MARKET OUTLOOK

Atrial fibrillation (AF) is the most commonly encountered, sustained cardiac arrhythmia and a condition associated with extreme morbidity, mortality, and cost. The currently available AADs have various safety risks and efficacy limitations. As a result, physicians report high unmet need for safe and efficacious therapies to improve quality of life for AF patients. Based on quantified physician perception of current therapies, we discuss the attractiveness of drug attributes and the implications for AF drug development. It is important to understand the influence of key efficacy, safety/tolerability, and nonclinical attributes on physician prescribing behavior to achieve commercial success with AADs within this indication. Our conjoint analysis reveals the key trade-offs that surveyed physicians are willing to make for these attributes when considering new treatment options for AF.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals for AF?
  • 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 AF?
  • What are the prevailing areas of unmet need and opportunity in AF?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European cardiologists for a hypothetical new AF 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 61 U.S. and 30 European cardiologists fielded in February 2018.

Key companies: Sanofi, GlaxoSmithKline, Bristol-Myers Squibb, Pfizer.

Key drugs: Amiodarone, dronedarone, flecainide, propafenone.

Table of contents

  • Atrial Fibrillation - Unmet Need - Detailed, Expanded Analysis (US & EU)
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
      • Rationale for Drug Selection
        • Products for Atrial Fibrillation
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Cardiologists' Prescribing Decisions in Atrial Fibrillation
      • Importance of Efficacy Attributes to Prescribing Decisions in Atrial Fibrillation: United States
      • Importance of Efficacy Attributes to Prescribing Decisions in Atrial Fibrillation: Europe
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Atrial Fibrillation: United States
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Atrial Fibrillation: Europe
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Atrial Fibrillation: United States
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Atrial Fibrillation: 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 Atrial Fibrillation: United States
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Atrial Fibrillation: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
      • Overall Performance of Key Therapies for Atrial Fibrillation: United States
      • Overall Performance of Key Therapies for Atrial Fibrillation: Europe
      • Relative Performance of Key Therapies for Atrial Fibrillation Across Select Efficacy Attributes: United States
      • Relative Performance of Key Therapies for Atrial Fibrillation Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for Atrial Fibrillation Across Select Safety and Tolerability Attributes: United States
      • Relative Performance of Key Therapies for Atrial Fibrillation Across Select Safety and Tolerability Attributes: Europe
      • Relative Performance of Key Therapies for Atrial Fibrillation Across Select Convenience of Administration Attributes: United States
      • Relative Performance of Key Therapies for Atrial Fibrillation Across Select Convenience of Administration Attributes: Europe
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Atrial Fibrillation
      • Surveyed Cardiologists’ Satisfaction with the Performance of Key Therapies for Atrial Fibrillation on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
      • Surveyed Cardiologists’ Satisfaction with the Performance of Key Therapies for Atrial Fibrillation on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Atrial Fibrillation: United States
      • Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Atrial Fibrillation: Europe
      • Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Atrial Fibrillation: United States
      • Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Atrial Fibrillation: Europe
      • Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Atrial Fibrillation: United States
      • Surveyed Cardiologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Atrial Fibrillation: Europe
      • Key Findings: Unmet Need in Atrial Fibrillation and Related Indications
      • Surveyed Cardiologists' Ascribed Level of Unmet Need in Atrial Fibrillation and Related Indications: United States
      • Surveyed Cardiologists' Ascribed Level of Unmet Need in Atrial Fibrillation and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the Atrial Fibrillation Market and Emerging Therapy Insights
        • Opportunity: A Novel Antiarrhythmic for Atrial Fibrillation Patients with Heart Failure or Structural Heart Disease
        • Opportunity: A Novel Agent That Reduces the Rate of Mortality in Atrial Fibrillation
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
      • Attribute Importance and Part-Worth Utilities
        • Atrial Fibrillation Target Product Profile: Attribute Importance
        • Duration of Normal Sinus Rhythm Following Treatment Initiation (Days)
        • Incidence of AF Recurrence at 12 Months (%)
        • Reduction in Rate of All-Cause Mortality (%)
        • Patients Experiencing Hospitalizations Due to Cardiovascular Events (%)
        • Percentage of Patients Developing Bradycardia
        • Dosing Burden (Route and Frequency of Administration)
        • Price per Day
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Atrial Fibrillation Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • Atrial Fibrillation Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • Atrial Fibrillation Market Simulations: Target Product Profiles Included in Scenario 1
        • Atrial Fibrillation Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • Atrial Fibrillation Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • Atrial Fibrillation Market Simulations: Target Product Profiles Included in Scenario 2
    • Appendix
      • Key Abbreviations
      • Bibliography

Author(s): Shreya Saxena, MBA

Shreya Saxena is a senior business insights analyst in the Cardiovascular, Metabolic and Renal disorders team at Decision Resources Group.

She obtained an M.B.A. degree with specializations in Marketing and HR, and a Bachelor's degree in Pharmacy from the GGSIPU University, Delhi, India. Prior to joining DRG, she has worked as a Business Analyst at the research firm Evalueserve. Her role involved in-depth commercial, and scientific secondary research, and competitive intelligence across multiple indications (such as atrial fibrillation, ACS, VTE, heart failure and women’s health), including pipeline analysis, clinical trials assessment, disease landscaping, product and company profiling, and financial assessment and benchmarking.