Cost greatest barrier to Avastin use, research reveals

The cost of Roche/Chugai’s Avastin, followed by concerns about its efficacy and side-effect profile, are the most common factors preventing oncologists’ use of the drug for non-small-cell lung cancer treatment.

These were the factors most frequently cited by 224 oncologists surveyed in Germany, France, Italy, Spain and the UK, as part of research conducted by Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues.

The new Special European Physician & Payer Forum report entitled Targeted Therapies for NSCLC: How High are the Barriers to Displacing Avastin in Europe? finds that Avastin is used more often for non-small-cell lung cancer in the first and second line in France and Germany than in Italy and Spain. The drug is not recommended for use within the UK’s NHS.

However, over the next 12 months, surveyed oncologists in Italy and Spain expect to increase first-line use of targeted agents such as Avastin, OSI Pharmaceuticals/Roche/Chugai’s Tarceva and AstraZeneca’s Iressa. According to the report, Tarceva is the second-most commonly prescribed targeted therapy in the first line after Avastin.

While Avastin, Tarceva and Iressa have shown modest efficacy in select patient populations, other agents in late-stage development have struggled to reach the non-small-cell lung cancer drug market. Three targeted therapies – Bristol-Myers Squibb/Eli Lilly/Merck KGaA’s Erbitux, AstraZeneca’s Zactima and Pfizer’s figitumumab – experienced recent setbacks in ongoing Phase III clinical trials or in receiving approval from the European Medicines Agency.

“The landscape for non-small-cell lung cancer will shift over the next several years as oncologists and payers grapple with the role of maintenance/consolidation therapy, increasing uptake of targeted therapies in the first-line setting and with the potential launch of new biologic agents,” said Decision Resources Director Madhuri Borde.