Prescribing Patterns and Perceptions of Pancreatic Enzyme Replacement Therapy among Healthcare Providers: A...

Pancreatic enzyme replacement therapy (PERT) is the central management strategy for symptomatic and confirmed exocrine pancreatic insufficiency (EPI). PERT products composed of pancrelipase (under the brand names Creon, Zenpep, Pancreaze, Viokace, Pertzye) differ in formulation-specific attributes and access/coverage considerations. Multiple factors impact healthcare providers' (HCPs) decision-making when selecting an appropriate PERT. The current study's primary objective is to assess real-world EPI management practice and HCP perceptions of PERT products in the United States.

An online survey was carried out with HCPs who had treated patients with EPI for ≥ 3 years and prescribed PERT products to ≥ 10 patients over a 12-month period. The survey collected de-identified data on HCP characteristics, prescribing patterns, and perceptions of PERT products across the domains of efficacy, convenience, and access. Descriptive statistics were calculated, and HCPs' perceptions were compared across PERT products.

A total of 250 HCPs were surveyed comprising 124 specialists, 95 generalists, and 31 advanced practice providers. HCPs managed a median of 30 patients with EPI on PERT in the 12 months preceding the survey. The most commonly prescribed PERT products were Creon (84.0%), Zenpep (60.4%), and Pancreaze (59.2%), with fewer HCPs prescribing Viokace (27.2%) and Pertzye (16.0%). Specific factors considered in prescribing decisions included improvement in abdominal and bowel symptoms (83.6%), affordability (72.4%), and formulary/insurance coverage (72.0%). A significantly higher proportion of HCPs reported favorable perceptions of Creon over other PERT products. Perceptions of formulary/insurance coverage across PERT products varied, with 8.0-56.0% of HCPs agreeing or strongly agreeing that a prescribed product had good coverage. These findings were generally consistent across different provider types.

HCPs consider multiple factors when prescribing PERT for patients with EPI. HCP perceptions varied across PERT products, and Creon was favorably perceived more often compared to the other therapeutic options. Various factors may contribute to barriers to treatment and should be addressed to improve access.