The recent spurt of available treatments for prostate cancer may prove encouraging for patients and physicians, the price tags for these medications are giving insurers pause. Specifically, 47 percent of US payers indicate they plan to tightly manage combination therapies, according to a new survey of pharmacy and medical directors at national and regional plans.
In addition, 25 percent of national plans would require a patient to fail Johnson & Johnson?s (JNJ) Zytiga as monotherapy before approving a combination regimen, and 19 percent would cover both Zytiga and Xtandi ? the new treatment from Medivation (MDVN) and Astellas Pharma ? only if the drug was on their oncology clinical pathway. And roughly half of all plans will require prior authorization.
?Coverage won?t be automatic,? says Rhonda Greenapple, president of Reimbursement Intelligence, a market research firm that queried directors whose plans represent more than 100 million lives. ?Provenge brought a lot of attention to this area and payers are worried about cost of prostate care. They?re trying to standardize care and not have doctors use expensive therapies.?
The concerns reflect the higher-than-expected pricing for Xtandi, which was approved in September and carries a monthly price tag of $7,450, or $89,400 annually, based on wholesale costs. By comparison, Zytiga costs about $5,500 a month, or $66,000 a year, and the Provenge vaccine sold by Dendreon (DNDN) goes for $93,000.
An early indication into Xtandi uptake among physicians will emerge tomorrow when Medivation reports earnings, a moment that investors and many others have been waiting for eagerly, especially since Medivation and Astellas do not yet have data that can link their drug to either improved outcomes or cost savings.
Both Xtandi and Zytiga, which are pills, have similar overall survival benefit relative to placebo, and quality-of-life data. And both target men with prostate cancer that has spread elsewhere in the body or returned despite treatment designed to hamper testosterone production.
Source: http://www.pharmalot.com/2012/11/how-payers-view-combo-therapy-for-prostate-cancer/
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