European prescribing trends for mCR prostate cancer

Johnson & Johnson (NYSE: JNJ)/AstraZeneca’s (LSE: ANZ) Zytiga (abiraterone acetate) is the clear agent of choice for second-line treatment of metastatic castrate-resistant prostate cancer (mCRPC) patients, according to surveyed oncologists from France, Germany, Italy, Spain and the UK (EU5).

According to a new report from Decision Resources Group, the average reported patient share of Medivation (Nasdaq: MDVN)/Astellas Pharma’s (TYO: 4503) Xtandi (enzalutamide) in the second-line mCRPC setting is comparable across the EU5 with the exceptions of Italy and Spain, where Xtandi is yet to complete pricing and reimbursement negotiations.

Dendreon’s (Nasdaq: DNDN) Provenge (sipuleucel-T) and Bayer’s (BAYN: DE) Xofigo (Radium 223 dichloride) received European approval in 2013, but have not yet completed pricing and reimbursement negotiations across all European countries; interviewed payers cite long delays in completing these negotiations, particularly in cost-constrained countries.

Other key findings from the European Physician and Payer Forum report include:

Decision Resources Group business insights analyst Sehrish Rafique commented: “Patient access schemes (PAS) are crucial for ensuring that expensive oncology drugs secure positive health technology assessment reviews. For example, interviewed payers from the United Kingdom tell us that the PAS for Zytiga was crucial to securing a positive NICE recommendation. Emerging therapies for mCRPC will need to demonstrate significant efficacy over an active comparator in order to justify a price premium over existing therapies, though interviewed payers from the EU5 cite that the maximum price has already been reached. Likely, drug manufacturers will need to use a cost-sharing scheme to help new therapies gain market access – particularly in the more cost constrained markets (Italy and Spain).”