Overall Uptake and High
Prescribing Rate in Retreatment for Gilead's Harvoni Solidify Its Stronghold on
the Hepatitis C Market
BURLINGTON, Mass., June
29, 2016 /PRNewswire/ -- Decision Resources Group finds that despite increasing
pressure from competitors, specifically AbbVie's Viekira Pak and Merck's
Zepatier, Gilead's hepatitis C virus (HCV) franchise continues to dominate the
market across all major genotypes in the United States. In addition to
capturing the lion's share of the market across key genotypes, surveyed
physicians report high prescribing rates of Gilead brands, mainly Harvoni, in
difficult-to-treat populations and among patients with negative prognostic
factors and comorbid conditions, including prior treatment failure, compensated
and decompensated cirrhosis, post-liver transplant, and patients coinfected
with HIV. While only a minority of patients fail treatment with current
interferon-free options (1-7 percent of patients, depending on regimen),
specialists note a strong preference for Harvoni in retreatment scenarios, even
when asked to consider hypothetical cases of Harvoni treatment failure.
Other key findings from
the U.S. Current Treatment report entitled Hepatitis C Virus:
--
Compared to 2015 reporting, surveyed physicians indicate an uptick in
treatment rates for HCV, notably in
treatment-naive non-cirrhotic
patients, where approximately half of
the patients under care have
undergone treatment in the past six
months, suggesting improved access
to
premium-priced direct-acting antivirals (DAAs).
--
Given the aggressive pricing of Zepatier, despite the deep discounts for
public payers, it is no surprise that
surveyed physicians report limited
prescribing of the brand, likely
reflective of ongoing pricing and
reimbursement negotiations during the
study period and its recent launch
in early 2016. However, physician preference for this agent
in patients
with renal impairment indicates a
segment where Zepatier will gain
traction.
--
While the combination of Sovaldi with Bristol-Meyer Squibb's Daklinza is
currently in a head-to-head competition
with the Sovaldi + ribavirin
regimen for the genotype 3 market, with
each regimen capturing nearly
one-third of the patient share for
non-cirrhotic patients, Sovaldi +
Daklinza is favored by specialists for
the treatment of cirrhotic,
genotype 3 patients.
--
According to survey results, Viekira Pak stands to lose patient share in
the near-term; a notable share of
physicians expect to decrease
prescribing of Viekira Pak in the next
six months. Physicians point to
pill burden and other factors
constraining the uptake of the brand.
Comments from Decision
Resources Group Business Insights Analyst, James Heeres, Ph.D.:
--
"DAA-experienced patients represent a growing unmet need; even
though
treatment failure is not common for
interferon-free regimens, the
importance of this subpopulation is
illuminated by the fact that several
next-generation DAA combinations are
targeting this patient segment.
Generally, the physicians' preferred
treatment strategy for
DAA-experienced patients is to switch
treatment. One notable exception
is that surveyed physicians prefer to
retreat patients with Harvoni,
highlighting the agent's deeply-rooted
market position that is likely to
constrain the uptake potential of
emerging therapies."
--
"The findings indicating high treatment rates among the
treatment-naive
non-cirrhotic population are noteworthy,
given that payer-imposed
treatment restrictions have historically
impacted the access of patients
with less severe liver disease to novel
therapies. Our data are
consistent with recent improvements in
access, including the relaxation
of liver fibrosis restrictions in
commercial and governmental insurance
plans."
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