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EXECUTIVE SUMMARY Scope Datamonitor insight into the breast cancer market Contrary to popular demand, the reimbursement of breast cancer treatments is not guaranteed. In recognition, companies must increase their investment in pharmacoeconomic studies and patient assistant programs, and intensify links with advocacy groups. As innovative breast cancer therapies, such as Herceptin, emerge, launch strategies will become an increasingly important component of reimbursement approval and price protection. Utilizing patient advocacy in breast cancer, as a disease of high patient numbers and unmet need, is an effective way to defend price premiums set at launch. Lifecycle-extension and price protection strategies are essential, and becoming increasingly complex. In the breast cancer market, where development is often costly and slow, success accompanies adept patent protection strategy. Taxanes are entering a new era. Healthcare payors will, at last, pay less for taxane therapy, and prescribe it for breast cancer patients more often. TABLE OF CONTENTS BREAST CANCER: AN OVERVIEW Cancer etiology Anatomy, genetics, and patterns of progression in breast cancer Anatomy of the breast Genetics of breast cancer The progression of breast cancer Prognostic factors in breast cancer Less common forms of breast cancer Diagnosis of breast cancer Epidemiology of breast cancer Standard treatment options Surgery Radiation therapy Systemic therapies Current clinical practices Treatment option overview by stage Overview of drug therapy options REIMBURSEMENT AND PRICING SYSTEMS: CONTROLLING COST THROUGH AND ARBITRARY PHARMACOECONOMICS-BASED PRICE CONTROLS Pharmacoeconomics: a tool towards, or barrier preventing reimbursement? The adoption of pharmacoeconomics: a historical perspective Industry perspective: why employ pharmacoeconomic evaluations? Reimbursement, pricing and pharmacoeconomics in major markets: setting the framework for pharmaceutical strategies France: retail versus hospital sales Germany: in patient versus outpatient care Italy: capping reimbursement of brands with generic alternatives Spain: stringent pricing control? The UK: NICE and the NHS Japan: cutting prices The US: insufficiencies, argument and reform COST COMPARISONS OF COMMON TREATMENT REGIMES Common treatment regimes: comparing cost per mg Regime 1: doxorubicin and cyclophosphamide (AC) Regime 2: cyclophosphamide, methotrexate and flurouracil (CMF) Regime 3: fluorouracil (5-FU), doxorubicin (Adriamycin) and cyclophosphamide (FAC) Common treatment regimes: comparing cost per regime/cycle Conclusions and recommendations CASE SCENARIOS: PRICING STRATEGIES FOR OLD, AGING AND NOVEL THERAPIES Tamoxifen: 'partnering' to prevent genericization The cost of tamoxifen: an inter-country analysis Taxanes: on the brink of decline? Taxol: maximizing return on investment or money for nothing? Patenting the unpatentable: methods to prolong market exclusivity Holding back the generics: orphan drug status Taxotere: also expensive, but twice as potent Comparative cost of taxanes: a country perspective Herceptin: pricing and patient advocacy COST LISTINGS Cost listings in France Cost listings in Germany Cost listings in Italy Cost listings in Japan Cost listings in Spain Cost listings in the UK Cost listings in the US APPENDIX Lists of tables and figures Table of tables Table of Figures Supplementary data Research methodology: pricing data Introduction Source prices Ex-manufacturer, wholesaler and retail prices Data validation and margin calculation Quality control Sources for OncoVision Oncovision references References Websites How to contact experts in your industry Contacts