TNF-alpha inhibitors (e.g., Janssen’s Remicade, AbbVie’s Humira) are the mainstay of biological treatment for moderate to severe Crohn’s disease (CD), while newer biologics (i.e., Takeda’s Entyvio, a CAM inhibitor, and Janssen’s Stelara, an IL-12/23 inhibitor) are mostly used as later-line therapies, following anti-TNF failure. These agents all have safety risks and efficacy limitations, and the launch of biosimilar alternatives has only increased the complexity of CD treatment. Significant need remains, especially in the treatment of patients refractory to available therapies and patients with fistulizing disease.


  • What are the treatment drivers and goals for moderate to severe CD?
  • What drug attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals for moderate to severe CD?
  • What are the prevailing areas of unmet need and opportunity in moderate to severe CD?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European gastroenterologists for a hypothetical new moderate to severe CD drug?


Unmet Need provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 60 U.S. and 31 European gastroenterologists fielded in January 2020

Key companies: AbbVie, Galapagos NV, Gilead, Janssen, Merck & Co., Takeda, TiGenix, Boehringer Ingelheim, Allergan, Celgene, Roche

Key drugs: Humira, Remicade, Entyvio, Stelara, Cimzia, infliximab biosimilar, adalimumab biosimilar

Table of contents

  • Detailed, Expanded Analysis (US & EU)
    • Executive Summary
      • Unmet Need - Moderate to Severe CD - Executive Summary - April 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
      • Rationale for Drug Selection
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Key Findings: Stated vs. Derived Importance
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Moderate to Severe Crohn's Disease
      • Key Findings: Unmet Need in Moderate to Severe Crohn's Disease and Related Indications
    • Opportunity Analysis
      • Areas of Opportunity in the Moderate to Severe CD Market and Emerging Therapy Insights
        • Opportunity: A Novel Therapy Able to Demonstrate Improved Efficacy in Long-Term Maintenance of Remission
        • Opportunity: A Novel Agent with Greater Efficacy in Mucosal Healing
        • Opportunity: A Novel Therapy with a Lower Risk of Serious Adverse Events Compared with Approved Biologics
        • Opportunity: A Novel Oral Agent with Efficacy Comparable or Superior to That of Biologics
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
      • Attribute Importance and Part-Worth Utilities
        • Moderate to Severe CD Target Product Profile: Attribute-Level Part-Worth Utilities
      • Conjoint Analysis-Based Simulation of a Market Scenario
        • Market Scenario
    • Appendix
      • Experts Interviewed
      • Bibliography

Author(s): Ritesh Gupta, PhD

Ritesh Gupta is a Lead Analyst on the immune and inflammatory disorders team at Decision Resources Group, whose work focuses primarily on Psoriatic Arthritis, Ulcerative Colitis and Crohn’s Disease. He holds a degree in Cell Biology from Max Delbrück Center for Molecular Medicine, Berlin, where he worked on development of novel inhibitors for HGF/MET signaling pathways. Prior to joining DRG, Ritesh has worked as an assistant manager with BioXcel corporation and provided insights on various consulting projects. He was also associated with GVK Biosciences and worked on drug repurposing projects.

Related Reports

Crohn's Disease | Current Treatment | Detailed, Expanded Analysis: Treatment Algorithms: Claims Data Analysis (US) - Pediatric

Children with Crohn’s disease (CD) have a more-complicated disease course compared with adult patients. However, similar to adult

View Details

Crohn's Disease | Landscape & Forecast | Disease Landscape & Forecast

The Crohn’s disease (CD) therapy market is expected to see increasing use of biologics and grow steadily over the next decade. The well-established

View Details

Crohn's Disease | Current Treatment | Detailed, Expanded Analysis: Treatment Algorithms: Claims Data Analysis (US) - Adult

Crohn’s disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract characterized by diarrhea, abdominal pain, and weight loss. The pr...

View Details

Crohn's Disease | Current Treatment | Detailed, Expanded Analysis (EU)

Multiple well-established therapies are available to treat Crohn’s disease (CD). In particular, the most widely used biologics—the

View Details