Conclusions Innovations in cancer therapy are costly and contribute to rising healthcare expenditures. may alleviate cost-related barriers to treatment and could increase patient access to HER2-directed therapy in all countries examined. = 200) and 11.3% (all other countries; = 75). 2.2. Survey Details The questionnaire focused on HER2+ breast cancer patients. Specific questions were related to: breast cancer disease categories; types of patient insurance; factors considered when making treatment decisions; use of treatment guidelines; use of trastuzumab; barriers to the use of trastuzumab; and the potential use of a less expensive biosimilar version of trastuzumab if it were available. Questions were answered in a variety of forms, including: yes/no; percentage; MAP2K7 5- or 7-point Likert scale; and select all that apply. In some cases, participants were offered a text box to further explain their answers. The survey was expected to take ~10 min to complete, and participants received an honorarium upon completion. The survey was administered from December, 2012, to January, 2013. 3. Results 3.1. Breast Cancer Patient Population Physicians reported that 41% (range, 36%C53%) of their patients had breast cancer, and nearly one-third (range, 25%C35%) of the cancers were characterized as HER2+ (Table 1). HER2+ breast cancer patients utilized different types of insurance coverage across markets. More than 50% of patients, particularly those in MEX, TUR and RUS, had government-funded insurance (overall = 55%, U.S. = 37%, BRZ = 34%, MEX = 69%, TUR = 93%, RUS = 74%). Twenty-two percent of patients received private medical insurance Afuresertib through their employer (U.S. = 38%, BRZ = 26%, MEX = 8%, TUR = 4%, RUS = 7%), while 18% (U.S. = 20%, BRZ = 36%, MEX = 16%, TUR = 2%, RUS = 8%) paid for their own private insurance. Patients in MEX and RUS were Afuresertib the most likely to pay for medical expenses out of pocket, compared with other markets (overall = 5%, U.S. = 5%, BRZ = 5%, MEX = 8%, TUR 1%, RUS = 11%). Table 1 Description of the breast cancer patient population. (%) of physicians) a,b. In a Neoadjuvant Setting(= 137)U.S. = 45)BRZ (= 15)MEX (= 14)TUR (= 13)RUS Afuresertib (= 50)Not included in the formulary of drugs covered by patients insurance = 41) U.S. (= 14) BRZ (= 1) MEX = 4) TUR (= 2) Afuresertib RUS (= 20) Not available in the hospital/clinic where I practice (= 39) U.S. (= 12) BRZ (= 0) MEX (= 5) TUR (= 2) RUS ((= 153)= 20)= 36)= 28)= 12)= 57)(= 223)= 58)= 40)= 47)= 17)= 61)innovator biologic for five common treatments in India estimated that the use of biosimilars would result in yearly savings of ~843 million U.S. dollars . Reditux? (Dr. Reddys Laboratories, Hyderabad, India), for example, the first intended biosimilar to the monoclonal anti-CD20 cancer agent rituximab, was launched in India in 2007 at 50% lower cost than the originator biologic (MabThera??, Hoffman-LaRoche, Basel, Switzerland). As a result, patient access to CD-20-directed therapy increased six-fold within three years of launch . Likewise, the availability of a trastuzumab biosimilar may alleviate the cost-related barriers to the access and use of HER2 antibody therapy. Many oncologists clearly understand the cost benefit of biosimilars, as a majority of those surveyed from the U.S. and the EU expect to prescribe biosimilars to common monoclonal antibody treatments within the first 12 months of their launch . In addition to HER2+ breast cancer patients, other patient populations may also benefit from the availability of a biosimilar to trastuzumab. Trastuzumab is also indicated for the treatment of HER2-overexpressing metastatic gastric or gastroesophageal junction adenocarcinoma, and its addition to chemotherapy significantly improves overall survival . In the future, these patients may also benefit from the availability of a biosimilar to trastuzumab. However, the current study does not address the use of trastuzumab or.