inVentiv Health Consulting Landmark Study
Turning Tides: Trends in Oncology Market Access
The high cost of cancer care presents unique challenges to market access. To better understand these challenges, inVentiv Health Consulting (formerly Campbell Alliance) conducted an in-depth analysis of the issues of greatest concern to the biopharmaceutical industry in the Landmark Study, Turning Tides: Trends in Oncology Market Access.
Campbell Alliance fielded an online survey in April 2012 to gather perspectives on oncology trends from respondents representing 38 managed care health plans and 181 million covered lives in the US. In addition, inVentiv Consulting conducted telephone interviews in May 2012 with respondents representing 15 community practices to gather their perspectives. This in-depth primary research was combined with marketplace surveillance through secondary research and hands-on industry experience to provide a comprehensive look at the key drivers and barriers associated with three key trends:
- Provider consolidation and site-of-care shifts
- The advent of oral oncolytics
- Payer management and clinical pathway experimentation
One of the most important trends impacting the oncology market is the increasing shift in cancer drug spending to hospitals, many of which have access to 340B pricing that limits the cost of drugs to eligible institutions. For pharmaceutical marketers, hospitals represent a very different sales channel in terms of the system structure, stakeholder incentives, and selling messages. Drugmakers will need to look for ways to mitigate site-of-care shifts by addressing the financial concerns of community oncologists.
Another important trend is the increased use of oral oncolytics in cancer treatment, which confers different advantages and disadvantages to patients, providers, and payers. As a result, drugmakers will need to optimize their investment in patient assistance programs, help physicians maintain their economic viability, and consider payer contracting strategies to defend or improve access.
Payers are looking for game changers to save them a meaningful amount of money. This has led them to look into payment reform and the use of clinical pathways to restrict choice, the third trend examined in the inVentiv Consulting study. In light of these moves by payers, drugmakers must ensure their target product profile does not inadvertently lead to a label that incurs highly restrictive payer management, and they must develop a compelling economic value proposition to ensure pathway inclusion.
Download a white paper summarizing the survey results.