While most interventional cardiologists are aware of the positive benefits associated with the antiplatelet agent prasugrel compared with clopidogrel, that awareness doesn't extend as widely to non-interventional cardiologists, ER physicians or pharmacy directors, according to a report published July 19 by market research firm Decision Resources.
The results are based on a survey of 57 interventional cardiologists, 52 non-interventional cardiologists, 50 emergency room physicians and 20 managed care organization (MCO) pharmacy directors, who were asked to report their attitudes toward various antiplatelet drugs including prasugrel (Effient, Daiichi Sankyo/Eli Lilly), clopidogrel (Plavix, Bristol-Myers Squibb/Sanofi-Aventis) and ticagrelor (Brilinta, AstraZeneca), among others, and rate the drugs' abilities to treat acute coronary syndrome and coronary heart disease.
While two-thirds of the interventional cardiologists surveyed said that they believe prasugrel to be the top antiplatelet drug for reducing adverse events, preferences of non-interventional cardiologists were split almost equally between clopidogrel and prasugrel.
Additionally, when clinicians were asked opinions on ticagrelor, 47 percent of interventional cardiologists, 40 percent of non-interventional cardiologists and 30 percent of ER physicians believed the drug offered a “major advance” in treating cardiac conditions.
"In the report, we have identified a lack of awareness among surveyed clinicians about the positive data shown for Effient in the TRITON-TIMI clinical trial with regard to evidence in reducing clinical events when compared to Plavix," said Conor Walsh, PhD, an analyst at the firm.
"Additionally, among managed care organizations' pharmacy directors, this lack of awareness regarding the TRITON-TIMI data was even greater than that of surveyed physicians,” said Walsh. Only 8 percent of ER physicians thought that prasugrel better reduced clinical events compared to clopidogrel.
The report found that prasugrel is excluded from 35 percent of Medicare prescription drug plans and is limited to a tier three in 60 percent of commercial health insurers. In comparison, clopidogrel is included as a tier one or two in 70 to 85 percent of the surveyed clinician’s MCO drug plans.