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Stakeholder Perspectives: Asthma - Improvements to Combination Inhalers Will Satisfy a Growing Patient BasePublished by: Datamonitor Published: Dec. 26, 2003 - 158 Pages Table of ContentsTABLE OF CONTENTS About Datamonitor healthcare 2 CHAPTER 1 EXECUTIVE SUMMARY 3 Scope of the analysis 3 Datamonitor insight into the asthma market 4 The patient potential for asthma is set to rise by 20% to 62.4 million in the seven major markets by 2013. Despite the FDA approval of Singulair for allergic rhinitis, relatively poor efficacy will prevent Merck from fully exploiting the overlap between asthma and allergic rhinitis. Conversely, although only 20% of COPD patients have co-existent asthma, high unmet need will ensure that the use of asthma therapies in COPD will remain significant. 5 Symptom control, side effects and compliance are the key factors that currently influence prescribing habits. Despite the anticipated launch of Altana’s/Aventis’ safe ICS therapy Alvesco in 2004, cost savings will ensure that combination ICS & LABA therapies will become the gold standard in all adult asthma patients. 7 Improvements to existing controller therapies and the launch of second generation PDE-4 inhibitors will be the most successful pipeline developments over the next decade. Off-label use of Spiriva in asthma will be minimal and the use of monoclonal antibody therapies will be limited to small patient groups. 9 Key metrics 13 CHAPTER 2 EPIDEMIOLOGY, PATIENT SEGMENTATION & DIAGNOSIS 22 Asthma definition 22 Asthma classification 22 Epidemiology of asthma 25 Current rates 25 Methodology 25 Caveats 28 Future trends 30 Key patient segmentations 31 Age 31 Allergic/Non-allergic asthma 33 Children 33 Adults 33 Overall 34 Genetics 35 Co-morbidities 36 Allergic Rhinitis 36 Level of co-morbidity 36 Time of onset 38 Treatment 39 COPD 39 Diagnosis 41 CHAPTER 3 CURRENT PRESCRIBING TRENDS, COMPLIANCE & INFLUENCING FACTORS 46 Treatment options 46 Current prescribing trends 47 Overview 47 Beta2-agonists 51 Corticosteroids 53 Combination ICS & BA 55 Leukotriene Modifiers 58 Anticholinergics 60 Other drug classes 61 Compliance 63 Non-compliance rates 63 Reasons for non-compliance 64 Inhalers 65 Factors influencing physician decision making 67 Choice of drug 67 Treatment outcomes 68 Switching 69 CHAPTER 4 FUTURE PRESCRIBING TRENDS & UNMET NEED 71 Future prescribing trends 71 Cost, pharmacoeconomics & compliance 72 Overlap with allergic rhinitis or COPD 72 Aggressive treatment of mild patients 73 New drug groups 73 Xolair 74 PDE-4 inhibitors 74 Alvesco (ciclesonide) 76 Anti-TNF 77 Unmet need in primary care 78 Guidelines 79 Greater utilization of pharmacists 79 Self-management plans 80 Unmet need in R&D 82 Disease modifiers 83 CHAPTER 5 OPINION LEADER TRANSCRIPTS 85 UK opinion leader 85 Combination inhalers 85 PDE-4 inhibitors 86 COPD 86 Prescribing trends 87 Pipeline developments 87 Unmet need 88 Inhalers 90 US opinion leader (epidemiology expert) 91 Asthma prevalence 91 Identification of patient subgroups 92 Link between asthma and allergic rhinitis 94 Link between asthma and COPD 95 Germany opinion leader 97 Combination inhalers 97 PDE-4 inhibitors 98 Prescribing trends 99 Pipeline developments 100 Unmet need 101 Inhalers 103 US opinion leader 104 Combination inhalers 104 PDE-4 inhibitors 105 COPD 106 Prescribing trends 106 Pipeline developments 107 Unmet need 109 Japan opinion leader 111 Combination inhalers 111 PDE-4 inhibitors 112 COPD 113 Pipeline developments 113 Prescribing trends 113 Unmet need 114 US opinion leader 115 Combination inhalers 115 PDE-4 inhibitors 116 COPD 117 Prescribing trends 117 Pipeline developments 118 Unmet need 119 Inhalers 121 Spain opinion leader 122 Combination inhalers 122 PDE-4 inhibitors 123 COPD 123 Pipeline developments 125 APPENDIX A BIBLIOGRAPHY 127 Epidemiology 127 Clinical trial data 130 Key associations and conferences 133 APPENDIX B PHYSICIAN SAMPLE BREAKDOWN & SURVEY QUESTIONNAIRE 134 Methodology 134 Physician Sample breakdown 134 Physician Survey questionnaire 135 1 Epidemiology 135 2 Concomitant allergic rhinitis 140 3 Treatment patterns 142 4 Patient compliance 150 AbstractIntroductionAsthma is a highly prevalent chronic disease that costs at least $13 billion in the US alone each year. In the UK, there are four times as many people with asthma than with diabetes. The patient potential for asthma therapies in the seven major markets is set to rise even further, from 51.4 million in 2003 to 62.4 million in 2013, stimulating greater demand for cost-effective asthma therapies. Scope Survey of 59 PCPs and pulmonologists in the 7 major markets on asthma epidemiology, co-morbidities, treatment and compliance trends and perceptions Assessment of treatment outcomes and unmet need from both a research and primary care perspective Prescribing trends for major drug classes, including corticosteroids, beta2-agonists, combinations, leukotriene modifiers for each patient severity In-depth interviews with seven key opinion leaders in asthma from the US, Japan, the UK, Germany and Spain Report Highlights Despite the FDA approval of asthma drug Singulair (montelukast) for allergic rhinitis, relatively poor efficacy will prevent Merck from fully exploiting the fact that at least three fifths of asthmatics suffer concomitant allergic rhinitis. However, high unmet need will ensure that the use of asthma therapies in COPD will remain significant. The launch of Altana’s/Aventis’ safe ICS therapy Alvesco (ciclesonide) in 2004 will be welcomed by pediatricians, but cost savings will ensure that combination inhaled corticosteroid & long-acting beta2-agonist therapies will become the gold standard in all adult asthma patients in the near future. Improvements to existing controller therapies & the launch of second generation PDE-4 inhibitors will be the most successful pipeline developments over the next decade. Although the concept of disease modification is highly attractive, research is at a very early stage, it will take at least 10 years before such compounds are clinically available. Reasons to Purchase Learn what drugs in late-development will have the greatest impact on future prescribing trends, and in particular the outlook for disease modifiers Investigate if Altana’s/Pfizer’s new PDE-4 inhibitor Daxas (roflumilast) will impact sales of Singulair (montelukast) Determine initial patient and physician reaction to Xolair (omalizumab) and the new COPD anticholinergic Spiriva (tiotropium) Get Full Details About This Report >> |
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