Oncologists Want To See Significant Improvement Before Adopting Targeted Polytherapy

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Targeted Polytherapy

Decision Resources finds that oncologists want to see significant improvement in overall survival before adopting targeted polypharmacy in first-line settings. According to the new Physician & Payer Forum report entitled Premium-Priced Targeted Agents in Oncology: Clinician and Payer Attitudes to Polypharmacy, surveyed oncologists were asked what the minimum benefit is that would persuade them to add ImClone/Bristol-Myers Squibb/Merck KGaA's Erbitux to Genentech/Roche's Avastin and chemotherapy for first-line treatment of advanced non-small-cell lung cancer (NSCLC).

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In this first-line treatment scenario, the largest group of oncologists (41 percent) would require a significant improvement in overall survival in order to add Erbitux to Avastin and chemotherapy. On average, oncologists require 24 percent improvement in median survival, which would represent close to three months' additional survival, a very difficult requirement to meet in advanced NSCLC. Only 37 percent of oncologists expect Erbitux/Avastin to increase median survival of NSCLC patients.

The report also finds that up to one quarter of managed care organizations (MCOs) fail to cover both agents where two similar targeted agents are available. Marketers of Tykerb, Nexavar, Sutent, and Sprycel need to address the fact that some MCOs appear to perceive Herceptin/Tykerb, Nexavar/Sutent, and Gleevec/Sprycel as interchangeable, "me too" agents.

"Evidence demonstrates that patients who have failed Herceptin in the metastatic setting should switch to Tykerb, patients who have failed Genentech should switch to Sprycel, and, according to National Cancer Institute guidelines, patients who fail Sutent could benefit from Nexavar,"said Mary Fletcher-Louis, analyst at Decision Resources. "To have only one from each of these couplets on formulary leaves important clinical scenarios uncovered."

Premium-Priced Targeted Agents in Oncology: Clinician and Payer Attitudes to Polypharmacy is based on a U.S. survey of 100 oncologists and 20 managed care pharmacy directors. Their responses were compared to assess similarities and differences of opinion regarding clinical and economic factors in the management of premium-priced targeted agents in oncology.

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