PBI8 UNKNOWN

Abstract

As price pressure increases in crowded therapy areas, particularly with the increase in development of biosimilars, healthcare systems are becoming increasingly reliant on the introduction of generics to reduce spending. In this research, we test if physician price awareness and sensitivity for comparable treatments is sufficient to drive cost reductions alone, or if payer-led controls and guidelines must be implemented to effect this change. Quantitative surveys with conjoint analysis were performed using a sample of 256 EU5 physicians. A patient conjoint is a powerful statistical technique to probe the value physicians place on drug features in prescribing decisions. Physicians were instructed to allocate patients to treatment scenarios based on a number of coverage and economic attributes. Analysis was then performed to probe how changing the price of a new oral treatment impacted preference share relative to more established intravenous and subcutaneous biologic therapies. Self-assessed ratings of price awareness and “interest” (impact of price on prescribing decisions) were comparatively analysed with the conjoint price sensitivity output to identify potential correlations. Through the conjoint exercise, physicians exhibited little price sensitivity, irrespective of how they rated their own price awareness. Significant reductions in the price of the oral drug was not associated with similarly significant increases in preference share. Even when discounted to biosimilars, preference was not shifted away from the established biologics, and most movement in share was within classes rather than between classes. There was very poor correlation between self-assessed price “interest” and analytically derived price sensitivity. Despite concern over the cost of treatment, physicians show limited awareness and sensitivity to the actual cost associated with treatment. For the potential saving of biosimilars and lower cost alternatives to be realised, relying on physicians’ price sensitivity will not be sufficient, and strict payer management will also be necessary to drive this change.