advair to a more favorable tier in the next 12 months, and 35% expect to either move Dulera to a less favorable tier or remove it from their formulary. These changes in tier placement could intensify current trends that promote access to Advair and restrict access to Dulera.
The report also finds that among the four novel LABA/long-acting muscarinic antagonist (LAMA) fixed-dose combinations included in the survey - Forest/Almirall formoterol/aclidinium, Boehringer Ingelheims olodaterol/tiotropium, Novartis indacaterol/glycopyrronium and GlaxoSmithKline/Theravance vilanterol/GSK-573719 - the greatest percentage of surveyed pulmonologists and primary care physicians selected vilanterol/GSK-5783719 as the most promising LABA/LAMA.
http://www.thepharmaletter.com/file/112533/price-and-preferred-tier-main-consideration-of-us-physicians-in-intent-to-prescribe-copd-drugs.html
Interesting....
Easy Breathing to all,
Love Holly
There's an interesting graph on the page link below comparing Relovair, vilanterol and novartis in phase III trials :
http://www.pharma-share.com/is-glaxosmithkline-breathing-easier-or-holding-its-breath-mixed-results-of-two-pivotal-phase-3-fixed-dose-combination-studies-in-copd-are-reported
It's all very interesting.
Hugs Peta x
I kinda chucked at the out of pocket expense part. Last I checked Combivent was well over $200 for one inhaler. Now, if add up all the medicine we are supposed to take you would have to be in the 1% to afford it out of pocket without insurance or additional help.