November 09, 2020
Increased Biosimilar Prescribing and New Subcutaneous Formulations Are Poised to Impact Biologic Switching in the EU Inflammatory Bowel Disease Market, According to Spherix Global Insights
Infliximab and adalimumab biosimilars continue to increase their presence in ulcerative colitis and Crohn’s disease therapy switching, while Entyvio SC and Remsima SC will cannibalize prescribing of their intravenous formulations
EXTON, Pa., November 9, 2020 /PRNewswire/ — According to the latest report published as part of Spherix’s RealWorld Dynamix™: Biologic/Small Molecule Switching in IBD (EU) service, EU gastroenterologists (n=299) are adjusting their inflammatory bowel disease (IBD) treatment algorithms by increasing their biosimilar prescribing as well as their receptivity to new subcutaneous biologics.
The Spherix study summarizes the wealth of patient-level data captured from 1,275 unique IBD patient records from France, Germany, Italy, Spain, and the United Kingdom (EU5) who were recently switched from one advanced therapy to another. The study also examines several aspects of the advanced therapy switch process, including the criteria for assessing a potential switch patient, the clinical attribute drivers in the decision to switch, and the consideration set for switched therapies.
Although still predominant in the first-line setting for both ulcerative colitis (UC) and Crohn’s disease (CD), branded TNF inhibitor use (e.g. AbbVie’s Humira, Janssen’s Remicade) has decreased over the past year – especially in UC. On the other hand, first-line prescribing for their biosimilar counterparts continues to increase in the EU5 (more so in CD) and is anticipated to surpass branded TNF use in this line of therapy.
With their longer tenure on the market, the infliximab biosimilars, namely Pfizer’s Inflectra and Celltrion’s Remsima (IV – intravenous), are the most prescribed biosimilars in the first-line setting. However, the adalimumab biosimilars (e.g. Amgen’s Amgevita) are also increasing their levels of use across all lines of therapy in UC and CD. With the decrease in branded TNF inhibitor prescribing, alternative mechanism of action therapies (e.g. Takeda’s Entyvio, Janssen’s Stelara, Pfizer’s Xeljanz) also increased their share of first- and second-line prescribing versus last year.
Continued growth of these biosimilar agents in the EU5 look promising, as the first subcutaneous formulation of an infliximab biosimilar, Remsima (SC – subcutaneous), is expected to become available for IBD in the EU before the end of 2020.1 Once the drug achieves EU-wide commercial availability, future share projections estimate that Remsima SC may cannibalize substantial share from its IV formulation in a “next-switch scenario” analysis within the report.
An analogous situation of cannibalization exists for Entyvio, which recently snagged the EU approval for its subcutaneous formulation. Of all UC and CD patients switched to Entyvio (IV and SC across all lines of therapy), about one-quarter were switched to Entyvio SC, with the remainder of switches going to Entyvio IV. This already represents an impressive 25% share for Entyvio SC of all Entyvio prescribing in the switch market, after just a few months. When asked prospectively which therapy Entyvio SC would most likely replace via any future switching, Entyvio IV was selected by more than 60% of gastroenterologists for both UC and CD patients.
With the increased use of the biosimilars and the new subcutaneous formulations, gastroenterologists have a growing list of options to treat their IBD patients. However, even more pipeline agents are on the horizon, and the RealWorld Dynamix™ study evaluates the prospects for those therapies by assessing them in the current EU5 switch dynamic.
Gilead’s filgotinib and AbbVie’s upadacitinib are the pipeline agents that were rated as most likely to replace current treatment options in both UC and CD. At least some of this receptivity was likely due to these therapies also achieving the highest ratings in pipeline agent familiarity. Spherix continues to monitor the potential for several pipeline agents in its RealTime Dynamix™: Inflammatory Bowel Disease (EU) service.
About RealWorld Dynamix™
RealWorld Dynamix™: Biologic/Small Molecule Switching in IBD (EU) is an independent, data-driven service unmasking real patient management patterns through annual reports based on chart audits of ~1,200 patients. The report uncovers the “why” behind treatment decisions, includes year over year trending to quantify key aspects of market evolution, and integrates specialists’ attitudinal & demographic data to highlight differences between stated and actual treatment patterns.
About Spherix Global Insights
Spherix Global Insights is a hyper-focused market intelligence firm that leverages our own independent data and expertise to provide strategic guidance, so biopharma stakeholders make decisions with confidence. We specialize in select immunology, nephrology, and neurology markets.
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