Introduction:
The relatively mature state of the asthma therapy market and
lack of widespread generic product availability contribute to stable U.S. market sales, which surpassed $7 billion in 2007. Nevertheless, the launches and
uptake of inhaled corticosteroids (ICSs) with more-favorable side-effect/safety
profiles and once-daily dosing (Schering-Plough’s Asmanex [mometasone] and
Sepracor/Nycomed’s Alvesco [ciclesonide]) and a long-acting beta2
agonist (LABA)/ICS combination therapy with faster onset of action
(AstraZeneca’s Symbicort [formoterol/budesonide]) promise to alter the
competitive landscape. In addition, the removal of chlorofluorocarbon
(CFC)-propelled albuterol inhalers from the market to comply with the December
31, 2008, deadline for the Montreal Protocol presents an opportunity for
manufacturers of branded hydrofluoroalkane (HFA)-propelled versions to expand
their market share. Using patient-level claims data, as well as insight from
154 U.S. pulmonologists, allergists, and PCPs, we determine the positioning of
ICSs and Advair (along with other key asthma therapies such as Merck’s
leukotriene receptor antagonist [LTRA] Singulair [montelukast]) in early lines
of therapy, analyze the factors driving physicians to choose one drug over another,
and discuss how this dynamic will change over the next two years.