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    Small but Valuable: How Unmet Need in the Severe Asthma Market is Driving Nucala Sales and Offers Opportunity for Others, Including, Teva, AstraZeneca, Sanofi, and Regeneron

    Decision Resources Group finds that Nucala’s novel mechanism of action and specific indication for eosinophilic asthma are key drivers behind the agent’s recent success in the severe asthma market. Although patients with severe asthma constitute only a small percentage of the total asthma population, they bear a disproportionate amount of financial and clinical burden. Until Nucala’s U.S. and European approvals in 2015, severe asthmatics in these markets had few treatment options, typically relying on Novartis/Roche’s anti-IgE agent Xolair or chronic oral corticosteroids.

    Since launching, Nucala has helped drive sales growth among new products for GlaxoSmithKline, helping to counter reducing sales of more mature products. Prescriptions are only expected to continue to increase, as the majority of surveyed U.S. pulmonologists and allergists who have not prescribed Nucala anticipate doing so within the next six months.

    However, our research indicates that despite Nucala’s success, opportunity remains for novel therapies targeting the severe asthmatic population. Indeed, Teva, AstraZeneca, and Sanofi/Regeneron are hoping to emulate—or even surpass—GlaxoSmithKline’s success with their own biologics targeting this population.

    When making treatment decisions for severe asthma, surveyed physicians strongly consider a drug’s effect in reducing exacerbations, reducing corticosteroid-use, and improving quality of life. Thus, clinical trial data, such as those released at the AAAAI meeting earlier this month from GlaxoSmithKline’s Phase IIIb MUSCA study for Nucala (in which quality of life was a primary end point), and Sanofi/Regeneron’s ongoing VENTURE study evaluating dupilumab for severe steroid-dependent asthma, could prove valuable for differentiating competitors in this space.

    Other key findings from the Emerging Therapies and Unmet Need reports for Asthma:

    • Physician familiarity with Nucala has only increased in the year following its launch, particularly among allergists. Continued promotion and face-to-face detailing by GlaxoSmithKline will support further growth.
    • Although a targeted treatment for eosinophilic asthma was well received, specialists continue to seek agents with an alternative mechanism of action, indicating opportunity still remains in this market.
    • Furthermore, given the severe morbidity in the severe asthma population coupled with relative paucity of treatment options, even incremental improvements in a novel competitor’s clinical profile compared with Nucala could allow such an agent to capture share from the first-in-class IL-5 antagonist (e.g. minor efficacy advantages or more convenient dosing).