Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that the majority of surveyed U.S. neurologists (63 percent) selected Biogen Idec/Elan's Tysabri as the most effective therapy for the treatment of relapsing-remitting multiple sclerosis, when compared to other currently available agents. However, no surveyed managed care organizations' (MCO) pharmacy directors chose Tysabri as the most efficacious available agent for the indication.
Decision Resources' analysis of the multiple sclerosis drug market reveals that surveyed neurologists' overwhelming response is consistent with the perception among interviewed experts that Tysabri is the most effective therapy for relapsing-remitting multiple sclerosis—a view supported by clinical studies and clinical experience that suggest the drug's efficacy is superior to other current agents. Surveyed neurologists indicate a high level of satisfaction with Tysabri's efficacy, more specifically its impact on relapses (which is sizable compared with other current therapies), disability progression and lesions.
"However, no surveyed MCO pharmacy directors selected Tysabri as the most effective therapy—this is an interesting finding, given that both surveyed neurologists and pharmacy directors agree that efficacy is the most important attribute for relapsing-remitting multiple sclerosis treatments with regard to prescribing and tier placement decisions, respectively," said Decision Resources Analyst Jonathan Searles. "This finding may reflect a lack of understanding about or experience with Tysabri given that it is, in fact, among the least well covered therapies on the formularies of indexed commercial and Medicare insurance plans that we queried. Notably, few survey respondents selected Tysabri as the safest and best tolerated agent, presumably owing to the drug's risk of progressive multifocal leukoencephalopathy."
The findings also reveal that, in regard to a drug's effect on relapses, clinical data and the opinions of interviewed thought leaders indicate that Tysabri and Novartis/Mitsubishi Tanabe Pharma's Gilenya—the first oral disease-modifying treatment launched for relapsing forms of MS in the major pharmaceutical markets—have advantages over sales-leading Teva's Copaxone on this attribute. Additionally, owing primarily to the competitive advantages in efficacy it has shown to date, Genzyme/Bayer HealthCare's Lemtrada is expected to displace Tysabri and earn Decision Resources' proprietary clinical gold-standard status for relapsing-remitting multiple sclerosis in 2014, following its projected U.S. launch for the indication in late 2012.
The launch of several high-priced novel disease-modifying therapies, including four oral agents approved to treat multiple sclerosis, will drive the total multiple sclerosis market to increase from approximately $8 billion in 2009 to nearly $11.3 billion in 2019 in the United States, France, Germany, Italy, Spain, United Kingdom and Japan. In 2019, oral disease-modifying agents are forecast to capture more than one-third of market share owing to patient demand, the clinical need for treatment alternatives, enhanced convenience and premium pricing.
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