MARKET OUTLOOK

Although TNF-alpha inhibitors remain the preferred choice for psoriatic arthritis (PsA) treatment following conventional DMARDs, the more recently introduced IL-17 inhibitors, Cosentyx and Taltz, and the oral therapies Otezla and Xeljanz have chipped away at the TNF inhibitors’ patient share. Understanding the unmet need in the treatment of PsA and the factors that can differentiate similar products from one another can determine the success of an agent in this competitive space. This report discusses the unmet needs associated with PsA treatment, based on the perceptions of U.S. and European rheumatologists, and which emerging therapies, if any, can capitalize on these opportunities.

QUESTIONS ANSWERED

  • How do Novartis’s Cosentyx, Celgene’s Otezla, and Pfizer’s Xeljanz compare with the other agents used to treat PsA in terms of efficacy, safety, convenience of administration, and access to reimbursement?
  • How do ACR response, PASI score, HAQ-DI improvement, risk of malignancy, and rate of infection affect rheumatologists’ prescribing decisions individually?
  • How do U.S. and European rheumatologists view the value of oral therapies in treating PsA?
  • What are the prevailing areas of unmet need and opportunity in the PsA therapy market?

PRODUCT DESCRIPTION

Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. Two market scenarios are profiled in detail by DRG experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

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

Primary research: Survey of 60 U.S. and 30 European rheumatologists fielded in February 2019

Key companies: AbbVie, Amgen, Janssen, Celgene, Novartis, Pfizer

Key drugs: Adalimumab, etanercept, infliximab, ustekinumab, apremilast, secukinumab, tofacitinib

Table of contents

  • Psoriatic Arthritis - Unmet Need - Detailed, Expanded Analysis (US & EU)
    • 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 Psoriatic Arthritis
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Rheumatologists' Prescribing Decisions in PsA
      • Importance of Efficacy Attributes to Prescribing Decisions in PsA: United States
      • Importance of Efficacy Attributes to Prescribing Decisions in PsA: Europe
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in PsA: United States
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in PsA: Europe
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in PsA: United States
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in PsA: Europe
      • Importance of Nonclinical Factors to Prescribing Decisions in PsA: United States
      • Importance of Nonclinical Factors to Prescribing Decisions in PsA: 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 PsA: United States
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in PsA: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
      • Overall Performance of Key Therapies for PsA: United States
      • Overall Performance of Key Therapies for PsA: Europe
      • Mean Overall Performance of Key Therapies for PsA: United States and Europe
      • Relative Performance of Key Therapies for PsA Across Select Efficacy Attributes: United States
      • Relative Performance of Key Therapies for PsA Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for PsA Across Select Safety and Tolerability Attributes: United States
      • Relative Performance of Key Therapies for PsA Across Select Safety and Tolerability Attributes: Europe
      • Relative Performance of Key Therapies for PsA Across Select Convenience of Administration Attributes: United States
      • Relative Performance of Key Therapies for PsA Across Select Convenience of Administration Attributes: Europe
      • Relative Performance of Key Therapies for PsA Across Select Nonclinical Attributes: United States
      • Relative Performance of Key Therapies for PsA Across Select Nonclinical Attributes: Europe
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in PsA
      • Surveyed Rheumatologists’ Satisfaction with the Performance of Key Therapies for PsA on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
      • Surveyed Rheumatologists’ Satisfaction with the Performance of Key Therapies for PsA on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in PsA: United States
      • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in PsA: Europe
      • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in PsA: United States
      • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in PsA: Europe
      • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in PsA: United States
      • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in PsA: Europe
      • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in PsA: United States
      • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in PsA: Europe
      • Key Findings: Unmet Need in PsA and Related Indications
      • Surveyed Rheumatologists' Ascribed Level of Unmet Need in PsA and Related Indications: United States
      • Surveyed Rheumatologists' Ascribed Level of Unmet Need in PsA and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the PsA Market and Emerging Therapy Insights
        • Opportunity: A More-Efficacious Oral Targeted Synthetic DMARD
        • Opportunity: A Biologic That Is More Efficacious than TNF-Alpha Inhibitors in Treating PsA-Associated Musculoskeletal Disease
        • Opportunity: A New Biologic with Longer Sustained Efficacy
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
      • Attribute Importance and Part-Worth Utilities
        • PsA Target Product Profile: Attribute Importance
        • ACR 50 (Response at Week 12, % of Patients, Placebo-Adjusted)
        • Malignancy Warning from the FDA
        • PASI 75 (Response at Week 24; % of Patients, Placebo-Adjusted)
        • HAQ-DI (Score at Week 12, Placebo-Adjusted, Baseline-Normalized)
        • Rate of Serious Infections (per 100 Patient-Years, Placebo-Adjusted)
        • Delivery Burden
        • Price
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • PsA Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • PsA Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • PsA Market Simulations: Target Product Profiles Included in Scenario 1
        • PsA Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • PsA Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • PsA Market Simulations: Target Product Profiles Included in Scenario 2
    • Appendix
      • Key Abbreviations
      • Experts Interviewed
      • Bibliography

Author(s): Yingdee Unhavaithaya

Yingdee Unhavaithaya is a Business Insights Analyst on the Immune and Inflammatory Disorders team at Decision Resources Group, primarily focusing on psoriasis.

Prior to joining DRG, Yingdee was an analyst at Citeline, where he analyzed data on oncology clinical trials progression.  He was also a business development intern at the Massachusetts General Hospital Research Ventures and Licensing office, where he performed market research to look for invention licensing opportunities.  Yingdee received his Ph.D. in cell biology from the University of Massachusetts Medical School, and a B.S. in biology from the University of Pittsburgh at Greensburg.


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