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Relevance of Physician Segmentation by Clinical Practice: Metastatic Colorectal Cancer (mCRC)

MDOutlook® are pleased to share excerpts from a recent MDOutlook’s OncoPulse™: Understanding Patient Pathways for mCRC in Europe. This analysis is based on an on-line survey of European oncologists managing (metastatic) Colorectal Cancer.

OncoPulse Methodology

  • Primary research phase involved European surveys to verified and validated medical oncologists with an identified involvement in mCRC utilizing targeting parameters within the proprietary MDOutlook® global cancer treater panel of 96,000+ oncologists
  • Fielded: late 2015 in 5 major European markets, translated into local languages
  • Research via 25-minute interactive web-based survey instruments, utilizing proven MDOutlook methodology and proprietary technology
  • Response: 125 oncologists with a minimum of 5 mCRC treated within the previous 3 months

Commercialization Considerations: Relevance of Physician Segmentation by Clinical Practice

Reporting and analyzing physicians’ prescribing habits and preferences by line of therapy provides insight into preferred therapies and relevant adoption trends. Yet, taking the analysis to the next level can yield a deeper understanding of the market: segmenting the respondents by clinical practice characteristics in addition to certain demographics offers previously unseen insights.

MDOutlook analysts performed a segmentation study of the treatment of mCRC cancer in the EU5. As one expects, there are differences by country in total use of doublets* in 1st line (*Doublet = FOLFOX or FOLFIRI). Diving a layer deeper, for instance, yields insight that patient volume (high vs. low volume) materially impacts prescribing of different doublets and combinations. Finally, adding practice setting (academic vs. community) as a third criteria yields targeting insights around the specific combination physicians prefer by setting (e.g. academic high volume mCRC treaters).

The key takeaway is that a deeper dive analysis across multiple regions and different identifiable characteristics of prescribers and their practices will lead to more targeted insights around behavior. Thus ultimately leading to more relevant commercialization and communication strategies and tactics.

1st Line Doublet mCRC Patient Share


  • Following on from Head to Head data comparing bevacizumab with EGFR therapy, despite only being eligible for use in around 50% of first line patients, EGFR use is close to or exceeding bevacizumab in the treatment of first line patients in the majority of European countries
  • Large majority of the mCRC patients (~65-90%) in EU5 countries receive doublet in 1st line therapy in combination with a targeted antibody, but understanding how physicians use it differently is critical
  • German physicians use the most doublet overall (87%), but the least doublet alone (5%)
  • Over 20% of 1st line mCRC patients in UK received no targeted antibody – more than twice the rate seen in other countries

Comparison 1st Line Doublet Spain UK


  • In Spain, the distribution of doublet usage (alone or with a biologic agent) in patients between the high and low volume treaters do not show a clinically meaningful difference
  • In the UK, however, the high volume treaters strongly prefer doublet + bevacizumab for their patients while the low volume treaters soundly favor doublet alone for their mCRC patients in 1st line therapy
  • The UK situation appears to reflect the relative complexity of gaining reimbursement for bevacizumab compared to the limited indication that is approved by NICE

Comparison 1st Line Doublet Setting DLD


  • In Germany, a meaningfully higher proportion of mCRC patients in 1st line receive doublet with a biologic in academic high vs academic low treaters
  • However, with the community physicians, the proportion of patients receiving doublet with a biologic agent is not significantly different between the high and low treaters

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Submitted by Dr. Robert Stephan, Vice President, Research and Physician Society, and Jan Heybroek, President of MDOutlook. All Rights Reserved ©2016.