In Relapsed/Refractory Multiple Myeloma, Thought Leaders Are Optimistic that the Combination of Carfilzomib, Lenalidomide and Dexamethasone Will Be the Most Efficacious Regimen Surveyed U.S. Payers Demand That New Therapies Provide Significant Efficacy Benefits to Justify Cost, According to a New Report from Decision Resources
BURLINGTON, Mass., May 14, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that surveyed U.S. and European hematological oncologists indicate that overall survival is the factor that most influences their prescribing decisions for relapsed/refractory multiple myeloma, and that increased overall survival is associated with the highest level of unmet need. Interviewed thought leaders are optimistic that the CRd regimen— carfilzomib (Onyx Pharmaceuticals/Ono Pharmaceutical's Kyprolis) in combination with lenalidomide (Celgene's Revlimid) and dexamethasone—will show advantages over sales-leading lenalidomide plus dexamethasone (the Rd regimen) on this attribute in the ongoing Phase III ASPIRE trial.
The DecisionBase 2013 report entitled As Carfilzomib and Pomalidomide Make Inroads Into the Market, What Key Attributes Will Differentiate Emerging Therapies According to Hematological Oncologists and Payers? finds that surveyed U.S. managed care organization (MCO) pharmacy directors demand that emerging therapies provide significant improvements in overall survival over Rd—a premium-priced standard-of-care regimen for relapsed/refractory multiple myeloma—to justify their cost and secure reimbursement. Notably, half of surveyed payers would not reimburse a new therapy priced the same as Rd or higher that offers a three-month improvement in overall survival over Rd, citing insufficient overall clinical benefit as one of the key reasons for not granting reimbursement.
The report also finds that surveyed U.S. and European hematological oncologists identified neurotoxicity as the safety and tolerability attribute that is most important to prescribing decisions in relapsed/refractory multiple myeloma, thus indicating the persisting high level of unmet need for therapies with a more favorable peripheral neuropathy profile.
"Despite the improvements effected by carfilzomib and the subcutaneous formulation of bortezomib (Takeda/Janssen-Cilag/Janssen's Velcade) on the incidence of peripheral neuropathy associated with standard intravenous bortezomib, our survey results suggest that further improvement in neurotoxicity remains a key opportunity for product differentiation," said Decision Resources Senior Business Insights Analyst Khurram Nawaz, M.Sc. "Early-stage clinical data suggest that the oral proteasome inhibitor MLN9708 (Takeda/Millennium) is associated with little peripheral neuropathy. MLN9708 has the potential to gain a competitive edge over currently available proteasome inhibitors if it can replicate these promising results in its ongoing Phase III trial, provided it is at least as efficacious as bortezomib and carfilzomib."
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SOURCE Decision Resources