The psoriasis therapy market has become increasingly lucrative owing to the growing use of biologics. The dominance of the tumor necrosis factor-alpha (TNF-alpha) inhibitors and interleukin-12 and -23 (IL-12/23) inhibitor ustekinumab (Janssen Biotech’s Stelara) is being challenged by the  introduction of two highly effective drug classes: IL-17 inhibitors and IL-23 inhibitors. Novel oral therapies are also generating considerable interest following the remarkable uptake of Celgene’s oral phosphodiesterase-4 (PDE4) inhibitor apremilast (Otezla) in the first year of its launch. Thus, opportunities exist for developing safer and more-efficacious oral treatments for psoriasis, although all emerging therapies will face growing cost constraints and an increasingly competitive market. Additionally, the landscape for the established biologics will change further once biosimilars reach the market.

Questions Answered:

  • Psoriasis is seeing increasing use of therapies beyond TNF-α inhibitors. How are the current TNF-α inhibitors and non-TNF-α inhibitors used in the treatment of psoriasis in the major pharmaceutical markets? Where is the oral therapy apremilast positioned in the treatment algorithm in the United States and EU5? Where is the first-in-class IL-17 inhibitor, secukinumab, positioned in the treatment algorithm?
  • The IL-12/23 inhibitor ustekinumab has experienced strong uptake since its launch for psoriasis in 2009 and has established an earlier position in the treatment algorithm on the strength of its favorable efficacy and safety and convenient dosing. How are dermatologists incorporating this agent in their treatment of patients with moderate to severe psoriasis? How will the entry of agents with novel mechanisms of action competing for use in the TNF-refractory population affect ustekinumab’s growth trajectory?
  • In patients with inadequate responses to TNF-α inhibitors, the competition between non-TNF-α inhibitors will become fierce during the forecast period. How do interviewed dermatologists view the efficacy and safety of new therapies such as the IL-17 inhibitors, IL-23 inhibitors, apremilast, and other novel oral therapies? Where will the novel agents be positioned in the treatment algorithm? How do physicians view novel psoriasis therapies, both biologic and oral, that will act on new immune-related targets? How will the next generation targeted biologics (e.g., IL-17 inhibitors, IL-23 inhibitors) fare in the competitive psoriasis market?
  • Following the launch of biosimilar infliximab in Japan and Europe, biosimilar versions of the other TNF-α inhibitors—etanercept and adalimumab—are expected to enter the psoriasis market during the early part of the forecast period. How fast will uptake of biosimilars be in psoriasis? Which agents will suffer the greatest erosion in sales?

Scope:

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

Primary research: 30 country-specific interviews with thought leaders.

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

Emerging therapies: Phase II: 10 drugs; Phase III/preregistration: 10 drugs; coverage of select preclinical and Phase I products.


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