Incivek versus Victrelis in hepatitis C virus treatment: US physician views

Article | 10 April 2012

For the treatment of hepatitis C virus (HCV), the majority of surveyed US physicians survey by advisory company Decision Resources who prescribe the Vertex (Nasdaq: VRTX) protease inhibitor Incivek (telaprevir) more often than the protease inhibitor Victrelis (boceprevir) from Merck & Co (NYSE: MRK) and Roche (ROG: SIX) perceive Incivek as offering a short, simple treatment duration and superior efficacy.

Similarly, surveyed managed care organizations’ (MCOs) pharmacy directors indicate that Incivek’s efficacy is the key driver of formulary inclusion. Physicians’ perception for sustained virologic response (SVR) as a key driver of prescribing for Incivek may suggest that emerging therapies with a higher SVR rate are likely to take patient share from Incivek unless they fall significantly short on other attributes such as safety or convenience.

The new US Physician & Payer Forum report, titled A New Era in the Treatment of Hepatitis C Virus: What Market Access Hurdles Are US Payers Erecting and How Are Physicians Responding? also finds that more surveyed physicians report that their HCV patients request treatment with Incivek over Victrelis. Although most surveyed physicians report that their HCV patients have not requested treatment with a specific protease inhibitor, requests for Incivek are more common than requests for Victrelis among physicians whose patients request a specific protease inhibitor.

“The greater interest among patients for Incivek suggests that information on its superior efficacy and/or dosing profile is well-known to the patient community and highlights the significant interest in new and emerging therapies for HCV,” said Decision Resources analyst Seamus Levine-Wilkinson.

Incivek and Victrelis increase treatment initiation

The report also finds that the availability of Incivek and Victrelis has increased the treatment initiation rate as nearly 80% of surveyed physicians indicate that they are treating more HCV patients since the launch of Incivek and Victrelis. Additionally, the pool of drug-treated HCV patients could continue to grow with the expected launch of new interferon-free therapies.

According to surveyed MCO pharmacy directors, efficacy is the key driver of Incivek’s formulary placement. The high efficacy of Incivek-based triple therapy is the most important driver of formulary inclusion and favorable tier placement of Incivek in commercial health plans. This support for Incivek’s efficacy likely influences pharmacy directors’ decisions to reimburse Incivek on the same tier as Victrelis, despite its higher cost. Efficacy is also the most important driver of formulary placement for Victrelis. The efficacy of Victrelis-based triple therapy is the most important driver of formulary inclusion and tier placement in commercial plans, although its influence is lower than for Incivek-based therapy.

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Also See: For the Treatment of Hepatitis C Virus, the Majority of Surveyed U.S. Physicians Who Prescribe Vertex’s Incivek More Often Than Merck/Roche’s Victrelis Perceive Incivek as Offering a Short, Simple and Highly Efficacious Treatment Option