Last Updated 15 December 2014
Tumor necrosis factor (TNF)-α inhibitors continue to dominate the multibillion-dollar rheumatoid arthritis (RA) market. An increase in the prevalent RA population, emphasis on early diagnosis and early initiation of disease-modifying antirheumatic drug (DMARD) treatment, and the need for therapies with better efficacy and safety profiles will continue to drive the growth of the RA market. Clear market opportunities exist for alternative biologics and oral compounds, especially in the population of patients refractory to TNF-α inhibitor therapy. The recently approved oral Jak inhibitor tofacitinib (Pfizer/Takeda’s Xeljanz) and other emerging agents in late clinical development have the potential to make a substantial impact on the current treatment algorithm for RA.

Questions Answered in This Report:

  • The TNF-α inhibitors—etanercept (Amgen/Pfizer/Takeda’s Enbrel), infliximab (Janssen/Merck/Mitsubishi Tanabe’s Remicade), adalimumab (AbbVie/Eisai’s Humira), golimumab (Janssen/Merck/Mitsubishi Tanabe’s Simponi/Simponi Aria), and certolizumab pegol (UCB/Astellas’s Cimzia)—are deeply entrenched as first-line biologics in RA. What are key opinion leaders’ perceptions of the advantages and disadvantages of these drugs? What factors influence the prescription of one TNF-α inhibitor over another?

  • In patients with inadequate responses to TNF-α inhibitors, the competition among non-TNF-α inhibitors is fierce and expected to further intensify with the entry of emerging therapies. What are key opinion leaders’ perceptions of the currently marketed non-TNF-α inhibitor biologics and novel oral kinase inhibitors, and where do these agents fit in their current treatment approach? Which emerging agents are likely to be most successful in targeting the TNF-refractory patient segment and gaining uptake in the RA market?

  • In addition to tofacitinib, two more oral Jak inhibitors are expected to launch during the forecast period. What will be the impact of the entry of novel oral therapies on the treatment algorithm for RA? What patient segments and which lines of treatment will these oral therapies most likely be used in?

  • Biosimilar versions of the TNF-α inhibitors infliximab, etanercept, and adalimumab are expected to enter the RA market by the midpoint of the forecast period. Biosimilars for the non-TNF-α inhibitors abatacept, rituximab, and tocilizumab are also expected to launch during the forecast period. How will the entry of biosimilars affect the market sales and patient shares of the currently marketed RA agents and the entry of emerging therapies?

Scope:

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

Primary research: 33 country-specific interviews with thought-leaders.

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

Emerging therapies: Phase II: 16 drugs; Phase III: 4 drugs.

Market forecast features: We forecast annualized drug use and sales for disease-modifying antirheumatic drugs (DMARDs) to treat RA from 2013 through 2023.

Author(s): Ronnie Yoo, Ph.D.
Lade Ayodele, M.B.B.S., M.P.H.

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