Treatment Algorithms: Psoriasis - Prescribing Trends Mirror Guidelines

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Treatment Algorithms: Psoriasis – Prescribing trends mirror guidelines

http://www.reportlinker.com/p0799251/Treatment-Algorithms-Psoriasis-–-Prescribing-trends-mirror-guidelines.html#utm_source=prnewswire&utm_medium=pr&utm_campaign=Pathology

Prescribing trends at earlier lines of therapy remain relatively unchanged. However, biologics Enbrel (etanercept; Amgen/Pfizer), Humira (adalimumab; Abbott/Eisai), and Stelara (ustekinumab; Janssen Biotech) continue to reshape the management of moderate to severe psoriasis patients. This trend is expected to continue over the next decade, as physicians gain clinical experience with these agents. Enhance understanding of patient flow and estimate the size of the psoriasis patient pool using interactive country-specific treatment trees. Assess the regional dynamics of pharmacological therapy (topical and systemic agents) choice in psoriasis. Access a snapshot of current patient-numbers receiving drug therapy at first line and second line and beyond (following first line therapy failure). Gain insight into how formulation impacts compliance and how this changes according to disease severity. Dermatologists reveal that most psoriasis patients receive a combination of drug and non-drug therapy to manage symptoms, with a seven major market mean of 36.1% of mild diagnosed patients receiving this treatment strategy, rising to 52.1% in severe patients. However, this is unsurprising and mirrors treatment guidelines for psoriasis. Biologics Enbrel and Humira continue to be heavily prescribed by dermatologists at first line for moderate to severe patients. In the US and EU, Stelara has gained traction and Datamonitor anticipates that greater familiarity and experience with its safety profile will fuel its ascendance across the seven major markets over the coming decade. Across all disease severities, the chief reason for psoriasis patients not progressing to second line and beyond of drug therapy is the exploration of other forms of non-drug therapy. Datamonitor speculates that the high annual cost of therapies such as biologics steers patients to seek cheaper, non-drug alternatives to control their symptoms. Which topical and biologic brands experience the greatest physician uptake in each seven major market? To what extent is Stelara challenging established biologic drugs Enbrel and Humira from dermatologists' viewpoint? What are the current psoriasis market dynamics and the competitive landscape in terms of patient numbers?

OVERVIEWCatalystSummaryEXECUTIVE SUMMARYStrategic scoping and focusDatamonitor key findingsRelated reportsCOUNTRY TREATMENT TREESIntroduction to treatment treesUSJapanFranceGermanyItalySpainUKDISEASE DEFINITION AND DIAGNOSISDisease definition EtiologyThe exact etiology of psoriasis remains unknownSymptomsVariant types of psoriasis display different symptomsPresentation and diagnosisTime to diagnosis: psoriasis patients wait over 10 months before presentingPATIENT SEGMENTATIONSeverity: moderate sufferers are the largest patient segmentCURRENT TREATMENT OPTIONSPharmacological versus non-pharmacological Most psoriasis patients are treated with non-pharmacological and pharmacological therapyCountry trends: most notable is the heavy reliance on pharmacological therapy by Japanese physiciansOverview of the available drug classesPrescribing trendsUse of combination therapy generally increases with disease severity and line of therapyBiologic usage by brand and line of therapyMajority of patients not progressing to second line and beyond of therapy explore other forms of non-pharmacological therapy Changes in therapyCompliance increases with disease severity and from topical to systemic therapiesTreatment outcomesMost mild patients reach desired outcomes after 6 months of treatmentBIBLIOGRAPHYJournal papersWebsitesDatamonitor reportsAPPENDIX A – SURVEY INFORMATIONPhysician research methodology 2011The 2011 survey questionnairePhysician research methodology 2009The 2009 survey questionnaireAPPENDIX BContributing expertsReport methodology

TABLES

Table: Mean percentage of psoriasis patients with each sub-type of the disease, by country (%), 2011

Table: Total length of time from onset of symptoms to psoriasis diagnosis across the seven major markets (months)

Table: Mean percentage of diagnosed psoriasis patients with each severity, by country (%), 2011

Table: Mean percentage of psoriasis patients treated with various forms of therapy, across the seven major markets, by disease severity, 2011

Table: Leading treatments in psoriasis, 2012

Table: Mean percentage of psoriasis patients receiving monotherapy versus combination therapy, by severity, line of therapy, and country (%), 2011

Table: Mean percentage of psoriasis patients across the seven major markets receiving each biologic, by line of therapy, severity, and country (%), 2011

Table: Reasons why patients do not progress to second-line pharmacological therapy and beyond, percentage of respondents, by severity and country (%), 2011

Table: Mean compliance rates for psoriasis patients in each of the seven major markets, by formulation and severity (%, n), 2011

Table: Mean percentage of psoriasis patients reaching the desired outcome after 6 months of treatment across the seven major markets, by severity (%)

Table: Dermatologists surveyed regarding psoriasis across the seven major markets

Table: Percentage of diagnosed psoriasis patients suffering with mild, moderate, and severe disease

Table: Percentage of all psoriasis patients suffering with each sub-type of psoriasis

Table: Percentage of psoriasis patients treated with a particular type of therapy

Table: Compliance rate percentage for psoriasis patients at each severity, receiving each formulation type (%), 2011

Table: Dermatologists surveyed regarding psoriasis across the seven major markets

FIGURES

Figure: US psoriasis diagnosed patient population, by physician-estimated treatment rates for each disease severity and usage of key brands at first line (%, n), 2011Figure: US psoriasis patients progressing to drug therapy at second line and beyond following first-line therapy failure (%, n), 2011Figure: Japan psoriasis diagnosed patient population, by physician-estimated treatment rates for each disease severity and usage of key brands at first line (%, n), 2011Figure: Japan psoriasis patients progressing to drug therapy at second line and beyond following first-line therapy failure (%, n), 2011Figure: France psoriasis diagnosed patient population, by physician-estimated treatment rates for each disease severity and usage of key brands at first line (%, n), 2011Figure: France psoriasis patients progressing to drug therapy at second line and beyond following first-line therapy failure (%, n), 2011 Figure: Germany psoriasis diagnosed patient population, by physician-estimated treatment rates for each disease severity and usage of key brands at first line (%, n), 2011Figure: Germany psoriasis patients progressing to drug therapy at second line and beyond following first-line therapy failure (%, n), 2011 Figure: Italy psoriasis diagnosed patient population, by physician-estimated treatment rates for each disease severity and usage of key brands at first line (%, n), 2011Figure: Italy psoriasis patients progressing to drug therapy at second line and beyond following first-line therapy failure (%, n), 2011 Figure: Spain psoriasis diagnosed patient population, by physician-estimated treatment rates for each disease severity and usage of key brands at first line (%, n), 2011Figure: Spain psoriasis patients progressing to drug therapy at second line and beyond following first-line therapy failure (%, n), 2011 Figure: UK psoriasis diagnosed patient population, by physician-estimated treatment rates for each disease severity and usage of key brands at first line (%, n), 2011Figure: UK psoriasis patients progressing to drug therapy at second line and beyond following first-line therapy failure (%, n), 2011Figure: Key features of the current understanding of psoriasis pathogenesis, with an illustration of targets for clinical candidates and marketed therapiesFigure: Total length of time from onset of symptoms to psoriasis diagnosis across the seven major marketsFigure: Physicians indicating that psoriasis is diagnosed immediately upon presentation versus those who believe that patients experience a delay in receiving a diagnosisFigure: Mean percentage of diagnosed psoriasis patients with each severity, by country (%), 2011Figure: Mean percentage of psoriasis patients treated with various forms of therapy, across the seven major markets, by disease severity, 2011Figure: Mean percentage of psoriasis patients receiving monotherapy versus combination therapy, by severity, line of therapy across the seven major markets (%), 2011Figure: Mean percentage of psoriasis patients receiving each biologic across the seven major markets, by line of therapy and severity (%), 2011Figure: Reasons why patients do not progress to second-line pharmacological therapy and beyond, percentage of respondents, by severity (%), 2011Figure: Mean compliance rates for psoriasis patients, by formulation and severity across the seven major markets (%), 2011Figure: Distribution of physician responses for percentage of patients reaching the desired outcome, by severity (%)Figure: Treatment flow: mild – first-line pharmacological therapy (initial therapy prescribed)Figure: Treatment flow: mild – second-line pharmacological therapy and beyondFigure: Treatment flow: moderate – first-line pharmacological therapy (initial therapy prescribed)Figure: Treatment flow: moderate – second-line pharmacological therapy and beyondFigure: Treatment flow: severe – first-line pharmacological therapy (initial therapy prescribed)Figure: Treatment flow: severe – second-line pharmacological therapy and beyond

Companies mentioned

GlaxoSmithKline Plc, Hutchison 3G UK Limited, Johnson & Johnson, RSA Insurance Group plc

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