Understanding Crohn's Disease Therapy Switch Patterns in Germany

Based on Real-World Evidence

Our therapy area experts and data scientists recently completed a study of Crohn’s Disease patient data from Germany to help our clients understand disease prevalence, explore which first line therapies are being prescribed, understand better how long patients are using first line therapies, and to understand the different products that are preferred at different stages of the prescribing continuum. We intend for this analysis to be used by researchers and biopharmaceutical manufacturers to help forecast assumptions for existing and projected Crohn’s Disease assets in central Europe based on German data and to understand how real-world evidence can be more broadly used as a methodology for obtaining these types of population-based insights.

Our study relied on German statutory claims data from 63 statutory insurance entities, covering 7 million lives (approximately 8.5% of the German population). The products compared in the analysis include the biological therapies used to treat Crohn’s Disease, (and other autoimmune conditions) such as Adalimumab, Certolizumab Pegol, Golimumab, Infliximab, Ustenkinumab, and Vedolizumab. Patients were selected based on ICD10 disease codes and n=2037. To perform this study, we identified and secured access to the most suitable data sources on Crohn’s Disease in Germany. Data used in this analysis is from January 2012 to June 2016 and this project was approved by German healthcare regulators.

What We Found:

  • Adalimumab is the preferred first line of biologic treatment for Crohn’s Disease in Germany (3.1% of market share), followed by Infliximab (2.0% market share).
  • Adalimumab (29.6% of market share) and Infliximab (22.4% market share) are mostly used in repeat patients (not new patients or switch patients).

Our Insights:

The TNF-alpha inhibitors, Adalimumab and Infliximab, continue to dominate the Crohn’s Disease market as the first-line biologic agents of choice. However, some patients do not respond to, or lose response to, the TNF-alpha inhibitors over time. The need for new therapies with novel mechanisms of action to treat TNF-refractory patients has likely driven the uptake of the cell adhesion molecule (CAM) inhibitor, Vedolizumab, particularly among switch patients. As the first non-TNF-alpha targeted biologic approved for Crohn’s Disease in Europe, Vedolizumab was the only available on-label alternative during the period under our study. Nevertheless, as indicated by experts interviewed by us and with the data presented here, patients whose disease is under control will not be switched to an alternative therapy. The relatively low switching rate and high repeat rate observed in our analysis, suggest that many biologic-treated Crohn’s Disease patients will remain on their first line agent.

Further Information:

For more information on our Global Real-World Evidence (GRWE) capabilities and other examples of how we unlock the transformative potential of GRWE across the clinical and commercial continuum, please visit www.decisionresourcesgroup.com/GRWE.

Contributors: Author: Dan Jacob; Vice President, Innovation & New Ventures. Study Contributors: Dr. Matthew Scutcher, Andrea Kravit, and Dr. Qinghui Yu.
Published on: 31 October, 2017