Chronic Pain – Unmet Need – Detailed, Expanded Analysis: Interstitial Cystitis (US/EU)

Interstitial cystitis/bladder pain syndrome (ICBPS) is a disorder characterized by chronic pain, discomfort, and pressure in the pelvic region that often includes symptoms of urinary frequency and urgency. Janssen/bene-Arzneimittel’s Elmiron and Mylan’s intravesical dimethyl sulfoxide (RIMSO-50) are the only two pharmacological treatments approved for ICBPS, but other antihistamines, antidepressants, and antiepileptics may be used off-label to ameliorate symptoms. Because pharmacological treatments are usually only partially effective, they are often combined with nonpharmacological therapies in a trial-and-error approach. As such, substantial unmet need persists for more effective treatment options.

QUESTIONS ANSWERED

  • What are the treatment drivers and goals for ICBPS?
  • What drug attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals for ICBPS?
  • What are the prevailing areas of unmet need and opportunity in ICBPS?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European urologists for a hypothetical new ICBPS drug?

PRODUCT DESCRIPTION

Unmet Need: Provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.

Markets covered: United States, United Kingdom, France, Germany.

Primary research: Survey of 60 U.S. and 30 European urologists fielded in March 2018.

Key companies: bene-Arzneimittel, Janssen, Mylan, Pfizer.

Key drugs: Elmiron, amitriptyline, hydroxyzine, duloxetine, Lyrica, gabapentin, intravesical medications (lidocaine, heparin, dimethyl sulfoxide, hyaluronic acid, others).

Key metrics included:

  • Stated versus derived analysis of U.S. and European physician prescribing behavior.
  • Conjoint analysis with U.S. and European physicians, including market simulator.
  • Assessment of current drug performance against treatment drivers and goals.
  • Physician perceptions of unmet need in disease/subpopulation covered and related diseases/subpopulations.

Table of contents

  • Chronic Pain - Unmet Need - Detailed, Expanded Analysis: Interstitial Cystitis (US/EU)
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Efficacy
        • Safety and Tolerability
        • Convenience of Administration
      • Rationale for Drug Selection
        • Products for Interstitial Cystitis
    • Treatment Drivers and Goals
      • Key Findings: Attribute Importance
      • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Urologists' Prescribing Decisions in Interstitial Cystitis
      • Importance of Efficacy Attributes to Prescribing Decisions in Interstitial Cystitis: United States
      • Importance of Efficacy Attributes to Prescribing Decisions in Interstitial Cystitis: Europe
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Interstitial Cystitis: United States
      • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Interstitial Cystitis: Europe
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Interstitial Cystitis: United States
      • Importance of Convenience of Administration Attributes to Prescribing Decisions in Interstitial Cystitis: Europe
      • Key Findings: Stated vs. Derived Importance
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Interstitial Cystitis: United States
      • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Interstitial Cystitis: Europe
    • Product Performance Against Treatment Drivers and Goals
      • Key Findings
      • Overall Performance of Key Therapies for Interstitial Cystitis: United States
      • Overall Performance of Key Therapies for Interstitial Cystitis: Europe
      • Relative Performance of Key Therapies for Interstitial Cystitis Across Select Efficacy Attributes: United States
      • Relative Performance of Key Therapies for Interstitial Cystitis Across Select Efficacy Attributes: Europe
      • Relative Performance of Key Therapies for Interstitial Cystitis Across Select Safety and Tolerability Attributes: United States
      • Relative Performance of Key Therapies for Interstitial Cystitis Across Select Safety and Tolerability Attributes: Europe
      • Relative Performance of Key Therapies for Interstitial Cystitis Across Select Convenience of Administration Attributes: United States
      • Relative Performance of Key Therapies for Interstitial Cystitis Across Select Convenience of Administration Attributes: Europe
    • Assessment of Unmet Need
      • Key Findings: Unmet Need in Interstitial Cystitis
      • Surveyed Urologistsu2019 Satisfaction with the Performance of Key Therapies for Interstitial Cystitis on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
      • Surveyed Urologistsu2019 Satisfaction with the Performance of Key Therapies for Interstitial Cystitis on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
      • Surveyed Urologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Interstitial Cystitis: United States
      • Surveyed Urologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Interstitial Cystitis: Europe
      • Surveyed Urologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Interstitial Cystitis: United States
      • Surveyed Urologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Interstitial Cystitis: Europe
      • Surveyed Urologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Interstitial Cystitis: United States
      • Surveyed Urologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Interstitial Cystitis: Europe
      • Key Findings: Unmet Need in Unmet Need and Related Indications
      • Surveyed Urologists' Ascribed Level of Unmet Need in Interstitial Cystitis and Related Indications: United States
      • Surveyed Urologists' Ascribed Level of Unmet Need in Interstitial Cystitis and Related Indications: Europe
    • Opportunity Analysis
      • Areas of Opportunity in the Interstitial Cystitis Market and Emerging Therapy Insights
        • Opportunity: A Therapy That More Effectively Reduces Bladder Pain
        • Opportunity: A Therapy That Improves Quality of Life
    • Target Product Profiles
      • Assessing Drug Development Opportunities
      • Target Product Profile Methodology
        • Attributes and Attribute Levels
      • Attribute Importance and Part-Worth Utilities
        • Interstitial Cystitis Target Product Profile: Attribute Importance
        • Reduction in Average Daily Pain Intensity from Baseline as Measured by 11-point NRS
        • Reduction in Interstitial Cystitis Symptom Index Score from Baseline
        • Reduction in Urinary Frequency/Urgency from Baseline
        • Percentage of Patients Experiencing Any Non-Serious Treatment Emergent Adverse Events
        • Percentage of Patients Experiencing Any Serious Treatment Emergent Adverse Events
        • Delivery Burden
        • Price Per Treated Day
      • Conjoint Analysis-Based Simulations of Market Scenarios
        • Interstitial Cystitis Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
        • Interstitial Cystitis Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
        • Interstitial Cystitis Market Simulations: Target Product Profiles Included in Scenario 1
        • Interstitial Cystitis Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
        • Interstitial Cystitis Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
        • Interstitial Cystitis Market Simulations: Target Product Profiles Included in Scenario 2
    • Appendix
      • Key Abbreviations
      • Experts Interviewed
      • Bibliography

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