Introduction:Last Updated 18 October 2013
Psoriasis is a skin disorder that, depending on its severity and location on the body, can have a major impact on patients’ quality of life. It is generally characterized as mild or moderate to severe and can be accompanied by the debilitating joint disease psoriatic arthritis (PsA). We expect the psoriasis therapy market to experience substantial growth over the 2012-2022 forecast period as a result of the launches of several new therapies and increasing drug-treatment rates.
Questions Answered in This Report:
Interviewed dermatologists report that adalimumab (AbbVie/Eisai’s Humira) has displaced the previous market leader, etanercept (Amgen/Stiefel/Pfizer/Takeda’s Enbrel), as the preferred first-line biologic for psoriasis in several markets under study, and physicians report that they plan to increase their use of adalimumab (at the expense of etanercept) in the future. Which current or emerging agents pose the greatest threat to the TNF-α inhibitors?
The interleukin-12 (IL-12)/23 inhibitor ustekinumab (Janssen’s Stelara) has experienced strong uptake since its launch for psoriasis in 2009 and has expanded treatment options for patients who fail the TNF-α inhibitors. How are dermatologists incorporating this agent in their treatment algorithms for patients with moderate to severe psoriasis? How will ustekinumab compete with first-line TNF-α inhibitors and other emerging biologics over the forecast period?
The launch of several emerging therapies with novel mechanisms of action—Novartis’s IL-17 inhibitor secukinumab (AIN-457), Pfizer’s oral Janus kinase (Jak) inhibitor tofacitinib (Xeljanz), Eli Lilly’s IL-17 inhibitor ixekizumab (LY-2439821), Amgen/AstraZeneca/Kyowa Hakko Kirin’s IL-17 inhibitor brodalumab (AMG-827), and Merck’s IL-23 inhibitor MK-3222—will increase competition for patient share in the TNF-α refractory space beginning in 2014. The oral phosphodiesterase-4 (PDE-4) inhibitor apremilast (Celgene) will also compete for uptake within the moderate to severe patient segment. What is the likely positioning of each of these emerging agents based on their efficacy and safety profiles? Which current therapies are they most likely to replace in the treatment algorithm for psoriasis?
Biosimilar versions of the TNF-α inhibitors will become available in all the major markets during the forecast period. We project that biosimilars will be priced at a discount to their branded counterparts, and we expect that positive clinical trial data from biosimilars in psoriasis will lead to more-aggressive erosion of branded agents over the forecast period. How will the availability of biosimilars affect the uptake of biologics in psoriasis? What is the sales potential of novel, premium-priced oral agents given the anticipated availability of biosimilar TNF-α inhibitors?
Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, Japan.
Primary research: 29 country-specific interviews with thought-leading dermatologists.
Epidemiology: Diagnosed prevalence of four psoriasis subpopulations—symptom-free, mild, moderate, severe.
Population segments in market forecast: Moderate-to-severe psoriasis and mild psoriasis.
Emerging therapies: Phase II: 10 drugs; Phase III/PR: 7 drugs.
Market forecast features: We forecast population sizes and drug sales for the total psoriasis population, the moderate-to-severe psoriasis subpopulation, and the mild psoriasis subpopulation through 2022.