Several effective anti-inflammatory agents and bronchodilators are available for controlling patients’ mild or moderate asthma. However, despite the entry of LAMAs (e.g., BI’s Spiriva) and novel biologics (e.g., AstraZeneca’s Fasenra, Teva’s Cinqair, Sanofi / Regeneron’s Dupixent, GSK’s Nucala) in the market, an unmet need remains for effective therapies for severe disease, especially for patients whose symptoms are not adequately controlled with current therapies or who depend on frequent SABA and/or oral corticosteroid use to achieve relief. This “Unmet Need” report provides quantitative insights into key treatment drivers and goals and the current level of unmet need in severe asthma, based on the perceptions of U.S. and European physicians. We analyze the commercial opportunities and how emerging therapies may capitalize on these opportunities.

Questions Answered

  • What are the treatment drivers and goals for severe asthma?
  • What attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do current inhaled (e.g., Spiriva) and biological (e.g., Dupixent, Nucala) therapies perform on key treatment drivers and goals in severe asthma?
  • What are the prevailing areas of unmet need and opportunity in severe asthma?
  • What trade-offs across different clinical attributes and prices are acceptable to U.S. and European physicians for a hypothetical new drug targeting severe asthma?

Geographies

United States, France, Germany, United Kingdom

Primary Research

Survey of approximately 30 U.S. pulmonologists, 30 U.S. allergists, and 30 European pulmonologists

Key Drugs Covered

Xolair, Nucala, Cinqair / Cinqaero, Fasenra, Dupixent, Spiriva (tiotropium), LABA / ICSFDCs

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

  • Asthma - Unmet Need - Detailed, Expanded Analysis (Severe Asthma)
    • Executive Summary
      • Unmet Need - Severe Asthma - Executive Summary - June 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Drug Selection
          • Products / Regimens for Severe Asthma 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 Pulmonologists’ and Allergists’ Prescribing Decisions in Severe Asthma
        • Importance of Efficacy Attributes to Prescribing Decisions in Severe Asthma: United States - Pulmonologists
        • Importance of Efficacy Attributes to Prescribing Decisions in Severe Asthma: United States - Allergists
        • Importance of Efficacy Attributes to Prescribing Decisions in Severe Asthma: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Severe Asthma: United States – Pulmonologists
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Severe Asthma: United States - Allergists
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Severe Asthma: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Severe Asthma: United States - Pulmonologists
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Severe Asthma: United States – Allergists
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Severe Asthma: Europe
        • Importance of Nonclinical Factors to Prescribing Decisions in Severe Asthma: United States – Pulmonologists
        • Importance of Nonclinical Factors to Prescribing Decisions in Severe Asthma: United States – Allergists
        • Importance of Nonclinical Factors to Prescribing Decisions in Severe Asthma: 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 Severe Asthma: United States – Pulmonologists
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Severe Asthma: United States – Allergists
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Severe Asthma: Europe
      • Product Performance Against Treatment Drivers and Goals
        • Key Findings
        • Overall Performance of Key Therapies for Severe Asthma: United States – Pulmonologists
        • Overall Performance of Key Therapies for Severe Asthma: United States – Allergists
        • Overall Performance of Key Therapies for Severe Asthma: Europe
        • Mean Overall Performance of Key Therapies for Severe Asthma: United States and Europe
        • Relative Performance of Key Therapies for Severe Asthma Across Select Efficacy Attributes: United States – Pulmonologists
        • Relative Performance of Key Therapies for Severe Asthma Across Select Efficacy Attributes: United States – Allergists
        • Relative Performance of Key Therapies for Severe Asthma Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for Severe Asthma Across Select Safety and Tolerability Attributes: United States – Pulmonologists
        • Relative Performance of Key Therapies for Severe Asthma Across Select Safety and Tolerability Attributes: United States – Allergists
        • Relative Performance of Key Therapies for Severe Asthma Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for Severe Asthma Across Select Convenience of Administration Attributes: United States – Pulmonologists
        • Relative Performance of Key Therapies for Severe Asthma Across Select Convenience of Administration Attributes: United States – Allergists
        • Relative Performance of Key Therapies for Severe Asthma Across Select Convenience of Administration Attributes: Europe
        • Relative Performance of Key Therapies for Severe Asthma Across Select Nonclinical Attributes: United States – Pulmonologists
        • Relative Performance of Key Therapies for Severe Asthma Across Select Nonclinical Attributes: United States – Allergists
        • Relative Performance of Key Therapies for Severe Asthma Across Select Nonclinical Attributes: Europe
      • Assessment of Unmet Need
        • Key Findings: Unmet Need in Severe Asthma
        • Surveyed Pulmonologists’ Satisfaction with the Performance of Key Therapies for Severe Asthma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Allergists' Satisfaction with the Performance of Key Therapies for Severe Asthma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Pulmonologists’ Satisfaction with the Performance of Key Therapies for Severe Asthma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
        • Surveyed Pulmonologists’ Ascribed Level of Unmet Need Across Key Efficacy Attributes in Severe Asthma: United States
        • Surveyed Allergists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Severe Asthma: United States
        • Surveyed Pulmonologists’ Ascribed Level of Unmet Need Across Key Efficacy Attributes in Severe Asthma: Europe
        • Surveyed Pulmonologists’ Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Severe Asthma: United States
        • Surveyed Allergists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Severe Asthma: United States
        • Surveyed Pulmonologists’ Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Severe Asthma: Europe
        • Surveyed Pulmonologists’ Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Severe Asthma: United States
        • Surveyed Allergists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Severe Asthma: United States
        • Surveyed Pulmonologists’ Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Severe Asthma: Europe
        • Surveyed Pulmonologists’ Ascribed Level of Unmet Need Across Key Nonclinical Factors in Severe Asthma: United States
        • Surveyed Allergists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Severe Asthma: United States
        • Surveyed Pulmonologists’ Ascribed Level of Unmet Need Across Key Nonclinical Factors in Severe Asthma: Europe
        • Key Findings: Unmet Need in Severe Asthma and Related Indications
        • Surveyed Pulmonologists’ Ascribed Level of Unmet Need in Severe Asthma and Related Indications: United States
        • Surveyed Allergists' Ascribed Level of Unmet Need in Severe Asthma and Related Indications: United States
        • Surveyed Pulmonologists’ Ascribed Level of Unmet Need in Severe Asthma and Related Indications: Europe
      • Opportunity Analysis
        • Areas of Opportunity in the Severe Asthma Market and Emerging Therapy Insights
          • Opportunity: Treatments with Robust Efficacy in Reducing Exacerbation Rates
          • Opportunity: Treatments Offering Less Burdensome Administration
          • Opportunity: Treatments with Demonstrated Efficacy in Patients with Non-TH2 Asthma
      • Target Product Profiles
        • Assessing Drug Development Opportunities
        • Target Product Profile Methodology
          • Attributes and Attribute Levels
          • Attributes of Key Current and Late-Phase Emerging Therapies for Severe Asthma
        • Attribute Importance and Part-Worth Utilities
          • Severe Asthma Target Product Profile: Attribute Importance
          • Reduction in Rate of Asthma Exacerbations per Year (%, Placebo-Adjusted)
          • Improvement in Baseline FEV1 at 24 Weeks (mL, Placebo-Adjusted)
          • Efficacy in Asthma Subtypes
          • Improvement in AQLQ Score at 48 Weeks (Points, Placebo-Adjusted)
          • Rate of Severe Adverse Events Over 48 Weeks (% of Patients, Placebo-Adjusted)
          • Dosing Burden (Drug Formulation and Frequency)
          • Price per Day
        • Conjoint Analysis-Based Simulation of a Market Scenario
          • Severe Asthma Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
          • Severe Asthma Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
          • Severe Asthma Market Simulation: Target Product Profiles Included in the Market Scenario
      • Appendix
        • Key Abbreviations
        • Experts Interviewed
        • Bibliography

    Author(s): Ritesh Gupta, PhD

    Ritesh Gupta is a Lead Analyst on the immune and inflammatory disorders team at Decision Resources Group, whose work focuses primarily on Psoriatic Arthritis, Ulcerative Colitis and Crohn’s Disease.

    He holds a Ph.D. degree in Cell Biology from Max Delbrück Center for Molecular Medicine, Berlin, where he worked on development of novel inhibitors for HGF/MET signaling pathways. Prior to joining DRG, Ritesh has worked as an assistant manager with BioXcel corporation and provided insights on various consulting projects. He was also associated with GVK Biosciences and worked on drug repurposing projects.


    Related Reports

    Asthma - Current Treatment - Detailed, Expanded Analysis (EU5)

    The asthma market in the EU5 is highly competitive. Ma...

    View Details

    Asthma - Landscape & Forecast - Disease Landscape & Forecast

    The asthma market consists of many well-established therapies, including inhaled agents (e.g., GlaxoSmithKline’s Advair / Seretide, AstraZeneca’s Symbicort, Boehringer Ingelheim’s...

    View Details