While the alternate mechanism of action agents are becoming increasingly popular in the second- or later-lines of therapy, they are also forfeiting a substantial amount of potential share
EXTON, Pa., September 13, 2019 /PRNewswire/ — The fourth annual patient chart audit included in Spherix’s RealWorld Dynamix™: Biologic/Small Molecule Switching in PsA (US) service includes the feedback of 192 US rheumatologists who profiled 994 psoriatic arthritis (PsA) patients recently switched from one biologic/small molecule agent to another.
As witnessed in the past several years, the percent of patients being switched from one TNF inhibitor to another has decreased from the prior year, with the bulk of those switches going to an alternate mechanism of action (AMOA) agent instead. The influx of IL-17 inhibitors (Novartis’ Cosentyx and Eli Lilly’s Taltz) and the first-to-market JAK inhibitor (Pfizer’s Xeljanz) has led to a shift in rheumatologists’ prescribing away from the TNF inhibitor class, with particular hits to AbbVie’s Humira and Amgen’s Enbrel.
Unlike in traditional claims data, Spherix experts are able to look into the reasons why patients are switching off their current brand, why they chose their switch-to brand over other available options, and what brand they would have chosen had the current choice not been available (i.e. “missed share”). Although Cosentyx has made substantial year-over-year gains since its launch and is the closest agent to actually competing with Humira in the PsA switch population, it is also the agent that left the highest amount of missed share on the table. Novartis’ IL-17 inhibitor was in the running (or was the “back-up” agent) for nearly 20% of all switches, had the chosen switch-to agent not been available.
What does this mean for Cosentyx? Surely the brand has had solid gains, but a number of factors are withholding its full potential. Analyzing the brands selected over the back-up agent gives companies an idea of who they are directly competing with in a crucial patient segment where they have the opportunity to gain overall market share; examining the “why” behind not ultimately selecting the agent allows manufacturers to focus on improving perceived weaknesses by both prescribers and patients.
Xeljanz, which gained FDA approval in December 2017 for the treatment of PsA, shows a similar pattern of growth as Cosentyx and has captured nearly three times the percent of recent switches compared to Taltz (which was approved in the same time period). Also similar to Cosentyx, Pfizer’s JAK was in the running to capture a considerable amount of recent PsA switches, though the patients were ultimately placed on other brands. In one-third of the cases where Xeljanz was the back-up agent, the patient was placed on BMS/Celgene’s (likely soon-to-be Amgen’s) Otezla, reinforcing the desirability of an oral regimen. Indeed, patient requests due to the desire for oral administration were notably higher in patients switching to these brands than for any biologic.
Taltz, which mentioned above has not grown to the same extent as the leading AMOAs, did not trail too far behind Cosentyx and Xeljanz in terms of missed share. Interestingly, in over half of the cases where Taltz was the back-up agent, it lost out to its fellow IL-17 inhibitor, Cosentyx. However, the reverse was not true in cases where Cosentyx was the runner-up, according to the Spherix audit. This implies that while Cosentyx is competing against traditional treatment regimens and old prescribing habits, Taltz is simply losing out to the first-in-class IL-17.
In addition to a thorough analysis behind treatment decisions, the audit captures and trends a host of clinical and non-clinical parameters. In an ever-evolving market, the audit also assesses candidacy for select pipeline agents including AbbVie’s Rinvoq & Skyrizi, Janssen’s Tremfya, Sun Pharma’s Ilumya, UCB’s bimekizumab, and BMS’ BMS-986165, along with brands most at risk for displacement.
About RealWorld Dynamix™
RealWorld Dynamix™: Biologic/Small Molecule Switching in PsA (US) is an independent, data-driven service unmasking real patient management patterns through annual reports based on chart audits of ~1,000 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.
To view media coverage on this release, click here.