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市場調查報告書

慢性阻塞性肺病 :關鍵意見領袖 (KOL) 的考察

COPD: KOL Insight

出版商 FirstWord 商品編碼 358500
出版日期 內容資訊 英文
商品交期: 最快1-2個工作天內
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慢性阻塞性肺病 :關鍵意見領袖 (KOL) 的考察 COPD: KOL Insight
出版日期: 2016年04月01日 內容資訊: 英文
簡介

本報告提供慢性阻塞性肺病的治療藥的關鍵意見領袖 (KOL) 的見解調查,主要的已上市藥物、開發平台藥物的見解,競爭環境,KOL對開發的期待等彙整資料。

已上市藥物

  • 長時間作用性毒蕈鹼受體拮抗劑 (LAMA)
    • Spiriva (tiotropium:Boehringer Ingelheim)
    • Eklira/Tudorza (aclidinium:AstraZeneca)
    • Seebri (glycopyrronium:Novartis)
    • Incruse (umeclidinium:GlaxoSmithKline)
    • Arcapta/Onbrez (Indacaterol:Novartis)
    • Striverdi (olodaterol:Boehringer Ingelheim)
  • LAMA/LABA組合藥物
    • Ultibro/Utibron (Indacaterol/gurikopironiumu:Novartis)
    • Anoro (umeclidinium/Vilanterol:GSK)
    • Stiolto/Spiolto (tiotropium/olodaterol:Boehringer Ingelheim)
    • Duaklir (aclidinium/Budesonide:AstraZeneca)
  • ICS/LABA組合藥物
    • Symbicort (Budesonide/Budesonide:AstraZeneca)
    • Advair/Seretide (fluticasone propionate/Salmeterol:GSK)
    • Breo/Relvar (fluticasone furoate/Vilanterol:GSK)

開發平台藥物

  • 抗IL5抗體
    • Benralizumab (AstraZeneca)
    • Mepolizumab (GSK)
  • 3成分混合劑 (Closed Triple) (ICS/LAMA/LABA)
    • PT010 (AstraZeneca)
    • CHF5993 (Chiesi)
    • FF/UMEC/VI (GSK)

調查課題、題目

  • 處方藥變更的想法
  • ICS的過剩處方的可能性
  • 早期發現的重要性
  • 3成分混合劑 (Closed Triple):只有服藥遵守上的優點嗎?
  • 未滿足需求
  • 設備的重要性
  • 確立的治療路徑相關問題
  • 藥的選擇和個人的愛好等
目錄
Product Code: 596200590

Is the COPD treatment market poised for a fundamental shift?

After years of dominance by a handful of brands, change is in the air for COPD treatment. Will deep set preferences finally be overturned, or will physicians need both cost and performance incentives to switch? How will device attributes impact future decision-making? Which are the key trials to watch and why?

Find out in FirstWord's new report, ‘COPD: KOL Insight’.

Covering 13 currently marketed brands and 5 Phase III drugs, this report examines today's market, looks at future trends and reveals insight from 12 key opinion leaders (KOLs) in North America and Europe.

Discover why the ‘open versus closed' triple therapy debate is set to intensify thanks to exciting new research. With IL-5 antibodies in Phase III development, targeted treatment could soon be a reality. Decide for yourself which brands will be the new ‘movers and shakers' in COPD treatment - and find out how new studies look set to change entrenched habits.

“These are provocative results. It shows that for reasons that we don't understand, long acting bronchodilators are quite effective in decreasing exacerbations. And they are equivalent to an ICS/LABA which suggests that we're are overusing ICS.” -US KOL.

Expert insight into the COPD treatment landscape

Recently Marketed Drugs

Long-acting muscarinic antagonists (LAMAs)

  • Spiriva (tiotropium; Boehringer Ingelheim): Is familiarity enough to keep Spiriva in the top position? Are physicians considering alternatives?
  • Eklira/Tudorza (aclidinium; AstraZeneca): Is patient preference for twice-daily dosing a trend to watch?
  • Seebri (glycopyrronium; Novartis): How does the efficacy of twice-daily US Seebri compare to the once a day EU version?
  • Incruse (umeclidinium; GlaxoSmithKline): Can Incruse beat Spiriva as the LAMA of choice now that comparative studies have revealed its superior lung function performance?
  • Arcapta/Onbrez (indacaterol; Novartis): What was behind the 25% drop in sales of Arcapta/Onbrez in 2015?
  • Striverdi (olodaterol; Boehringer Ingelheim): Find out why the FDA rejected Boehringer Ingelheim's attempt to make Striverdi the first COPD brand with exercise endurance benefits.

LAMA/LABA combinations

  • Ultibro/Utibron (indacaterol/glycopyrronium; Novartis): Will the Ultibro FLAME trial redefine the treatment path for patients with exacerbations, with ICS added as a last resort?
  • Anoro (umeclidinium/vilanterol; GSK): Where next for Anoro? IF GSK's companion triple ICS/LAMA/LABA is approved, will Anoro's easy treatment sequencing trump all else?
  • Stiolto/Spiolto (tiotropium/olodaterol; Boehringer Ingelheim): If KOLs view all LAMA/LABAs as comparable, what is Stiolto/Spiolto's differentiator?
  • Duaklir (aclidinium/formoterol; AstraZeneca): Will device differences between Duaklir and other AstraZeneca products create a drug sequencing issue?

ICS/LABA combinations

  • Symbicort (budesonide/formoterol; AstraZeneca): Can Symbicort catch up with Advair? Do KOLs favour MDIs or DPIs?
  • Advair/Seretide (fluticasone propionate/salmeterol; GSK): When are US generics expected? Will payers prefer low cost Breo/Relvar to generic Advair/Seretide?
  • Breo/Relvar (fluticasone furoate/vilanterol; GSK): Was pricing or clinical benefit behind the trebling of Breo/Relvar sales last year?

Pipeline Drugs

Anti-IL5 antibody

  • Benralizumab (AstraZeneca): Do KOLs believe the clinical benefit of benralizumab will be enough to justify the expected cost?
  • Mepolizumab (GSK): How important are eosinophil levels for patient selection? Will differing views about the minimum level be an issue for mepolizumab?

Closed triple (ICS/LAMA/LABA)

  • PT010 (AstraZeneca): Is improved lung function or reduced exacerbations the primary focus for current studies with PT010?
  • CHF5993 (Chiesi): KOLs say adherence is the key benefit of closed triples; will two separate 52-week studies for CHF5933 throw any more light on this issue?
  • FF/UMEC/VI (GSK): With so much at stake, what exactly does GSK hope to gain from extensive trials of its FF/UMEC/VI closed triple?

Top takeaways

  • Reluctance to switch: KOLs view all LAMAs and LAMA/LABAs as equivalent and still believe ICS are an important treatment option for recurrent exacerbations. Concerns about the unknown effect of withdrawal of ICS will prevent physicians from changing existing patient therapies. Will this slow the growth of LAMA/LABAs?
  • Potential overuse of ICS: The first comparative trial of LAMA/LABA versus ICS/LABA (the FLAME study) looks like a game-changer. GSK's much anticipated IMPACT study may settle once and for all the optimal treatment approach. Will continuing uncertainty regarding asthma vs. COPD in primary care continue to prompt ICS use?
  • KOLs want earlier detection: Late presentation is common as early symptoms such as a cough can be missed in primary care settings. Diagnosis often follows exacerbations or significant loss of lung function. How will spirometry be leveraged in the future?
  • Belief that closed triples will simply improve adherence: With ICS/LAMA/LABA combinations expected to be approved in 2018, KOLs are focused on the benefits of a simplified treatment path rather than any clinical advantages. But will payers agree?
  • Unmet needs remain: Existing therapies reduce symptoms and exacerbations, but none slow the progressive decline in lung function or reduce mortality. Other needs such as improving drug adherence and identifying predictive biomarkers are being addressed to some degree. Where next for the treatment of COPD?

Themes Explored

  • The importance of the device: KOLs are uninspired by device choices. Although they recognise an impact on adherence, most do not have favourites; drug choice is the deciding factor. Triple combinations via one device could be a step forward. GSKs plans for consistency of device across the entire treatment pathway could have far-reaching implications.
  • Questions about established treatment pathways: GOLD guidelines provide little clarity. New studies are offering a different perspective on entrenched choices. LAMA/LABA combinations may prove to be more effective for some patients than ICS/LABA. Closed triples are simpler for patients. Eosinophils may be a promising biomarker.
  • Individual preference as a key driver: Are incremental benefits enough to challenge entrenched prescribing habits? KOLs also consider cost, adherence and patient preferences before switching. As none of the drug companies can yet promise to cure COPD, is symptomatic relief and reducing exacerbations the only choice on offer?

A report based on expert knowledge

Key Opinion Leaders Interviewed for This Report

North American KOLs

  • Prof Robert Wise, MD; Johns Hopkins Medical School, US
  • Prof David Mannino, MD; Head of Pulmonary Care, Critical Care, and Sleep Medicine, University of Kentucky in Lexington, KY
  • Prof Richard H Casaburi, MD; Chief, Division of Respiratory and Critical Care Physiology and Medicine, University of California at Los Angeles Medical Center
  • Prof James Donahue, MD; Professor of Medicine, UNC Chapel Hill Medical Center
  • Prof Nadia Hansel, MD; Associate Professor of Medicine, Johns Hopkins University School of Medicine
  • Prof Fernando Martinez, MD; Adjunct Professor, Department of Internal Medicine, Division of Pulmonary & Critical Care Medicine, University of Michigan

European KOLs

  • Prof Fan Chung, MD; Professor of Respiratory Medicine & Head of Experimental Studies, National Heart & Lung Institute, Imperial College London, UK
  • Professor Anoop Chauhan, MD; Consultant Physician in Respiratory and General Medicine, Portsmouth Hospitals NHS Trust, UK
  • Prof Stefano Centanni; MD; University Hospital Milan, Italy
  • Three anonymous German KOLs
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