Parkinson’s Disease – Current Treatment – Detailed, Expanded Analysis (US)

Parkinson’s disease (PD) treatment is complex; the disease is heterogeneous, requiring individualized treatment and frequent adjustments (e.g., in dosing, in regimens) to achieve symptom control throughout a patient’s disease course. Since 2015, a handful of new therapies that address PD motor and nonmotor symptoms have reached the U.S. market, and a dynamic pipeline comprising a range of therapies designed to optimize levodopa or reduce the frequency and impact of motor response complications could further expand the treatment landscape. As such, understanding the many forces that drive neurologists’ clinical decision making in PD today is crucial for developers of new or newly launched PD therapies facing a complicated market. How PD is treated and the factors behind those treatment decisions in the United States and across the major markets are provided in the Current Treatment Overview. The detailed, expanded analysis in the Current Treatment US content offers deep insights regarding how PD patients are being treated in the United States today, backed by real-world evidence wherever possible.

Table of contents

  • Parkinson's Disease - Current Treatment - Detailed, Expanded Analysis (US)
    • Physician Prescribing Practices
      • Key Findings
      • Patient Characteristics
        • Variation Exists Among PD Patients in Coverage Type, Disease Stage, Age, and Comorbidities
        • Distribution of Healthcare Plans Among PD Patients (Survey Data)
        • Age Distribution Among PD Patients (RWD: EHR)
        • Disease Stage Distribution Among PD Patients (Survey Data)
        • Percentages of PD Patients Experiencing Key Comorbidities (Survey Data)
      • Treatment Practices
        • Treatment Choice in PD is Individualized, Based on Many Factors
        • Most PD Patients Initiate Drug Therapy Soon After Diagnosis
        • Average Time to Treatment Initiation Among PD Patients (Survey Data)
        • The Majority of PD Patients Are Drug-Treated
        • Treatment Rate for PD Patients (Survey Data)
        • Treatment Rate for PD Patients (RWD: EHR)
        • Levodopa Is the Patient-Share Leader Among PD Therapies
        • Patient Shares for Key PD Drugs and Drug Classes Among Drug-Treated PD Patients (Survey Data)
        • Patient Shares for PD Motor Therapies Among Drug-Treated PD Patients (Survey Data)
        • Patient Shares for Antipsychotics and Antidementia Agents Among Drug-Treated PD Patients (Survey Data)
        • Current Prescriber Bases for PD Drugs and Drug Classes (Survey Data)
        • Current Prescriber Bases for PD Motor Therapies (Survey Data)
        • Current Prescriber Bases for Antipsychotics and Antidementia Agents (Survey Data)
        • Current Prescriber Bases for PD Brands by Specialty (Survey Data)
        • Patient Share by Product Among Recently Treated PD Patients (RWD: Claims)
        • Quarter-over-Quarter Patient Share by Product Among Recently Treated Patients Diagnosed with PD (RWD: Claims)
        • PD Therapies with Lasting Efficacy and Tolerability See Chronic Use Throughout the Disease Course
        • Use of DBS Among PD Patients Is Limited
        • Patient Share for DBS Among PD Patients (Survey Data)
        • Positioning for Early-Line Use Is Important in the PD Market
        • Nearly Half of PD Patients Are Currently on First-Line Therapy
        • Line of Therapy Distribution Among PD Patients (Survey Data)
        • Physicians Prefer to Add Adjunctive Therapies Rather Than Switch
        • Time to Progression by Line of Therapy Among Newly Diagnosed PD Patients Within a Year of Diagnosis (RWD: Claims)
        • Percentage of PD Patients Failing First-Line Therapy Due to Common Motor-Related Reasons (Survey Data)
        • Common Strategies for Second-Line Treatment Due to Re-appearance of Primary Motor Symptoms by First-Line Therapy (Survey Data)
        • Common Strategies for Second-Line Treatment Due to Appearance of Motor Fluctuations by First-Line Therapy (Survey Data)
        • Levodopa and Other PD Agents with Monotherapy Labeling Claim the Most First-Line Patient Share
        • Patient Share for Key PD Drugs and Drug Classes Among First-Line PD Patients (Survey Data)
        • Product Patient Share by Line of Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Quarter-over-Quarter Product Patient Share in First-Line Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Quarter-over-Quarter Product Patient Share in Second-Line Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Quarter-over-Quarter Product Patient Share in Third-Line Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Polypharmacy Plays a Major Role in PD Treatment
        • Drug Burden Among Recently Treated PD Patients (RWD: Claims)
        • Drug Burden by Line of Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
      • Persistency and Compliance
        • Compliance and Persistence is High Among PD Patients
        • Rates of Discontinuation by Therapy Among PD Patients Within One Year of Initiation (Survey Data)
        • Persistency by Therapy Among Recently Treated PD Patients (RWD: Claims)
        • Compliance Rates by Therapy Among PD Patients (Survey Data)
        • Compliance by Therapy Among Recently Treated PD Patients (RWD: Claims)
      • Sequencing of Treatment
        • Adjusting Levodopa Therapy and Adding Adjunctive Agents Are Common Strategies in PD Management
        • Common Treatment Sequencing Strategies for Primary Motor Symptoms (Survey Data)
        • Common Treatment Sequencing Strategies for Motor Fluctuations (Survey Data)
        • Common Treatment Sequencing Strategies for Dyskinesias (Survey Data)
        • Comparison of Progression Patterns for Key Therapy Sources Among Recently Treated PD Patients (RWD: Claims)
        • Levodopa Patient Flow in Newly Diagnosed PD Patients (RWD: Claims)
        • Levodopa Patient Flow in Recently Treated PD Patients (RWD: Claims)
        • Entacapone-Levodopa-Carbidopa Patient Flow in Newly Diagnosed PD Patients (RWD: Claims)
        • Entacapone-Levodopa-Carbidopa Patient Flow in Recently Treated PD Patients (RWD: Claims)
        • Neupro Patient Flow in Newly Diagnosed PD Patients (RWD: Claims)
        • Neupro Patient Flow in Recently Treated PD Patients (RWD: Claims)
        • Azilect Patient Flow in Newly Diagnosed PD Patients (RWD: Claims)
        • Azilect Patient Flow in Recently Treated PD Patients (RWD: Claims)
      • Recent/Anticipated Changes in Brand Usage/Treatment Approach
        • Physicians Expect Brand Prescribing Will Increase over the Next Year
        • Changing Use of PD Therapies in the Past Year (Survey Data)
        • Current and Anticipated Brand Patient Shares by Therapy (Survey Data)
        • Current and Anticipated Brand Prescriber Bases by Therapy (Survey Data)
        • Anticipated Change in Brand Prescriber Base by Specialty (Survey Data)
    • Physician Insight on Medical Practice
      • Key Findings
      • Drivers of Treatment Selection
        • Efficacy, Side Effects, and Cost Drive Drug Selection in PD
        • Treatment Selection in PD Is Influenced by Multiple Factors
        • Factors Influencing Treatment Selection in Treatment-Naive and Other PD Patients (Survey Data)
        • Physician Opinion on Levodopa-Sparing Strategies (Survey Data)
        • Initial Treatment Selection in PD Patients by Age at Diagnosis (Survey Data)
        • Physician Opinion on Deferring or Discontinuing Treatment for Dementia and Psychosis in PD Patients (Survey Data)
        • Efficacy Is a Strong Driver of Prescribing for Most PD Therapies
        • Major Drivers of Therapy Usage in PD (Survey Data)
        • Cost and Coverage Are Key Obstacles to Use of Branded PD Therapies
        • Major Obstacles of Brand Usage (Survey Data)
        • Adding/Adjusting Therapy Is More Common Than Switching in the PD Treatment Algorithm
        • Tolerability Issues and Lack of Efficacy Drive Discontinuations for Most PD Therapies (Survey Data)
        • Common Reasons for Patient Discontinuation by Therapy (Survey Data)
        • Newly Diagnosed PD Patients Who Delay Therapy for More Than a Year Are Generally Those Who Do Not Yet Require Treatment
        • Common Reasons for Treatment Deferral
      • Face-to-Face Product Detailing Effectiveness
        • Brand Details Are Infrequent but Can Be Effective
        • PD Therapy Detailing Reach Among Surveyed Neurologists Is Limited
        • Sales Representative Access to Surveyed Neurologists (Survey Data)
        • Detailing Reach by Brand (Survey Data)
        • Detailing Frequency by Brand Within the Past Six Months (Survey Data)
        • Detailing Reach by Brand Within the Past Month (Survey Data)
        • Sales Representative Satisfaction Ratings Are High for All Branded PD Therapies
        • Satisfaction with Sales Representative Among Recently Detailed Neurologists (Survey Data)
        • Messages Given During Brand Detailing Cover a Wide Range of Topics
        • Messages from Recent PD Brand Detailing (Survey Data)
    • Appendix
      • Primary Market Research
        • Physician Definition of PD Stages
      • Real-World Data
        • Gender Distribution Among PD Patients (RWD: EHR)
        • Race Distribution Among PD Patients (RWD: EHR)
        • Body Mass Index Distribution Among PD Patients (RWD: EHR)
        • Treatment Duration of Preceding Therapy by Product Among Recently Treated PD Patients (RWD: Claims)
        • Source of Business by Product Among Recently Treated PD Patients (RWD: Claims)
        • Progression Rates from First Line of Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Progression Rates from Second Line of Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Monotherapy vs. Combination Therapy Use in First-Line Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Monotherapy vs. Combination Therapy Use in Second-Line Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Monotherapy vs. Combination Therapy Use in Third-Line Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Combination Therapies in First-Line Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Combination Therapies in Second-Line Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Combination Therapies in Third-Line Therapy Among Newly Diagnosed PD Patients (RWD: Claims)
        • Ranges of Medication Possession Ratios Among Recently Treated PD Patients (RWD: Claims)
        • Persistency Sample Sizes Among Drug-Treated Patients Diagnosed with PD (RWD: Claims)
        • Amantadine Patient Flow in Newly Diagnosed PD Patients (RWD: Claims)
        • Amantadine Patient Flow in Recently Treated PD Patients (RWD: Claims)
        • Entacapone Patient Flow in Newly Diagnosed PD Patients (RWD: Claims)
        • Entacapone Patient Flow in Recently Treated PD Patients (RWD: Claims)
        • Pramipexole Patient Flow in Newly Diagnosed PD Patients (RWD: Claims)
        • Pramipexole Patient Flow in Recently Treated PD Patients (RWD: Claims)
        • Ropinirole Patient Flow in Newly Diagnosed PD Patients (RWD: Claims)
        • Ropinirole Patient Flow in Recently Treated PD Patients (RWD: Claims)

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