The increasingly crowded RA market boasts many different targeted agents representing several distinct drug classes, including blockbuster TNF-α inhibitors, five non-TNF-α biologics (including the second IL-6 inhibitor, Regeneron / Sanofi’s Kevzara), and three oral Jak inhibitors, Xeljanz (Pfizer), Olumiant (Eli Lilly), and Rinvoq (AbbVie). The TNF-α inhibitors are the most widely prescribed biologics for RA refractory to conventional DMARDs, and the non-TNF-α biologics and Jak inhibitors largely compete for use in the TNF-refractory population. With the impending entry of additional Jak inhibitors (e.g., Gilead / Galapagos’s filgotinib) and biosimilars of several TNF and non-TNF biologics, marketers are facing fierce competition and increasing challenges to gain market share.

Questions answered:

  •  What are physicians’ preferred TNF-α inhibitors, and what factors are influencing this perception? Given the increasingly fragmented RA market, how likely are physicians to cycle through multiple anti-TNF agents before progressing to a novel MOA?
  • What are physicians’ perceptions of the currently marketed non-TNF-α inhibitor biologics and oral Jak inhibitors, and where do these agents fit in their current treatment approach? Which of these agents has been/will be most successful in targeting the TNF-refractory patient segment?
  • How will the entry of additional novel oral therapies affect the RA treatment algorithm, and in which patient segments and lines of treatment will these therapies most likely be used? How will the entry of biosimilars affect the market sales and patient share of currently marketed RA agents and the entry of emerging therapies?


Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, Japan.

Primary research: 27 country-specific interviews with thought leaders.

Epidemiology: Number of total, diagnosed, and drug-treated prevalent cases of RA; number of diagnosed prevalent cases of RA by severity.

Emerging therapies: Preregistered: 1 drug; Phase III: 3 drugs; coverage of 11 select early-phase pipeline products.

Table of contents

  • Disease Landscape & Forecast
    • Key Findings
      • Rheumatoid Arthritis - Key Findings - November 2019
    • Key Updates
      • November 2019
      • September 2019
      • June 2019
      • October 2018
    • Market Outlook
      • Key Findings
      • Market Drivers and Constraints
        • What Factors Are Driving the Market for Rheumatoid Arthritis?
        • What Factors Are Constraining the Market for Rheumatoid Arthritis?
      • Drug-Class-Specific Trends
        • TNF-Alpha Inhibitors
        • Selective Costimulation Modulators
        • B-Cell-Targeted Therapies
        • Interleukin-6 Inhibitors
        • Jak Inhibitors
        • GM-CSF Inhibitors
        • RANKL Inhibitors
        • Adenosine Receptor Agonists
        • Conventional DMARDs
    • Forecast
      • Market Forecast Assumptions
      • Market Forecast Dashboard
    • Etiology and Pathophysiology
      • Disease Overview
        • Disease Overview
      • Etiology
        • Genetic Factors
        • Environmental Risk Factors
      • Pathophysiology
        • Disease Progression
        • Adaptive and Innate Immune Responses in Disease Pathogenesis
      • Key Pathways and Drug Targets
    • Epidemiology
      • Key Findings
      • Epidemiology Populations
        • Total Prevalent Cases
        • Severity
        • Diagnosed Prevalent Cases of Rheumatoid Arthritis
        • Drug-Treated Cases of Rheumatoid Arthritis
    • Current Treatment
      • Key Findings
      • Treatment Goals
      • Key Current Therapies
        • Overview
        • TNF-Alpha Inhibitors
        • Selective Costimulation Modulators
        • B-Cell-Targeted Therapies
        • Interleukin-6 Inhibitors
        • Janus Kinase Inhibitors
        • RANKL Inhibitors
      • Medical Practice
        • Overview
        • Region-Specific Treatment Practices
    • Unmet Need Overview
      • Current and Future Attainment of Unmet Needs in Rheumatoid Arthritis
    • Emerging Therapies
      • Key Findings
      • Key Emerging Therapies
        • Jak Inhibitors
        • Interleukin-6 Inhibitors
        • A3 Adenosine Receptor Agonists
        • Granulocyte-Macrophage Colony-Stimulating Factor Inhibitors
      • Early-Phase Pipeline Analysis
      • Key Discontinuations and Failures in Rheumatoid Arthritis
    • Access & Reimbursement Overview
      • Region-Specific Reimbursement Practices
        • United States
        • EU5
        • Japan
      • Looking for More?
    • Methodology
      • Bottom-Up Forecasting Overview
        • Patient Populations
        • Drug-Specific Assumptions
      • Bottom-Up Forecast Assumptions
        • General Sources of Data
        • Agents Included in Our Market Analysis
        • General Statements About Pricing
        • Dosing, Days of Therapy, and Compliance
        • Generic Erosion
        • Biosimilar Erosion
        • Out-Year Forecasting
        • Emerging Therapy Prices
      • Primary Market Research
        • Experts Interviewed
    • Appendix
      • Rheumatoid Arthritis Bibliography

Author(s): Andrea Buurma Kravit; Sunali D. Goonesekera, SM; Colleen E. Albacker, PhD

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 ;

Sunali Goonesekera is an Associate Epidemiologist at Decision Resources Group. Sunali holds a Master’s degree in Epidemiology from the Harvard School of Public Health and a in Biology (Honors) from Dartmouth College. Prior to joining Decision Resources Group, Sunali conducted epidemiological research and lead authored two manuscripts on racial/ethnic disparities in metabolic diseases at the New England Research Institutes. She has contributed to multiple publications in peer-reviewed journals in epidemiology and in the biological sciences.

Colleen E. Albacker, is a director with the Immune and Inflammatory Disorders group at Decision Resources Group, where she comanages a team of analysts generating syndicated market research content. She has authored market research reports analyzing physician, payer, and market trends in respiratory indications, including asthma and COPD. Prior to joining Decision Resources Group, Dr. Albacker conducted her graduate research on chromatin-modifying factors in zebrafish cancer and hematopoietic development at Harvard Medical School and Boston Children’s Hospital. She also gained experience with market research through a fellowship with the Harvard Office of Technology Development. Dr. Albacker holds a in genetics from Harvard University and a in biology with honors from the Pennsylvania State University.

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