Treatment Algorithms

November 2013

Key Findings from Treatment Algorithms: Ulcerative Colitis

Introduction:

As more biologics are approved to treat ulcerative colitis (UC), it is important to analyze the changes in gastroenterologists’ prescribing behaviors. This report uses national patient-level claims data to explore the use of key therapies in newly diagnosed UC patients with a quantitative analysis of treatment patterns and share by line of therapy, as well as progression between lines, duration of treatment on each line, and use of concomitant treatment. Among recently treated patients, the report quantifies a drug’s source of business compared with its competitors and details which drugs precede others through an analysis of add-versus-switch patterns. Additional analyses explore persistency and compliance by brand.

Questions Answered in This Report:

  *   Newly diagnosed patients: 28% of UC patients begin treatment with a key therapy within a year of their initial diagnosis. What percentage of these patients progress to a second- or third-line drug within the first year? Which products capture the most patient share in the first, second, and third lines of treatment? How often is combination therapy used in each line of therapy?

  *   Recently treated patients: Consistent with historical treatment patterns, oral 5-ASAs continue to capture the majority of recent prescriptions. Which specific drugs garner the most patient share for recently treated UC patients? When do patients progress from one therapy to the next in UC, and how does this pattern differ between key drugs? Are most recently treated patients with each key brand coming through new (adds/switches) or continuing business?

  *   Pathways to key therapies: Longitudinal claims data reveal relatively consistent use patterns of key therapies among recently treated patients; use of TNF-alpha inhibitors for UC increases as the line of therapy progresses. Which therapies have experienced market growth or decline over the key therapy periods studied? To what extent are key therapies prescribed concomitantly to recently treated patients? What has been the impact of recently approved drugs for UC?

Scope:

Primary patient-level data: Quantitative findings from our analysis of data covering approximately 40 million lives providing the most representative sample of U.S. treatment practice for Medicare and commercially insured patients. This report is delivered as a key findings slide deck and a dashboard that can be accessed using the Internet with claims that are less than six months old at the time of publication.

Patient Sample:

- Patients who are continuously enrolled for the complete two-year study period must meet the following condition: at least one claim with a diagnosis code for UC (International Classification of Diseases, Ninth Revision [ICD-9] diagnostic codes 556.0, 556.1, 556.2, 556.3, 556.4, 556.5, 556.6, 556.8, 556.9) during the study period.

- Quantified lines of therapy analysis showing exact share of each agent in each line of therapy, including rate of progression between lines and length of time patients are on each line.

Newly Diagnosed Patients:

- Patient share by drug class and key products across three lines of therapy, within one year of diagnosis.

- Patient flowchart through one year of treatment for all first-line products, including progression rates and add/switch behavior.

- Polypharmacy and key concomitant therapies by line of therapy.

- Quarterly trending of patient share by line of therapy.

Recently Treated Patients:

- Quarterly snapshot of patient share by drug class and key products.

- Pathway to key therapy flowcharts tracking the preceding therapy patterns for all key therapies, including add/switch behavior.

- Brand source of business including share for continuing, new (switches/adds), and new (initial therapy) business.

- Polypharmacy and key concomitant therapies.

- Drug persistence and compliance.

- Quarterly trending of patient share for all key therapies.


Search Reports

Mentioned in this report:

  • - AbbVie
  • - Astellas Pharma
  • - Axcan Pharma
  • - Biogen Idec
  • - Dava Pharmaceuticals
  • - Gate Pharmaceuticals
  • - Janssen
  • - Novartis
  • - Pfizer
  • - Prometheus Laboratories
  • - Salix
  • - Shire
  • - Takeda
  • - UCB
  • - Warner Chilcott
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