Parkinson’s Disease – Unmet Need – Detailed, Expanded Analysis: Psychosis In PD (US/FR/DEU/UK)
Parkinson’s disease (PD) is widely recognized as a motor disorder, but PD is also associated with a diverse set of nonmotor symptoms. Surveyed neurologists estimate that 20% of their PD patients experience psychosis, and DRG Epidemiology data suggest the percentage could be even higher. Few antipsychotic agents have been rigorously tested in the PD population, but prescribing of these agents is common; left untreated, psychosis can have a devastating effect on PD patients’ quality of life. One antipsychotic agent is approved for PD psychosis in the United States (Nuplazid) and one in Europe (clozapine), but clear unmet need remains. Understanding prescriber perceptions of the available on- and off-label options and the drivers of clinical decision-making in PD psychosis will help developers of antipsychotics and other agents gauge the market opportunity in PD and identify levers for new product positioning and differentiation in this underserved therapy market.
QUESTIONS ANSWERED
- What drug attributes are most influential in prescribing for psychosis in the PD population? How do Nuplazid, clozapine, and commonly prescribed off-label agents perform on these attributes?
- What are the specific areas of unmet need and opportunity in the treatment of PD psychosis?
- Based on conjoint analysis and TPP simulation, what trade-offs between efficacy, safety, and price are neurologists willing to make for a hypothetical new antipsychotic agent for PD psychosis?
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 neurologists, fielded in February 2020
Key drugs: Nuplazid (pimavanserin), clozapine, quetiapine, aripiprazole, olanzapine, risperidone, ziprasidone
Table of contents
- Parkinson's Disease - Unmet Need - Detailed, Expanded Analysis: Psychosis In PD (US/FR/DEU/UK)
- Executive Summary
- Unmet Need - PD Psychosis - Executive Summary - March 2020
- Introduction
- Overview
- Methodology
- Rationale for Treatment Drivers and Goals Selection
- Rationale for Drug Selection
- Products for PD Psychosis and Rationale for Drug Selection
- Treatment Drivers and Goals
- Key Findings: Attribute Importance
- Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Neurologists' Prescribing Decisions in PD Psychosis
- Importance of Efficacy Attributes to Prescribing Decisions in PD Psychosis: United States
- Importance of Efficacy Attributes to Prescribing Decisions in PD Psychosis: Europe
- Importance of Safety and Tolerability Attributes to Prescribing Decisions in PD Psychosis: United States
- Importance of Safety and Tolerability Attributes to Prescribing Decisions in PD Psychosis: Europe
- Importance of Nonclinical Factors to Prescribing Decisions in PD Psychosis: United States
- Importance of Nonclinical Factors to Prescribing Decisions in PD Psychosis: Europe
- Key Findings: Stated vs. Derived Importance
- Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, and Nonclinical Attributes to Prescribing Decisions in PD Psychosis: United States
- Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, and Nonclinical Attributes to Prescribing Decisions in PD Psychosis: Europe
- Product Performance Against Treatment Drivers and Goals
- Key Findings
- Overall Performance of Key Therapies for PD Psychosis: United States
- Overall Performance of Key Therapies for PD Psychosis: Europe
- Mean Overall Performance of Key Therapies for PD Psychosis: United States and Europe
- Relative Performance of Key Therapies for PD Psychosis Across Select Efficacy Attributes: United States
- Relative Performance of Key Therapies for PD Psychosis Across Select Efficacy Attributes: Europe
- Relative Performance of Key Therapies for PD Psychosis Across Select Safety and Tolerability Attributes: United States
- Relative Performance of Key Therapies for PD Psychosis Across Select Safety and Tolerability Attributes: Europe
- Relative Performance of Key Therapies for PD Psychosis Across Select Nonclinical Attributes: United States
- Relative Performance of Key Therapies for PD Psychosis Across Select Nonclinical Attributes: Europe
- Assessment of Unmet Need
- Key Findings: Unmet Need in PD Psychosis
- Surveyed Neurologistsu2019 Satisfaction with the Performance of Key Therapies for PD Psychosis on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
- Surveyed Neurologistsu2019 Satisfaction with the Performance of Key Therapies for PD Psychosis on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
- Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in PD Psychosis: United States
- Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in PD Psychosis: Europe
- Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in PD Psychosis: United States
- Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in PD Psychosis: Europe
- Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in PD Psychosis: United States
- Surveyed Neurologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in PD Psychosis: Europe
- Key Findings: Unmet Need in PD Psychosis and Related Indications
- Surveyed Neurologists' Ascribed Level of Unmet Need in PD Psychosis and Related Indications: United States
- Surveyed Neurologists' Ascribed Level of Unmet Need in PD Psychosis and Related Indications: Europe
- Opportunity Analysis
- Areas of Opportunity in the PD Psychosis Market and Emerging Therapy Insights
- Opportunity: A Novel Agent Approved for Psychosis in PD
- Areas of Opportunity in the PD Psychosis Market and Emerging Therapy Insights
- Target Product Profiles
- Assessing Drug Development Opportunities
- Target Product Profile Methodology
- Attributes and Attribute Levels
- Attributes of Key Current Therapies for PD Psychosis
- Attribute Importance and Part-Worth Utilities
- PD Psychosis Target Product Profile: Attribute Importance
- Average Improvement in SAPS-PD Score vs. Placebo: United States
- Average Improvement in SAPS-PD Score vs. Placebo: Europe
- Average Improvement in CGI-S Score vs. Placebo: United States
- Average Improvement in CGI-S Score vs. Placebo: Europe
- Average Worsening of PD Motor Function (UPDRS Part III Score) vs. Placebo: United States
- Average Worsening of PD Motor Function (UPDRS Part III Score) vs. Placebo: Europe
- Warning for Increased Mortality in Elderly Patients with Dementia-Related Psychosis: United States
- Warning for Increased Mortality in Elderly Patients with Dementia-Related Psychosis: Europe
- Incidence of Somnolence vs. Placebo: United States
- Incidence of Somnolence vs. Placebo: Europe
- Incidence of Dizziness and/or Postural Hypotension vs. Placebo: United States
- Incidence of Dizziness and/or Postural Hypotension vs. Placebo: Europe
- List Price per Day: United States
- List Price per Day: Europe
- Conjoint Analysis-Based Simulation of a Market Scenario
- PD Psychosis Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
- PD Psychosis Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
- PD Psychosis Market Simulation: Target Product Profiles Included in the Market Scenario
- Appendix
- Key Abbreviations
- Bibliography
- Executive Summary
Bethany Christmann, Ph.D., is a principal analyst on the CNS/Ophthalmology team at DRG, part of Clarivate. In this role, she covers the neurology space, specializing in Parkinson’s disease and epilepsy; she provides expert insight and authors primary market research and forecasting content focused on these and other neurology indications. Prior to joining DRG, she earned her Ph.D. in neuroscience from Brandeis University, where she studied the cellular interactions involved in memory consolidation and their link to sleep behavior.