The moderate to severe ulcerative colitis (UC) drug market still offers substantial opportunity for companies that can address the remaining unmet needs in this patient population. The TNF-α inhibitors (e.g., Janssen’s Remicade, AbbVie’s Humira, biosimilars of both drugs, where available) are the mainstay of biological treatment for moderate to severe UC. However, these agents carry safety risks and have efficacy limitations. Takeda’s Entyvio (a CAM inhibitor), Pfizer’s Xeljanz / Xeljanz XR (an oral Jak inhibitor), and Janssen’s Stelara (an IL-12/23 inhibitor) have expanded the treatment options for moderate to severe UC, but despite the number of currently available agents, significant unmet need exists, especially for patients refractory to these therapies. Although several agents in late-phase development, including additional Jak agents, are poised to enter the moderate to severe UC market over the next several years, their ability to fulfill these areas of unmet need is unknown at this time.


  • What are the treatment drivers and goals for moderate to severe UC?
  • In addition to efficacy, what other drug attributes influence physician prescribing behavior the most, and which attributes have limited impact?
  • How do TNF-α inhibitors (branded and biosimilars), Entyvio, and novel agents (i.e., Xeljanz / Xeljanz XR, Stelara) perform on treatment drivers and goals?
  • What are the prevailing areas of high unmet need and hidden opportunity in moderate to severe UC?
  • What trade-offs across different clinical attributes and prices are acceptable to U.S. and European gastroenterologists for a hypothetical new UC drug?


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.

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

Primary research: Survey of 60 U.S. and 30 European gastroenterologists fielded in February – March 2020

Key companies: AbbVie, Janssen, Takeda, Pfizer

Key drugs: Remicade and infliximab biosimilars, Humira and adalimumab biosimilars, Simponi, Entyvio, Xeljanz / Xeljanz XR, Stelara

Table of contents

  • Detailed, Expanded Analysis (US & EU)
    • Executive Summary
      • Unmet Need - Moderate to Severe Ulcerative Colitis - 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 Ulcerative Colitis
      • Key Findings: Unmet Need in Moderate to Severe Ulcerative Colitis and Related Indications
    • Opportunity Analysis
      • Areas of Opportunity in the Moderate to Severe Ulcerative Colitis Market and Emerging Therapy Insights
        • Opportunity: A Novel Therapy Demonstrating Greater Effect on Long-Term Maintenance of Remission
        • Opportunity: A Novel Therapy Demonstrating Improved Mucosal Healing Rates
        • Opportunity: A Novel Therapy Demonstrating Improved Corticosteroid-Free Remission Rates
        • Opportunity: A Novel Oral Therapy Demonstrating Improved Safety
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
      • Attribute Importance and Part-Worth Utilities
        • Moderate to Severe Ulcerative Colitis Target Product Profile: Attribute-Level Part-Worth Utilities
      • Conjoint Analysis-Based Simulation of a Market Scenario
        • Market Scenario
    • Appendix
      • Experts Interviewed
      • Bibliography

Author(s): Andrea Buurma Kravit

Andrea Kravit is a director in Decision Resources Group’s Immune and Inflammatory division, where she manages, and supports, a team of therapeutically-aligned analysts who conduct extensive primary and secondary market research in the gastrointestinal and respiratory space. Prior to this role, she was a principal analyst for Decision Resources Group's Central Nervous Systems and Ophthalmology division, where she provided expert insight into the commercial aspects of drug development and market sizing across Pain indications. Her project experience includes patient-based market forecasting, market opportunity assessments, early to late-stage pipeline analyses, and competitive analytics for the life-science ;

Related Reports

Ulcerative Colitis | Landscape & Forecast | Disease Landscape & Forecast

The ulcerative colitis (UC) market is expected to grow steadily over the next decade. The entry of first-in-UC oral...

View Details

Ulcerative Colitis | Current Treatment | Detailed, Expanded Analysis: Treatment Algorithms: Claims Data Analysis (US) - Pediatric

MARKET OUTLOOK Conventional therapies (5-ASAs, corticosteroids) are typically used to treat mild to moderate pediatric ulcerative co...

View Details

Ulcerative Colitis | Disease Landscape and Forecast | G7 | 2019

The ulcerative colitis (UC) market is expected to grow steadily over the next decade. The entry of first-in-UC oral t...

View Details

Ulcerative Colitis | Epidemiology | Extrapolated Worldwide Coverage

DRG’s Extrapolated Worldwide Coverage is the first and only evidence-based data set of epidemiological forecasts for key ulcerative colitis pat...

View Details