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TNF Cycling in Psoriatic Arthritis Declines for the Second Year in a Row as Newly Approved Agents Such as Pfizer’s Xeljanz and Eli Lilly’s Taltz Claim Their Share of the Switching Population

According to Spherix Global Insights, data from over 1,000 psoriatic arthritis patients who recently switched therapies reveals that clinical factors, such as joint and skin efficacy, often drive the decision to switch, while non-clinical factors often influence the choice of the new brand.

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EXTON, Pa., May 30, 2018 /PRNewswire/ — With four new drug approvals for psoriatic arthritis (PsA) in 2017 (BMS’ Orencia, Eli Lilly’s Taltz, Janssen’s Simponi Aria, and Pfizer’s Xeljanz), the market has become crowded and competitive. In April 2018, Spherix Global Insights collaborated with 214 US rheumatologists to analyze the records of 1,009 patients with PsA who were recently switched from one biologic or small molecule (either Celgene’s Otezla or Xeljanz) to another brand. This marks the third year of the study, and the results reveal a rapidly evolving market with numerous opportunities for brands to capture a larger piece of the switching pool.

Some key highlights include:
• Rheumatologists report that more than one-quarter of their PsA patients treated with biologics or targeted small molecules were switched to a different brand within the past year.
• The most prevalent switch combination is from one anti-TNF to another, although for the second year in a row, this pattern has decreased significantly in favor of switching from anti-TNFs to alternative mechanism agents.
• Three-quarters of the switches are triggered by a desire for improved joint efficacy, but other factors, including improved skin efficacy, patient requests, difficulty with administration, and safety/tolerability issues also play a role. Payer policies were a factor in 16% of the switches.
• While new brands are often chosen for their clinical profile, non-clinical factors cannot be ignored. Patient requests often influence the choice of the switch-to brand, disproportionately so for the oral agents, Xeljanz and Otezla. Importantly, promotional factors, including influence of the sales representative, manufacturer reputation, and the availability of a patient assistance program also play a role in the choice of the new brand, and Spherix found that several brands seem to be leveraging promotional muscle more effectively than others.
• Certain patient characteristics are strongly correlated with new brand choice. For example, patients switched to Taltz, which has a newly-minted label update to include efficacy in genital psoriasis, were more than three times as likely to have this condition compared to patients switched to other agents. The severity of psoriasis also highlights challenges for brands indicated for PsA but lacking a corresponding indication in skin, such as BMS’ Orencia and Xeljanz.
• Switching results in the most favorable net gains for Novartis’ Cosentyx and Xeljanz, the latter of which only received an indication for PsA in December. Collectively, Cosentyx and Xeljanz capture one-fifth of the most recent second-line market, though switch share among these agents is highly correlated to the treating rheumatologists’ preferred alternate MOA agent in PsA. Indeed, those preferring Cosentyx have a significantly higher audited switch share for the IL-17 inhibitor than those preferring Xeljanz and vice versa, setting the stage for an evolving rivalry between these drugs.

“Claims data and analysis from electronic health records highlight the switching frequency and patterns, but the big question for manufacturers is what triggers switching and what factors can be influenced to optimize gains from switching,” according to Lynn Price, Immunology Franchise Head at Spherix.RealWorld Dynamix enables brands to explore these opportunities by offering analysis which includes the integration of physician attitudes and demographics with the clinical and non-clinical details of the switch.”

RealWorld Dynamix: Biologic and Small Molecule Switching in PsA integrates physician survey responses with in-depth audits of over 1,000 patients with PsA who were recently switched between brands. Variables captured in the audit include time since diagnosis and referral, presentation at diagnosis, referral, and most recent switch (including key laboratory measures, swollen/tender joint counts and specific joints affected, BSA/location affected by psoriasis, presence/severity of enthesitis and dactylitis, etc.), line of therapy and prior brand exposure, patient co-morbidities, concomitant medications, health-related quality of life metrics, reasons for the switch, rationale for new brand selection, back-up brand choice, and next step in the treatment paradigm. For a full list of the variables collected or to learn more about the RealWorld Dynamix offering, please contact us to speak with an expert.

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.

All company, brand or product names in this document are trademarks of their respective holders.

For more information contact:
Lynn Price, Immunology Franchise Head

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