Reports / Neurology Reports / RealWorld Dynamix: DMT Switching in Multiple Sclerosis US
RealWorld Dynamix: DMT Switching in Multiple Sclerosis US
The US multiple sclerosis (MS) market has become fiercely competitive with the introduction of multiple disease-modifying therapies (DMTs), including Genentech’s Ocrevus for relapsing forms of MS (RMS) and primary progressive MS (PPMS), over the past several years. Pipeline therapies, such a Novartis’ Mayzent, the first potential secondary progressive MS (SPMS) therapy, and EMD Serono’s Mavenclad, an oral induction therapy, could further transform patient management. While the availability of multiple therapeutic tools is theoretically beneficial to the patient and neurologist, deciphering which treatment is best for which patient and when to switch therapies is a major challenge. With diagnosis occurring earlier in the disease course, the possibility of cycling through multiple therapies is a reality for a substantial subset of MS patients. Understanding when, why, and to which product a neurologist will transition a patient is critical to building an effective commercial strategy for both first-line and later-line therapies.
RealWorld Dynamix™: DMT Switching in MS (US) blends attitudinal and demographic physician survey data with patient record data to uncover how practice type and setting and certain beliefs influence the treatment pathway and to understand how marketed DMTs are being used by physicians and for what patient types. The report also captures physician’s perspectives about products in development and the impact they will have on the current treatment paradigm among recently switched patients.
The 2019 wave is the fourth wave of the report (first published in 2016).
Learn more about RealWorld Dynamix™ reports here.
- How has switching patterns changed compared to previous years? Has oral DMTs and Ocrevus moved up in the treatment algorithm like neurologists perceive?
- What are the most frequently prescribed agents for efficacy/safety/tolerability/patient/payer-driven switches?
- How do second-line switches differ from third and later line switches? How much time do patients spend on their previous agent before switching?
- What is the profile of a patient being switched from first-line injectable DMT versus oral DMT? Where do patients go if being switched from first-line induction therapy?
- How does switching decisions differ between MS subtypes?
- What is the opportunity cost for each brand (e.g., where would their brand have been selected if the first choice was not available)?
- Are neurologists willing to sacrifice safety risk for more efficacy in certain populations of MS patients? How does anti-JC virus antibody serostatus shape the patient pathway?
- What is the patient profile for switching to Novartis’ Mayzent? EMD Serono’s Mavenclad? Celgene’s ozanimod? Biogen/Alkermes’ diroximel fumarate?
Bayer (Betaseron), Biogen [Avonex, Plegridy, Tecfidera, Tysabri, (historically) Zinbryta (with AbbVie)], EMD Serono (Rebif), Genentech (Ocrevus, Rituxan), Genzyme (Aubagio, Lemtrada), Mylan (generic glatiramer acetate), Novartis (Gilenya, Extavia), Sandoz (Glatopa), Teva (Copaxone)
AB Science (masitinib), Biogen [diroximel fumarate (with Alkermes)], Celgene (ozanimod), EMD Serono (Mavenclad), J&J/Actelion (ponesimod), MedDay (MD-1003), MediciNova (ibudilast), Novartis (Mayzent*, ofatumumab), TG Therapeutics (ublituximab)
*Could move to commercial products based upon regulatory outcomes
Novartis’ Gilenya, Sanofi’s Aubagio, Biogen’s Tysabri and Tecfidera Capture the Majority of Recent Switches in the European Multiple Sclerosis Market Boosted by Frequent Neurologist Endorsement – August 13, 2019
Biogen’s Tecfidera Share of the Multiple Sclerosis Switch Segment Continues a Three-Year Downward Trend to the Benefit of Novartis’ Gilenya and Genentech’s Ocrevus – April 29, 2019