November 15, 2023
Eli Lilly’s Olumiant and Pfizer’s Litfulo Strengthen Alopecia Areata Arsenal, Yet Resounding Opportunity for JAK Expansion and New Assets in Development Remain
Despite little prescriber differentiation between the JAKs, including satisfaction and manufacturer perceptions, Olumiant is projected to maintain a significant market lead over Litfulo.
[Exton PA, November 15, 2023] — Spherix Global Insights has been monitoring the alopecia areata (AA) market for the past four years and has found that the entry of JAK inhibitors has had a notable impact on the overall unmet need for those suffering from severe AA. Analysis from the 2023 update of Market Dynamix™: Alopecia Areata reveal the majority of US dermatologists (n=105) are currently prescribing Olumiant to their AA patients, while over half have begun trial of Litfulo. As expected, the overall advanced systemic share of Eli Lilly’s first-to-market JAK inhibitor far outpaces the more recent Pfizer entrant, but six-month projections for both brands are favorable and include both expanded breadth and depth of use. Despite this, Olumiant is anticipated to maintain a substantial lead over Litfulo in the market.
Prescribers of both brands express high and comparable satisfaction levels, far surpassing the satisfaction rates associated with non-advanced systemic treatment options. Specifically, both brands receive equally favorable assessments concerning SALT score, eyebrow and eyelash regrowth, and overall patient satisfaction. However, there is recognition that improvements in safety metrics are necessary due to the JAK class black box warning, indicating an area where both brands, and other assets with plans to join the market, have room for improvement.
Recent data from Spherix’s published studies highlight minimal differentiation among prescribers regarding the two JAK inhibitors. A significant portion—two-fifths—explicitly state no differentiation between the two, while one-quarter of the remaining respondents emphasize that dosing represents the most notable contrast. Fewer than one-fifth report differences in access and efficacy between the brands. Furthermore, barriers preventing increased use of either JAK inhibitor remain closely contested, with safety concerns topping the list for each asset.
While the demand for safer treatment options takes precedence, there’s a notable absence of options for patients under 12 years old, effective topical therapies, treatments tailored for mild and moderate cases, more cost-effective alternatives, and elements of enhanced efficacy. Broadly speaking, among the attributes sought in future AA therapies, long-term safety data emerges as the paramount concern for dermatologists. Nearly equal in significance is sustained efficacy, demonstrating its pivotal role alongside safety in shaping the expectations for forthcoming treatments.
Analysis of specific AA patient charts (n=520 patients) as part of Spherix’s Patient Chart Dynamix™: Alopecia Areata service reaffirms Olumiant’s dominance as the market leader, commanding the majority of the current share for advanced systemic AA treatments. Notably, prescribers highlight that patients were predominantly placed on Olumiant due to familiarity and comfort, whereas the primary driver for initiating patients on the oral JAK3/TEC option, Litfulo, was the desire to trial the newest entrant; aspects likely to diminish as both brands enjoy a longer market tenure.
Moreover, in assessing the support and engagement of both Lilly and Pfizer, no distinct allegiances are discernible. In fact, across various attributes associated with manufacturers, dermatologists were equally inclined, if not more so, to opt for ‘neither company’ as the top-performing manufacturer. This trend was particularly evident concerning attributes like flexibility/accommodation in communication, virtual presence quality, HUB services, and availability of patient education materials.
Specifically addressing areas for improvement, both manufacturers received similar feedback. Dermatologists expressed a shared need for support in access/improvement of patient assistance programs, increased provision of samples, enhanced resources for patient and physician education, and an overall demand for more comprehensive data. These highlighted areas for improvement were equally emphasized for both Lilly and Pfizer.
Given the striking lack of differentiation between the agents and manufacturers, a resounding opportunity remains for new assets to come to market and win over prescribers. Indeed, nearly two-thirds of audited patients remain untreated with either JAK, however, three-quarters of those are considered candidates for an advanced systemic therapy – whether it be a biologic or small molecule.
Despite this, prescribers are generally unaware of the AA pipeline, with the majority only able to recall additional JAK inhibitors in development. Following prompting, dermatologists are most familiar and show preference for well-known line-extensions, including AbbVie’s Rinvoq (upadacitinib) and BMS’ Sotyktu (Deucravacitinib). Topping the familiarity list of novel assets in development for AA are SUN Pharmaceuticals’ deuruxolitinib, Pfizer’s etrasimod, Q32 Bio/Amgen’s (Horizon) bempikibart, and Arcutis’ ivarmacitinib. Other novel therapies in development with overall lower familiarity include Amgen’s (Horizon) daxdilimab, Aslan’s farudostat, and Equillium’s EQ101.
Following the recent acceptance of deuruxolitinib’s new drug application by the FDA in October, it stands as the foremost contender awaiting approval. Of note, despite the developmental lead, interest in deuruxolitinib has waned over the past several years and it garners the overall lowest interest and advance on the market ratings of all pipeline assets queried on. In addition to overall metrics for the AA pipeline, the 2023 Market Dynamix™ presents a comprehensive pre-launch evaluation of Sun’s JAK1/2 inhibitor. This assessment delves into various aspects including awareness, familiarity, interest, perceived advance, likelihood of prescription, anticipated placement in the treatment algorithm, candidacy rates, projected six-month post-launch market share, and the ramifications of the partial clinical hold issued by the FDA in May. Where relevant, all pre-launch metrics are benchmarked against Olumiant and Litfulo.
Spherix will continue to monitor the launches of Olumiant and Litfulo via their Launch Dynamix™ service, providing monthly updates on key performance indicators benchmarked against other key dermatology analogue launches, accompanied with quarterly deep dive reports including qualitative and quantitative analyses, capturing critical perspectives from prescribers.
Patient Chart Dynamix™ is an independent, data-driven service unveiling real patient management patterns through rigorous analysis of large-scale patient chart audits. Insights reveal the “why” behind treatment decisions, include year over year trending to quantify key aspects of market evolution, and integrate specialists’ attitudinal and demographic data, connecting trends at the patient level to the prescribing physicians.
Market Dynamix™ is an independent service providing analysis of markets anticipated to experience a paradigm shift within the next three to five years. Insights highlight market size, current treatment approaches, unmet needs, and expert opinions on the likely disruption introduced by pipeline agents.
Launch Dynamix™ is an independent service providing monthly benchmarking of newly launched products for the first eighteen months of commercial availability, augmented by a quarterly deep dive into promotional activity, barriers to uptake, and patient types gravitating to the launch brand.
About Spherix Global Insights
Spherix Global Insights is a leading provider of market research, business intelligence and advisory services to the global life sciences industry. The company’s unique service offerings are powered by deep therapeutic knowledge, the Spherix Network specialty physician panel, and commercially relevant analyses to enable strategic decision-making by our valued customers.
A trusted advisor and industry thought leader, Spherix Global Insights provides specialized market expertise in six (6) focused therapeutic areas including: dermatology, gastroenterology, nephrology, neurology, rheumatology, and ophthalmology.
To learn more about Spherix Global Insights, visit spherixglobalinsights.com or connect through LinkedIn and Twitter.
For more details on Spherix’s primary market research reports and interactive dashboard offerings, visit or register here: https://clientportal.spherixglobalinsights.com
NOTICE: All company, brand or product names in this press release are trademarks of their respective holders. The findings and opinions expressed within are based on Spherix Global Insight’s analysis and do not imply a relationship with or endorsement by any company, brand, or product aforementioned.