 Physician & Payer Forum --
March 2008
 In This Issue...
Patients with low levels of high-density lipoprotein (HDL)
cholesterol are at elevated risk for cardiovascular disease, even if their
levels of LDL cholesterol are well controlled. An estimated 50% of
cardiovascular events occur in patients with low HDL, an under-treated disorder
that afflicts nearly 30 million individuals in the United States. In 2007, agents that target low HDL achieved less than $800 million
in sales in the United States, compared with close to $8 billion achieved by agents targeting high
LDL.
Decision Resources’ Physician and Payer Forum report,
"Are Payers and Physicians
Ready for a Paradigm Shift in Preventive Cardiology? An Assessment of Current
and Future Use of HDL-Targeting Therapies" explores what impact new
HDL-raising agents will have on this market. We surveyed. 73 U.S. cardiologists, 73 PCPs, and 21 MCO pharmacy
directors and compared their responses to assess similarities and differences.
This survey enabled Decision Resources to achieve the following:
- Understand variations in HDL screening practices, by
patient age, risk factor, and clinician specialty.
- Understand clinicians’ attitudes toward treating low HDL:
How do clinicians rank the importance of low HDL against other lipid
abnormalities? At what threshold do clinicians consider treatment is
necessary?
- Understand how torcetrapib data have impacted HDL-related
prescribing and attitudes towards emerging
HDL-raising therapies.
- Analyze how PCPs and cardiologists use available drug classes, including statins, to treat HDL.
How will this change during 2008? Do clinicians consider that statins have
differential efficacy in relation to HDL? How do they rank them?
- Determine how clinicians perceive the relative efficacy
and tolerability of available HDL-raising classes. To what extent does
flushing limit use of Niaspan and other niacin
derivatives? What would be the impact on prescribing of eliminating
certain drawbacks of current brands?
- Uncover alignments and misalignments in the attitudes and
behaviors of clinicians versus MCO pharmacy
directors in factors that will influence the uptake of HDL-raising therapies. What is the magnitude of
impact on HDL that would make PCPs and cardiologists prescribe a novel
agent? That would make pharmacy directors reimburse a novel agent?
- Analyze the current formulary tier assignments of HDL-raising
agents and other treatments for dyslipidemia based
on plan type (including Medicare PDP and private
plans), and review the level of copayments associated with each tier and
the cost controls imposed by agent and plan type.
- Understand the factors influencing formulary inclusion,
and analyze the future tier assignments of emerging agents fulfilling a
range of profiles.
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