Cancer Immunotherapy: Payer Insight
Immunotherapies are some of the most promising new weapons in the fight against cancer. But are they promising enough to justify their sky-high prices? Payers aren’t convinced, and say they need better data to make effective market access and reimbursement decisions.
FirstWord’s Payer Insight: Cancer Immunotherapy report explains why. This 111-page report gives you an in-depth account of how 12 leading payers in the US and Europe see the cancer immunotherapy landscape.
You’ll discover payers’ top concerns, find out how they assess the value of new cancer immunotherapy drugs, and get their candid thoughts on pricing, reimbursement, market access, and what they expect from pharma companies.
The report also includes analyses of 4 leading approved immunotherapies, and 10 pipeline drugs currently in clinical trials.
View: US Payers, EU Payers, Approved drugs, Pipeline drugs
“The financial burden of the prices of these drugs is putting a very high strain on the overall budget for CMS and managed care.” - US Payer
Order the report and you’ll also receive three quarterly FirstWord Therapy Trends Update Bulletins absolutely free!
Answering key questions:
Get answers to key questions about approved and pipeline immunotherapies
US Payers
Get Payer Insights Into
Approved Cancer Immunotherapy Drugs
At FirstWord, we stand behind our reports. If you're not completely satisfied, we’ll refund your money. Guaranteed.
Update Bulleton Offers Ongoing Benefits
The world of pharma is ever changing and executives must always be up-to-date with new developments that could affect their own products, position and research. That is why FirstWord’s guarantee to keep Therapy Trends clients up to date with Update Bulletins offers a real commercial advantage.
Update Bulletins include expert insight and analysis based on FirstWord analyst re-engagement with the KOLs after major events such as product approvals, key data releases and major conferences to deliver the most valuable insights with each update.
Your Therapy Trends Report purchase entitles you to receive three Update Bulletins, which are published approximately every three months for 12 months following the report's publication date, October.
You will receive a copy of each Update Bulletin once available, which are issued each quarter after the publication date.
FirstWord’s Payer Insight: Cancer Immunotherapy report explains why. This 111-page report gives you an in-depth account of how 12 leading payers in the US and Europe see the cancer immunotherapy landscape.
You’ll discover payers’ top concerns, find out how they assess the value of new cancer immunotherapy drugs, and get their candid thoughts on pricing, reimbursement, market access, and what they expect from pharma companies.
The report also includes analyses of 4 leading approved immunotherapies, and 10 pipeline drugs currently in clinical trials.
View: US Payers, EU Payers, Approved drugs, Pipeline drugs
“The financial burden of the prices of these drugs is putting a very high strain on the overall budget for CMS and managed care.” - US Payer
Order the report and you’ll also receive three quarterly FirstWord Therapy Trends Update Bulletins absolutely free!
Answering key questions:
Get answers to key questions about approved and pipeline immunotherapies
- Checkpoint Inhibitors: how will competition affect pricing negotiations as late-stage pipeline checkpoint inhibitors come on the market?
- Cancer Vaccines: how will new market entrants escape the shadow of Provenge—a costly early cancer vaccine that overpromised and underdelivered, leaving payers feeling sceptical?
- CD19-targeted CAR-T Treatments: with only preliminary data available, how will payers evaluate these new treatments?
- Combination therapies: how will changes to policy and legislation help payers accommodate complex and extremely costly combination therapies?
- Rising Costs: though promising, cancer immunotherapies are set to increase the already high cost of oncology drugs. Find out how higher costs are straining healthcare systems and challenging payers.
- Restricted Access: high costs are prompting payers in both the US and EU to restrict access to immunotherapies. Find out why payers expect better data and screening techniques to help identify candidates for immunotherapy treatment.
- Effect of Health Reforms: in the EU, healthcare reforms are having a big impact on pricing, reimbursement and market access for expensive treatments. In the US “Obamacare” is expected to have a similar effect. Learn how these reforms affect payer decision-making for cancer immunotherapies.
- Pricing Problems: pharma companies are setting prices for cancer immunotherapies without giving payers the clinical data they need for cost-benefit analyses. Find out how this affects long-term budgeting, and how payers are responding.
- Risk Sharing Too Complex: without the clinical data they need to properly assess risk-sharing, payers are considering other types of agreements for cancer immunotherapies. Find out what those are and how they affect the way new drugs are brought to market.
- Payers Demand Data: payers expect pharma companies to justify the high prices they charge for cancer immunotherapy drugs. That means providing more and better clinical data to help payers make reimbursement and access decisions. Find out what kind of data payers want and why.
- Costs for cancer treatments are rising, and will continue to rise as regulators approve more immunotherapies. Governments are bearing a larger share of these costs.
- Payers use a variety of data to evaluate new drugs and make reimbursement and access decisions. The lack of real-world data about the clinical benefits of cancer immunotherapies is a growing challenge.
- Recent healthcare reforms (e.g., the US’s Obamacare, the UK’s EAMS and Cancer Drugs Fund, Germany’s AMNOG law, France’s law of formal HAS assessment) are having a significant impact on reimbursement and access decisions for cancer immunotherapies.
- Payers believe that pharma companies do not properly appreciate their budget limitations. Reducing the costs of immunotherapy drugs is a top priority.
- Bottom line: to justify the high cost of cancer immunotherapies, pharma companies must give payers more and better clinical data. Payers see increasing competition in the immunotherapy space as an opportunity to demand it.
US Payers
- Medical Director; Policy, Formulary Management, Managed Care Organisation
- Chief Medical Officer and Chair of the P&T (Pharmacy and Therapeutics) in charge of Medical and Quality; Managed Care Organisation
- Pharmacy Director; Community Health Plan
- National Managing Senior Medical Director; Managed Care Organisation
- Medical Director; Managed Care Organisation
- Director of Clinical Pharmacy Services; Pharmacy Benefit Manager
- Leading Health Economist (France)
- Medical Director; Association of Statutory Health Insurance Physicians (Germany)
- G-BA member (Germany)
- Chief Pharmacist; Specialist Oncology Hospital (UK)
- Formulary Pharmacist; large teaching hospital focused on oncology (UK)
- Transparency Committee Member (France)
Get Payer Insights Into
Approved Cancer Immunotherapy Drugs
- Keytruda (pembrolizumab; Merck & Co.)
- Opdivo (nivolumab; Bristol-Myers Squibb)
- Provenge (Sipuleucel-T; Dendreon, now acquired by Valeant)
- Yervoy (ipilimumab; Bristol-Myers Squibb)
- Cancer Immunotherapy Pipeline Drugs
- MEDI4736 (durvalumab; AstraZeneca [MedImmune])
- MPDL3280A/RG7446 (atezolizumab; Roche, Genentech)
- CP-675/CP-675,206 (tremelimumab, AstraZeneca)
- T-VEC (talimogene laherparepvec; Amgen [BioVex])
- PROSTVAC (rilimogene galvacirepvec-rilimogene glafolivec; Bavarian Nordic, Bristol-Myers Squibb)
- Tisagenlecleucel-T (anti-CD19-CAR transduced T cells; Novartis)
- KTE C19 (anti-CD19 chimeric antigen receptor transduced T cells; Kite)
- JCAR 014 (anti-CD19/4-1BB/zeta modified CAR CD8+ central memory and CD4+ T lymphocyte therapy; Juno Therapeutics)
- JCAR 017 (anti-CD19-EGFRt-4-1BB-zeta modified CAR CD8+ and CD4+ T lymphocyte therapy; Juno Therapeutics)
- JTCR 016 (WT1-sensitised allogeneic T-lymphocytes; Juno Therapeutics)
At FirstWord, we stand behind our reports. If you're not completely satisfied, we’ll refund your money. Guaranteed.
Update Bulleton Offers Ongoing Benefits
The world of pharma is ever changing and executives must always be up-to-date with new developments that could affect their own products, position and research. That is why FirstWord’s guarantee to keep Therapy Trends clients up to date with Update Bulletins offers a real commercial advantage.
Update Bulletins include expert insight and analysis based on FirstWord analyst re-engagement with the KOLs after major events such as product approvals, key data releases and major conferences to deliver the most valuable insights with each update.
Your Therapy Trends Report purchase entitles you to receive three Update Bulletins, which are published approximately every three months for 12 months following the report's publication date, October.
You will receive a copy of each Update Bulletin once available, which are issued each quarter after the publication date.
1. EXECUTIVE SUMMARY
2. RESEARCH OBJECTIVES
3. RESEARCH FOCUS
4. CANCER IMMUNOTHERAPY MARKET OVERVIEW
4.1. Financial burden of cancer
4.2. Targeting the immune system to develop cancer treatments
4.3. Approved cancer immunotherapy drugs
4.4. Opdivo (nivolumab; Bristol-Myers Squibb)
4.5. Keytruda (pembrolizumab; Merck & Co.)
4.6. Yervoy (ipilimumab; Bristol-Myers Squibb)
4.7. Provenge (Sipuleucel-T; Dendreon, now acquired by Valeant)
4.8. Pipeline Cancer immunotherapy drugs
4.9. Checkpoint inhibitors
4.10. Cancer vaccines
4.12. CD19-targeted CAR-T treatments
5. PRICING, REIMBURSEMENT (PR) AND MARKET ACCESS (MA)
5.1. Current processes of reviewing new drugs
5.2. Process of drug review in the US
5.3. Process of drug review in the EU
5.4. Key influences over reimbursement decision making
5.5. Key data for PR and MA decision making
5.6. Current scenarios for managing PR and MA
5.7. Current ways of providing access to drugs in the US
5.8. Current ways of providing access to drugs in the EU
6. PERSPECTIVES ON FUTURE DRUG LAUNCHES
6.1. How do payers assess the value of new drugs?
6.2. Payer awareness and key concerns about new drugs
6.3. Checkpoint inhibitors
6.4. Cancer vaccines
6.5. CD19 targeted CAR-T treatments
7. PERSPECTIVES ON PRICING, REIMBURSEMENT AND MARKET ACCESS
7.1. for future drugs
7.2. Impact of healthcare reforms in shaping PR and MA strategies
7.3. Impact of Obamacare
7.4. Future of the CDF and impact of EAMS
7.5. Impact of AMNOG law and sickness fund
7.6. Impact of formal health assessment in France
7.7. Payers’ sentiments and challenges in making reimbursement and access decisions
7.8. Pharma’s insensitivity to pricing excess and payer’s difficulty
7.9. planning long-term budgets
7.10. Cancer immunotherapies as first line therapy will not reduce costs in the longer term
7.11. Challenges in PR and MA decisions for cancer immunotherapy drugs
7.12. Future strategies for controlling reimbursement & access to new drugs
7.13. Payers’ perspective on the future of cancer immunotherapy drugs market
7.14. Payer opinions on outcome-based risk sharing contracts
7.15. Discounting and rebating expectation
7.16. What payers will, and will not, pay for
7.17. Past mistakes, lessons learned and advice for pharmaceutical companies
7.18. Past mistakes and lessons learned
8. ADVICE TO PHARMACEUTICAL COMPANIES
8.1. Appendix
8.2. Payers interviewed for this report
8.3. US payers
8.4. EU payers
8.5. Cancer Immunotherapy Drugs: Key Clinical Trials
8.6. Opdivo
8.7. Keytruda
8.8. Yervoy
8.9. Atezolizumab
8.10. Durvalumab
8.11. T-VEC
8.12. CD19-targeted CAR-T treatments
8.13. Cancer Immunotherapy Combinations
8.14. Abbreviations
8.15. Glossary
2. RESEARCH OBJECTIVES
3. RESEARCH FOCUS
4. CANCER IMMUNOTHERAPY MARKET OVERVIEW
4.1. Financial burden of cancer
4.2. Targeting the immune system to develop cancer treatments
4.3. Approved cancer immunotherapy drugs
4.4. Opdivo (nivolumab; Bristol-Myers Squibb)
4.5. Keytruda (pembrolizumab; Merck & Co.)
4.6. Yervoy (ipilimumab; Bristol-Myers Squibb)
4.7. Provenge (Sipuleucel-T; Dendreon, now acquired by Valeant)
4.8. Pipeline Cancer immunotherapy drugs
4.9. Checkpoint inhibitors
4.10. Cancer vaccines
4.12. CD19-targeted CAR-T treatments
5. PRICING, REIMBURSEMENT (PR) AND MARKET ACCESS (MA)
5.1. Current processes of reviewing new drugs
5.2. Process of drug review in the US
5.3. Process of drug review in the EU
5.4. Key influences over reimbursement decision making
5.5. Key data for PR and MA decision making
5.6. Current scenarios for managing PR and MA
5.7. Current ways of providing access to drugs in the US
5.8. Current ways of providing access to drugs in the EU
6. PERSPECTIVES ON FUTURE DRUG LAUNCHES
6.1. How do payers assess the value of new drugs?
6.2. Payer awareness and key concerns about new drugs
6.3. Checkpoint inhibitors
6.4. Cancer vaccines
6.5. CD19 targeted CAR-T treatments
7. PERSPECTIVES ON PRICING, REIMBURSEMENT AND MARKET ACCESS
7.1. for future drugs
7.2. Impact of healthcare reforms in shaping PR and MA strategies
7.3. Impact of Obamacare
7.4. Future of the CDF and impact of EAMS
7.5. Impact of AMNOG law and sickness fund
7.6. Impact of formal health assessment in France
7.7. Payers’ sentiments and challenges in making reimbursement and access decisions
7.8. Pharma’s insensitivity to pricing excess and payer’s difficulty
7.9. planning long-term budgets
7.10. Cancer immunotherapies as first line therapy will not reduce costs in the longer term
7.11. Challenges in PR and MA decisions for cancer immunotherapy drugs
7.12. Future strategies for controlling reimbursement & access to new drugs
7.13. Payers’ perspective on the future of cancer immunotherapy drugs market
7.14. Payer opinions on outcome-based risk sharing contracts
7.15. Discounting and rebating expectation
7.16. What payers will, and will not, pay for
7.17. Past mistakes, lessons learned and advice for pharmaceutical companies
7.18. Past mistakes and lessons learned
8. ADVICE TO PHARMACEUTICAL COMPANIES
8.1. Appendix
8.2. Payers interviewed for this report
8.3. US payers
8.4. EU payers
8.5. Cancer Immunotherapy Drugs: Key Clinical Trials
8.6. Opdivo
8.7. Keytruda
8.8. Yervoy
8.9. Atezolizumab
8.10. Durvalumab
8.11. T-VEC
8.12. CD19-targeted CAR-T treatments
8.13. Cancer Immunotherapy Combinations
8.14. Abbreviations
8.15. Glossary
