Early Adopters in Germany and the United Kingdom Are Prescribing Merck KGaA's Mavenclad as First-Line Induction Therapy for the Treatment of Multiple Sclerosis
European neurologists predict substantial uptake of Roche's Ocrevus among primary progressive multiple sclerosis patients driven by favorable market access status and an absence of on-label competition, according to a new EU5 report from Spherix Global Insights
EXTON, Pa., Nov. 21, 2017 /PRNewswire/ -- The multiple sclerosis (MS) market in the EU is poised to become even more fiercely competitive with the August 2017 approval of Merck KGaA's Mavenclad (cladribine) and imminent approval of Roche's Ocrevus (ocrelizumab). In a new report by Spherix Global Insights, 261 EU neurologists were surveyed about their current disease-modifying therapy (DMT) use and management of MS patients, with a focus on post-approval Mavenclad metrics and pre-launch Ocrevus metrics. In Germany and the UK, one in five surveyed neurologists have initiated at least one patient on Mavenclad with most Mavenclad-treated patients diagnosed with relapsing remitting MS (RRMS) or active secondary progressive MS (aSPMS) ─ consistent with the EMA's highly active RMS label. Suggesting that Mavenclad may expand the DMT-treated patient pool, the greatest percentage of patients had no prior DMT treatment, while later line patients were most likely to be switched from glatiramer acetate, interferons, or Novartis' Gilenya. With no limitation in the label for line of therapy, early adopters appear to be incorporating the selective immune reconstitution therapy (SIRT) as a first-line induction therapy in a substantial proportion of Mavenclad-treated patients, especially in the UK where neurologists report a greater preference for an induction approach. However, many EU neurologists are not comfortable with prescribing Mavenclad first line suggesting this source of business will shrink as later adopters enter the prescriber base.
As would be expected two months post-approval and pre-access in many markets, lack of familiarity is the most common barrier to Mavenclad uptake followed by limited market access. Two out of five EU neurologists report having not been detailed on Mavenclad and more than one-third have not participated in any launch activities since approval. Among those who have participated in launch activities, most were non-Merck KGaA activities such as independent research or colleague discussions. Additional Merck KGaA outreach to both neurologists and patients would help address neurologists' barriers to trial and uptake and facilitate influential patient inquires.
The current report captures EU neurologists' perceptions and anticipated use of Ocrevus immediately prior to the November 2017 CHMP recommendation for approval. Ocrevus is by far the DMT in development that neurologists are most interested in adding to their treatment armamentarium due to the anticipated efficacy and safety balance, novel mechanism of action, infrequent infusion dosing, and first-in-class PPMS label. More than twice as many neurologists anticipate using Ocrevus as a first-line DMT for progressive MS compared with those who anticipate first-line use for RMS, stressing the large unmet need for therapies for progressive MS and the stated belief that regulatory authorities will find Ocrevus to have added benefits over PPMS comparators. As a result, EU neurologists estimate that more than twice as many of their PPMS patients are appropriate candidates for Ocrevus compared with their RRMS patients. In the parallel US report published in October, US neurologists estimated that three times their PPMS patients are appropriate candidates for Ocrevus compared to RRMS patients and yet the RRMS and PPMS trial rates reported by Ocrevus early adopters were similar four months post-launch. Indeed, upon European Commission approval, the actual PPMS candidate pool in the EU may be diminished if the more restrictive early PPMS label recommended by CHMP is granted. While Biogen's Tysabri, Gilenya, and rituximab will be among the DMTs most impacted by the availability of Ocrevus, EU neurologists continue to anticipate continued rituximab share growth over the next six months most likely due to delayed Ocrevus market access and the availability of lower-cost rituximab biosimilars.
RealTime Dynamix™: Multiple Sclerosis (EU) is an independent report series published on a biannual basis that provides rapid response trending on the key issues affecting the MS market based upon surveys fielded in France, Germany, Italy, Spain, and the United Kingdom. The series provides a close-quarters analysis of key performance metrics, focusing on brand gains and losses, industry contact rates, familiarity and adoption rates of recently launched products and awareness of products in development. Product perceptions, disease awareness and attitudes, practice management and other topics are rotated throughout the year to provide an ongoing probe of the crucial drivers of change. The next wave of EU research will be published in March 2018.
RealTime Dynamix™: Multiple Sclerosis (US), an independent report series published on a quarterly basis, will next be published in December 2017.
About Spherix Global Insights Spherix Global Insights is an independent business intelligence and market research company, specializing in renal, autoimmune, neurologic and rare disease markets. Our aim is to apply our commercial experience and unique relationships within core specialty markets to translate data into insight, enabling our clients to make smarter business decisions.
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