With Ocrevus Uptake in Primary Progressive Multiple Sclerosis a Relative Lock, Genentech and US Neurologists are Increasingly Focused on Ocrevus Positioning in Relapsing Forms of Multiple Sclerosis
Swift uptake of Mylan's generic glatiramer acetate 20mg and 40mg is being driven by perceptions of preferential payer coverage although a dispensed-as-written strategy for Teva's Copaxone may be limiting greater conversion, according to a new report from Spherix Global Insights
EXTON, Pa., Dec. 7, 2017 /PRNewswire/ -- Seven months post-launch, the clear majority of US neurologists (n=103) have initiated at least one patient on Genentech's Ocrevus, with the brand share being boosted by uptake in both relapsing remitting multiple sclerosis (RRMS) and primary progressive multiple sclerosis (PPMS) patients. Reflecting the great unmet need for PPMS treatments and Ocrevus' first-in-class PPMS label, Ocrevus prescribers and non-prescribers do not differ in their sizeable and stable PPMS candidate pool estimates for the brand. However, neurologists now estimate that significantly more RRMS patients ─ up 50% compared to three months ago ─ are appropriate candidates for Ocrevus. Consistent with prescribers' positive clinical experience in the RRMS patient subtype, Ocrevus prescribers are projecting a significantly greater RRMS candidate pool compared to non-prescribers. Genentech appears to be reinforcing the greater focus on relapsing forms of MS (RMS) with recently detailed neurologists recalling more discussion with sales representatives around Ocrevus use in patients refractory to other disease-modifying therapies (DMTs) and surrounding the RMS indication compared to the previous quarter. With neurologists predominantly using Ocrevus as a second-line or later agent in RMS patients, intensified switching to Ocrevus will pull from Biogen's Tecfidera and Tysabri, Novartis' Gilenya, and the interferon DMT class. Continued uptake of Ocrevus could also trigger new business opportunity loss for the other monoclonal antibody DMTs, including Genentech's Rituxan and Sanofi Genzyme's Lemtrada, as well as Tysabri. Thus far, Sanofi-Genzyme's Aubagio has been relatively buffered from the Ocrevus onslaught, with neurologists anticipating significant growth of the oral DMT's share over the next six months.
The remaining Ocrevus non-prescribers are unlikely to initiate a trial in the next six months reflecting the subgroup's more conservative approach to new product adoption and significantly reduced access to onsite infusion capabilities compared to prescribers. Indeed, significantly more Ocrevus non-prescribers report referring patients out for Ocrevus as a primary barrier to trial and significantly less are current prescribers of the other monoclonal antibody agents (even highly preferred Tysabri) consistent with limited infusion resources. However, qualitative feedback suggests that some neurologists are considering building infusion capabilities to better provide patients with monoclonal antibody DMT access ─ a practice shift that could propel even greater uptake across infused DMTs.
Launched in early October, Mylan's generic glatiramer acetate (GA) 20mg and first-to-market generic GA 40mg have already captured 15% of the GA class share (which includes Copaxone and Sandoz's Glatopa 20mg). In fact, just one month post-launch, neurologists perceive Mylan's generics to be preferentially covered by payers ─ slightly more so than Glatopa 20mg or the Copaxone formulations ─ with payer or pharmacy pressure driving the preponderance of generic GA 40mg initiations. Due to generic GA 40mg prescribers' slightly greater willingness to use generic GA 40mg as a switch from a GA 20mg agent (versus GA 40mg or other DMTs), Glatopa 20mg has felt the greatest immediate impact from Mylan's generic GA launches with significant decreases in both prescriber base and share compared to three months ago. Conversely, with 71% of recent Copaxone 40mg prescriptions marked dispensed-as-written (DAW) and neurologists successfully challenging almost half of payer/pharmacy contacts suggesting generic switches, Copaxone prescriber base and share have remained stable. Looking forward, neurologists anticipate that significant increases in both generic GA 40mg prescriber base and share will begin to erode Copaxone share over the next six months. Early generic GA 40mg adopters will be leading the brand-to-generic conversion ─ attributable to their reported comfort using the generic in place of Copaxone 40mg and agreement that generics/biosimilars are a good thing for their multiple sclerosis patients.
RealTime Dynamix™: Multiple Sclerosis (US) is an independent report series published on a quarterly basis. 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 research will be published in March 2018.
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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