The market for disease-modifying therapies for the treatment
of relapsing-remitting multiple sclerosis (RR-MS) is active and commercially
compelling. Despite a small diagnosed prevalent population relative to many
other neurological indications, drug-treatment rates for RR-MS are high, and
neurologists emphasize early treatment intervention to improve long-term
outcomes in this chronic disease. The number of disease-modifying therapies
approved to treat RR-MS is expanding steadily—including the launches of the
first oral disease-modifying drugs in this historically injectable market—but
marketed agents have drawbacks that leave ample opportunity for new therapies
offering clinical improvements in efficacy, safety and tolerability, and
Attributes included in conjoint-analysis-based assessment of target product profiles for RR-MS:
- Reduction in ARR relative to placebo.
- Reduction in risk of six-month sustained disability progression (i.e., Kurtzke Expanded Disability Status Scale [EDSS] progression) relative to placebo.
- Incidence of serious or life-threatening side effects (e.g., opportunistic infections, bradycardia, autoimmune adverse events).
- Incidence of less-serious side effects (e.g., injection-site reactions, flu-like symptoms, flushing).
- Monitoring burden: frequency (e.g., first-dose only, monthly) and complexity (e.g., number/difficulty of unique tests).
- Delivery burden (i.e., dosing frequency and formulation).
Attributes included in assessment of U.S. payers’ receptivity to new therapies for RR-MS:
- Effect on ARR.
- Effect on risk of six-month sustained disability progression.
- Monitoring burden.
- Burden of delivery (dosing frequency and formulation).
Physicians surveyed: 61 U.S. and 30 European neurologists.
Payers surveyed: 20 U.S. MCO PDs.
Comprehensive List of Therapies Included in Our Research and Modeling:
- Glatiramer acetate (Teva’s Copaxone)
- Interferon-beta-1a intramuscular (Biogen Idec’s Avonex)
- Natalizumab (Biogen Idec/Elan’s Tysabri)
- Fingolimod (Novartis/Mitsubishi Tanabe Pharma’s Gilenya/Imusera)
- Teriflunomide (Sanofi/Genzyme’s Aubagio)
- BG-12 (Biogen Idec’s Tecfidera)
- Alemtuzumab (Genzyme/Sanofi/Bayer HealthCare’s Lemtrada)
- Daclizumab (AbbVie/Biogen Idec)
- Ocrelizumab (Roche/Genentech)
- Laquinimod (Teva/Active Biotech)