Rheumatoid Arthritis – Unmet Need – Detailed, Expanded Analysis: TNF-Alpha Refractory Rheumatoid Arthritis (US & EU)

Rheumatoid arthritis (RA) patients who are refractory to one or more tumor necrosis factor-alpha (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 launch of AbbVie’s Rinvoq in the United States and Europe, along with Pfizer’s Xeljanz in Europe and Eli Lilly / Incyte’s Olumiant in both the United States and Europe, gives physicians more treatment options with a convenient route of administration (i.e., oral). However, recent safety data raise new concerns about JAK inhibitors, highlighting an unmet need for a lower risk of cardiovascular events or malignancy. Although the RA therapy market offers multiple efficacious and relatively safe agents, patients refractory to TNF-α inhibitors have limited options, even with the recent entry of newer agents; therefore, substantial unmet need remains in the treatment of tumor necrosis factor inhibitor (TNFi)-refractory RA.

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QUESTIONS ANSWERED

  • What are the treatment drivers and goals for TNFi-refractory RA?
  • What drug attributes are key influences, 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 for TNFi-refractory RA?

PRODUCT DESCRIPTION

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 rheumatologists fielded in February 2021

Key companies: Amgen, Pfizer, Roche, Biogen, Bristol Myers Squibb, Eli Lilly, AbbVie

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

Table of contents

  • Rheumatoid Arthritis - Unmet Need - Detailed, Expanded Analysis: TNF-Alpha Refractory Rheumatoid Arthritis (US & EU)
    • Executive Summary
      • Unmet Need - TNFi-Refractory RA - Executive Summary - May 2021
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Drug Selection
          • Products for RA 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 Rheumatologists' Prescribing Decisions in TNFi-Refractory RA
        • Importance of Efficacy Attributes to Prescribing Decisions in TNFi-Refractory RA: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in TNFi-Refractory RA: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in TNFi-Refractory RA: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in TNFi-Refractory RA: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in TNFi-Refractory RA: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in TNFi-Refractory RA: Europe
        • Importance of Nonclinical Factors to Prescribing Decisions in TNFi-Refractory RA: United States
        • Importance of Nonclinical Factors to Prescribing Decisions in TNFi-Refractory RA: 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 TNFi-Refractory RA: United States
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in TNFi-Refractory RA: Europe
      • Product Performance Against Treatment Drivers and Goals
        • Key Findings
        • Overall Performance of Key Therapies for TNFi-Refractory RA: United States
        • Overall Performance of Key Therapies for TNFi-Refractory RA: Europe
        • Mean Overall Performance of Key Therapies for TNFi-Refractory RA: United States and Europe
        • Relative Performance of Key Therapies for TNFi-Refractory RA Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for TNFi-Refractory RA Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for TNFi-Refractory RA Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for TNFi-Refractory RA Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for TNFi-Refractory RA Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for TNFi-Refractory RA Across Select Convenience of Administration Attributes: Europe
        • Relative Performance of Key Therapies for TNFi-Refractory RA Across Select Nonclinical Attributes: United States
        • Relative Performance of Key Therapies for TNFi-Refractory RA Across Select Nonclinical Attributes: Europe
      • Assessment of Unmet Need
        • Key Findings: Unmet Need in TNFi-Refractory RA
        • Surveyed Rheumatologistsu2019 Satisfaction with the Performance of Key Therapies for TNFi-Refractory RA on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Rheumatologistsu2019 Satisfaction with the Performance of Key Therapies for TNFi-Refractory RA on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
        • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in TNFi-Refractory RA: United States
        • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in TNFi-Refractory RA: Europe
        • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in TNFi-Refractory RA: United States
        • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in TNFi-Refractory RA: Europe
        • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in TNFi-Refractory RA: United States
        • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in TNFi-Refractory RA: Europe
        • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in TNFi-Refractory RA: United States
        • Surveyed Rheumatologists' Ascribed Level of Unmet Need Across Key Nonclinical Factors in TNFi-Refractory RA: Europe
        • Key Findings: Unmet Need in TNFi-Refractory RA and Related Indications
        • Surveyed Rheumatologists' Ascribed Level of Unmet Need in TNFi-Refractory RA and Related Indications: United States
        • Surveyed Rheumatologists' Ascribed Level of Unmet Need in TNFi-Refractory RA and Related Indications: Europe
      • Opportunity Analysis
        • Areas of Opportunity in the TNFi-Refractory RA Market and Emerging Therapy Insights
          • Opportunity: A New Therapy That Offers Increased Efficacy
          • Opportunity: A New Therapy with an Improved Safety Profile
      • Target Product Profiles
        • Assessing Drug Development Opportunities
        • Target Product Profile Methodology
          • Attributes and Attribute Levels
          • Attributes of Key Current and Late-Phase Emerging Therapies for TNFi-Refractory RA
        • Attribute Importance and Part-Worth Utilities
          • TNFi-Refractory RA Target Product Profile: Attribute Importance
          • ACR 20 Response in TNFi-Refractory Patients at Six Months (% of Patients)
          • Remission (DAS28 < 2.6) in TNFi-Refractory Patients at Six Months (% of Patients)
          • Change from Baseline in SF-36 Physical Component Score at Six Months
          • Rate of Cardiovascular Events (% of Patients)
          • Rate of Malignancy (% of Patients)
          • Delivery Burden (Route and Frequency of Administration)
          • Price per Day (Relative to SC Orencia)
        • Conjoint Analysis-Based Simulation of a Market Scenario
          • TNFi-Refractory RA Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
          • TNFi-Refractory RA Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
          • TNFi-Refractory RA Market Simulation: Target Product Profiles Included in the Market Scenario
      • Appendix
        • Key Abbreviations

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