The moderate to severe atopic dermatitis (AD) market is at the beginning of a revolution with the recent approval of Sanofi/Regeneron’s first-in-class biologic, Dupixent, and a promising suite of late-phase agents advancing in the pipeline (e.g., Eli Lilly’s baricitinib, Pfizer’s abrocitinib, LEO Pharma’s tralokinumab and delgocitinib, AbbVie’s upadacitinib, Dermira’s lebrikizumab, Galderma’s nemolizumab). In this report, we assess the commercial opportunity remaining in the topical-refractory moderate to severe AD space through a comprehensive analysis of dermatologists’ treatment goals; the key efficacy, safety, and delivery attributes driving prescribing choice; the gaps in treatment left by current therapies; and the interplay of clinical and nonclinical attributes in determining the commercial potential of new AD products.

QUESTIONS ANSWERED

  •  What are the key treatment drivers for topical-refractory moderate to severe AD patients? How do current therapies such as Dupixent perform against these key treatment drivers and goals?
  • Where do surveyed dermatologists perceive the largest gaps in the treatment of topical-refractory moderate to severe AD patients? Which present the most compelling commercial opportunities?
  • What trade-offs among queried clinical attributes and price are acceptable to U.S. or European dermatologists when considering whether to prescribe a hypothetical new AD therapy?

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

Primary research: Survey of 60 U.S. and 30 European dermatologists treating pediatric patients

Key companies:Sanofi, Regeneron, Pfizer, AbbVie, LEO Pharma, Eli Lilly, Incyte

Key drugs: Dupixent, cyclosporine, methotrexate, azathioprine, mycophenolate, oral prednisone

KEY METRICS INCLUDED

  • Target Product Profile (TPP) simulator based on conjoint analysis methodology.
  • Stated versus derived importance of product attributes on prescribing behavior.
  • Assessment of current drug performance against treatment drivers and goals.
  • Physician perceptions of unmet needs in the indication and related indications.
  • Analysis of remaining drug development opportunities.

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. One market scenario is profiled in detail by DRG experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

Table of contents

  • Atopic Dermatitis/Atopic Eczema - Unmet Need - Detailed, Expanded Analysis - Moderate To Severe (US/EU)
    • Executive Summary
      • Introduction
        • Overview
        • Methodology
        • Rationale for Treatment Drivers and Goals Selection
          • Rationale for Drug Selection
            • Products for Atopic Dermatitis 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 Dermatologists' Prescribing Decisions in Topical-Refractory Moderate to Severe Atopic Dermatitis
          • Importance of Efficacy Attributes to Prescribing Decisions in Topical-Refractory Moderate to Severe Atopic Dermatitis: United States
          • Importance of Efficacy Attributes to Prescribing Decisions in Topical-Refractory Moderate to Severe Atopic Dermatitis: Europe
          • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Topical-Refractory Moderate to Severe Atopic Dermatitis: United States
          • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Topical-Refractory Moderate to Severe Atopic Dermatitis: Europe
          • Importance of Convenience of Administration Attributes to Prescribing Decisions in Topical-Refractory Moderate to Severe Atopic Dermatitis: United States
          • Importance of Convenience of Administration Attributes to Prescribing Decisions in Topical-Refractory Moderate to Severe Atopic Dermatitis: Europe
          • Importance of Nonclinical Factors to Prescribing Decisions in Topical-Refractory Moderate to Severe Atopic Dermatitis: United States
          • Importance of Nonclinical Factors to Prescribing Decisions in Topical-Refractory Moderate to Severe Atopic Dermatitis: 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 Topical-Refractory Moderate to Severe Atopic Dermatitis: United States
          • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Topical-Refractory Moderate to Severe Atopic Dermatitis: Europe
        • Product Performance Against Treatment Drivers and Goals
          • Key Findings
          • Overall Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis: United States
          • Overall Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis: Europe
          • Mean Overall Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis: United States and Europe
          • Relative Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis Across Select Efficacy Attributes: United States
          • Relative Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis Across Select Efficacy Attributes: Europe
          • Relative Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis Across Select Safety and Tolerability Attributes: United States
          • Relative Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis Across Select Safety and Tolerability Attributes: Europe
          • Relative Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis Across Select Convenience of Administration Attributes: United States
          • Relative Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis Across Select Convenience of Administration Attributes: Europe
          • Relative Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis Across Select Nonclinical Attributes: United States
          • Relative Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis Across Select Nonclinical Attributes: Europe
        • Assessment of Unmet Need
          • Key Findings: Unmet Need in Topical-Refractory Moderate to Severe Atopic Dermatitis
          • Surveyed Dermatologists’ Satisfaction with the Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
          • Surveyed Dermatologists’ Satisfaction with the Performance of Key Therapies for Topical-Refractory Moderate to Severe Atopic Dermatitis on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
          • Surveyed Dermatologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Topical-Refractory Moderate to Severe Atopic Dermatitis: United States
          • Surveyed Dermatologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Topical-Refractory Moderate to Severe Atopic Dermatitis: Europe
          • Surveyed Dermatologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Topical-Refractory Moderate to Severe Atopic Dermatitis: United States
          • Surveyed Dermatologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Topical-Refractory Moderate to Severe Atopic Dermatitis: Europe
          • Surveyed Dermatologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Topical-Refractory Moderate to Severe Atopic Dermatitis: United States
          • Surveyed Dermatologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Topical-Refractory Moderate to Severe Atopic Dermatitis: Europe
          • Surveyed Dermatologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Topical-Refractory Moderate to Severe Atopic Dermatitis: United States
          • Surveyed Dermatologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Topical-Refractory Moderate to Severe Atopic Dermatitis: Europe
          • Key Findings: Unmet Need in Topical-Refractory Moderate to Severe Atopic Dermatitis and Related Indications
          • Surveyed Dermatologists' Ascribed Level of Unmet Need in Topical-Refractory Moderate to Severe Atopic Dermatitis and Related Indications: United States
          • Surveyed Dermatologists' Ascribed Level of Unmet Need in Topical-Refractory Moderate to Severe Atopic Dermatitis and Related Indications: Europe
        • Opportunity Analysis
          • Areas of Opportunity in the Topical Refractory, Moderate to Severe Atopic Dermatitis Market and Emerging Therapy Insights
            • Opportunity: Systemic Therapies That Are More Effective in Clearing Eczema and Reducing Itch
            • Opportunity: Additional Effective Therapies That Have Good Safety and Delivery Profiles
            • Opportunity: Systemic Therapies with a More Rapid Onset of Action
        • Target Product Profiles
          • Assessing Drug Development Opportunities
          • Target Product Profile Methodology
            • Attributes and Attribute Levels
          • Attribute Importance and Part-Worth Utilities
            • Topical-Refractory Moderate to Severe AD Target Product Profile: Attribute Importance
            • Percentage of Patients Achieving IGA of 0-1 and ≥ 2-Unit Improvement at Week 16 (Monotherapy)
            • Percentage Improvement from Baseline in Pruritus NRS at Week 16 (Monotherapy)
            • EASI-75 Responder Rate at Week 16 (Monotherapy)
            • Percentage of Patients Improving ≥ 4 Points on Pruritus NRS at Week 2 (Monotherapy)
            • Delivery Burden (Route of Administration and Dosing Frequency)
            • Percentage of Patients with Noncutaneous Infectious Adverse Events at Week 16 (Monotherapy)
            • Price Per Treated Day
          • Conjoint Analysis-Based Simulations of a Market Scenario
            • Topical-Refractory Moderate to Severe AD Market Simulations: Share of Preference of Target Product Profiles Included in the Market Scenario
            • Topical-Refractory Moderate to Severe AD Market Simulations: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
            • Topical-Refractory Moderate to Severe Atopic Dermatitis Market Simulations: Target Product Profiles Included in the Market Scenario
        • Appendix
          • Key Abbreviations
          • Bibliography

      Author(s): Pallavi Rajput, Ph.D

      Pallavi Rajput joined Decision Resources Group as an associate analyst in 2019. Her focus is on the disease landscape and forecast of infectious diseases, niche and rare diseases.

      She holds a Ph.D. in molecular biology and virology from the International Centre for Genetic Engineering and Biotechnology, New Delhi, India. Prior to joining Decision Resources Group, Pallavi was a postdoctoral fellow at the University of California- Davis, where her research focused on the role of DNA repair in cancer development.


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