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Prescription DrugsSales of medication to treat ulcerative colitis in seven key markets are expected to double over the next decade, reaching $3.7 billion by 2021, according new research.

The rapid growth will be largely driven by two premium-priced tumour necrosis factor-alpha (TNF-alpha) inhibitors - Abbott/Eisai's Humira and Janssen/Merck/Mitsubishi Tanabe's Simponi - and two novel therapies - Takeda's cell adhesion molecule (CAM) inhibitor, vedolizumab, and Pfizer's oral Janus-activated kinase inhibitor, tofacitinib.

The report from Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, noted that the market also anticipates to receive a boost by the increasing number of diagnosed prevalent cases of ulcerative colitis in the seven markets - France, Germany, Italy, Japan, Spain, UK and US.

Increased physician acceptance of TNF-alpha inhibitors for the treatment of moderate to severe disease, plus patient preference for convenient subcutaneous administration will feed the uptake of the newer TNF-alpha inhibitors, Humira and Simponi, through the period to 2021, Decision Resources’ report forecasts.

As a result of Simponi’s observed greater efficacy, in comparison to Humira, in separate Phase III trials, alongside favourable gastroenterologist opinion, the inhibitor will contest the standing of Janssen/Merck/Mitsubishi Tanabe's intravenous Remicade (infliximab) as the most frequently-prescribed agent in the TNF-alpha inhibitor class.

However, Remicade will continue to be the forerunner in terms of patient share among the TNF-alpha inhibitors, upholding a reasonably constant patient share across the seven markets, founded on its well-established efficacy.

The sales of Simponi, however, will overtake those of Remicade in 2017, based largely on the drug’s premium price and assumed high dosing in ulcerative colitis, driving the market’s growth as the new sales leader, the report claims.

The launches of two premium-priced novel agents, vedolizumab and tofacinib, in 2014 and starting in 2016 respectively, will contribute to growing sales over the period to 2021, gaining most initial use in the TNF-refractory population.

“These agents will likely extend the treatment algorithm by offering, for the first time, additional lines of therapy for patients with inadequate response to the TNF-alpha inhibitors,” noted Kathrina Quinn, an analyst at Decision Resources.

“Although the TNF-refractory market is relatively limited in size, the high unmet need for treatments that cater for this population and potentially delay or prevent colectomy will drive major-market sales of approximately $740 million in 2021, constituting about 20% total market share,” she predicts.

The report also forecasts that, towards the end of the study period, vedolizumab and tofacitinib will start to surpass use of Humira, as gastroenterologists move to another drug class after trying up to two TNF-alpha inhibitors.

Even though vedolizumab's launch is expected to be earlier, uptake for tofacitinib is expected to surpass that of vedolizumab, based on the strengths of its oral delivery and post-marketing safety data for other immune indications, the report concludes.

Links:
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