Prime market access levers for molecularly targeted oncology agents

In the EU5 countries (France, Germany, Italy, Spain and the UK), interviewed payers and surveyed oncologists recognize that molecularly driven management is a valuable innovation in cancer care, according to the findings of health care advisory firm Decision Resources. However, payer insight and oncologist survey findings show that targeted populations must be highly defined, companion diagnostics optimized, and the cost of diagnostic testing subsidized in order to maximize a new brand’s market access potential.

A validated biomarker predictive of response to a premium-priced targeted agent allows health care funds to be channeled towards the treatment of patients most likely to respond, which helps payers at national, regional and local/hospital level keep control of their budgets. As more of these costly therapies are approved and prices continue to rise, however, it is vital that emerging agents have biomarkers demonstrating a very strong relationship with a clinically relevant end point. Additionally, the cost of diagnostic testing, which largely falls to the hospital or clinic, negatively impacts health care budgets, and interviewed payers stress that the overall costs of these agents must not outweigh the benefits as they strive to cut health care costs.

Role of cost-sharing schemes