Biologic therapies have had a major impact on the psoriasis market since the first such agent was approved by the FDA in 2003. In the moderate-to-severe psoriasis market, biologic agents alone totaled over $900 million in 2006. The psoriasis market is currently dominated by two classes of biologic agents: TNF-alpha inhibitors (Amgen/Wyeth/Takeda' s Enbrel and Centocor/Schering-Plough/Tanabe' s Remicade) and T-cell modulators (Genentech/Merck Serono' s Raptiva, Astellas Pharmaceutical' s Amevive). Several new agents are set to enter the market during the 2005-2010 such as Abbott Laboratories/Eisai' s Humira, a fully-human TNF-alpha inhibitor with highly competitive efficacy, Centocor' s CNTO-1275, the first interleukin inhibitor in the psoriasis market, and Isotechnika' s voclosporine, a small-molecule analogue of cyclosporine with reportedly a much better safety profile. The launch of these drugs will impact both currently available therapies and expand the share of patients treated with branded agents.

Questions Answered in This Report

Enbrel is the undisputed leader of the moderate-to-severe psoriasis market because dermatologists are comfortable with the agent' s safety profile and efficacy, patients have responded well to the therapy, and third-party payers have granted the drug more favorable reimbursement than its peers. How have Amgen and Wyeth secured such a dominant market share for Enbrel? What strategies have shown success in the psoriasis market?
Dermatologists have been cautious in their uptake of biologic agents due to concerns over potential safety risks and the high cost of the drugs. Amevive, the first biologic to market, was sold by Biogen Idec to Astellas Pharmaceuticals in 2006 due to disappointing sales. What do physicians identify as the key attributes of currently marketed agents? What are the perceived advantages and/or disadvantages of emerging therapies versus available therapies?
On April 2, 2007, Abbott Laboratories filed regulatory submissions with the FDA and EMEA seeking approval for the company' s monoclonal antibody Humira in the moderate-to-severe psoriasis indication. What is Abbott doing to position Humira in the psoriasis market in advance of its anticipated approval? How will Enbrel and other agents be affected by Humira' s launch and uptake?
TNF-alpha inhibitors currently are the gold-standard for psoriasis therapy; however, Centocor' s highly anticipated IL-12/IL-23 inhibitor CNTO-1275 has the potential to radically change the market on the strength of hitherto unseen efficacy. Other companies also have agents in their pipelines with novel mechanisms of action. What products are being developed in the major competitors' pipelines? How will CNTO-1275 perform if it is approved to treat psoriasis?
Psoriasis is part of a broader set of chronic autoimmune and inflammatory conditions with similar pathophysiologies such as rheumatoid arthritis and inflammatory bowel disease. These diseases can be best treated with biologic agents and some pharmaceutical companies are increasingly organizing therapeutic areas around this opportunity. How does psoriasis fit into the wider autoimmune and inflammatory therapeutic areas of companies in the market? What strategies are being pursued to achieve success in this treatment area?

Scope

Markets Covered: United States, France, Germany, Italy, Spain, United Kingdom, and Japan.
Competitive Analysis: Detailed discussion of major competitors including Amgen, Wyeth, Genentech, Merck Serono, Centocor, Schering-Plough, Abbot Laboratories, and Astellas Pharmaceuticals in addition to the emerging competitor Isotechnika. Included is an analysis of each company' s autoimmune and inflammatory product portfolio, strategic positioning, and development pipeline. The report features an in-depth discussion of leading brands including approval history, sales and market position, SWOT analysis, and on-going life cycle management initiatives.
Physician Perception of Key Brands: Analysis of physician perceptions of the psoriasis market based on a custom survey of over 50 US-based dermatologists. The survey is brand-focused and examines physician perceptions of key competitors, brand attributes, and uptake of emerging agents.
Epidemiology: Total prevalent and diagnosed cases for each of the major markets are presented in an annualized forecast from 2005 to 2010.
Market Forecast: Annualized sales forecasts for branded agents presented by region, drug class, molecule, and brand for 2005 to 2010, including the uptake of new agents.

Table of Exhibits

Executive Summary

Market Summary
Competitive Landscape
Brand Overview
Physician Perspectives

Section 1: Introduction

Scope of Report
Primary Research Methodology

Section 2: Psoriasis Disease Dynamics

Psoriasis Background
Prevalence and Diagnosis
- Major Markets Statistics and Key Findings
- US Statistics and Key Findings
- Europe Statistics and Key Findings
- Japan Statistics and Key Findings
Prescribers
- General Prescriber Trends
- Key Drivers of Prescriber Decisions
Reimbursement Issues
Treatment Dynamics
- Existing Therapies
- Emerging Therapies

Section 3: Competitive Analysis

Overview of Competitive Landscape
Promotional Spending
Survey Results: Physician Perceptions
- Perceptions of Competitors in the Psoriasis Market
- Perceptions of Brands in the Psoriasis Market

Section 4: Established Brands

Enbrel
- Development and Commercial Overview
- Current Positioning
- Enbrel Competitive Analysis
- Key Brand Strategies
  - Current Strategy in the Psoriasis Market
  - Lifecycle management and future strategy
- Future Positioning
- Amgen
  - Inflammatory Disease Product Portfolio
  - Goals and Vision in Inflammatory Disease
  - Current Positioning
  - Market Strategy
  - Outlook
- Wyeth
  - Inflammatory Disease Product Portfolio
  - Goals and Vision in Inflammatory Disease
  - Current Positioning
  - Market Strategy
  - Outlook
Raptiva
- Development and Commercial Overview
- Current Positioning
- Raptiva Competitive Analysis
- Key Brand Strategies
  - Current Strategy in the Psoriasis Market
  - Lifecycle Management and Future Strategy
- Future Positioning
- Genentech
  - Immunology Product Portfolio
  - Goals and Vision in Immunology
  - Current Positioning
  - Market Strategy
  - Outlook
- Merck Serono
  - Autoimmune & Inflammatory Product Portfolio
  - Goals and Vision in Autoimmune & Inflammatory Disease
  - Current Positioning
  - Market Strategy
  - Outlook
Remicade
- Development and Commercial Overview
- Current Positioning
- Remicade Competitive Analysis
- Key Brand Strategies
  - Current Strategy in the Psoriasis Market
  - Lifecycle Management and Future Strategy
- Future Positioning
- Centocor
  - Immune-Mediated Inflammatory Disorder Product Pipeline
  - Goals and Vision in Inflammatory Disease
  - Current Positioning
  - Market Strategy
  - Outlook
- Schering-Plough
  - Inflammation Product Portfolio
  - Goals and Vision in Inflammatory Disease
  - Current Positioning
  - Market Strategy
  - Outlook
Humira
- Development and Commercial Overview
- Current Positioning
- Humira Competitive Analysis
- Key Brand Strategies
  - Current Strategy in the Psoriasis Market
  - Lifecycle Management and Future Strategy
- Future Positioning
- Abbott Laboratories
  - Immunology Product Portfolio
  - Goals and Vision in Immunology
  - Current Positioning
  - Market Strategy
  - Outlook
Amevive
- Development and Commercial Overview
- Current Positioning
- Amevive Competitive Analysis
- Key Brand Strategies
  - Biogen/Biogen Idec' s Strategies for Amevive
  - Astellas Pharma' s Strategies for Amevive
- Future Positioning
- Astellas Pharma
  - Dermatology Product Portfolio
  - Current Positioning and Market Strategy
  - Outlook

Section 5: Emerging Brands

CNTO-1275
- Overview
- CNTO-1275 Competitive Analysis
- Key Brand Strategies
- Future Positioning
Voclosporine (ISA-247)
- Overview
- Voclosporine Competitive Analysis
- Key Brand Strategies
- Isotechnika

Section 6: Market Forecast

Drug Sales by Region
Drug Sales by Class

Section 7: Appendices

Acronyms and Abbreviations

Bibliography

Methodology

Epidemiological Forecast Methodology
Market Forecast Methodology
Competitive Analysis Methodology

Table of Exhibits

Executive Summary

Exhibit ES-1: Key Parameters of the Psoriasis Market
Exhibit ES-2: Psoriasis Branded Market, ($US), Major Markets, 2005- 2010
Exhibit ES-3: Psoriasis Market Competitive Position, 2005 and 2010
Exhibit ES-4: Psoriasis Brand Sales ($US), by Brand, as a Percent of Total, 2005 and 2010
Exhibit ES-5: Dermatologist Rankings of Companies in Psoriasis Treatment
Exhibit ES-6: Humira in Dermatologist' s Line of Therapy

Section 1: Introduction

Exhibit 1-1: Surveyed Physicians' Years of Practice
Exhibit 1-2: Surveyed Physicians' Patients per Month
Exhibit 1-3: Surveyed Physicians' Geographic Distribution

Section 2: Psoriasis Disease Dynamics

Exhibit 2-1: Drug Classes Used in the Treatment of Psoriasis
Exhibit 2-2: Prevalent and Diagnosed Psoriasis Cases, Major Markets
Exhibit 2-3: Prevalent and Diagnosed Psoriasis Cases, US
Exhibit 2-4: Prevalent and Diagnosed Psoriasis Cases, Europe
Exhibit 2-5: Prevalent and Diagnosed Psoriasis Cases, Europe, Continued
Exhibit 2-6: Prevalent and Diagnosed Psoriasis Cases, Japan
Exhibit 2-7: Dermatologist Information Channels Used in Psoriasis Treatment
Exhibit 2-8: End Points Used in Clinical Trials for Psoriasis, 2007
Exhibit 2-9: Biologic Agents in the Psoriasis Market, 2006
Exhibit 2-10: Approved Indications for Biologic Therapies in Current Psoriasis Treatment
Exhibit 2-11: Timeline of Recent Approvals in the Psoriasis Market, 1998- 2007

Section 3: Competitive Analysis

Exhibit 3-1: Psoriasis Market Competitive Position, 2005 and 2010
Exhibit 3-2: Market for Biologic Psoriasis Therapies, by Company, 2005-2010
Exhibit 3-3: Psoriasis Market Share, by Competitor, as a % of Total, 2005
Exhibit 3-4: Psoriasis Market Share, by Competitor, as a % of Total, 2010
Exhibit 3-5: Promotional Spending, by Brand, as a % of Total Spending for All Indications of Biologic Agents in Psoriasis, 2004- 2006
Exhibit 3-6: Promotional Spending, by Competitor, as a % of Total Spending for All
Indications of Biologic Agents in Psoriasis, 2004- 2006 [Tabular Format]
Exhibit 3-7: Promotional Spending, by Competitor, as a % of Total Spending for All
Indications of Biologic Agents in Psoriasis, 2004- 2006 [Graphical Format]
Exhibit 3-8: Dermatologist Perceptions of Psoriasis Market Competitors, 2007
Exhibit 3-9: Dermatologist Rankings of Best Company in the Psoriasis Market, 2007
Exhibit 3-10: Dermatologist Efficacy Rankings, by Brand, 2007
Exhibit 3-11: Dermatologist Safety Rankings, by Brand, 2007
Exhibit 3-12: Dermatologist Convenience Rankings, by Brand, 2007
Exhibit 3-13: Dermatologist Reimbursement Rankings, by Brand, 2007
Exhibit 3-14: Dermatologist-Reported Rankings of Biologic Therapies in Psoriasis, 2005 versus 2007
Exhibit 3-15: Dermatologist Efficacy Rankings, Detail, 2007
Exhibit 3-16: Dermatologist Safety Rankings, Detail, 2007
Exhibit 3-17: Dermatologist Safety Rankings, Detail (continued), 2007
Exhibit 3-18: Dermatologist Convenience Rankings, Detail, 2007

Section 4: Established Brands

Exhibit 4-1: Established Brands in the Psoriasis Market, 2006 and 2010
Exhibit 4-2: Timeline of Notable Milestones in Enbrel' s Development for Psoriasis
Exhibit 4-3: Enbrel' s Rank Among Biologic Therapies in Psoriasis Treatment
Exhibit 4-4: Predominant Reasons for Discontinuing Enbrel Therapy, Cumulative Rankings, 2007
Exhibit 4-5: Enbrel' s Rank among Biologic Therapies for Psoriasis, by Key Efficacy and Safety Attributes
Exhibit 4-6: Enbrel' s Rank among Biologic Therapies for Psoriasis, by Key Convenience Attributes
Exhibit 4-7: Enbrel' s Rank among Biologic Therapies for Psoriasis, by Long-term Safety Data
Exhibit 4-8: Dermatologist Rankings of TNF-� Inhibitor Efficacy in Psoriasis
Exhibit 4-9: Summary of Key Clinical Trials Supporting Enbrel' s Psoriasis Approvals
Exhibit 4-10: Select Ongoing Phase III Clinical Trials for Enbrel in Psoriasis
Exhibit 4-11: Select Ongoing Phase IV Clinical Trials for Enbrel in Psoriasis
Exhibit 4-12: Enbrel Psoriasis Revenue ($US), by Country, 2005- 2010
Exhibit 4-13: Enbrel Psoriasis Revenue ($US), by Country, 2005- 2010
Exhibit 4-14: Price to Treat per Day ($US), Enbrel, by Country, 2006
Exhibit 4-15: Amgen' s Pharmaceutical Product Revenue, by Brand, 2006
Exhibit 4-16: Summary of Amgen' s Inflammatory Disease Product Portfolio
Exhibit 4-17: Physician-Reported Rankings of Amgen/Wyeth
Exhibit 4-18: Enbrel Revenue ($US), by Company and Region, 2005- 2010 [Graphical Format]
Exhibit 4-19: Enbrel Revenue ($US), by Company and Region, 2005- 2010 [Tabular Format]
Exhibit 4-20: Wyeth' s Pharmaceutical Product Revenue, with Enbrel Revenue Allocation, 2006
Exhibit 4-21: Summary of Wyeth' s Inflammatory Disease Product Portfolio
Exhibit 4-22: Wyeth' s Enbrel Psoriasis Revenue ($US), by Country, 2005- 2010, [Graphical Format]
Exhibit 4-23: Wyeth' s Enbrel Psoriasis Revenue ($US), by Country, 2005- 2010, [Tabular Format]
Exhibit 4-24: Important Milestones in Raptiva' s Development for Psoriasis
Exhibit 4-25: Raptiva' s Rank Among Biologic Therapies in Psoriasis Treatment
Exhibit 4-26: Raptiva' s Rank Among Biologic Agents, by Efficacy and Safety Attributes
Exhibit 4-27: Raptiva' s Rank Among Biologic Agents in terms of Continuous Monitoring Requirements
Exhibit 4-28: Predominant Reasons for Discontinuing Raptiva Therapy
Exhibit 4-29: Clinical trials cited by the FDA in Raptiva' s approval using predominantly XOMA-produced drugs
Exhibit 4-30: Clinical Trials Cited by the FDA in Raptiva' s Approval Using Genentech- Produced Raptiva
Exhibit 4-31: Raptiva Psoriasis Revenue ($US), by Country, 2005- 2010
Exhibit 4-32: Raptiva Psoriasis Revenue ($US), by Country, 2005- 2010
Exhibit 4-33: Price to Treat per Day ($US), Raptiva, by Country, 2006
Exhibit 4-34: Genentech Product Revenue and Growth, 2006
Exhibit 4-35: Summary of Genentech' s Immunology Product Portfolio
Exhibit 4-36: Merck Serono' s Products and Revenue
Exhibit 4-37: Summary of Merck Serono' s Autoimmune & Inflammatory Product Portfolio
Exhibit 4-38: Timeline of Notable Milestones in Remicade' s Development for Psoriasis
Exhibit 4-39: Remicade' s Revenue Rank in Marketed Biologic Agents, by Indication
Exhibit 4-40: Remicade' s Rank Among Biologic Therapies in Psoriasis Treatment, 2007
Exhibit 4-41: Remicade' s Rank Among Biologic Therapies in Psoriasis Treatment, by Efficacy and Safety Attributes, 2007
Exhibit 4-42: Remicade' s Rank Among Biologic Therapies in Psoriasis Treatment, by Efficacy and Safety Attributes, 2007
Exhibit 4-43: Remicade' s Safety Rank Among Biologic Agents
Exhibit 4-44: Summary of Key Clinical Trials Supporting Remicade' s Psoriasis Approvals
Exhibit 4-45: Select Ongoing or Unreported Phase III Clinical Trials for Remicade in Psoriasis
Exhibit 4-46: Remicade Psoriasis Revenue ($US), by Country, 2005- 2010
Exhibit 4-47: Remicade Psoriasis Revenue ($US), by Country, 2005- 2010
Exhibit 4-48: Price to Treat per Day ($US), Remicade, by Country, 2006
Exhibit 4-49: Summary of Centocor and J&J' s IMID Product Portfolio
Exhibit 4-50: Centocor' s Psoriasis Revenue ($US), by Country and Brand, 2005- 2010
Exhibit 4-51: Schering-Plough' s Pharmaceutical Revenue, 2006
Exhibit 4-52: Summary of Schering-Plough' s Inflammation Product Portfolio
Exhibit 4-53: Important Milestones in Humira' s Development for Psoriasis
Exhibit 4-54: Humira' s Rank among Biologic Therapies for Psoriasis
Exhibit 4-55: Humira' s Rank among Biologic Agents, by Dosing Attributes
Exhibit 4-56: Humira versus Enbrel, Rank among Biologic Agents, by Long-Term Safety Data
Exhibit 4-57: Humira' s Phase III Trials in Psoriasis
Exhibit 4-58: Humira' s Current and Forecast Position in Dermatologist' s Line of Therapy for Moderate to severe Psoriasis
Exhibit 4-59: Physician-Selected Patient Groups Appropriate for Humira Therapy following FDA Approval
Exhibit 4-60: Humira vs. Enbrel, Rank among Biologic Agents, by Short-Term Efficacy
Exhibit 4-61: Humira versus Enbrel, Rank among Biologic Agents, by Maintenance Efficacy
Exhibit 4-62: Humira versus Enbrel, Rank among Biologic Agents, by Delivery Method
Exhibit 4-63: Humira versus Enbrel, Rank among Biologic Agents, by Dosing Frequency
Exhibit 4-64: Humira Psoriasis Revenue ($US), by Country, 2005- 2010
Exhibit 4-65: Humira Psoriasis Revenue ($US), by Country, 2005- 2010
Exhibit 4-66: Price to Treat per Day ($US), Humira, by Country, 2005
Exhibit 4-67: Abbott' s Pharmaceutical Revenues, by Brand and Business Revenues, by Business Segment
Exhibit 4-68: Summary of Abbott' s Immunology Product Portfolio
Exhibit 4-69: Notable Milestones in Amevive' s Development for Psoriasis
Exhibit 4-70: Amevive' s Rank among Biologic Therapies for Psoriasis, by General Attributes
Exhibit 4-71: Amevive' s Rank among Biologic Therapies for Psoriasis, by Key Efficacy and Safety Attributes
Exhibit 4-72: Amevive' s Rank among Biologic Therapies for Psoriasis, by Key Convenience and Reimbursement Attributes
Exhibit 4-73: Amevive Psoriasis Revenue ($US), 2005- 2010
Exhibit 4-74: Amevive Psoriasis Revenue ($US), 2005- 2010
Exhibit 4-75: Astellas' North American Pharmaceutical Revenue as a % of Total Revenue
Exhibit 4-76: Physician-Reported Rankings of Astellas Pharma

Section 5: Emerging Brands

Exhibit 5-1: CNTO-1275' s Efficacy Results in its Phase II Psoriasis Trial
Exhibit 5-2: Ongoing Phase III Trials of CNTO-1275 in Psoriasis
Exhibit 5-3: CNTO-1275' s Attributes Compared to Enbrel
Exhibit 5-4: Price Per Treated Day of Branded Agents for Psoriasis in 2010
Exhibit 5-5: Voclosporine' s Completed Phase II/III Clinical Trials in Psoriasis
Exhibit 5-6: Isotechnika' s Strategic Alliances

Section 6: Market Forecast

Exhibit 6-1: Psoriasis Branded Therapies Market ($US), Major Markets, 2005- 2010 (Tabular Format)
Exhibit 6-2: Psoriasis Branded Therapies Market ($US), Major Markets, 2005- 2010 [Graphical Format]
Exhibit 6-3: Psoriasis Branded Therapies Market ($US), by Country, 2005- 2010 [Graphical Format]
Exhibit 6-4: Psoriasis Branded Therapies Market ($US), by Country, 2005- 2010 [Tabular Format]
Exhibit 6-5: Psoriasis Branded Therapies Market ($US), by Drug Class, 2005- 2010

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