BURLINGTON, Mass., Dec. 5, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that, for the treatment of non-small-cell lung cancer (NSCLC), biomarker testing is already widely employed in the China and South Korea markets, and is set to increase to European levels in the next two years.
Decision Resources' new Emerging Markets Physician & Payer Forum report entitled NSCLC in China and South Korea: Physician and Payer Perspectives on Prescribing Trends, Patient Access, and Reimbursement Challenges Facing Current and Emerging Therapies finds that surveyed oncologists in China (most of whom practice in Tier 3 hospitals) estimate that one-half of their NSCLC patients are currently tested for EGFR mutations, and that by year-end 2016 almost three-quarters will be tested. ALK–translocation testing rates are currently low, at around one-fifth of patients, but will increase even more dramatically in the next three years. Pfizer's Xalkori, an oral, dual inhibitor of ALK and c-Met, was the first targeted agent to be approved for NSCLC with a companion diagnostic test. On the basis of impressive overall response data, Xalkori received regulatory approval in China in January 2013 and became available in a number of regions about six months later. Lack of reimbursement for testing and the high cost treatment are the key barriers to testing in China, but surveyed oncologists also point to lack of patient willingness to be tested.
In South Korea, the EGFR-mutation testing rate is already comparable with Europe as 69 percent of survey respondents' patients are currently tested, and such testing is expected to increase to 80 percent by year-end 2016, despite the lack of reimbursement by the National Health Insurance.
The report also finds that in China, inclusion in the NRDL—China's national formulary—is key to securing reimbursement and widespread uptake; however, no NSCLC targeted agents are included in the current list, and interviewed payers do not expect targeted agents to be included in the next version of the NRDL, due for publication in 2014.
"Coverage of targeted agents on the 30-plus provincial formularies, the PRDLs, is patchy," said Decision Resources Product Director Andreia Ribeiro, Ph.D. "However, payers report that provinces with surplus funds sometimes agree to reimburse agents without formal PRDL inclusion. PRDLs are prepared in the year following NRDL publication so 2014/2015 will be the window of opportunity for companies to negotiate PRDL listing. Access to targeted agents has been accomplished at the municipal level for certain brands; marketers have been successful in striking deals with social security bureaus in prosperous eastern cities with sufficient budgets to underwrite local reimbursement schemes."
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