For the Treatment of Asthma, Surveyed Physicians’ Prescribing Practices of LABA/ICS Fixed-Dose Combinations (FDCs) Show that Competition is Tight Between GlaxoSmithKline’s Seretide and AstraZeneca’s Symbicort in Each EU5 Country
Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that, for the treatment of asthma, surveyed physicians’ prescribing practices of LABA/ICS fixed-dose combinations (FDCs) show that competition is tight between GlaxoSmithKline’s Seretide and AstraZeneca’s Symbicort in each EU5 country (France, Germany, Italy, Spain and the United Kingdom), with neither drug completely dominating over the other. Additionally, while pulmonologists tend to favor Symbicort as their first-line FDC, primary care physicians (PCPs) largely opt for Seretide. Chiesi Farmaceutici’s Foster has gained notable patient share in most countries, with the exception of the United Kingdom, even though it was the third LABA/ICS FDC to launch in the asthma market. According to interviewed payers in the EU5, Foster is an attractive option because it is less expensive than Seretide and Symbicort.
“By the end of 2014, by which time several more FDCs, including generic versions of Seretide and Symbicort will be available, those surveyed—especially pulmonologists—largely expect to continue prescribing their currently preferred first-line FDC, with any changes driven primarily by price,” said Decision Resources Analyst Colleen Albacker, Ph.D.
The new European Physician & Payer Forum report entitled also finds that payers in the EU5 indicate that emerging FDCs will likely be admitted for reimbursement at the national level but warn that reimbursement price will depend on the strength of the data. Payers in all countries say that demonstrating superior efficacy over current therapies in head-to-head trials is crucial for favorable reimbursement. Surveyed physicians agree, most frequently citing superior efficacy as the reason they prefer the FDC they expect to prescribe in 2014. Improved compliance, offered by the emerging first once-daily FDC Relvar (GlaxoSmithKline/Theravance) is a persuasive argument in some countries, but efficacy over the gold-standard therapy remains key overall. Of note, if priced at an 8 percent premium to Symbicort, fewer physicians envision prescribing Relvar than if it is priced the same as Symbicort.
The report also finds that each EU5 country has measures in place to strongly encourage the use of generics, and surveyed physicians predict reasonable uptake of generic FDCs upon approval. Interviewed payers report that use of separate generic LABAs and ICSs is limited in France, Italy, Spain, and the U.K., where physicians prefer to prescribe an FDC. However, surveyed physicians, particularly in France and the U.K., indicate that they would use emerging generic FDCs anytime they would currently prescribe a branded version, although many physicians also indicated that a trustworthy manufacturer and easy-to-use device were key considerations. Additionally, physicians, especially in Germany, note that they will prescribe generic FDCs to ease patients’ and their own cost burden.
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