Decision Resources: 68% of gastroenterologists select Remicade for Crohn's treatment

Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that more than two-thirds (68 percent) of surveyed gastroenterologists selected Centocor Ortho Biotech/Merck & Co./Mitsubishi Tanabe's Remicade (infliximab) as the most efficacious therapy for Crohn's disease, when compared to other currently available agents. Physicians' favorable opinion of Remicade's efficacy for treating moderate to severe Crohn's disease and the drug's higher price compared with Crohn's disease therapies for which generic versions are available, such as prednisone and azathioprine, contribute to Remicade's status as the current sales leader in this market.

Decision Resources' analysis of the Crohn's disease drug market reveals that surveyed physicians who regard Remicade as the most efficacious therapy were most satisfied with the drug's efficacy in induction of remission and response and its impact on quality of life. However, they were least satisfied with Remicade's effect on maintenance of remission, corticosteroid-free remission, and response, presumably because of patients' tendency to lose response to the drug over time.

In contrast to surveyed gastroenterologists, the majority (60 percent) of surveyed managed care organizations' (MCOs) pharmacy directors selected Abbott/Eisai's Humira (adalimumab) as the most efficacious therapy for Crohn's disease. Surveyed payers who selected Humira as the most efficacious therapy were most satisfied with the drug's induction and maintenance of remission and response. The findings also reveal that surveyed gastroenterologists who selected Humira as most efficacious were most satisfied with its ability to improve patients' quality of life.

"Although only 23 percent of surveyed gastroenterologists chose Humira as the most efficacious therapy for Crohn's disease, these physicians expressed a high level of satisfaction with Humira's impact on quality of life and its effect on maintenance of remission, which will likely contribute to Humira's increased use in the maintenance setting," said Decision Resources Analyst MaryEllen Klusacek, Ph.D. "Considering all assessed efficacy end points, surveyed gastroenterologists were least satisfied with Humira's effect on mucosal healing and fistula closure."

The findings also reveal that the Crohn's disease drug market will experience modest growth over the next decade, increasing from approximately $3.2 billion in 2009 to $4.2 billion in 2019 in the United States, France, Germany, Italy, Spain, the United Kingdom and Japan. This moderate growth rate will mask dramatic changes as market growth from newer and emerging biological agents outpaces the decline in sales of older, established agents, which will face increasing generics competition and declining use. Tumor necrosis factor-alpha (TNF-alpha) inhibitors, namely Remicade and Humira, dominated the market in 2009, capturing nearly 77 percent of major-market sales.

Additionally, several therapies with novel mechanisms of action are expected to launch for Crohn's disease beginning in 2013, including Millennium Pharmaceuticals' vedolizumab, Centocor Ortho Biotech/Janssen-Cilag's Stelara (ustekinumab) and GlaxoSmithKline/ChemoCentryx's GSK-1605786 (formerly CCX-282B or Traficet-EN). However, none of these agents will rival the efficacy or market share of the TNF-alpha inhibitors.


The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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