The Psoriatic Arthritis Market Will Reach More than $3.5 Billion in 2023, Owing to Continued Uptake of Biologics and Penetration of Premium-Priced Orals

BURLINGTON, Mass., Sept. 8, 2014 /PRNewswire/ -- Decision Resources Group finds that the market for psoriatic arthritis (PsA) therapies will grow nearly 66 percent, increasing to $3.7 billion in 2023, owing to the continued uptake of premium-price biologics and novel therapies that are expected to launch during the 2013 to 2023 forecast period. In 2013, five marketed TNF-alpha inhibitors dominated sales in the PsA market with over 90 percent of the $2.3 billion major-market total; adalimumab (AbbVie/Eisai's Humira) was the overall sales leader. Over the next decade, TNF-alpha inhibitors will retain their sales-leading position, but recently launched treatments ustekinumab (Janssen's Stelara) and apremilast (Celgene's Otezla), together with noval therapies—which include the anti-interleukin-17 monoclonal antibodies secukinumab (Novartis), ixekizumab (Eli Lilly), and brodalumab (Amgen/AstraZeneca/Kyowa Hakko Kirin) and the Janus-kinase inhibitor tofacitnib (Pfizer's Xeljanz)—will account for approximately 21 percent of 2023 PsA sales combined in the United States, France, Germany, Italy, Spain, United Kingdom and Japan.

Other key findings from the Pharmacor report entitled Psoriatic Arthritis:

• Novel oral therapies address "stop gap" needs: Of the five agents entering the PsA market, tofacitinib (Pfizer's Xeljanz) will experience the most uptake during the forecast period. Tofacitinib and recently launched apremilast feature oral formulations and unique mechanisms of action, thus allowing them to compete for TNF-alpha inhibitor-refractory patients, as well as experience uptake as "stop gaps" for conventional DMARD failures before stepping up to treatment with biologics.
• Biosimilars will modulate sales growth: Less-expensive biosimilar versions of several biologics will launch beginning in 2015 and will erode biologics' sales through 2023, with the largest impact on the TNF-alpha inhibitor class.
• Current therapies remain relevant: Interviewed thought leaders report that conventional DMARDs and TNF-alpha inhibitors are the clinical mainstays for mild and moderate-to-severe PsA, respectively, and will face only moderate loss of patient shares to recently launched and incoming novel therapies.

Comments from Decision Resources Group Director Bingnan Kang, Ph.D.:

• "The addition of the TNF-alpha inhibitors to the PsA treatment algorithm represented a significant step forward in the management of this heterogeneous disease. Despite advances in the diagnosis and treatment of PsA, significant opportunity remains for developers of additional disease-modifying agents and agents with a high degree of efficacy against multiple disease manifestations."
• "Physicians are keen for results of pivotal clinical trials of emerging PsA therapies. Interviewed thought leaders tell us that should ixekizumab and/or tofacitinib prove to be as or more effective than active comparator arms (versus adalimumab) in their respective Phase III trials, these therapies would experience stronger uptake compared with other novel agents entering the PsA market."
• "Biosimilar versions of etanercept, adalimumab and infliximab are expected to launch in most or all of the major markets during the forecast period and to account for approximately 36 percent of TNF-alpha inhibitor sales for PsA in 2023. Our primary research indicates that most rheumatologists will feel comfortable prescribing biosimilars for PsA, based on biosimilars' clinical trial data in RA, thereby reducing biosimilars' barrier to entry in this market."

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SOURCE Decision Resources Group