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バイオシミラー:米国における保険者の展望

Biosimilars: US Payer Perspectives

発行 FirstWord 商品コード 328749
出版日 ページ情報 英文
納期: 即日から翌営業日
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本日の銀行送金レート: 1USD=104.18円で換算しております。
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バイオシミラー:米国における保険者の展望 Biosimilars: US Payer Perspectives
出版日: 2015年04月01日 ページ情報: 英文
概要

米国における生物製剤への支出は今後数年間で1,000億米ドルに達すると見られています。

当レポートでは、米国の生物製剤市場について、薬剤給付管理 (PBM:Pharmacy Benefit Manager) 、マネージドケア組織および統合デリバリーネットワークを含めた、多様な組織における12の保険者による詳細かつ実用的な洞察を提供しています。

主な要点

  • 計画に基づいて生物製剤治療のコスト削減に注力している保険者、会員の減少を抑制するためにはどの程度のコスト削減が望まれるか
  • 米国におけるバイオシミラー利用の最大の促進因子・阻害因子と見なされる保険者の特定、また米国において医療保険設計・保険者の活動がどのようにバイオシミラー市場を形成できるか
  • 価格戦略、教育努力、医師の関与および臨床データの提供を含め、保険者が考える米国のバイオシミラー市場における重要な成功要因とは何か
  • モダンインスリン、フィルグラスチム、エポエチンアルファ、腫瘍 mAbおよび非腫瘍 mAbを含む、5つの製品クラスの潜在的な価格、市場シェアおよびビジネスソースのベンチマーク
目次
Product Code: 596200355

Biosimilars: US Payer Perspectives pulls back the curtain on the US biologics market and provides detailed and actionable insights from 12 expert US payers from a range of different organisations, including Pharmacy Benefit Managers, Managed Care Organisations and Integrated Delivery Networks. In addition, receive an Advisory Highlights management summary which covers key findings from the report.

Spending on biologics is set to reach $100 billion in the US over the next couple of years, and biosimilars are seen as a potential safety valve that can relieve some of the pressure on a healthcare system that is creaking under the weight of declining resources, increasing demands and expensive new product launches.

Caught in the middle of this are the payers, an important stakeholder group whose voice and insight is critically important in understanding the opportunities, challenges and critical success factors that companies operating in the US biosimilars market need to know and understand.

With the US lagging behind many other developed nations in terms of making biosimilars available to its healthcare system, it's perhaps ironic that recent events have put opportunities and challenges within the US biosimilars market firmly on the pharma industry's radar. Five 351(k) submissions have now been made to the FDA, and a biosimilar has been approved - filgrastim-sndz from Sandoz, called Zarxio. Companies are partnering and acquiring assets that will allow them to maximise the opportunities, and investors in biosimilar companies have been cheered by share price surges and forecasts from some leading investment banks claiming that biosimilars in the US are on the cusp of greatness.

Biosimilars: US Payer Perspectives provides a much needed tonic to perhaps the overly optimistic sentiment that has seeped into the discussions about the US biosimilars opportunity. Critically it provides unique payer insights on some of the critical market shaping issues that are dominating discussions, including pricing, substitution, switching, indication extrapolation, naming and originator company defensive tactics.

The US market holds many opportunities for biosimilar developers, but in order to leverage these opportunities and maximise chances of success, biosimilar developers and originator companies must read this report to understand what payers really think, and how they will act in response to cheaper biologics becoming available.

Top Takeaways

  • Understand what payers are focused on in their efforts to cut the costs of biologic therapies on their plans, and how they would prefer to make savings in order to limit disruption to their members
  • Identify what payers perceive as the biggest drivers and resistors to biosimilar usage in the US, and how health plan design and payer activities could shape the biosimilars market in the US
  • Learn what payers believe are the critical success factors in the US biosimilars market, including pricing strategies, educational efforts, physician engagement and provision of clinical data
  • Benchmark potential pricing, market share and source of business across five key classes of product, including modern insulin, filgrastim, EPO-alfa, oncology mAbs and non-oncology mAbs

Get Answers to Critical Questions

  • What current strategies for cost-containment in biologic therapy are being used by payers in the US?
  • How do payers expect to manage inclusion of biosimilars on to their formularies, and what critical pieces of information will they need to see before making any decisions?
  • From the payers' perspective, what are the current levels of awareness, familiarity and acceptance of biosimilars at the payer and physician level, both personally and generally across each stakeholder group?
  • What do payers see as the key drivers and resistors of biosimilar usage in the US?
  • Do payers agree with the current US Food and Drug Administration (FDA) requirements for biosimilars, and what are their expectations for future regulatory refinements?
  • What do US payers see as the most important reimbursement challenges for biosimilars, including insights on rebating and payment models?
  • How do payers expect pricing dynamics within the US biosimilars market to evolve, and what are their expectations in relation to the pricing of originator biologics in response to biosimilar competition?
  • What are the views of US payers in relation to the key market shaping issues of switching, automatic substitution, extrapolation of indications and biosimilar naming?
  • What do US payers see as the critical success factors for the US biosimilars market, both from a biosimilar and originator biologic manufacturer perspective?
  • Request Sample Pages

Experts Interviewed

FirstWord interviewed 12 payers and also sought the opinions of a range of commercial, regulatory, legal and clinical experts to deliver contemporary, actionable and robust insight on the US biosimilars market:

  • Pharmacy Director, Health Plan Division; Pharmacy Benefit Manager
  • Chief Medical Officer & Chair of P&T Committee; Regional Health Plan
  • VP, Pharmacy Services; Managed Care Organisation
  • Executive VP, Rx Analytics; Pharmacy Benefit Manager
  • Chief Medical Officer; Integrated Delivery Network
  • VP, Formulary Management; Medicaid Plan
  • National Senior Medical Director; Managed Care Organisation
  • Pharmacy Director; Managed Care Organisation
  • Medical Director; Managed Care Organisation
  • Chief Pharmacy Officer; Pharmacy Benefit Manager
  • Pharmacy Director; Regional Health Plan
  • Pharmacy Director; Managed Care Organisation
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