Stelara expected to change dermatologists’ prescribing habits and alter patient flow models

Decision Resources, one of the world's leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds that Centocor Ortho Biotech's Stelara, the first interleukin (IL)-12/23 inhibitor to enter the psoriasis drug market in the U.S., is expected to change the prescribing habits of dermatologists and substantially alter patient flow to currently marketed biologic agents, including Amgen's Enbrel and Abbott's Humira.

Humira will suffer the most as the agent garners use as a second-line biologic therapy following Enbrel and surveyed dermatologists indicate that more of their Stelara prescriptions will be as a second-line biologic agent than as a first-line biologic.

The new Treatment Algorithms in Psoriasis report also finds that 5.8 percent of newly diagnosed psoriasis patients receive systemic drugs as second-line therapy compared with last year's analysis. This suggests that dermatologists are more readily moving patients from first-line topical corticosteroids to second-line conventional systemic agents and foregoing additional lines of topical treatment in the second line.

"The trends we're seeing with increased systemic therapy use and the expected uptake of Stelara, suggest a major shift in dermatologists' prescribing habits, a greater willingness to initiate biologic therapy earlier in treatment and a potential increase in the total percentage of patients who receive treatment with biologics," stated Amanda Puffer, analyst at Decision Resources.

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 24 percent of patients using Humira in later lines of therapy switch to Humira from Enbrel whereas only 4.4 percent of patients using Enbrel in later lines of therapy switch to Enbrel from Humira. Survey findings suggest that physician perception about Enbrel's safety and their familiarity with the agent are the leading reasons for its use ahead of Humira.