Tourette syndrome is a neurological disorder characterized by repetitive, uncontrollable movements and/or unwanted vocal sounds (tics) and typically begins in childhood. Tics range from mild to severe and can therefore significantly affect communication, daily functioning, and quality of life. Aripiprazole, pimozide, and haloperidol are the only therapies with formal approval in either the United States or Europe for Tourette syndrome, but alpha-2 agonists and dopamine-depleting agents are also used off-label. Because pharmacological treatments are usually only partially effective for controlling tics and carry unwanted side effects including somnolence, weight gain, and drug-induced movement disorders, substantial unmet need persists for more effective treatment options.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals for Tourette syndrome?
  • What drug attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • What are the prevailing areas of unmet need and opportunity in Tourette syndrome?
  • What are the commercial opportunities for emerging Tourette syndrome therapies, such as Teva’s deutetrabenazine, Therapix Biosciences’ dronabinol / palmitoylethanolamide, Emalex Biosciences’ ecopipam, and Abide / Lundbeck’s ABX 1431?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European neurologists for a hypothetical new Tourette syndrome drug?

PRODUCT DESCRIPTION

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 January 2020

Key companies: Janssen, Lundbeck, Otsuka Pharmaceutical, Teva, Emalex Biosciences

Key drugs: Aripiprazole, clonidine, guanfacine, pimozide, risperidone, tetrabenazine, tiapride

Table of contents

  • Tourette Syndrome - Unmet Need - Detailed, Expanded Analysis (US/FR/DEU/UK)
    • Executive Summary
      • Unmet Need - Tourette Syndrome - Executive Summary - March 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Drug Selection
          • Products for Tourette Syndrome and Rationale for Drug Selection
      • 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 Tourette Syndrome
        • Importance of Efficacy Attributes to Prescribing Decisions in Tourette Syndrome: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in Tourette Syndrome: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Tourette Syndrome: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Tourette Syndrome: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Tourette Syndrome: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Tourette Syndrome: 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 Tourette Syndrome: United States
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Tourette Syndrome: Europe
      • Product Performance Against Treatment Drivers and Goals
        • Key Findings
        • Overall Performance of Key Therapies for Tourette Syndrome: United States
        • Overall Performance of Key Therapies for Tourette Syndrome: Europe
        • Mean Overall Performance of Key Therapies for Tourette Syndrome: United States and Europe
        • Relative Performance of Key Therapies for Tourette Syndrome Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for Tourette Syndrome Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for Tourette Syndrome Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for Tourette Syndrome Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for Tourette Syndrome Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for Tourette Syndrome Across Select Convenience of Administration Attributes: Europe
      • Assessment of Unmet Need
        • Key Findings: Unmet Need in Tourette Syndrome
        • Surveyed Neurologists’ Satisfaction with the Performance of Key Therapies for Tourette Syndrome on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Neurologists’ Satisfaction with the Performance of Key Therapies for Tourette Syndrome on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Tourette Syndrome: United States
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Tourette Syndrome: Europe
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Tourette Syndrome: United States
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Tourette Syndrome: Europe
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Tourette Syndrome: United States
        • Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Tourette Syndrome: Europe
        • Key Findings: Unmet Need in Tourette Syndrome and Related Indications
        • Surveyed Neurologists' Ascribed Level of Unmet Need in Tourette Syndrome and Related Indications: United States
        • Surveyed Neurologists' Ascribed Level of Unmet Need in Tourette Syndrome and Related Indications: Europe
      • Opportunity Analysis
        • Areas of Opportunity in the Tourette Syndrome Market and Emerging Therapy Insights
          • Opportunity: A Tourette Syndrome Therapy with An Improved Risk/Benefit Profile
        • Lack of Opportunity in the Tourette Syndrome Market and Emerging Therapy Insights
        • Target Product Profiles
          • Assessing Drug Development Opportunities
          • Target Product Profile Methodology
            • Attributes and Attribute Levels
            • Assigned Prohibitions for the Conjoint Module
          • Attribute Importance and Part-Worth Utilities
            • Tourette Syndrome Target Product Profile: Attribute Importance
            • Reduction in Tic Severity from Baseline as Measured By YGTSS-TTS (Placebo-Adjusted)
            • % Patients With a CGI-I Score of Very Much Improved (1) or Much Improved (2)
            • % Patients Responding to Treatment (> 50% Improvement in YGTSS-TTS from Baseline)
            • % Patients Experiencing ≥ 7% Increase in Body Weight (Placebo-Adjusted)
            • % Patients Experiencing Drug-Induced Movement Disorders (Placebo-Adjusted)
            • Dosing Burden
            • Price Per Treated Day
          • Conjoint Analysis-Based Simulation of a Market Scenario
            • Tourette Syndrome Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
            • Tourette Syndrome Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
            • Tourette Syndrome Market Simulation: Target Product Profiles Included in the Market Scenario
        • Appendix
          • Key Abbreviations
          • Bibliography

      Author(s): Natalie Taylor, PhD

      Natalie Taylor, Ph.D. is a Principal Business Insights Analyst with the central nervous system/ophthalmology disorders team at Decision Resources Group. She has over ten years of experience authoring primary and market research reports for pharmaceutical industry clients across multiple psychiatry, pain, neurology, and ophthalmology therapy areas.

      Prior to joining DRG, Dr. Taylor worked at QuintilesIMS as manager of the central nervous system portfolio of Disease Insights market forecasting offerings. She completed her Ph.D. in Physiology at Dartmouth College in Hanover, New Hampshire, where she studied the role of serotonergic neurons in the medullary raphe on modulating respiratory responses in mammals. She holds a B.S. in Biology from Dickinson College in Carlisle, Pennsylvania.