Despite Most Specialty Physician Practices Reopening, Engagement with the Pharmaceutical Industry Continues to be Largely Virtual, Placing Added Pressure on Manufacturers Attempting to Introduce New Therapies
Though surveyed US specialists report shrinking trepidation prescribing certain drugs amid the COVID-19 pandemic, hesitation to prescribe new brands remains
EXTON, Pa., Sept. 15, 2020 /PRNewswire/ -- In March, Spherix began tracking the impact of COVID-19 among specialty physicians, specifically dermatologists, gastroenterologists, nephrologists, neurologists, and rheumatologists. In each wave, approximately 250 specialists share their experience and opinions about practice management during the pandemic.
The tenth wave of research was fielded on September 4th with full results being available to subscribed clients in the next two weeks. Topline take-aways indicate a slow return to normalcy, albeit with some lasting effects. Importantly for industry, most engagement continues to be virtual, but the impact of the pandemic on pharmaceutical brands appears to be nominal with some notable exceptions.
Disease modifying therapies (DMTs) in the multiple sclerosis (MS) space have perhaps seen the greatest impact. Many surveyed neurologists report lower than normal use of immunosuppressive DMTs, such as Sanofi-Genzyme's Lemtrada, Roche-Genentech's Ocrevus, Biogen's Tysabri, and EMD Serono's Mavenclad, in favor of less immunosuppressive drugs in the interferon class (Biogen's Avonex, EMD Serono's Rebif, and Bayer's Betaseron) and glatiramer acetate (Teva's Copaxone, Sandoz' Glatopa, and Mylan's generic glatiramer acetate). As one neurologist shared, "Many of my patients with MS and related diseases are on immunosuppressive agents, which makes me really concerned about them."
In the autoimmune space, there is lingering controversy among dermatologists, gastroenterologists, and rheumatologists as to whether treatment with biologic agents places patients at greater risk from COVID-19. Importantly, the hesitation to initiate these therapies has dwindled with time across all specialties. For example, in March, more than half of the dermatologists reported being less likely to initiate IL-17 inhibitors (Novartis' Cosentyx, Eli Lilly's Taltz); as of September, only 12% report being less likely to initiate these drugs.
Among gastroenterologists, in late March, roughly two-thirds reported a lower likelihood of initiating TNF inhibitor agents (AbbVie's Humira, Janssen's Remicade, UCB's Cimzia) and Janus Kinase (JAK) inhibitors (namely Pfizer's Xeljanz, the only JAK inhibitor with a gastrointestinal indication). Presently, only 15% indicate there is less likelihood of initiating a TNF agent. JAKs, on the other hand, have not fared as well, as nearly one-third still have some lingering trepidation with initiating this MOA.
In the renal space, which was somewhat buffered throughout the pandemic by the ongoing needs of dialysis patients, several trends have emerged. First, greater consideration of home dialysis modalities as opposed to in-center treatment has been fostered by the pandemic. Second, an initial pause on new patient initiations for Otsuka's Jynarque for polycystic kidney disease appears to have rebounded. Finally, about 20% of surveyed nephrologists say that, in reaction to the pandemic, they have been more likely to prescribe potassium-binding agents for patients at risk of hyperkalemia, such as Relypsa's Veltassa and AstraZeneca's Lokelma.
Specialists are more focused on getting their practices back to normal operations than they are with re-engaging with industry. Most encounters with pharma continue to be virtual, and more than 40% say they will have less time to meet with representatives for the foreseeable future. Companies with newly launched brands will need to factor in the importance of virtual engagement in an environment where only about one-quarter of specialists say they would engage in a virtual speaker program even if new data is being presented and more than one-quarter say they are less likely to prescribe new brands in the current climate.
Concerns about COVID-19 have evolved over time, with early fears about personal exposure and a lack of personal protective equipment (PPE) diminishing. The leading concerns at present include worries about a resurgence, the economic impact of the virus, and the politicizing of the pandemic. A small, but growing percent of specialists believe that we should be pursuing "herd immunity" as opposed to continued social distancing – reflecting frustration that the general public is not adherent to masking or social distancing guidelines.
There is also controversy among medical professionals about whether schools should be fully reopened with in-person instruction and concerns about schools not reopening and the impact that could have on staffing. As one gastroenterologist noted, "Mid-level APPs are very common in GI. They are overwhelmingly female. My observation is that they are being torn to stay home with children who are doing online/virtual school. This has been a significant impact to my practice."
Some alarming observations include feedback that the vast majority of specialists do not anticipate the availability of a vaccine by November, although 71% would take one if FDA-approved. Secondly, attention should be paid to physician burnout as more than half say that they are feeling burned out and almost one in five say that, if they had to do it all over again, they would not pursue a career as a physician. One respondent urges, "I would say that it is very important for the government, health organizations/clinics to maintain salaries of providers otherwise burnout will progress to extremely high levels," and another notes, "I fear that this pandemic will be used to further enslave medical professionals with more paperwork and regulations." According to the respondents in the current wave, only 22% believe the federal government is doing a good job managing the crisis.
About the Special Report
Special Report: Multi-Specialty Impact of COVID-19 is an ongoing series of monthly monitoring that evaluates the impact of COVID-19 on physicians and their practices – including, but not limited to, the utilization of telemedicine, at-risk patient groups, key concerns, support from industry, and future changes in prescribing patterns. Specialty reports are available for dermatology, gastroenterology, nephrology, neurology, and rheumatology and will continue through the remainder of 2020.
About Spherix Global Insights
Spherix Global Insights is a hyper-focused market intelligence firm that leverages our own independent data and expertise to provide strategic guidance, so biopharma stakeholders make decisions with confidence. We specialize in select immunology, nephrology, and neurology markets.
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