Declining use of Advair for COPD, Spiriva patient share increasing

Decision Resources, one of the world's leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds that since the 2008 retrospective analysis of patient-level claims data, Boehringer Ingelheim/Pfizer's Spiriva has closed the gap in patient share between itself and GlaxoSmithKline's Advair in newly diagnosed chronic obstructive pulmonary disease (COPD) patients. Although Advair's patient share in the first line is still greater than Spiriva's, Spiriva has surpassed Advair in the second line and will continue to overcome and widen the gap between itself and Advair over the next two years.

"Surveyed U.S. primary care physicians (PCPs) expect to use more of Spiriva over the next two years while their enthusiasm around Advair is waning compared to last year's analysis," stated Decision Resources Analyst Amanda Puffer. "Almost 60 percent of PCPs say they will increase their use of Spiriva over the next two years and only eight percent think their use of the drug will decline. This is important to note because last year's analysis indicated that a lot of Advair's use was driven by PCPs."

The new report entitled Treatment Algorithms in Chronic Obstructive Pulmonary Disease also finds that the declining use of Advair may be due in part to increased use of AstraZeneca's Symbicort, which was approved for COPD in February of 2009. Patient-level claims data indicates that even prior to its approval, Symbicort was gaining ground in this market and compared to last year's analysis, Symbicort's patient share in the second line increased by 2.8 percentage points.

By combining patient-level claims data with physician survey data, this report can be used to build patient-flow models and analyze the assumptions driving these models. Patient-level claims data show that more patients (11%) use Symbicort directly after having used Advair while a significantly lower number (2%) of Advair users arrive at the drug after having used Symbicort. Compared to last year's analysis, 15.3 percent of second-line and later Symbicort patients moved to the agent after having tried Advair. This indicates that Symbicort is being used more frequently as a first-line maintenance therapy than one year ago.