With more than 32 million people in the United States diagnosed with osteoarthritis (OA), it is the most common type of arthritis and a leading cause of disability. Among the symptoms characteristic of OA, pain is experienced by the majority of OA patients and thus has become a prominent therapeutic target for drug development. Indeed, OA pain represents the second largest segment of the chronic pain market. The OA pain market is expected to grow over the next ten years, driven by the aging population and increased prevalence of obesity; however, a truly novel therapy has not emerged for this indication in over 15 years. A successful launch of a new therapy for OA pain requires a deep understanding of current treatment patterns in a market replete with generic and OTC products. While nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics dominate the OA pain market, high unmet need still exists for therapies lacking the severe gastrointestinal, cardiovascular, and abuse risks associated with the current standard of care. Over the past few years, branded therapies have launched in the OA pain market, providing incremental safety, tolerability, and/or dosing benefits to overcome the drawbacks of the NSAIDs and opioid analgesics—but how have these agents fared in this highly generic market? Using national patient-level claims data, this report analyzes patient share for these new agents in OA patients who have been newly diagnosed as well as longitudinal data in OA patients treated within the last three months of our two-year study period. The report also analyzes the degree of polypharmacy in these patient populations as well as compliance and persistency rates. Among newly diagnosed patients, this report provides a quantitative analysis of treatment patterns and share by line of therapy, as well as the progression between lines, the durations of treatment on each line, polypharmacy rates, and the most widely used drug combinations. Among recently treated patients, the report quantifies a drug’s source of business compared with its competitors and details which drugs precede others through an analysis of add-versus-switch patterns. Additional analyses explore persistency and compliance by brand.

Questions Answered in This Report:

  • Newly diagnosed patients: More than 45% of OA patients begin treatment with a key therapy within a year of their initial diagnosis. What percentage of these patients progress to a second- or third-line drug within the first year? Which products capture the most patient share in the first, second, and third lines of treatment? How often is combination therapy used in each line of therapy?

  • Recently treated patients: Unsurprisingly, the opioid analgesics and NSAID drug classes capture the majority of recently treated patient prescriptions. However, which specific drugs garner the most patient share for recently treated OA patients? How long do OA patients remain on a preceding therapy before progressing to the key therapies under study, and how does this pattern differ among key drugs? Are most patients recently treated with each key brand coming through new (adds/switches) or continuing business? To what extent are branded analgesics used by recently treated patients?

  • Pathways to key therapies: Longitudinal claims data reveal relatively consistent use patterns of key therapies among recently treated patients; use of antiepileptic agents and antidepressants for OA increases in the later lines of therapy. Which therapies have experienced market growth or decline over the key therapy periods studied? To what extent are key therapies prescribed concomitantly to recently treated patients? What has been the impact of recently approved drugs for OA on the patient share of established therapies?

Scope:

Primary patient-level data: Quantitative findings from our analysis of data covering approximately 40 million lives providing the most representative sample of U.S. treatment practice for Medicare and commercially insured patients. This report is delivered as a key findings slide deck and a dashboard that can be accessed using the Internet with claims that are less than six months old at the time of publication.

Patient Sample:

Patients who are continuously enrolled for the complete two-year study period must meet the following condition: at least one claim with a diagnosis code for OA (International Classification of Diseases, Ninth Revision [ICD-9] diagnostic codes 715.00, 715.04, 715.09, 715.10-18,, 715.20-28, 715.30-38, 715.80, 715.89, 715.90-98) during the study period.

Quantified lines of therapy analysis showing exact share of each agent in each line of therapy, including rate of progression between lines and length of time patients are on each line.

Newly Diagnosed Patients:

- Patient share by drug class and key products across three lines of therapy, within one year of diagnosis.

- Patient flowcharts through one year of treatment for all first-line products, including progression rates and add/switch behavior.

- Polypharmacy and key concomitant therapies by line of therapy.

- Quarterly trending of patient share by line of therapy.

Recently Treated Patients:

- Quarterly snapshot of patient share by drug class and key products.

- Pathway to key therapy flowcharts tracking the preceding therapy patterns for all key therapies, including add/switch behavior.

- Brand source of business including share for continuing, new (switches/adds), and new (initial therapy) business.

- Polypharmacy and key concomitant therapies.

- Drug persistence and compliance.

- Quarterly trending of patient share for all key therapies.


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