Stakeholder Insight: Rheumatoid arthritis - Rising competition by line and severity

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1 Brochure More information from Stakeholder Insight: Rheumatoid arthritis - Rising competition by line and severity Description: Introduction Disease-modifying antirheumatic drugs (DMARDs) underpin the current management of rheumatoid arthritis. This will likely remain unchanged over the next decade. In spite of high costs, rheumatologists perceive there will be an increased penetration of biologic therapies in patients of all severities by 2015, with competition between biologic classes intensifying at earlier lines of therapy. Scope - Snapshot of the current rheumatoid arthritis market based on a survey of 183 rheumatologists, supported with views from key opinion leader interviews - Robust epidemiology forecasts for the prevalence of rheumatoid arthritis in the seven major markets, from 2009 through to Overview of treatment options at the class, molecule and brand level, as well as treatment trends by line of therapy and treatment outcome analysis - Assessment of select brands used in rheumatoid arthritis treatment, including biologics and the scope for novel small molecule DMARDs Highlights In 2010, traditional DMARDs are the foundation of drug therapy in rheumatoid arthritis and will remain at the core of treatment going forward. Methotrexate is the most highly utilized DMARD across all disease severities and will stay as gold-standard owing to its ease of administration, manageable side-effect profile, good efficacy and low cost. Rheumatologists predict a significant rise in the number of patients receiving biologic therapy across each severity by There will also be a greater drive from physicians to use non-tnf biologics much earlier in the treatment algorithm, with over a third of first-line patients expected to receive such therapies in the next five years The future position in the treatment algorithm of novel, oral, small molecule DMARDs, such as tasocitinib (CP-690,550; Pfizer), will decide uptake and sales success. The majority of physicians expect to use these agents in methotrexate-failure patients and prior to a biologic, potentially delaying the move to biologics. Reasons to Purchase - Target rheumatologists more effectively, through an understanding of their prescribing behavior and key factors that influence decision making - Validate new product forecasting based on diagnosis, therapy trends and the likely rate of uptake for new products utilizing physician perception - Estimate the size of the rheumatoid arthritis population using the interactive country-specific treatment trees that incorporate patient numbers Contents: Overview Catalyst Summary About Datamonitor healthcare About the Immunology & Inflammation pharmaceutical analysis team About the Epidemiology team EXECUTIVE SUMMARY Strategic scoping and focus Datamonitor insight into the disease market

2 1. Introduction and scope Coverage of the Stakeholder Insight Survey 2. Country treatment trees Introduction to treatment trees 3. Epidemiology Disease definition, classification and diagnosis criteria Epidemiology of rheumatoid arthritis Epidemiologic forecasting of rheumatoid arthritis Epidemiological results Discussion 4. Diagnosis and patient segmentation Diagnosis Patient segmentation 5. Treatment classes and guidelines Rheumatoid arthritis treatment algorithms Pharmacological versus non-pharmacological therapy Pharmacological therapy Drug classes 6. Treatment trends by line of therapy Traditional DMARDs Biologic DMARD prescribing trends Country trends in biologic use by line of therapy 7. Prescribing factors and brand assessment Factors influencing physician decision making Brand assessment Enbrel (etanercept; Amgen, Pfizer, Takeda) Cimzia (certolizumab; UCB, Otsuka) Humira (adalimumab; Abbott, Eisai) Remicade (infliximab; Centocor Ortho Biotech, Merck & Co., Mitsubishi Tanabe) Rituxan/MabThera (rituximab; Biogen Idec, Roche) Actemra/RoActemra (tocilizumab; Chugai, Roche) Orencia (abatacept; Bristol-Myers Squibb) Simponi (golimumab; Centocor Ortho Biotech, Merck & Co., Mitsubishi Tanabe) Kineret (anakinra; Biovitrum) Biologic DMARD switching by brand Novel small molecule DMARDs have potential in methotrexate-failure population Tasocitinib (CP-690,550; Pfizer) Other novel small molecule DMARDs in the pipeline 8. Treatment outcomes Introduction Outcome measure definitions Outcome trends Compliance Treatment challenges and unmet needs Bibliography Journal papers Websites Datamonitor reports Appendix Physician research methodology

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