Rheumatoid Arthritis | Unmet Need | TNF-alpha Refractory | US/EU | 2019


Rheumatoid arthritis (RA) patients refractory to one or more TNF-α inhibitors are generally prescribed a non-TNF-targeted therapy (e.g., Bristol-Myers Squibb’s Orencia, Roche’s Actemra / RoActemra, Roche’s Rituxan / MabThera). The recent launch of Pfizer’s Xeljanz in Europe and Eli Lilly / Incyte’s Olumiant in both the United States and Europe provides physicians additional treatment options with a convenient oral route of administration. The launch of an additional IL-6 inhibitor, Regeneron / Sanofi’s Kevzara, has further expanded the treatment armamentarium. Although the RA market offers multiple efficacious and relatively safe agents, patients refractory to TNF-α inhibitors have limited options, even with the recent entry of these newer agents; therefore, unmet need still exists for the TNFi-refractory RA subpopulation.


  • What are the treatment drivers and goals for TNFi-refractory RA?
  • 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 TNFi-refractory RA?
  • What are the prevailing areas of unmet need and opportunity in TNFi-refractory RA?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European rheumatologists for a hypothetical new drug targeting TNFi-refractory RA?


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 31 European rheumatologists fielded in February 2019

Key companies: Bristol-Myers Squibb, Roche, Pfizer, Eli Lilly, Incyte, Regeneron, Sanofi

Key drugs: Rituxan / MabThera, Orencia, Actemra / RoActemra, Xeljanz, Olumiant, Kevzara

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