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Cancer Immunotherapy: Update Bulletin [December 2015]

Product Code:
Publication Date:
December 2015

Gain new payer insights on the latest events with the potential to shape the cancer immunotherapy market. Topics covered include recent drug approvals, such as the combination of Bristol-Myers Squibb’s Opdivo and Yervoy for the treatment of BRAF V600 wild-type unresectable or metastatic melanoma, as well as the expanded approval of Merck & Co.'s Keytruda for non-small cell lung cancer (NSCLC), and Opdivo monotherapy for previously untreated BRAF wild-type unresectable or metastatic melanoma. Payer insights were also sought on the need for PD-L1 testing for reimbursement decisions and on cost management strategies as checkpoint inhibitors acquire broader indications. 

Key Questions Answered in this Update Bulletin:

  • Given the high price tag, how widely do US payers expect to cover the recently approved combination of Opdivo and Yervoy for BRAF V600 wild-type unresectable or metastatic melanoma?
  • How will reimbursement decisions change, if the combination of Opdivo and Yervoy gains extended approval for NSCLC?
  • What factors will be considered in reimbursement decisions for the combination of Opdivo plus Yervoy?
  • Opdivo monotherapy recently gained extended approval for BRAF V600 wild-type unresectable or metastatic melanoma. What methods will payers employ to choose between this and the high cost combination of Yervoy plus Opdivo?
  • Will PD-L1 testing be required before allowing access to the combination of Yervoy plus Opdivo or Opdivo monotherapy?
  • What are payers’ reactions to the expanded approval of Keytruda to include NSCLC and how widely will it be covered?
  • How will payers choose between Keytruda and Opdivo for the treatment of NSCLC, given that both drugs are now available for the same indication and PD-L1 testing is required by label for Keytruda but not for Opdivo?
  • How important is continued ongoing verification of data for providing access to cancer immunotherapies?
  • How will companion diagnostic tests impact pricing and reimbursement decisions for cancer immunotherapy drugs?
  • What are payers’ views on contracting cancer immunotherapies through preferred therapy rebates?
  • What long-term cost management strategies do payers envisage for cancer immunotherapies?
  • What data are likely to reduce payers’ aversion to risk-sharing contracts for cancer immunotherapies?

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.


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