Stakeholder Insight: Osteoarthritis - Drug development lags behind rising osteoarthritis population

Stakeholder Insight: Osteoarthritis - Drug development lags behind rising osteoarthritis population published by Datamonitor in December, 2009. This report consists of 210 pages and the price starts from US $ 15200.

Introduction

Abstract

Introduction

Datamonitor expect osteoarthritis prevalence to grow by over 10 million by 2020, owing mainly to an aging population. In the near-term the approach to treatment will remain constant, with improved side-effects dominating the unmet needs. However, therapies which target the underlying causes of osteoarthritis have the potential to reshape osteoarthritis treatment.

Scope of this research

• Snapshot of the osteoarthritis market based on a survey of 180 rheumatologists/primary care physicians, with views from key opinion leader interviews
• Analysis of osteoarthritis epidemiology, with future projections of prevalence and patient numbers to 2020
• Overview of treatment options at the class and molecule level, as well as treatment outcome analysis
• Assessment of treatment satisfaction, unmet needs and physicians' awareness of key pipeline therapies

Research and analysis highlights

The estimated diagnosis rate of 55% reflects a lack of treatment-seeking by mild sufferers of the disease, who often resort to self-medication. This equates to nearly 37 million undiagnosed patients in 2009 and with a predicted rise in osteoarthritis numbers this is a market with growth potential.

Pain-relieving drugs, particularly, oral non-steroidal anti-inflammatory drugs (NSAIDs) are the foundation of pharmacological therapy in osteoarthritis. Physicians continue to be concerned over NSAID toxicity, with three-quarters of severe patients who are receiving NSAIDs currently co-prescribed a gastroprotectant.

Physicians are generally unsatisfied with current osteoarthritis pharmacological treatments. A clear need for alternative drugs exists to treat this prevalent condition. 41% of physicians ranked disease modifying osteoarthritis drugs (DMOADs) as the highest unmet need, but the majority of physicians estimate that DMOADs are 8 years from the market.

Key reasons to purchase this research

• Understand current therapy trends for the major drug classes used in osteoarthritis split by disease severity and assess unmet needs in the disease
• Validate new product forecasting based on diagnosis rates and treatment by patient segmentation and drug class
• Use the interactive Excel model of treatment trees and patient numbers to estimate the osteoarthritis population in each of the seven major markets

Table of Contents

EXECUTIVE SUMMARY

• Scope of the analysis
• Datamonitor insight into the osteoarthritis market
• Contributing experts
• Related reports
• Upcoming related reports

INTRODUCTION AND SCOPE

• Coverage of the Stakeholder Insight Survey
  • Epidemiology and patient segmentation in osteoarthritis
  • Treatment options and guidelines
  • Improving treatment outcomes

• Future trends

COUNTRY TREATMENT TREES

• Introduction to treatment trees
  • US
  • Japan
  • France
  • Germany
  • Italy
  • Spain
  • UK

EPIDEMIOLOGY AND PATIENT SEGMENTATION

• Definition and classification of osteoarthritis
  • Primary (idiopathic) osteoarthritis
  • Secondary osteoarthritis

• Epidemiology of osteoarthritis
  • Datamonitor estimates 81.4 million osteoarthritis sufferers in the seven major markets in 2009
  • Measures used to determine radiographic and clinical osteoarthritis
  • US
  • Japan
  • Europe
  • Changes in the osteoarthritis population
  • Additional international osteoarthritis epidemiology studies

• Co-morbidities and risk factors in osteoarthritis
  • Co-morbidities in patients with osteoarthritis are common
  • Other co-morbidities present in osteoarthritis patients
  • Risk factors and patient-group segmentation are critical to osteoarthritis definition

• Presentation and diagnosis
  • Diagnosis of osteoarthritis
  • Severity of osteoarthritis

TREATMENT OPTIONS AND GUIDELINES

• Treatment guidelines
  • Several guidelines exist for the treatment of osteoarthritis

• Treatment options
  • Pharmacological versus non-pharmacological treatment
  • Non-pharmacological treatment of osteoarthritis
  • Pharmacological treatment of osteoarthritis
  • Branded versus generic drug use

IMPROVING TREATMENT OUTCOMES

• Treatment outcomes and satisfaction
  • Efficacy assessment
  • Osteoarthritis patients usually require joint surgery after 7 - 8 years
  • Physicians are generally unsatisfied with current pharmacological treatment for osteoarthritis

• Unmet needs
  • Disease modifying osteoarthritis drugs is the highest unmet need in osteoarthritis
  • Disease modifying osteoarthritis drugs (DMOADs)

• Pipeline products
  • Eli Lilly' s Cymbalta (duloxetine) is the late-stage drug therapy which most physicians are aware of

BIBLIOGRAPHY

• Journal papers
• Websites
• Datamonitor reports

APPENDIX A

• Physician research methodology
  • Physician sample breakdown

APPENDIX B

• The survey questionnaire
  • Diagnosis and patient segmentation
  • Treatment
  • Unmet needs
  • Treatment outcomes and Prescribing patterns

TABLES

• Table: Estimated adult osteoarthritis populations in the seven major markets, split by sex and age group, 2009
• Table: Epidemiological studies of osteoarthritis in the seven major markets, 1984 - 2009
• Table: US osteoarthritis population by age group and gender, 2009
• Table: US gender-specific prevalence of radiographic and symptomatic osteoarthritis in different anatomical sites, 2008
• Table: Estimated adult osteoarthritis population in Japan by age and gender, 2009
• Table: Estimated adult osteoarthritis population in five major EU markets by age and gender, 2009
• Table: Spanish EPISER study showing prevalence of knee and hand osteoarthritis , 200 8
• Table: Combined sample of northern England studies, radiographic knee osteoarthritis by age and gender
• Table: Datamonitor' s future projection of the adult osteoarthritis population in the seven major markets, 2010 - 2020
• Table: International epidemiological studies on osteoarthritis prevalence, 2001 - 09
• Table: Mean percentages of the co-morbidities suffered by osteoarthritis patients in the seven major markets (%), 2009
• Table: Association between doctor-diagnosed* arthritis and body mass index from the BFRSS study, 2009
• Table: Mean percentage of osteoarthritis patients suffering from cardiovascular, endocrinology and pulmonary co-morbidities (%) , 2009
• Table: Mean percentages of gastrointestinal co-morbidities suffered by osteoarthritis patients in the seven major markets (%), 2009
• Table: Percentage of osteoarthritis patients diagnosed by primary care physicians versus rheumatologists (%), 2009
• Table: Mean percentage of osteoarthritis patients receiving each type of therapy across the seven major markets, 2009
• Table: Mean percentage of osteoarthritis patients receiving oral NSAIDs in the seven major markets (%), 2009
• Table: Osteoarthritis patients receiving oral NSAIDs split by molecule and disease severity in the seven major markets (%), 2009
• Table: Mild osteoarthritis patients receiving oral NSAIDs split by molecule in the seven major markets (%), 2009
• Table: Moderate osteoarthritis patients receiving oral NSAIDs split by molecule in the seven major markets (%), 2009
• Table: Severe osteoarthritis patients receiving oral NSAIDs split by molecule in the seven major markets (%), 2009
• Table: Osteoarthritis patients receiving oral NSAIDs a gastroprotectant in the seven major markets (%), 2009
• Table: Mean percentage of osteoarthritis patients receiving topical NSAIDs in the seven major markets (%), 2009
• Table: Osteoarthritis patients receiving a topical NSAID by molecule in the seven major markets (%), 2009
• Table: Mild osteoarthritis patients receiving a topical NSAID by molecule in the seven major markets (%), 2009
• Table: Moderate osteoarthritis patients receiving a topical NSAID by molecule in the seven major markets (%), 2009
• Table: Severe osteoarthritis patients receiving a topical NSAID by molecule in the seven major markets (%), 2009
• Table: Osteoarthritis patients receiving a cyclo-oxygenase-2 (COX-2) inhibitor by molecule and disease severity in the seven major markets(%), 2009
• Table: Osteoarthritis patients receiving injectable hyaluronic acids split by physician type and disease severity in the seven major markets (%), 2009
• Table: Hyaluronic acid brands most commonly prescribed by physicians in the seven major markets (n; %), 2009
• Table: Number of physicians who use each outcome measure in the seven major markets (n), 2009
• Table: Priority ranking allocated by physicians to unmet needs in the treatment of osteoarthritis in the seven major markets, 2009
• Table: Physician opinion of promising molecular targets for disease-modifying osteoarthritis drugs (DMOADs), in the seven major markets, 2009
• Table: Primary care physicians' and rheumatologists' response to promising molecular targets for disease-modifying osteoarthritis drugs (DMOADs), 2009
• Table: Physicians' awareness of drugs in development for osteoarthritis in the seven major markets, 2009
• Table: Physicians surveyed regarding osteoarthritis, 2009

FIGURES

• Figure: US osteoarthritis patient population, split by physician-estimated diagnosis, disease severity, drug-treated population and drug-class usage, 2009
• Figure: Japan osteoarthritis patient population, split by physician-estimated diagnosis, disease severity, drug-treated population and drug-class usage
• Figure: France osteoarthritis patient population, split by physician-estimated diagnosis, disease severity, drug-treated population and drug-class usage, 2009
• Figure: Germany osteoarthritis patient population, split by physician-estimated diagnosis, disease severity, drug-treated population and drug-class usage, 2009
• Figure: Italy osteoarthritis patient population, split by physician-estimated diagnosis, disease severity, drug-treated population and drug-class usage, 2009
• Figure: Spain osteoarthritis patient population, split by physician-estimated diagnosis, disease severity, drug-treated population and drug-class usage, 2009
• Figure: UK osteoarthritis patient population, split by physician-estimated diagnosis, disease severity, drug-treated population and drug-class usage, 2009
• Figure: Adult osteoarthritis population in the seven major markets, 2009
• Figure: Estimated adult osteoarthritis population in five major EU markets, by age and gender, 2009
• Figure: Datamonitor' s future projection of the adult osteoarthritis population, split by age group, in the seven major markets, 2010 - 2020
• Figure: Datamonitor future projection of the adult osteoarthritis population, split by region, in the seven major markets, 2010 - 2020
• Figure: Datamonitor future projection of the 65 years and older osteoarthritis population in Japan, 2010 - 2020
• Figure: Mean percentages of osteoarthritis patients suffering from a co-morbidity in the seven major markets (%), 2009
• Figure: Cardiovascular, endocrinology and pulmonary co-morbidities suffered by osteoarthritis patients in the seven major markets (%), 2009
• Figure: Gastrointestinal co-morbidities in osteoarthritis patients in the seven major markets (%), 2009
• Figure: Musculoskeletal co-morbidities in osteoarthritis patients in the seven major markets (%), 2009
• Figure: Central nervous system co-morbidities in osteoarthritis patients in the seven major markets (%), 2009
• Figure: Lifestyle factors commonly present in osteoarthritis patients in the seven major markets (%), 2009
• Figure: Other co-morbidities that 10% or more of osteoarthritis patients suffer from in the seven major markets (%), 2009
• Figure: Techniques used in the diagnosis of osteoarthritis sufferers in the seven major markets, 2009
• Figure: Percentage of osteoarthritis patients diagnosed versus undiagnosed in the seven major markets (%), 2009
• Figure: Percentage of osteoarthritis patients diagnosed by primary care physicians versus rheumatologists (%), 2009
• Figure: Percentage of diagnosed osteoarthritis patients with mild, moderate or severe osteoarthritis, 200 9
• Figure: NICE clinical guidelines for the care and management of osteoarthritis in adults, 2008
• Figure: Mean percentage of osteoarthritis patients receiving each type of therapy across the seven major markets, 2009
• Figure: Mean percentage of osteoarthritis patients receiving a non-pharmacological therapy (%), 2009
• Figure: Mean percentage of osteoarthritis patients receiving weight loss therapy split by physician type (%), 2009
• Figure: Mean percentage of osteoarthritis patients receiving exercise therapy split by physician type in the seven major markets (%), 2009
• Figure: Mean percentage of osteoarthritis patients receiving physical therapy split by physician type in the seven major markets (%), 2009
• Figure: Mean percentage of osteoarthritis patients receiving a pharmacological therapy in the seven major markets (%), 2009
• Figure: Mean percentage of osteoarthritis patients receiving simple analgesics in the seven major markets (%), 2009
• Figure: Mean percentage of osteoarthritis patients receiving oral NSAIDs in the seven major markets (%), 2009
• Figure: Osteoarthritis patients receiving oral NSAIDs split by molecule and disease severity in the seven major markets (%), 2009
• Figure: Osteoarthritis patients receiving oral NSAIDs a gastroprotectant, split by disease severity in the seven major markets (%), 2009
• Figure: Mean percentage of osteoarthritis patients receiving topical NSAIDs in the seven major markets (%), 2009
• Figure: Osteoarthritis patients receiving a topical NSAID by molecule in the seven major markets (%), 2009
• Figure: Percentage of osteoarthritis patients receiving a COX-2 (cyclooxygenase) inhibitor by molecule in the seven major markets (%), 2009
• Figure: Percentage of osteoarthritis patients receiving a COX-2 (cyclooxygenase-2) inhibitor continuously versus intermittently, 2009
• Figure: Percentage of osteoarthritis patients receiving injectable hyaluronic acids by molecule in the seven major markets (%), 2009
• Figure: Mean percentages of osteoarthritis patients receiving treatment with each drug class in the seven major markets (%), 2009
• Figure: Mean percentages of osteoarthritis patients receiving treatment with each drug class by physician type in the seven major markets (%), 2009
• Figure: Percentage of osteoarthritis patients in the US receiving branded versus generic treatment for each drug class (%), 2009
• Figure: Percentage of osteoarthritis patients in Japan receiving branded versus generic treatment for each drug class (%), 2009
• Figure: Percentage of osteoarthritis patients in France receiving branded versus generic treatment for each drug class (%), 2009
• Figure: Percentage of osteoarthritis patients in Germany receiving branded versus generic treatment for each drug class (%), 2009
• Figure: Percentage of osteoarthritis patients in Italy receiving branded versus generic treatment for each drug class (%), 2009
• Figure: Percentage of osteoarthritis patients in Spain receiving branded versus generic treatment for each drug class (%), 2009
• Figure: Percentage of osteoarthritis patients in the UK receiving branded versus generic treatment for each drug class (%), 2009
• Figure: Outcome measures used by physicians to assess treatment efficacy in osteoarthritis patients in the seven major markets, 2009
• Figure: Number of months needed to assess treatment efficacy in osteoarthritis patients in the seven major markets, 2009
• Figure: Number of months needed to assess treatment efficacy in osteoarthritis patients by physician type in the seven major markets, 2009
• Figure: Osteoarthritis patients who will eventually require joint surgery in the seven major markets (%), 2009
• Figure: Average number of months between treatment initiation and joint surgery for osteoarthritis patients in the seven major markets, 2009
• Figure: Physicians level of satisfaction with current pharmacological treatments for osteoarthritis in the seven major markets, 2009
• Figure: Physicians' overall satisfaction with currently available pharmacological treatments for osteoarthritis in the seven major markets, 2009
• Figure: Priority ranking allocated by physicians to unmet needs in the treatment of osteoarthritis, 2009
• Figure: Physicians' response to whether or not it is possible to develop a disease-modifying osteoarthritis drug (DMOAD), 2009
• Figure: Physicians' estimates of the time it will take for a disease-modifying osteoarthritis drug (DMOAD) to reach market, 2009
• Figure: Physicians' rating on the importance that a disease-modifying osteoarthritis drug shows both disease modification and pain relief in clinical trial data (n), 2009
• Figure: Physicians' response to promising molecular targets for disease-modifying osteoarthritis drugs (DMOADs) in the seven major markets, 2009
• Figure: Physicians' awareness of drugs in development for osteoarthritis, 2009
• Figure: Physicians' awareness of drugs in development for osteoarthritis in the seven major markets, 2009
• Figure: Physicians' response to awareness of Synvisc-One for treatment of osteoarthritis in the seven major markets, 2009

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