Market Outlook

The most important clinical distinction in the first-line treatment of multiple myeloma is determining whether the patient is eligible to undergo autologous stem-cell transplantation (ASCT). Approximately one-quarter of diagnosed multiple myeloma patients are not eligible to undergo a transplant owing to their age and/or performance status. For years, melphalan-based regimens were the standard of care for these patients, but Celgene’s Revlimid and Thalomid/Thalidomide and Janssen/Takeda’s Velcade have revolutionized the treatment of transplant-ineligible multiple myeloma patients and are now the cornerstones of therapy. Nevertheless, because of the older age and comorbidities of most ASCT-ineligible patients, physicians must focus on treating the symptoms of the disease while managing the toxicity of treatment and improving patients’ quality of life. Thus, significant unmet need remains for well-tolerated agents that can also delay disease progression and extend the survival of this frail patient subpopulation.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals that are most likely to influence a therapy’s uptake for transplant-ineligible multiple myeloma?
  • How do current therapies perform on key clinical drug attributes for this patient population?
  • What are the prevailing areas of unmet need and hidden opportunities in this patient population?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European hematologist-oncologists when considering hypothetical new treatment options for first-line transplant-ineligible multiple myeloma?

PRODUCT DESCRIPTION

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.

SCOPE OF THE REPORT

  • Markets covered: United States, France, Germany, United Kingdom
  • Primary research: Survey of 60 hematologist-oncologists in the United States and 30 medical oncologists in Europe
  • Key companies: Celgene, Janssen, Takeda
  • Key drugs: Revlimid, Velcade, Thalomid/Thalidomide Celgene
  • Key metrics included:
    • Stated versus derived analysis of U.S. and European physician prescribing behavior.
    • Conjoint analysis with U.S. and European physicians, includes market simulator.
    • Assessment of current drug performance against treatment drivers and goals.
    • Physician perceptions of unmet need in disease/subpopulation covered and related diseases/subpopulations. Analysis of remaining drug development opportunities.

Table of contents

  • Multiple Myeloma - Unmet Need - Detailed, Expanded Analysis (US & EU)
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
      • Rationale for Drug Selection
        • Regimens for Transplant-Ineligible Multiple Myeloma
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Hematologist-Oncologists' Prescribing Decisions in Transplant-Ineligible Multiple Myeloma
      • Importance of Efficacy Attributes to Prescribing Decisions in Transplant-Ineligible Multiple Myeloma: United States
      • Importance of Efficacy Attributes to Prescribing Decisions in Transplant-Ineligible Multiple Myeloma: Europe
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Transplant-Ineligible Multiple Myeloma: United States
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Transplant-Ineligible Multiple Myeloma: Europe
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Transplant-Ineligible Multiple Myeloma: United States
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Transplant-Ineligible Multiple Myeloma: 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 Transplant-Ineligible Multiple Myeloma: United States
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Transplant-Ineligible Multiple Myeloma: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
      • Overall Performance of Key Therapies for Transplant-Ineligible Multiple Myeloma: United States
      • Overall Performance of Key Therapies for Transplant-Ineligible Multiple Myeloma: Europe
      • Relative Performance of Key Therapies for Transplant-Ineligible Multiple Myeloma Across Select Efficacy Attributes: United States
      • Relative Performance of Key Therapies for Transplant-Ineligible Multiple Myeloma Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for Transplant-Ineligible Multiple Myeloma Across Select Safety and Tolerability Attributes: United States
      • Relative Performance of Key Therapies for Transplant-Ineligible Multiple Myeloma Across Select Safety and Tolerability Attributes: Europe
      • Relative Performance of Key Therapies for Transplant-Ineligible Multiple Myeloma Across Select Convenience of Administration Attributes: United States
      • Relative Performance of Key Therapies for Transplant-Ineligible Multiple Myeloma Across Select Convenience of Administration Attributes: Europe
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Transplant-Ineligible Multiple Myeloma
      • Surveyed Hematologist-Oncologists’ Satisfaction with the Performance of Key Therapies for Transplant-Ineligible Multiple Myeloma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
      • Surveyed Hematologist-Oncologists’ Satisfaction with the Performance of Key Therapies for Transplant-Ineligible Multiple Myeloma on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Transplant-Ineligible Multiple Myeloma: United States
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Transplant-Ineligible Multiple Myeloma: Europe
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Transplant-Ineligible Multiple Myeloma: United States
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Transplant-Ineligible Multiple Myeloma: Europe
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Transplant-Ineligible Multiple Myeloma: United States
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Transplant-Ineligible Multiple Myeloma: Europe
      • Key Findings: Unmet Need in First-Line Transplant-Ineligible Multiple Myeloma and Related Indications
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need in Transplant-Ineligible Multiple Myeloma and Related Indications: United States
      • Surveyed Hematologist-Oncologists' Ascribed Level of Unmet Need in Transplant-Ineligible Multiple Myeloma and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the Transplant-Ineligible Multiple Myeloma Market and Emerging Therapy Insights
        • Opportunity: A New Therapy with Improved Progression-Free Survival
        • Opportunity: A Novel Agent with a Better Safety and Tolerability Profile
        • Opportunity: A Novel Regimen with a Simple Dosing Schedule
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
        • Assigned Prohibitions for the Conjoint Module
      • Attribute Importance and Part-Worth Utilities
        • Transplant-Ineligible Multiple Myeloma Target Product Profile: Attribute Importance
        • Median Overall Survival
        • Median Progression-Free Survival
        • Overall Response Rate
        • Incidence of Grade 3/4 Neutropenia
        • Incidence of Grade 3/4 Thrombocytopenia
        • Incidence of Grade 3/4 Thromboembolism
        • Price per Cycle
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • First-Line Transplant-Ineligible Multiple Myeloma Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • First-Line Transplant-Ineligible Multiple Myeloma Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • First-Line Transplant-Ineligible Multiple Myeloma Market Simulations: Target Product Profiles Included in Scenario 1
        • First-Line Transplant-Ineligible Multiple Myeloma Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • First-Line Transplant-Ineligible Multiple Myeloma Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • First-Line, Transplant-Ineligible Multiple Myeloma Market Simulations: Target Product Profiles Included in Scenario 1
    • Appendix
      • Key Abbreviations
      • Bibliography

Author(s): Anamika Ghosh, Ph.D.

Anamika Ghosh, Ph.D.,is a Senior Analyst for the oncology team at Decision Resources.

Prior to joining DRG, Anamika was a Research Lead with Evalueserve Pvt. Ltd., a business solutions provider to pharmaceutical companies. At Evalueserve, she worked on various strategic insights solutions for a variety of indications, including oncology, cardiovascular, ophthalmology etc. Anamika holds a PhD on host-pathogen interactions in the context of M. tuberculosis from the International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India, where she also worked as a Research Associate working on Dengue viral infection.


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