Multiple Sclerosis – Unmet Need – Detailed, Expanded Analysis: Primary-Progressive Multiple Sclerosis (US/FR/DE/UK)

Roche / Genentech achieved a clinical and regulatory milestone with the approval of Ocrevus for the treatment of primary-progressive multiple sclerosis (PP-MS)—making it the first agent to approved for this MS subpopulation. According to Clarivate research and company reports, uptake of the drug in PP-MS has been understandably strong, with significant revenue coming from the PP-MS market. Nevertheless, opportunity in the space remains because the drug may not be appropriate for all patients. Ocrevus targets neuroinflammation, which is not observed in all PP-MS patients, and according to some KOLs interviewed by Clarivate, it imparts a modest clinical effect in PP-MS. This report will examine neurologists’ satisfaction with Ocrevus and DMTs used off-label today in PP-MS, and gauge the opportunity and value-drivers for alternatives to treat this underserved MS subpopulation. Ocrevus could soon face competition in PP-MS from Sanofi’s tolebrutinib, Roche’s fenebrutinib, and AB Science’s masitinib. However, with only a handful of therapies aimed at halting disability progression in PP-MS in late-phase development, this market segment is primed for new investment and drug discovery.


  • What are the top areas of unmet need in PP-MS, and which therapies in development, if any, are poised to meet these needs?
  • Which clinical endpoints and drug attributes are most influential in prescribing for PP-MS? How do Ocrevus (the only approved agent) and other MS DMTs perform on these attributes?
  • What magnitude of reduction in disease progression will result in a novel therapy being considered the gold standard for treating PP-MS?
  • Based on conjoint analysis and TPP simulation, which 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. One market scenario is profiled in detail by Clarivate experts, and additional customized market scenarios can be evaluated with the corresponding TPP Simulator.

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

Primary research: Survey of 61 U.S. and 32 European neurologists fielded in January 2023

Key companies: Sanofi, Teva, Novartis, Merck KGaA / EMD Serono, Roche / Genentech, Biogen

Key drugs: Aubagio, Copaxone / glatiramer acetate, Gilenya, Mavenclad, Ocrevus, Tecfidera / dimethyl fumarate, Tysabri

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