EXTON, Pa., Oct. 8, 2018 /PRNewswire/ — The most recent quarterly results of a study conducted by Spherix Global Insights with 100 US rheumatologists reveals that Xeljanz’s user base has increased by a greater margin than the user base for Taltz for the treatment of psoriatic arthritis (PsA) over the last three months. Close to three-quarters of rheumatologists are now prescribing the JAK inhibitor, versus less than two-thirds for Eli Lilly’s IL-17 inhibitor. Though rheumatologists’ estimated brand share has remained unchanged over the prior quarter, recent prescribing estimates reveal that use of both Xeljanz and Taltz is likely on the rise (along with Novartis’ Cosentyx), especially when compared to traditional TNF-inhibiting agents.
Despite a steadily increasing user base in PsA, the average number of patient initiations on Xeljanz has remained relatively flat since last quarter, suggesting the growth in user base is not being reflected in volume. Furthermore, current users report that many of their recent Xeljanz initiations received samples of the product, though only 15% agree it is easy to get commercial insurance approval of Xeljanz, even after providing information that patients have a positive response to treatment via samples. Another disconcerting finding reveals that Xeljanz discontinuations are on the rise compared to the previous quarter. While a good proportion of discontinuations are due to efficacy or tolerability concerns, a substantial amount is due to insurance coverage or out-of-pocket costs issues, which may be indicative of Pfizer’s sampling strategy or difficulties with patient access programs. In fact, fewer rheumatologists share a positive opinion of Pfizer’s patient assistance program than earlier in the year. Despite these limitations, Xeljanz is still considered as the go-to option for needle-phobic patients, at parity with Celgene’s Otezla.
While the Taltz user base appears to be stabilizing, the brand has been able to capitalize on Cosentyx’s success in the IL-17 space, with nearly half of the surveyed rheumatologists reporting that they consider these agents to be interchangeable. Familiarity with Taltz is up from the previous quarter which is likely attributed to a successful rollout from Eli Lilly sales representatives. Taltz’s strong skin data is reflected by a growing number of physicians considering it to be a preferred option for patients with severe skin involvement, despite the dominance of AbbVie’s Humira in skin-focused disease. The biggest barrier for Taltz appears to be an increasing rate of pre-authorization denials, which may be the result of the difficulties a second-in-class agent has in obtaining adequate formulary coverage with payers.
Performance of Simponi Aria and Orencia remain unchanged from the summer months. While both brands have high levels of awareness, familiarity, and user bases, neither agent is disrupting the treatment landscape. Less than half of all Simponi use is reserved for the IV formulation. Both brands struggle to be associated with any specific patient types, although Orencia tends to be preferred when safety is of concern, but to a lesser extent than Otezla.
Even with the availability of new treatments which are nibbling away share from the older TNFs like Amgen’s Enbrel, and Humira, close to half of respondents believe there is a high level of unmet need for new PsA treatments. Rheumatologists report sustained long-term efficacy, beneficial coverage and access, as well as a significant reduction in joint pain to be the most important features that a developmental agent must possess to ensure success in this crowded market. Regardless of this stated need, awareness and familiarity of developmental agents like AbbVie’s upadacitinib and risankizumab, Janssen’s Tremfya (guselkumab), and UCB’s bimekizumab remains low.
About RealTime Dynamix™
RealTime Dynamix: Psoriatic Arthritis US is an independent report series published on a quarterly basis. The series tracks the evolution of the PsA market, provides a deep dive on launch effectiveness, and highlights opportunities for pipeline agents.
About Spherix Global Insights
Spherix Global Insights is an independent business intelligence and market research company, specializing in renal, autoimmune, neurologic and rare disease markets. Our aim is to apply our commercial experience and unique relationships within core specialty markets to translate data into insight, enabling our clients to make smarter business decisions.
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