March 2018

An increasing number of clinically unique disease-modifying therapies (DMTs) have been approved for the treatment of relapsing forms of multiple sclerosis (MS), the most prevalent form of MS. Nevertheless, all approved drugs present clinical shortcomings in efficacy, safety, tolerability, and/or delivery, creating opportunities for new and improved alternatives. This content provides quantitative insight into U.S. and European physicians’ perceptions of key treatment drivers and goals in the management of relapsing forms of MS and the current level of unmet need in this area. We analyze the commercial opportunities and how emerging therapies may capitalize on these opportunities, with a subfocus on next-generation oral DMTs in our conjoint-based Target Product Profile simulator.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals for relapsing forms of MS?
  • What drug attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals for relapsing forms of MS?
  • What are the prevailing areas of unmet need and opportunity in relapsing forms of MS?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European neurologists for a hypothetical new oral drug for relapsing forms of MS?

PRODUCT DESCRIPTION

Unmet Need provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.

Markets covered: United States, United Kingdom, France, Germany.

Primary research: Survey of 60 U.S. and 30 European neurologists fielded in December 2017.

Key companies: Biogen, Novartis, Teva, Roche, Merck, Sanofi/Genzyme.

Key drugs: Gilenya, Aubagio, Tecfidera, Copaxone, Avonex, Tysabri, Ocrevus, Mavenclad.

Key metrics included:

  • Stated versus derived analysis of U.S. and European physician prescribing behavior.
  • Conjoint analysis of oral DMTs with U.S. and European physicians, includes market simulator.
  • Assessment of current drug performance against treatment drivers and goals.
  • Physician perceptions of unmet need in disease covered and related diseases.
  • Analysis of remaining drug development opportunities.

Table of contents

  • Multiple Sclerosis - Unmet Need - Detailed, Expanded Analysis - Relapsing Forms Of Multiple Sclerosis
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
        • Nonclinical Factors
      • Rationale for Drug Selection
        • Products for Relapsing Forms of MS
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Neurologists' Prescribing Decisions in Relapsing Forms of MS
      • Importance of Efficacy Attributes to Prescribing Decisions in Relapsing Forms of MS: United States
      • Importance of Efficacy Attributes to Prescribing Decisions in Relapsing Forms of MS: Europe
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Relapsing Forms of MS: United States
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Relapsing Forms of MS: Europe
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Relapsing Forms of MS: United States
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Relapsing Forms of MS: Europe
      • Importance of Nonclinical Factors to Prescribing Decisions in Relapsing Forms of MS: United States
      • Importance of Nonclinical Factors to Prescribing Decisions in Relapsing Forms of MS: Europe
      • Key Findings: Stated vs. Derived Importance
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Relapsing Forms of MS: United States
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Relapsing Forms of MS: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
      • Overall Performance of Key Therapies for Relapsing Forms of MS: United States
      • Overall Performance of Key Therapies for Relapsing Forms of MS: Europe
      • Relative Performance of Key Therapies for Relapsing Forms of MS Across Select Efficacy Attributes: United States
      • Relative Performance of Key Therapies for Relapsing Forms of MS Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for Relapsing Forms of MS Across Select Safety and Tolerability Attributes: United States
      • Relative Performance of Key Therapies for Relapsing Forms of MS Across Select Safety and Tolerability Attributes: Europe
      • Relative Performance of Key Therapies for Relapsing Forms of MS Across Select Convenience of Administration Attributes: United States
      • Relative Performance of Key Therapies for Relapsing Forms of MS Across Select Convenience of Administration Attributes: Europe
      • Relative Performance of Key Therapies for Relapsing Forms of MS Across Select Nonclinical Attributes: United States
      • Relative Performance of Key Therapies for Relapsing Forms of MS Across Select Nonclinical Attributes: Europe
    • Assessment of Unmet Need
      • Surveyed Neurologists’ Satisfaction with the Performance of Key Therapies for Relapsing Forms of MS on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
      • Surveyed Neurologists’ Satisfaction with the Performance of Key Therapies for Relapsing Forms of MS on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Relapsing Forms of MS: United States
      • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Relapsing Forms of MS: Europe
      • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Relapsing Forms of MS: United States
      • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Relapsing Forms of MS: Europe
      • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Relapsing Forms of MS: United States
      • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Relapsing Forms of MS: Europe
      • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Relapsing Forms of MS: United States
      • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Relapsing Forms of MS: Europe
      • Key Findings: Unmet Need in Relapsing Forms of MS and Related Indications
      • Surveyed Neurologists' Ascribed Level of Unmet Need in Relapsing Forms of MS and Related Indications: United States
      • Surveyed Neurologists' Ascribed Level of Unmet Need in Relapsing Forms of MS and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the Relapsing Forms of MS Market and Emerging Therapy Insights
        • Opportunity: Novel DMTs That Offer a Greater Effect on Disability Progression in Relapsing MS Without Exacerbating Risk
        • Opportunity: Oral DMTs That Address Clinical Shortcomings of Current Oral Agents
        • Opportunity: New Alternatives with Differentiated Delivery Profiles
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
      • Attribute Importance and Part-Worth Utilities
        • Oral DMTs for Relapsing Forms of MS Target Product Profile: Attribute Importance
        • Reduction in ARR vs. IFN-Beta over Two Years
        • Reduction in Risk of Three-Month SDP vs. IFN-Beta over Two Years
        • Incidence of GI-Related Side Effects (not Placebo-Adjusted)
        • Overall Risk of PML
        • Dosing Frequency
        • Monitoring Requirements
        • Price per Day
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Oral DMTs in Relapsing Forms of MS Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • Oral DMTs in Relapsing Forms of MS Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • Oral DMTs in Relapsing Forms of MS Market Simulations: Target Product Profiles Included in Scenario 1
        • Oral DMTs in Relapsing Forms of MS Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • Oral DMTs in Relapsing Forms of MS Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • Oral DMTs in Relapsing Forms of MS Market Simulations: Target Product Profiles Included in Scenario 2
    • Appendix
      • Key Abbreviations
      • Bibliography

Author(s): Niyati Khetarpal, Ph.D

"Niyati Khetarpal is a business insights analyst on the Central Nervous System, Pain, and Ophthalmology team at Decision Resources Group. In this role, she conducts primary and secondary research to analyze pharmaceutical markets, with a focus on neurology indications, including epilepsy and MS. She also has specific expertise in patent/IP research. Prior to joining the company, Niyati obtained her doctorate from the International Centre for Genetic Engineering and Biotechnology for her research on Dengue virus vaccines. She received the Fulbright-Nehru doctoral scholarship in 2014 for her research on Dengue and West Nile virus envelope proteins.”


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