Although motor fluctuations in Parkinson’s disease (PD) can be managed effectively in the early stages of the disease, today’s treatment paradigm is suboptimal owing to the considerable pill burden, a risk of motor and nonmotor complications associated with dopaminergic therapy, and a progressive loss of efficacy. In response, the pipeline for adjunctive therapies targeting motor fluctuations has swelled. With the recent launches of Xadago and Ongentys and with Nouriast and tozadenant in late-phase development, understanding the drivers of clinical decision-making for treating motor fluctuations and prescriber perceptions of approved options will help innovators identify levers for new product positioning and differentiation in this evolving market niche.

Questions Answered:

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

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

Primary research: Survey of 60 U.S. and 31 European neurologists fielded in February 2017

Key companies: Teva, UCB, Newron, Zambon, US WorldMeds, Bial, Neurocrine, Kyowa Hakko Kirin, Acorda

Key drugs: oral dopamine agonists, rotigotine (Neupro), rasagiline (Azilect), selegiline, safinamide (Xadago), entacapone, Ongentys (opicapone), tozadenant, Nouriast (istradefylline)

Table of contents

  • Detailed, Expanded Analysis: Adjunctive Therapies for Motor Fluctuations
    • Key Updates
      • October 2017
      • July 2017
      • April 2017
    • Treatment Drivers and Goals
      • Overview
      • Treatment Drivers and Goals
        • Methodology
        • Physician Weighting of Clinical and Nonclinical Attributes
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
        • Nonclinical Factors
      • Physician Rating of Treatment Drivers and Goals for Motor Fluctuations in Parkinson's Disease
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
        • Nonclinical Factors
      • Stated vs. Derived Importance of Treatment Drivers and Goals
    • Product Performance Against Treatment Drivers and Goals
      • Overview
      • Rationale for Drug Selection
      • Current Brand Performance on Key Treatment Drivers and Goals
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
        • Nonclinical Factors
    • Assessment of Unmet Need
      • Overview
      • Overall Satisfaction with Current Treatment
      • Physician Rating of Unmet Need for Motor Fluctuations in Parkinson's Disease
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
        • Nonclinical Factors
      • Unmet Need in the Treatment of Motor Fluctuations in PD and Related Indications
    • Opportunity Analysis
      • Areas of Opportunity and Emerging Therapy Insights
        • Opportunity: A Therapy with Greater Efficacy in Preventing Motor Fluctuations
        • Opportunity: A Novel Agent with Low Risk of Motor and Nonmotor Complications
        • Opportunity: A Rescue Therapy for the Acute Treatment of "Off" Episodes
      • Lack of Opportunity and Emerging Therapy Insights
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
      • Attribute Importance and Part-Worth Utilities
        • Motor Fluctuations in Parkinson's Disease Target Product Profile: Attribute-Level Part-Worth Utilities
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Scenario 1
        • Scenario 2
    • Appendix
      • Experts Interviewed
      • Bibliography

Author(s): Bethany Christmann, PhD

Bethany Christmann, has been with DRG since 2015, and is a Senior Business Insights Analyst with the Central Nervous System/Ophthalmology team. In this role, she covers the neurology space, specializing in Parkinson’s disease and epilepsy; she provides expert insight and authors primary market research and forecasting content focused on these and other neurology indications. Prior to joining DRG, Bethany earned her in neuroscience from Brandeis University, where she studied the cellular interactions involved in memory consolidation and their link to sleep behavior.


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