As a result of low diagnosis and drug-treatment rates, the
market for alcohol addiction therapies remains very small despite the
relatively high prevalence of the disease. Current therapies approved for
alcohol addiction, such as disulfiram (Teva
Pharmaceuticals/Actavis/Nycomed/Laboratorio BOHM’s Antabuse/Antabus, AFOM
Medical’s Etiltox, Sanofi’s Esperal, Mitsubishi Tanabe Pharma’s Nocbin),
naltrexone (Teva’s ReVia, various brands and generics), and acamprosate (Forest
Laboratories’ Campral, Merck Serono’s Campral/Aotal, Almirall’s Zulex), suffer
from limited efficacy—further dissuading physicians from treating the disorder
with pharmacotherapy. Historically, therapies for alcohol addiction have been
indicated for the support of abstinence; however, BioTie/Lundbeck’s nalmefene
(Selincro) recently received approval in the EU for reducing alcohol
consumption in alcohol-dependent patients, and marketers are hopeful that
physicians will accept harm reduction as a meaningful treatment goal.
Attributes included in conjoint analysis-based assessment of target product profiles for alcohol addiction:
- Percentage of patients maintaining complete abstinence (following lead-in abstinence).
- Cumulative abstinence duration (% days abstinent during study period).
- Percentage of patients with no heavy drinking days.
- Reduction in alcohol consumption.
- Rate of nausea.
- Delivery burden.
- Patient out-of-pocket cost (for 30-day prescription).
Attributes included in assessment of U.S. payers’ receptivity to new therapies for alcohol addiction:
- Improved maintained abstinence from alcohol.
- Greater reduction in alcohol consumption.
- Lower rate of minor side effects.
- Reduced delivery burden.
Physicians surveyed: 61 U.S. and 30 European psychiatrists.
Payers surveyed: 20 U.S. MCO PDs.
Comprehensive List of Therapies Included in Our Research and Modeling:
- Acamprosate (Forest Laboratories’ Campral, Merck Serono’s Campral/Aotal, Almirall’s Zulex)
- Naltrexone microspheres (Alkermes’ Vivitrol)
- Naltrexone (Teva’s ReVia, Bristol-Myers Squibb’s Nemexin/Nalorex, Lacer’s Celupan, Merck & Co.’s Nalorex, Zambon’s Antaxone, Britannia Pharmaceuticals’ Opizone, Sirton Pharmaceuticals’ Narcoral, generics)
- Disulfiram (Teva Pharmaceuticals/Actavis/Nycomed/Laboratorio BOHM’s Antabuse/Antabus, AFOM Medical’s Etiltox, Sanofi’s Esperal, Mitsubishi Tanabe Pharma’s Nocbin)
- Cyanamide (Faes Farma’s Colme, Mitsubishi Tanabe Pharma’s Cyanamide)
- Nalmefene (BioTie Therapies/Lundbeck’s Selincro)
- Samidorphan (Alkermes’ ALKS-33)
- AD-04 (ADial Pharmaceuticals)
- VLY-686 (Vanda Pharmaceuticals)