Decision Resources Group finds that surveyed U.S. retinal specialists are highly willing to prescribe key emerging therapies for the treatment of geographic atrophy (GA), the dry form of advanced age-related macular degeneration (AMD). In particular, clinicians expect to prescribe Roche/Genentech’s lampalizumab and Acucela/Otsuka’s emixustat, two mid-stage compounds, to a median 30% and 50% of their diagnosed GA patients, respectively. Respondents expect the other products queried—GlaxoSmithKline’s GSK-933776, Advanced Cell Technology’s MA09-hRPE cell transplantation and Alimera Sciences/pSivida’s Iluvien/Medidur (sustained-release fluocinolone acetonide)—to capture lower, but nonetheless meaningful, patient shares.

 

Other key findings from the DecisionBase report:

 

• End point importance: While effect on GA area progression—an anatomic measure—is the primary end point in both completed and ongoing clinical trials of key emerging therapies, surveyed U.S. and European retinal specialists indicate a greater likely importance of a drug’s demonstrated effect on visual acuity—a familiar clinical metric—in future prescribing decisions for GA. 
• Delivery as a differentiator: Part-worth utilities derived from a conjoint study reveal that, to surveyed U.S. retinal specialists, the attractiveness of a GA therapy is not heavily influenced by any one specific dosing frequency or unique formulation among a broad range presented. These data correlate with the responses of surveyed U.S. and European retinal specialists, who identify infrequent dosing or convenient delivery as areas of moderate opportunity for therapy differentiation. 
• The payer perspective: Surveyed U.S. managed care organization pharmacy directors are receptive to reimbursing GA therapies—75% of surveyed U.S. payers indicated high or very high willingness to grant favorable formulary status to GA therapies demonstrated to maintain visual acuity. Moreover, would-be reimbursers accepted a high yearly cost for emerging therapies demonstrating a reduction in GA area progression. This cost was comparable to that of branded agents used in the treatment of the wet form of advanced AMD.

 

Comments from Decision Resources Group Analyst Nadja Rozovsky, Ph.D.:

 

•  “Although limited clinical trial data are available to support the efficacy and safety of pipeline agents, the need for GA therapies where none are currently approved drives the high level of physician willingness to prescribe the emerging treatments profiled to their GA patients once they become available.” 
• “Generally speaking, both U.S. payers and retinal specialists appear ready to embrace future high-cost GA drugs, suggesting a smooth path to market entry and potentially strong uptake for the first agents approved for this highly underserved patient population.”

 

Date: June 4, 2014

Source: Decision Resources Group