The moderate to severe ulcerative colitis (UC) therapy 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) are the mainstay of biological treatment for moderate to severe UC. However, these agents have safety risks and efficacy limitations. Two additional agents, Takeda’s Entyvio (a CAM inhibitor) and Pfizer’s Xeljanz (an oral, first-in-class Jak inhibitor), have expanded the treatment options for moderate to severe UC, but significant unmet need remains, especially for patients refractory to available therapies. Several agents in late-phase development are poised to enter the moderate to severe UC market over the next several years, including Janssen’s Stelara, an IL-12/23 inhibitor, and additional Jak agents (e.g., Galapagos/Gilead’s filgotinib), but their ability to fulfill the unmet need remains to be seen.


  • What are the treatment drivers and goals for moderate to severe UC?
  • 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 UC?
  • What are the prevailing areas of unmet need and opportunity in moderate to severe UC?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European gastroenterologists for a hypothetical new UC 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 30 European gastroenterologists fielded in December 2018

Key companies: AbbVie, Celgene, Galapagos NV, Gilead, Janssen, Merck & Co., Pfizer, Roche, Takeda

Key drugs: Remicade, Humira, Simponi, Entyvio, Xeljanz, biosimilar infliximab, MMX delayed-release mesalamine (brand and generics)

Table of contents

  • Detailed, Expanded Analysis (US & EU)
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
        • Nonclinical Factors
      • 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 UC
      • Key Findings: Unmet Need in Moderate to Severe UC and Related Indications
    • Opportunity Analysis
      • Areas of Opportunity in the Moderate to Severe UC 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 New Agent Demonstrating Improved Corticosteroid-Free Remission Rates
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
      • Attribute Importance and Part-Worth Utilities
        • Moderate to Severe UC 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): Ajay Puri, MBA

Ajay Puri is an Associate Analyst in the Immune and Inflammatory team at Decision Resources Group and works on indications like Ulcerative Colitis, Crohn’s disease, and Systemic Lupus Erythematosus. He holds a Bachelor’s degree in Pharmacy and has earned his MBA (Pharmaceutical) in marketing from NIPER, Mohali. Prior to joining DRG, Ajay worked as a Knowledge Management Associate (Oncology Vertical) at ZS Associates and worked on strategic projects such as competitive assessment, company and product profiling, conference coverage for clients, client specific newsletters and other business development initiatives.  

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