Gastroenterologists select efficacy over safety, tolerability when prescribing new drug for Crohn's disease

Decision Resources GroupMay 22 2014

Decision Resources Group finds that, when asked to indicate the relative importance of product attributes when prescribing a new drug for Crohn's disease (CD), the highest percentages of surveyed gastroenterologists in the United States and Europe selected efficacy over safety and tolerability or delivery. Decision Resources Group's findings reveal that maintenance of remission and improvement in quality of life are the efficacy attributes that most influence surveyed U.S. and European gastroenterologists' prescribing decisions in moderate to severe CD. While some emerging CD therapies hold promise, they lack the efficacy, safety and tolerability, and/or delivery features that would allow them to offer better overall clinical profiles than that of AbbVie/Eisai's Humira.

Other key findings from the DecisionBase report entitled Crohn's Disease (Moderate to Severe): Physicians Would Welcome Therapies Causing Lower Rate of Serious Infections than Remicade, But Will Payers View Such Agents Favorably?:

• Stelara: Surveyed U.S. gastroenterologists would prescribe Janssen's Stelara to 10 percent of their drug-treated CD patients (considering mild, moderate and severe forms together), if it was priced at a premium (10 percent) to Janssen/Merck/Mitsubishi Tanabe's Remicade.
• Unmet need: U.S. and European physicians differ in their perceptions of the greatest unmet need in the treatment of moderate to severe CD -- U.S. gastroenterologists rated the unmet need for a greater percentage of patients achieving mucosal healing the highest, while European physicians ascribed the highest unmet need score to improvements in quality of life.
• Formulary inclusion: Surveyed U.S. managed care organization pharmacy directors are particularly willing to grant favorable formulary status to new moderate to severe CD therapies that offer improved effect on maintenance of remission over currently available treatment options.

Comments from Decision Resources Group Analyst Alexandra Makarova, M.D., Ph.D.:

• "Nearly all surveyed U.S. gastroenterologists said they would prescribe Stelara to their moderate to severe CD patients, and around 40 percent of those who would prescribe Stelara indicated that they would use it in place of Remicade. However, the actual uptake will likely be restricted by the significant price premium Stelara will hold over Remicade."
• "Interviewed physicians would welcome the addition of novel CD therapies that offer more convenient oral administration. However, clinicians agree, such a therapy must have an efficacy and safety profile at least comparable to that of the TNF-alpha inhibitors."