For Treatment of HCV, Surveyed European Gastroenterologists Will Prescribe Telaprevir and Boceprevir to Nonresponder and Treatment-Naive Patients Following Launch, Leading to Higher Treatment Costs Than Interviewed Payers Expect

Owing to the Increasing Use of Generics Across the EU5, Interviewed European Payers Expect Drug Makers to Implement Considerable Voluntary Price Cuts for Their Branded Ribavirin Products, According to a New Report from Decision Resources

BURLINGTON, Mass.--(BUSINESS WIRE)--Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that, for the treatment of hepatitis C virus (HCV), the highest percentage of surveyed gastroenterologists in the EU5 (France, Germany, Italy, Spain and the United Kingdom) indicate that they will likely use Vertex/Johnson & Johnson/Mitsubishi Tanabe’s telaprevir and Merck’s boceprevir initially after launch to a greater extent in nonresponder HCV genotype 1 patients than in treatment-naive patients. However, a significant proportion of HCV-1 treatment-naive patients will also receive these new HCV-specific antiviral agents within the first year of launch and treatment rate estimates in this subpopulation will be nearly 60 percent by 2014.

“Because the novel direct-acting antivirals have vastly improved efficacy in hard-to-treat patients over the current standard of care, surveyed clinicians expect drug-treated rates to grow as a result of an increase in the volume of patients seeking treatment”

The new European Physician & Payer Forum report entitled Hepatitis C Virus: Physician & Payer Perspective on Future Treatment and Reimbursement of Novel HCV Therapies in the European Union finds that a clash in expectations exists between surveyed gastroenterologists and interviewed payers across the EU5 as payers predict physicians will initially only use telaprevir and boceprevir in nonresponder patients, which could lead to prescribing restrictions if treatment costs become significantly higher than anticipated due to use in treatment-naive patients.

The current armamentarium for treating HCV is relatively modest and consists of pegylated interferon (peg-IFN) products—Roche’s Pegasys (peg-IFN-alpha-2a) and Merck’s PegIntron/ViraferonPeg (peg-IFN-alpha-2b)—as well as equivalent branded ribavirin products: Roche’s Copegus, Merck’s Rebetol and generic ribavirin. The current standard of care for most patients is a dual-therapy with a peg-IFN and ribavirin, which has poor cure rates in hard-to-treat patients and considerable safety and tolerability issues. As a result, significant unmet needs remain in HCV treatment. The report also finds that surveyed European gastroenterologists expect to treat more patients when emerging HCV-specific drugs become available.

“Because the novel direct-acting antivirals have vastly improved efficacy in hard-to-treat patients over the current standard of care, surveyed clinicians expect drug-treated rates to grow as a result of an increase in the volume of patients seeking treatment,” said Decision Resources Analyst Courtney Stanton, Ph.D. “Surveyed German clinicians expect to have the greatest increase in the amount of patients they will treat once the new HCV-specific drugs are available, a maximum 77 percent increase over the amount of patients they currently treat on average each month. Increases will be much less dramatic in the other surveyed European countries, especially the United Kingdom, where clinicians only expect a maximum six percent increase over current average monthly patient numbers. The remaining countries—France, Italy and Spain—will see increases between 39 and 47 percent over current patient numbers.”

The report also finds that mounting pressure from EU5 governments for increased generic use will likely encourage uptake of generic ribavirin and trigger price-cuts from brand manufacturers. Although government regulation regarding the use of generics varies between surveyed countries, there is a shift towards increased generic use across the EU5 and interviewed payers expect drug makers to implement considerable voluntary price cuts for their branded ribavirin products in order to remain competitive.

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