Breast cancer is the most common non-skin cancer and the second leading cause of cancer-related death in women in the US. However, the incidence of breast cancer began decreasing in 2000 and has remained steady, and the overall breast cancer death rate has progressively decreased over the past two decades, a fact that is attributable to advances in prevention, early detection, and treatment.1
Source: NCI Funded Research Portfolio. http://www.cancer.gov/researchandfunding/progress/snapshots/breast
While early breast cancer is treated with any number of generics on the market, advanced breast cancer treatments include a long list of more targeted branded products with a range of administration routes, including tablets, solutions, and implants. Pfizer’s Ibrance is the newest brand to the market, gaining approval in February of this year as the first hormone-based therapy for metastatic estrogen receptor (ER)-positive, HER2-negative advanced breast cancer.
PARP inhibitors, developed to target BRCA mutations, have shown promise in clinical trials treating breast, ovarian, and prostate cancers that had spread and were resistant to other treatments. The first of these agents was approved for the treatment of BRCA-mutated advanced ovarian cancer, and as with many other novel targeted agents, the indication calls for patients to be tested with an FDA-approved BRCA mutation companion diagnostic. With a number of drugs in development falling into this new class of targeted therapies, we will be watching to see a new treatment course for metastatic tumors emerge in the coming years.
With more than ten branded treatments on the market, there is a range of different coverage and reimbursement approaches across both pharmacy and medical benefits. There is a strong correlation between the type of administration route and the type of coverage given, with tablets and injectables processing through the pharmacy benefit, and solutions and implants covered by medical policies. Furthermore, the majority of these products process through a specialty pharmacy. Companies marketing in this class or with products in the pipeline will need to be able to understand a broad view of the market across both benefit types to accurately understand their competitive position.
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1NCI Funded Research Portfolio. http://www.cancer.gov/researchandfunding/progress/snapshots/breast