AstraZeneca and Merck are still leading the pack when it comes to how oncologists perceive makers of cancer drugs, according to a new report from ZoomRx.

Though Merck edged out AstraZeneca by a single point in last year’s analysis, this year’s version of the annual perception report saw the British Big Pharma pull ahead.

ZoomRx polled 50 experienced oncologists and hemato-oncologists about 20 cancer drugmakers, asking the doctors to rank the top three pharmas in each of 10 attributes, grouped under five core areas: innovation, patient-centricity, reputation, HCP-centricity and promotion.

Those rankings were then used to assign each company a total score out of 100, based on a weighted average of the percentage of doctors who placed a given company in the top three in each area.

In the overall ratings, AstraZeneca scored a 43, thanks to pack-leading performance in the areas of innovation, patient-centricity and HCP-centricity, where an average 44%, 49% and 42% of doctors, respectively, put it in the top three. Merck was close behind, with a total score of 39, as it took the lead in the remaining two categories: reputation and promotion, where it made the top three for a respective 51% and 33% of oncologists.

Rounding out the top five were Bristol Myers Squibb, Pfizer and Roche, with overall scores of 32, 24 and 21.

The doctors surveyed rated innovation as the most important area by far for makers of cancer drugs, followed by patient-centricity and brand reputation.

AstraZeneca earned the leading score in that realm, according to one respondent, “because they have broad products and they are also leader in innovation, including the targeted therapy, ADC therapy, etc.,” a nod to antibody-drug conjugates like Enhertu and Datroway, plus AZ’s broader portfolio of cancer meds, including Tagrisso, Lynparza, Calquence and Imfinzi.

Merck’s second-place slot, meanwhile, was attributed largely to Keytruda’s continued dominance, which upped the New Jersey pharma’s reputation and promotion scores. ZoomRx noted that Merck has some “room for improvement,” however, in patient-centricity, which can be boosted by support programs and improved access.

Though BMS, Pfizer and Roche all showed strength in at least one or two of the five areas, they fell behind AstraZeneca and Merck in all except promotion, where BMS landed squarely between the two leaders. Overall, according to the report, “HCPs prioritize innovation, patient support, and brand reputation. Declines in these areas signal missed opportunities to build trust and loyalty.”