Current expert thinking on how real-world evidence can refine orphan drug research, demonstrate stakeholder value and prove clinical effectiveness.
Alarmed at the number of often highly-priced orphan drugs coming to market, regulators, HTAs and payers are demanding a higher level of evidence for clinical utility and value. With limited clinical research data available, companies are increasingly looking to persuasive real-world evidence (RWE) to bolster their product propositions. But what RWE do stakeholders want? At what stage in a products lifecycle is RWE critical, and why? How do patient groups play into RWE generation? How can RWE be used to support physicians/HCPs in making treatment decisions?
In Orphan Drugs: The Importance of Real-World Evidence experienced executives from leading orphan drug players such as Takeda, Janssen, and Zelluna Immunotherapy assess the current RWE trends in the rare disease sector and identify the stakeholder, clinical research and technological factors that are driving regulatory approval, positive HTA assessment, physician uptake and patient satisfaction.
Orphan drug experts tackle key RWE questions:
What our experts say…
"In today's environment, having an approved drug doesn't mean you're going to get access for those drugs. There's a lot of payer as well as physician scrutiny coming down on rare diseases, especially when it comes to pricing and their value profile. Any company that wants to position its rare disease portfolio successfully needs to understand the value components that drive these stakeholder needs, and real-world evidence is the key to that. Real-world evidence helps you understand what is happening with the patients, how the patients are connecting to the physicians and given the strength of the databases these days, it gives you a very positive and powerful picture in terms of the payer positioning and how you would be able to address market access and health technology assessment considerations."
Usman Iqbal, Chief Medical Officer
"In my experience if you engage with payers, they will provide guidance. Unfortunately, some of them are stuck in very rigid technology evaluation processes, which are not necessarily adapted very well to orphan drugs, particularly at the rarer end of the spectrum, but they will engage. I think engaging with payers about what will be appropriate, particularly longer-term real-world evidence measures that will support the value of a product, and when would you be expected to supply them and so on, is feasible. Payers are generally not unrealistic about these things and about the industry. The payers are being clearer. It can't be a nice place to be the payers who are being seen to deny patients access to the use of 'wonder drugs'. But these things always work better if people try to work in concert, rather than being confrontational."
Damian Marron, Non-Executive Director and Corporate Advisor
"You should start looking at those data when you think about starting the development of a new drug. So, if you do a Phase I study, you should ideally have looked at what is out there. For example, in terms of our registries, which describe the natural history of disease, the epidemiology, and potentially treatment patterns. Ideally, I'd say you do this in Phase I. In Phase II you start collecting safety data, but also you would start looking at efficacy and make sure you recruit the right patient profiles, so ideally, you do it in Phase I when you prepare for Phase II."
Head of Market Access and External Affairs, Rare Diseases Division of Top 30 Pharma Company, Europe
"What I think is being required more and more is comparative real-world efficacy data between competitive treatment decisions. It's not a direct head-to-head, but it's a bit like head-to-head but done in a real-world context. For many diseases there are multiple treatment options possible and there are registries for those, so you can compare. Of course, the patient characteristics between those groups are not always fully identical, but it gives an idea of efficacy, length of treatment, discontinuation, those kinds of things. Quality of life is more difficult to look at, but those are comparable, and I hear more and more that payers want to see those kinds of data. And then there's also the difference between patients on treatment or without treatment, or the difference between a monotherapy and a combination therapy; that's also something that they payers like to see."
Global Marketing Director, Janssen, Europe
What to expect
Expert payer contributors
This report harnesses the critical insights of senior pharma executives directly engaged in the collection and interpretation of RWE for orphan drugs. In some cases, their identities have been kept anonymous to ensure free and frank expression of views.
Why buy now?
FirstWord ExpertViews reports reveal the real world insights of knowledgeable experts to analyse in detail key commercial and market trends that pharma management need to understand if they are to effectively respond to critical developments. These highly-focused reports:
All Contents Copyright © 2021 Doctor's Guide Publishing Limited All Rights Reserved