Biogen Idec’s Avonex and Teva’s Copaxone continue to capture almost one-half of multiple sclerosis (MS) patient share of first-line disease-modifying agent (DMA) therapy
November 6, 2012 - Exton, Penn.
– BioTrends Research Group, one of the world’s leading research and advisory firms for specialized biopharmaceutical issues, finds that while Biogen Idec’s Avonex and Teva’s Copaxone continue to capture almost one-half of multiple sclerosis (MS) patient share of first-line disease-modifying agent (DMA) therapy, Avonex share in 2012 (25 percent) has decreased significantly compared to the 2011 audit (29 percent). However, Avonex still represents a greater share of first-line therapy compared to Copaxone (21 percent). In ChartTrends®: Multiple Sclerosis (US) 2012
, patients switching from first-line Avonex are significantly more likely to switch to second-line Novartis’s Gilenya (17 percent) compared to the previous year (9 percent). Copaxone, Biogen Idec / Elan’s Tysabri and Gilenya now split the overall majority of all second-line DMA therapy. While, in general, the choice of a specific DMA brand is frequently driven by the desire to impact disability progression and relapse rate, a comparison of self-reported perceptions and actual patient-level data suggests that CNS lesion reduction and product familiarity may play a greater role than neurologists realize in brand choice.
The recently published audit also finds that 17 percent of DMA-treated patients have been tested with the STRATIFY JCV™ assay, which became commercially available in January 2012 for progressive multifocal leukoencephalopathy (PML) risk stratification for MS patients treated with Tysabri. Neurologists report that the majority of tested patients were checked with the assay because they were seen as possible candidates for Tysabri or were currently on Tysabri. In fact, 63 percent of audited patients currently treated with Tysabri have been tested with the anti-JC virus antibody assay. Prevalence of seropositive status (17 percent) among tested patients is similar to both self-reported estimates (29 percent) and 2011 patient-level seropositive prevalence (23 percent), but continues to be lower than expected based upon published clinical data (~55 percent). Regardless of serostatus, the majority of patients remain on their current DMA following testing.
When pushed to hypothetically choose one DMA in development to switch the audit patient to, 7 percent of audit patients were identified by the surveyed neurologists as potential candidates for Genzyme’s Aubagio, approved towards the end of audit fielding. Conversely, 26 percent of patients were identified as candidates for Biogen Idec’s BG-12. Compared to non-candidates, BG-12 candidates are significantly more likely to be on a second-line or later therapy, frequently Gilenya, and to have been tested with the STRATIFY JCV assay, suggesting that they had been considered a possible candidate for Tysabri.
ChartTrends: Multiple Sclerosis (US)
is a syndicated annual patient audit designed to compare what physicians self-report about disease management to what actually occurs at the patient level. The 2012 audit captures information from 1034 patient charts provided by 224 U.S. neurologists in August and September 2012. All patients are on one of the commercially-available DMA brands (Avonex, Betaseron, Copaxone, Extavia, Gilenya, Rebif, Tysabri) at the time of the audit. Through an in-depth review of specific patient charts, details such as product initiation, switching, exacerbation management, and a host of laboratory tests and patient demographic variables help define patient types and identify therapy triggers. Patient profiles for the eight DMAs in late clinical development (Aubagio, BG-12, alemtuzumab, PEG-Avonex, Copaxone 40mg 3x weekly, daclizumab, laquinimod, ocrelizumab) are also characterized.