EU5 payers looking to superior clinical efficacy for COPD

30 June 2014

Surveyed pulmonologists in the European Union (EU5; France, Germany, Italy, Spain and the UK) estimate that the majority of their COPD patients currently receiving either a long-acting muscarinic antagonist (LAMA) or a long-acting beta2 agonist (LABA) are concomitantly receiving the other long-acting bronchodilator.

These patients represent a potential pool for emerging LABA/LAMA fixed-dose combinations, according to a new report form Decision Resources Group. However, although payers agree that these combinations are likely to be reimbursed nationally, they caution that the strength of the data will determine pricing and their place in the treatment algorithm.

Other key findings from the European Physician & Payer Forum report, titled What Market Access Challenges Will Emerging Bronchodilators for COPD Face in the EU5, include:

Impact of emerging generics: Most payers and pulmonologists across the EU5 are open to prescribing generic versions of Seretide (fluticasone propionate/salmeterol xinafoate, Symbicort budesonide/formoterol fumarate dihydrate) and Spiriva (tiotropium bromide) when they launch. However, pulmonologists are hesitant to prescribe a drug if the device is not easy to use, and payers also demonstrate concern about patient compliance with cheaper, harder to use inhalers.
Optimal market access lever: Clinical trials demonstrating superiority over the standard of care comprises the strongest market access lever in pricing and reimbursement negotiations. Even without such data, novel COPD therapies can still expect to be reimbursed - payers recognize the importance of having increased treatment options for this chronic disease—but without a premium price.
Projections for Relvar: Surveyed pulmonologists anticipate that Relvar (fluticasone furoate/vilanterol [FF/VI]), developed by UK pharma giant GlaxoSmithKline (LSE: GSK), the first once-daily LABA/inhaled corticosteroid (ICS) fixed-dose combination, will experience healthy uptake in this crowded drug class, prescribing the drug to a variety of patient groups. However, payers indicate that they do not plan to distinguish Relvar from the twice-daily LABA/ICS combinations, which might limit uptake.

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