Patients with osteoporosis have an increased risk of fractures owing to a loss in bone strength. A significant unmet need exists for treatment that is more effective than current therapies and well tolerated, thereby improving patient compliance. We assess how current therapies are differentiated based on the performance of key drug attributes and measure their impact on rheumatologists’ and endocrinologists’ prescribing behavior. We also evaluate the most important unmet needs in the treatment of osteoporosis and discuss the impact of the launch of Evenity on these needs. Our conjoint analysis reveals the trade-offs in key attributes, such as risk of fracture, safety, dosing burden, and price, that surveyed physicians are willing to make when considering new treatment options for osteoporosis.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals for osteoporosis?
  •  What drug attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do U.S. and European physicians rate the performances of current therapies, including Eli Lilly’s Forteo, Amgen / UCB’s Evenity, Amgen’s Prolia, and Radius Health’s Tymlos, on key treatment drivers and goals?
  • How has the launch of Evenity in the United States affected the need for more-efficacious osteoporosis treatments?
  • What trade-offs across different clinical attributes and prices are acceptable to U.S. and European physicians for a hypothetical new osteoporosis drug?

PRODUCT DESCRIPTION

Unmet Need 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 60 U.S. and 30 European rheumatologists and endocrinologists fielded in March 2020

Key companies: Eli Lilly, Amgen, Radius Health, Merck, Novartis

Key drugs: Evenity, Prolia, Forteo, Tymlos

Table of contents

  • Osteoporosis - Unmet Need - Detailed, Expanded Analysis (US/EU)
    • Executive Summary
      • Unmet Need - Osteoporosis - Executive Summary - May 2020
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Treatment Drivers and Goals
      • Rationale for Drug Selection
        • Products for Osteoporosis 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 Rheumatologists' and Endocrinologists' Prescribing Decisions in Osteoporosis
      • Importance of Efficacy Attributes to Prescribing Decisions in Osteoporosis: United States
      • Importance of Efficacy Attributes to Prescribing Decisions in Osteoporosis: Europe
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Osteoporosis: United States
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Osteoporosis: Europe
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Osteoporosis: United States
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Osteoporosis: Europe
      • Importance of Nonclinical Factors to Prescribing Decisions in Osteoporosis: United States
      • Importance of Nonclinical Factors to Prescribing Decisions in Osteoporosis: 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 Osteoporosis: United States
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Osteoporosis: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
      • Overall Performance of Key Therapies for Osteoporosis: United States
      • Overall Performance of Key Therapies for Osteoporosis: Europe
      • Mean Overall Performance of Key Therapies for Osteoporosis: United States and Europe
      • Relative Performance of Key Therapies for Osteoporosis Across Select Efficacy Attributes: United States
      • Relative Performance of Key Therapies for Osteoporosis Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for Osteoporosis Across Select Safety and Tolerability Attributes: United States
      • Relative Performance of Key Therapies for Osteoporosis Across Select Safety and Tolerability Attributes: Europe
      • Relative Performance of Key Therapies for Osteoporosis Across Select Convenience of Administration Attributes: United States
      • Relative Performance of Key Therapies for Osteoporosis Across Select Convenience of Administration Attributes: Europe
      • Relative Performance of Key Therapies for Osteoporosis Across Select Nonclinical Attributes: United States
      • Relative Performance of Key Therapies for Osteoporosis Across Select Nonclinical Attributes: Europe
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Osteoporosis
      • Surveyed Rheumatologists' and Endocrinologists' Satisfaction with the Performance of Key Therapies for Osteoporosis on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
      • Surveyed Rheumatologists' and Endocrinologists' Satisfaction with the Performance of Key Therapies for Osteoporosis on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Surveyed Rheumatologists' and Endocrinologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Osteoporosis: United States
      • Surveyed Rheumatologists' and Endocrinologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Osteoporosis: Europe
      • Surveyed Rheumatologists' and Endocrinologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Osteoporosis: United States
      • Surveyed Rheumatologists' and Endocrinologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Osteoporosis: Europe
      • Surveyed Rheumatologists' and Endocrinologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Osteoporosis: United States
      • Surveyed Rheumatologists' and Endocrinologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Osteoporosis: Europe
      • Surveyed Rheumatologists' and Endocrinologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Osteoporosis: United States
      • Surveyed Rheumatologists' and Endocrinologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in Osteoporosis: Europe
      • Key Findings: Unmet Need in Osteoporosis and Related Indications
      • Surveyed Rheumatologists' and Endocrinologists' Ascribed Level of Unmet Need in Osteoporosis and Related Indications: United States
      • Surveyed Rheumatologists' and Endocrinologists' Ascribed Level of Unmet Need in Osteoporosis and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the Osteoporosis Market and Emerging Therapy Insights
        • Opportunity: Focus on Developing Drugs with Enhanced Efficacy
        • Opportunity: Availability of Therapies That Are Cost-Effective with Convenient Dosing Regimens to Improve Compliance Rates
        • Opportunity: Therapies with an Improved Safety and Tolerability Profile to Address Patients’ Reluctance and Improve Drug Acceptance
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
      • Attribute Importance and Part-Worth Utilities
        • Osteoporosis Target Product Profile: Attribute Importance
        • Relative Risk Reduction of Vertebral Fractures
        • Relative Risk Reduction of Non-Vertebral Fractures
        • Time to Achieve Significant Change (2-4%) in Lumbar Spine BMD
        • Clinical Tolerability of Less-Serious Side Effects
        • Risk of Serious Adverse Events
        • Dosing Burden: Formulation and Frequency
        • Price per Day of Therapy
      • Conjoint Analysis-Based Simulation of a Market Scenario
        • Osteoporosis Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
        • Osteoporosis Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
        • Osteoporosis Market Simulation: Target Product Profiles Included in the Market Scenario
    • Appendix
      • Key Abbreviations
      • Bibliography

Author(s): Shambhavi Shukla

David Rees, , is a Business Insights Analyst with the Cardiovascular, Metabolic, and Renal Disorders team at Decision Resources Group. Prior to joining Decision Resources Group, Dr. Rees was a Postdoctoral Research Associate at Imperial College London, and the Institute of Cancer Research. For his doctoral research, he studied the structures of molecular machines in the Nobel Prize winning laboratory of Prof. Sir John Walker at the University of Cambridge. Dr. Rees earned his undergraduate from the University of Bath.


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