The moderate to severe atopic dermatitis (AD) market is at the beginning of a revolution with the recent approval of Sanofi/Regeneron’s first-in-class biologic, Dupixent, and a promising suite of late-phase agents advancing in the pipeline (e.g., Eli Lilly’s baricitinib, Pfizer’s abrocitinib, LEO Pharma’s tralokinumab and delgocitinib, AbbVie’s upadacitinib, Dermira’s lebrikizumab, Galderma’s nemolizumab). In this report, we assess the commercial opportunity remaining in the topical-refractory moderate to severe AD space through a comprehensive analysis of dermatologists’ treatment goals; the key efficacy, safety, and delivery attributes driving prescribing choice; the gaps in treatment left by current therapies; and the interplay of clinical and nonclinical attributes in determining the commercial potential of new AD products.


  •  What are the key treatment drivers for topical-refractory moderate to severe AD patients? How do current therapies such as Dupixent perform against these key treatment drivers and goals?
  • Where do surveyed dermatologists perceive the largest gaps in the treatment of topical-refractory moderate to severe AD patients? Which present the most compelling commercial opportunities?
  • What trade-offs among queried clinical attributes and price are acceptable to U.S. or European dermatologists when considering whether to prescribe a hypothetical new AD therapy?

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

Primary research: Survey of 60 U.S. and 30 European dermatologists treating pediatric patients

Key companies:Sanofi, Regeneron, Pfizer, AbbVie, LEO Pharma, Eli Lilly, Incyte

Key drugs: Dupixent, cyclosporine, methotrexate, azathioprine, mycophenolate, oral prednisone


  • Target Product Profile (TPP) simulator based on conjoint analysis methodology.
  • Stated versus derived importance of product attributes on prescribing behavior.
  • Assessment of current drug performance against treatment drivers and goals.
  • Physician perceptions of unmet needs in the indication and related indications.
  • Analysis of remaining drug development opportunities.


Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. One market scenario is profiled in detail by DRG experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

Table of contents

  • Detailed, Expanded Analysis - Moderate to Severe (US/EU)
    • Executive Summary
    • 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 Topical-Refractory Moderate to Severe Atopic Dermatitis
      • Key Findings: Unmet Need in Topical-Refractory Moderate to Severe Atopic Dermatitis and Related Indications
    • Opportunity Analysis
      • Areas of Opportunity in the Topical Refractory, Moderate to Severe Atopic Dermatitis Market and Emerging Therapy Insights
        • Opportunity: Systemic Therapies That Are More Effective in Clearing Eczema and Reducing Itch
        • Opportunity: Additional Effective Therapies That Have Good Safety and Delivery Profiles
        • Opportunity: Systemic Therapies with a More Rapid Onset of Action
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
      • Attribute Importance and Part-Worth Utilities
        • Topical-Refractory Moderate to Severe Pediatric Atopic Dermatitis Target Product Profile: Attribute-Level Part-Worth Utilities
      • Conjoint Analysis-Based Simulations of a Market Scenario
        • Market Scenario
    • Appendix
      • Bibliography

Author(s): Pallavi Rajput, Ph.D

Pallavi Rajput joined Decision Resources Group as an associate analyst in 2019. Her focus is on the disease landscape and forecast of infectious diseases, niche and rare diseases. She holds a in molecular biology and virology from the International Centre for Genetic Engineering and Biotechnology, New Delhi, India. Prior to joining Decision Resources Group, Pallavi was a postdoctoral fellow at the University of California- Davis, where her research focused on the role of DNA repair in cancer development.