IBS-D is a highly prevalent disorder regularly encountered in general practice that is marked by excessive defecation and abdominal pain/discomfort. Currently, its etiology and pathophysiology are poorly characterized, and there are no objective means to diagnose the disease (e.g., a biomarker), guide development of new therapeutic approaches, or target IBS-D patients who are likely to respond adequately to treatment. Current treatments for IBS-D and clinical investigations of new therapies focus on amelioration of symptoms (e.g., decreased pain, reduced frequency of defecation). However, this market is highly underserved, with the majority of available agents offering suboptimal efficacy or being associated with undesirable side effects. Thus, unmet need is high in this indication, leaving significant commercial opportunity for novel IBS-D therapies.

The Unmet Need content provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need in IBS-D. We analyze the commercial opportunities in the IBS-D therapy market and discuss how emerging therapies may be able to capitalize on these opportunities.

Questions Answered:

  • What are the treatment drivers and goals for IBS-D?
  • What 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 IBS-D?
  • What are the prevailing areas of unmet need and opportunity in IBS-D?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European gastroenterologists for a hypothetical new IBS-D drug?

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

Primary research: Survey of 61 U.S. and 32 European gastroenterologists fielded in February 2017

Key companies: Allergan, Sebela Pharmaceuticals, Valeant Pharmaceuticals

Key drugs: Viberzi, Truberzi, Xifaxan, Lotronex, Imodium

Table of contents

  • Irritable Bowel Syndrome - Unmet Need - Detailed, Expanded Analysis (US/EU): Irritable Bowel Syndrome-Diarrhea Predominant
    • Treatment Drivers and Goals
      • Overview
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
        • Nonclinical Factors
      • Physician Rating of Treatment Drivers and Goals in IBS-D
        • Importance of Efficacy Attributes to Prescribing Decisions in IBS-D: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in IBS-D: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in IBS-D: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in IBS-D: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in IBS-D: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in IBS-D: Europe
        • Importance of Nonclinical Factors to Prescribing Decisions in IBS-D: United States
        • Importance of Nonclinical Factors to Prescribing Decisions in IBS-D: Europe
      • Stated Versus Derived Importance of Treatment Drivers and Goals
        • Stated Versus Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in IBS-D: United States
        • Stated Versus Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in IBS-D: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Overview
      • Rationale for Drug Selection
        • Products for IBS-D
      • Current Brand Performance on Key Treatment Drivers and Goals
        • Overall Performance of Key Therapies for IBS-D: United States
        • Overall Performance of Key Therapies for IBS-D: Europe
        • Relative Performance of Key Therapies for IBS-D Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for IBS-D Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for IBS-D Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for IBS-D Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for IBS-D Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for IBS-D Across Select Convenience of Administration Attributes: Europe
        • Relative Performance of Key Therapies for IBS-D Across Select Non-Clinical Attributes: United States
        • Relative Performance of Key Therapies for IBS-D Across Select Non-Clinical Attributes: Europe
    • Assessment of Unmet Need
      • Overview
      • Overall Satisfaction with Current Treatment
        • Surveyed Gastroenterologists' Satisfaction with the Performance of Key Therapies for IBS-D on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Gastroenterologists’ Satisfaction with the Performance of Key Therapies for IBS-D on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Physician Rating of Unmet Need in IBS-D
        • Surveyed Gastroenterologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in IBS-D: United States
        • Surveyed Gastroenterologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in IBS-D: Europe
        • Surveyed Gastroenterologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in IBS-D: United States
        • Surveyed Gastroenterologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in IBS-D: Europe
        • Surveyed Gastroenterologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in IBS-D: United States
        • Surveyed Gastroenterologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in IBS-D: Europe
        • Surveyed Gastroenterologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in IBS-D: United States
        • Surveyed Gastroenterologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in IBS-D: Europe
      • Unmet Need in IBS-D and Related Indications
        • Surveyed Gastroenterologists' Ascribed Level of Unmet Need in IBS-D and Related Indications: United States
        • Surveyed Gastroenterologists' Ascribed Level of Unmet Need in IBS-D and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the IBS-D Market and Emerging Therapy Insights
        • Opportunity: A Novel Agent Offering Improved Efficacy in Reducing Abdominal Pain
        • Opportunity: A Novel Therapy That Rapidly Improves Stool Consistency
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
      • Attribute Importance and Part-Worth Utilities
        • IBS-D Target Product Profile: Attribute Importance
        • Percentage of Patients Reporting Improvement in Global Symptoms for ≥ 50% Days at 12 Weeks
        • Percentage of Patients with ≥ 30% Abdominal Pain Reduction from Baseline for ≥ 50% days at 12 Weeks
        • Percentage of Patients Reporting a Bristol Stool Form Score < 5 for ≥ 50% Days at 12 Weeks
        • Health-Related Quality of Life (Change from Baseline in IBS-QOL Score at 12 Weeks)
        • Rate of Constipation
        • Dosing Frequency
        • Price/Day
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • IBS-D Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • IBS-D Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • IBS-D Market Simulations: Target Product Profiles Included in Scenario 1
        • IBS-D Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • IBS-D Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • IBS-D Market Simulations: Target Product Profiles Included in Scenario 2
    • Appendix
      • Key Abbreviations
      • Bibliography

Author(s): Matthew W. Scutcher, MEng PhD; Andrea Buurma Kravit

Matthew Scutcher is Therapy Leader for the Immune & Inflammatory research team at DRG.  

In this role, he leads a team of 13 Research Associates, Business Insights Analysts and Directors responsible for analyzing some of the largest and most dynamic markets in the pharmaceutical industry

He has been with DRG since 2009 and holds a Ph.D. from University College London and a Master’s degree in Chemical Engineering from Imperial College London.

Andrea Kravit is a director in Decision Resources Group’s Immune and Inflammatory division, where she manages, and supports, a team of therapeutically-aligned analysts who conduct extensive primary and secondary market research in the gastrointestinal and respiratory space. Prior to this role, she was a principal analyst for Decision Resources Group's Central Nervous Systems and Ophthalmology division, where she provided expert insight into the commercial aspects of drug development and market sizing across Pain indications. Her project experience includes patient-based market forecasting, market opportunity assessments, early to late-stage pipeline analyses, and competitive analytics for the life-science industry.