The oral disease-modifying therapy class remains the switch share leader although a shift into the first-line position and recent branded and generic launches has consistently chipped away at class share year-over-year, according to a new independent audit from Spherix Global Insights
EXTON, Pa., April 25, 2018 /PRNewswire/ — With the highest self-reported disease-modifying therapy (DMT) switch rates within the past three months reported by US neurologists (n=260), the active secondary progressive multiple sclerosis (SPMS) and primary progressive MS (PPMS) patient segments are the most dynamic segments of the MS switch market, with the need for greater efficacy driving much of the new business. However, due to their lower prevalence and DMT treatment rate compared to the relapsing remitting MS (RRMS) segment, the two subtypes still represent only 19% of the recently switched audit patient population (versus 21% of the diagnosed MS population). The higher churn rate among these progressive patients benefits Genentech’s Ocrevus most with the brand capturing about one in five active SPMS switches and an impressive majority share of PPMS switches, according to the third annual edition of Spherix Global Insights’ DMT switching patient chart audit (n=1,035). The not active SPMS segment is reported to have the lowest switch rate with triggers more commonly due to tolerability concerns as opposed to the need to control ongoing inflammatory activity.
The oral DMT class manages to remain the switch share class leader even as it experiences consistent share decline since the audit was first conducted in Q4 2015 with more patients switched instead to a monoclonal antibody (mAb) or between agents in the glatiramer acetate (GA) class. More than two out of five audited patients who were switched to an oral DMT migrated to Biogen’s Tecfidera, resulting in the brand being the share leader in the class and as well as the overall DMT switch market. However, as Tecfidera moves more strongly into a first-line position, switches from the DMT have increased substantially over the past two years, while at the same time switches to Tecfidera have decreased, resulting in a shrinking net gain for the brand within the switching source of business. Similarly, Novartis’ Gilenya is gaining less from recent switches compared to previous audits with lost opportunities instead having gone to a mAb or another oral DMT. In the end, Aubagio is the only oral DMT which had a slightly greater net gain compared to last year with switches being driven by the brand’s blend of good tolerability and once-daily oral dosing. However, with most audit patients having experienced their first switch to a second-line DMT, Gilenya is the only oral DMT that stands to potentially gain more share from a next-line switch compared to the most recent switch, consistent with its later line use among the oral DMTs and alignment with the high-efficacy mAb DMT class.
With less switch share for Teva’s Copaxone in the current audit, the GA class switch share has managed to remain stable compared to the previous year solely based on switch share gained by Mylan’s recently launched generic GA agents. Four months post-launch, generic GA 40mg, competing with Copaxone and Sandoz’s Glatopa for switches, captured almost 5% of the overall switch share and is the only GA agent poised to gain overall market share. Low copay and payer preference, as well as GA class-related tolerability and safety attributes, are drivers of generic GA switches with neurologists rating payers as significantly more influential in the individual decisions to switch to generic GA compared to Copaxone 40mg. Indeed, emphasizing the impact of payer- or pharmacy-mandated generic switches, neurologists originally wrote a prescription for Copaxone in more than half of the cases where the patient went on to switch to generic GA 40mg. When generic agents lost potential switch share to an alternative DMT, the switch typically went to Copaxone owing to neurologist or patient challenges to managed care or pharmacy switches to generics.
RealWorld Dynamix™: DMT Switching in Multiple Sclerosis (US) blends physician self-reported data with actual patient chart records from the same physicians to uncover differences in how physicians report managing their patients and how specific populations are managed differently. It augments claims data by providing the “why” behind the switching behavior and by providing essential details not available in claims data that may be driving the switch, such as MS subtype, payer pressure, co-morbid conditions, or patient requests. A parallel report, RealWorld Dynamix™: DMT New Starts in Multiple Sclerosis (US), will be published in May 2018.
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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