Last Updated 23 December 2015
The psoriasis market has become increasingly lucrative owing to the growing use of biologics. The dominance of the tumor necrosis factor-alpha (TNF-α) inhibitors is being challenged by the interleukin-12 and 23 (IL-12/23) inhibitor, ustekinumab (Janssen Biotech’s Stelara), and more recently, by the introduction of Novartis’s IL-17 inhibitor, secukinumab (Cosentyx), and Celgene’s oral phosphodiesterase-4 (PDE4) inhibitor, apremilast (Otezla). Novel oral therapies are generating interest following the remarkable uptake of Otezla in the first year of its launch. Thus, opportunities exist for developing safer and more-efficacious treatments in different drug classes for psoriasis; however, emerging therapies will have to deal with growing cost constraints and an increasingly competitive market. Additionally, the landscape will change further once biosimilars of frequently prescribed TNF-alpha inhibitors for psoriasis arrive in the major markets.
Questions Answered in This Report:
- Psoriasis is seeing increasing use of therapies beyond TNF-α inhibitors. How are the current TNF-α inhibitors and non-TNF-α inhibitors used among current treatment therapies for psoriasis across the major 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 in the major markets, where it has been available since early 2015?
- The interleukin-12 (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, safety profile, 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 among non-TNF-α inhibitors will become fierce during the forecast period. How do interviewed dermatologists view the efficacy and safety of emerging therapies such as IL-17 inhibitors, IL-23 inhibitors, janus kinase (Jak) inhibitors and other novel oral therapies? Where will the novel agents be positioned in the treatment algorithm? How do physicians view emerging topical therapies with new mechanisms? How do physicians view novel psoriasis therapies, both biologic and oral, that will act on new immune-related targets? How will the emerging 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?
Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, Japan.
Primary research: 26 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: 6 drugs; Phase III/preregistration: 10 drugs; coverage of select preclinical and Phase I products.
Nicole Zhang, M.P.H.