Multiple Sclerosis | Unmet Need | Primary-Progressive Multiple Sclerosis | US/EU5 | 2019

Roche/Genentech achieved a clinical and regulatory milestone with the approval of Ocrevus for the treatment of primary-progressive multiple sclerosis (PP-MS), the first of its kind. According to DRG research and company reports, uptake of the drug for PP-MS has been swift, and the revenue generated has been significant. Nevertheless, opportunity remains because the drug may not be appropriate for all patients. Ocrevus targets neuroinflammation, which may not be present in all PP-MS patients; in addition, according to some KOLs interviewed by DRG, it has only a modest clinical effect. This report examines neurologists’ satisfaction with Ocrevus and the disease-modifying therapies used off-label for PP-MS and gauges the opportunity and value drivers for alternatives to treat this perennially underserved MS subpopulation. With only a handful of therapies in late-stage development that are aimed at halting disability progression in PP-MS—such as MediciNova’s ibudilast—this market is primed for new investment and drug discovery.


  • What are the top unmet needs in the treatment of PP-MS, and which therapies in development, if any, are poised to meet these needs?
  • Which clinical end points and drug attributes are most influential in prescribing for PP-MS? How does the only approved agent, Ocrevus, and other MS disease-modifying therapies perform on these attributes?
  • What magnitude of reduction in disease progression will result in a novel therapy being considered the gold-standard treatment for PP-MS?
  • Based on conjoint analysis and TPP simulation, what trade-offs between efficacy, safety, and price are neurologists willing to make for a hypothetical new PP-MS drug?


Unmet Need supports clinical development decisions by identifying key attributes and assessing areas of unmet need for a specific disease or subpopulation. Based on surveys with U.S. and European physicians, this report provides insight into key treatment drivers and goals, the performance of current therapies, and the remaining commercial opportunities. Two market scenarios are profiled in detail by DRG experts, and additional customized market scenarios can be evaluated with the corresponding TPP simulator.

Geographies: United States, France, Germany, United Kingdom

Primary research: Survey of 60 U.S. and 30 European neurologists fielded in January 2019

Key drugs covered: Avonex, Aubagio, glatiramer acetate (Copaxone, generics), Gilenya, Ocrevus, Tecfidera, Tysabri

Key metrics included:

  • Target Product Profile (TPP) simulator based on conjoint analysis methodology.
  • Stated versus derived importance of product attributes on prescribing behavior.
  • Assessment of current drug performance against treatment drivers and goals.
  • Physician perceptions of unmet needs in the indication and related indications.
  • Analysis of remaining drug development opportunities.
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