Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that, for the treatment of moderate to severe psoriasis, the highest proportion of surveyed dermatologists and managed care organizations' (MCOs) pharmacy directors indicate that Abbott/Eisai's Humira and Amgen/Pfizer/Stiefel/Takeda's Enbrel have the best overall clinical profile when compared to other currently available agents. However, when asked to identify which available psoriasis agent was the most efficacious, most surveyed MCO pharmacy directors chose Humira or Enbrel while nearly half of surveyed dermatologists chose Centocor Ortho Biotech/Merck/Mitsubishi Tanabe's Remicade.
“This perception of Enbrel's inferior efficacy compared with other agents in its class is supported by clinical trial data.”
The findings from Decision Resources' analysis of the psoriasis drug market reveal that surveyed dermatologists who selected Remicade as the most efficacious agent reported higher satisfaction with the drug's effect on psoriatic plaques at ten or 12 weeks than with any other efficacy attribute. In contrast, when asked to identify the most efficacious psoriasis therapy, surveyed MCO pharmacy directors identified Humira (45 percent) or Enbrel (41 percent), while only nine percent of surveyed MCO pharmacy directors selected Remicade. Additionally, despite robust efficacy data from clinical trials, only 13 percent of surveyed dermatologists selected Centocor Ortho Biotech/Janssen-Cilag's Stelara—the first IL-12/23 inhibitor to launch for the indication—as the most efficacious therapy for moderate to severe psoriasis.
Although Enbrel, the current market leader in psoriasis, was selected as the most efficacious therapy by a slightly higher percentage of surveyed dermatologists than its closest competitor, Humira, the report findings suggest that Enbrel's market position is at risk.
"Surveyed dermatologists who consider Enbrel the most efficacious drug gave it lower satisfaction scores on most efficacy attributes compared with the scores awarded to Humira by the surveyed dermatologists who selected it as the most efficacious," said Decision Resources Therapeutic Area Director Madhuri Borde, Ph.D. "This perception of Enbrel's inferior efficacy compared with other agents in its class is supported by clinical trial data."
The findings also reveal that surveyed experts agree that long-term response with continuous therapy is one of the attributes that most influences their prescribing and tier placement decisions in moderate to severe psoriasis. Clinical data and the opinions of interviewed thought leaders indicate that Stelara has advantages on this attribute over Enbrel.
The continued uptake of interleukin inhibitors and TNF-alpha inhibitors and an almost twofold increase in the penetration of biologics in the moderate-to-severe population will drive a robust increase in the psoriasis drug market, from $3.4 billion in 2009 to more than $6.1 billion in 2019 in the United States, France, Germany, Italy, Spain, United Kingdom and Japan. Although Enbrel maintained its market dominance in 2009, it will face stiff competition from Humira and Stelara, which—along with the entry of biosimilar formulations—will lead to a decline of Enbrel's market share from more than one-third of sales in 2009 to less than one-fifth of sales in 2019.