Stakeholder Opinions: Physician perception of biologics in Autoimmune Disease - Targeted detailing is the key to success

Stakeholder Opinions: Physician perception of biologics in Autoimmune Disease - Targeted detailing is the key to success published by Datamonitor in March, 2009. This report consists of 137 pages and the price starts from US $ 3800.

Introduction

Abstract

Introduction

Factors influencing a prescribing decision can diverge from clinical facts. In the highly competitive autoimmune area, misconceptions and physician habits can result in loss of sales. Targeted detailing of specialist physicians, differentiating by indications is the key to success. Datamonitor has surveyed gastroenterologists, rheumatologists and dermatologists on attribute and brand perceptions.

Scope of this research

• Opinion from 540 physicians including rheumatologists, dermatologists and gastroenterologists is included
• Physicians and opinion leaders across the seven major markets of the US, Japan, France, Germany, Spain, Italy and the UK
• Analysis of the extent to which certain factors affect physician prescribing, with comparison across each specialty
• Analysis of the opinion dynamics for the key brands used across prominent autoimmune diseases

Research and analysis highlights

Efficacy and safety factors will always be any physician' s main consideration, drawing an average of 62% of the weighting by importance when prescribing a biologic therapy. Actemra' s positive perception from rheumatologists, despite known side-effects, exemplifies the importance of informing physicians about issues, rather than masking them.

New TNF inhibitors in autoimmune disease battle against ' me-too' status and the strong positive opinion of the existing three products in the category. Humira leads the group with a total score 16% above the average. Newcomer anti-TNF options Simponi (golimumab) and Cimzia (certolizumab) are not well perceived by EU prescribing rheumatologists.

Dermatologists' exhibit cynicism towards biologic therapies, scoring all brands lower than other physician types, less surprising when considering the nature of most psoriasis therapies. However, Centocor' s Stelara (ustekinumab) is highly anticipated with dermatologists scoring it 40% above average in terms of predicted efficacy.

Key reasons to purchase this research

• Target physicians more efficiently by understanding the differences in brand perception between physician specialties
• Tailor your marketing message to the attributes most important to prescribing physicians
• Assess the regional dynamics of physician perception in autoimmune disease across the seven major markets

Table of Contents

EXECUTIVE SUMMARY

• Datamonitor insight into the autoimmune biologics market
• Contributing experts
  • Related reports
  • Upcoming 2009 reports

PHYSICIAN DYNAMICS AND QUESTIONNAIRE DESIGN

• Physician types surveyed
• Questionnaire design
  • Importance of attributes
  • Rating of brands

• Physician demographics
• Rheumatologists
• Dermatologists
• Gastroenterologists

FACTORS INFLUENCING PHYSICIAN DECISION MAKING

• Comparative importance of factors to the prescribing decision
  • Disease modification and side-effects are the most important factors to all prescribing physicians

• Variation by country and physician type
  • Little variation seen between physician type
  • The UK and US show commonality while Japan is still an outlier in all but rheumatology

• Prescribing factors
  • Efficacy
  • Side effects
  • Formulary or reimbursement status
  • Marketing and familiarity

BRAND DYNAMICS

• Brand overview
• Brand sales trends
  • Biologic sales overview shows Enbrel leads in terms of total brand sales for all indications

• Brand awareness
  • Trends in preliminary brand scores by physician type

• Brand assessment comparisons
  • Total score by brand shows future promise for Humira
  • Trends in brand scores by country

• Brand profiles
  • Enbrel (etanercept; Amgen, Wyeth)
  • Remicade (infliximab; Centocor, Schering-Plough, Mitsubishi Tanabe)
  • Humira (adalimumab; Abbott)
  • Orencia (abatacept; Bristol-Myers Squibb)
  • Rituxan/MabThera (rituximab; Roche, Genentach, Biogen Idec)
  • Raptiva (efalizumab; Genentech, Xoma, Merck Serono)
  • Amevive (alfacept; Astellas, Biogen Idec)
  • Tysabri (natalizumab; Biogen Idec, Elan)

• Pipeline profiles
  • Pipeline overview
  • Licensing opportunities

• Pipeline anti-TNFs
  • The three available anti-TNFs are perceived to be similar, but pipeline anti-TNFs offer little apparent improvement
  • Cimzia (certolizumab; UCB)
  • Simponi (golimumab; Centocor, Schering-Plough, Mitsubishi Tanabe, Janssen)

• Other pipeline mechanisms
• Stelara (ustekinumab; Centocor, Janssen Cilag)
• Actemra (tocilizumab; Chugai, Roche)

BIBLIOGRAPHY

• Journal papers
• Websites

TABLES

• Table: Physician type surveyed
• Table: Comparison of physician demographics
• Table: Characteristics of rheumatologists surveyed across the seven major markets, 2008
• Table: Characteristics of dermatologists surveyed across the seven major markets, 2008
• Table: Characteristics of gastroenterologists surveyed across the seven major markets, 2007
• Table: Attributes assessed by each physician type
• Table: Anti-TNF prescribing information efficacy comparison across indications
• Table: Other mechanism prescribing information efficacy data
• Table: Summary of pros and cons of biomarkers to predict response to TNF therapy
• Table: Summary of prescribing information black box and major warnings by brand
• Table: Percent of patients showing positive antibodies against each brand according to prescribing information
• Table: Formulary prices across the seven major markets, 2008
• Table: Importance of dosing frequency and delivery method to prescribing of biologics, by country and by physician specialty, %
• Table: Overview of brand details including mechanism, indications and launch dates
• Table: Number and percent of physicians able to rate each brand, by country
• Table: Score given to each brand by attribute, by rheumatologists, 2008
• Table: Score given to each brand by attribute, by dermatologists, 2008
• Table: Score given to each brand by attribute, by gastroenterologist, 2007
• Table: Brand scores by country
• Table: Enbrel' s attribute scores, by country and physician type
• Table: Remicade' s attribute score, by country and physician type
• Table: Humira' s scores by country, attribute and physician type
• Table: Orencia' s scores from rheumatologists by country
• Table: Rituxan/MabThera' s scores, from rheumatologists by country
• Table: Raptiva' s scores by attribute and country, from dermatologists
• Table: Amevive scores by country and attribute, from dermatologists
• Table: Tysabri scores by country and attribute, from gastroenterologists
• Table: Antibody products in clinical trials for autoimmune diseases (rheumatoid arthritis, inflammatory bowel disease, psoriasis)
• Table: Late stage pipeline product profiles and status by indication and region
• Table: Cimzia' s attribute scores by country and physician type
• Table: Simponi scores by country and attribute, from rheumatologists
• Table: Stelara scores by country and attribute, from dermatologists
• Table: Actemra scores by country and attribute, from rheumatologists

FIGURES

• Figure: Grouped attribute average importance
• Figure: Attribute importance, split by physician type
• Figure: Average attribute importance to prescribing decision for biologic therapies, by country
• Figure: Importance of grouped attributes to the prescribing decision by physician specialty
• Figure: Mapping country dynamics with reference to attribute importance, split by physician type
• Figure: Importance of efficacy factors to prescribing decision for biologic therapies, by country and specialist
• Figure: Biologic comparative brand scores for efficacy factors, by physician type
• Figure: Speed of action scores by dermatologists and gastroenterologists, non-weighted
• Figure: Importance of a good side-effect profile to prescribing decision for biologic therapies, by country and specialist
• Figure: Importance of formulary and reimbursement status to prescribing decision for biologic therapies, by country and specialist
• Figure: Brand comparison scores for formulary/reimbursement status, by physician type
• Figure: Ankylosing spondylitis treatment tree, 2008, seven major markets
• Figure: Importance of dosing frequency and delivery method to prescribing of biologic, by country and by physician specialty
• Figure: Brand scores comparison for administration attributes
• Figure: Importance of marketing and familiarity to prescribing of biologics, by country and by physician specialty
• Figure: Representation of influences of prescribing
• Figure: Total representative count, 2003 - 2007
• Figure: Brand scores comparison for marketing and familiarity attributes
• Figure: Time on the market versus score for marketing/familiarity factors
• Figure: Humira' s website messages
• Figure: Enbrel' s directed messages for each indication
• Figure: Remicade' s US website messages
• Figure: Online marketing for non-TNF mechanisms
• Figure: Total brand sales for the top autoimmune biologics in the US, five major EU markets and Japan, $m, 2007
• Figure: Total brand sales across the seven major markets, split by indication, $bn, 2007
• Figure: Sales growth versus market share by indication for the major biologic brands in the seven major markets, 2004 - 07
• Figure: Percentage of physicians able to rate each brand, by country
• Figure: Sum of score for all attributes, by brand and physician type
• Figure: Average score for each of the eight comparable attributes, by brand
• Figure: Overview brand map of attributes versus brand perception by physician specialty
• Figure: Average weighted brand scores by attribute
• Figure: Brand scores by country
• Figure: Enbrel' s weighted score compared to average
• Figure: Enbrel map, country preference to prescribing attributes
• Figure: Remicade' s weighted score compared to the average
• Figure: Remicade map, country preference to prescribing attributes
• Figure: Humira' s weighted score compared to the average
• Figure: Humira map, country preference for prescribing attributes
• Figure: Orencia' s weighted scores compared to all physicians average scores and rheumatologists average
• Figure: Rituxan/MabThera' s weighted scores compared to all physicians average scores and rheumatologists average
• Figure: Raptiva' s weighted score compared to all physicians average scores and dermatologists average
• Figure: Amevive weighted score compared to all physicians average scores and dermatologists average
• Figure: Tysabri weighted score compared to all physicians average scores and gastroenterologist average
• Figure: Phase I to pre-registration projects in the pipeline, split by mechanism, 2009
• Figure: Comparative physician perception of the pipeline and marketed anti-TNF inhibitors
• Figure: Cimzia' s weighted score compared to the average
• Figure: Cimzia map, country preference for prescribing attributes
• Figure: Simponi (golimumab) weighted score compared to the average
• Figure: Stelara' s weighted score compared to all physicians' average scores and dermatologists' average
• Figure: Actemra' s weighted score compared to all physicians average scores and rheumatologist average

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