Good times ahead for psoriasis drug Stelara

[Fred]

The psoriasis drugs market is set to experience huge growth over the next few years, with Stelara representing nearly 22 percent of total psoriasis sales by 2023.

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Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that the psoriasis market will experience robust growth over the next decade as sales increase from $6.6 billion in 2013 to $10.7 billion in 2023 in the United States, France, Germany, Italy, Spain, the United Kingdom and Japan. The continued uptake of Janssen’s interleukin (IL)-12/23 inhibitor Stelara in earlier lines of therapy and the entry of therapies with novel mechanisms of action (notably the IL-17 inhibitors), will drive sales growth. Stelara is forecast to achieve major-market sales of approximately $2.4 billion in 2023, representing nearly 22 percent of total psoriasis sales.

Emerging agents will drive sales: The launches and uptake of several emerging agents—the IL-17 inhibitors (Novartis’s secukinumab, Eli Lilly’s ixekizumab, and Amgen/AstraZeneca/Kyowa Hakko Kirin’s brodalumab), and Pfizer’s Jak inhibitor Xeljanz—will also drive sales over the 2013-2023 forecast period.

Competition from emerging biologics: TNF-alpha inhibitors and Stelara will experience competition from emerging biologics and oral agents with novel mechanisms of action. Although concerns about their long-term safety profiles will restrict uptake initially, the emerging IL-17 inhibitors, Xeljanz, and emerging IL-23 inhibitors (Sun Pharma/Merck’s tildrakizumab and Janssen’s guselkumab), will increase competition within the TNF-alpha-refractory space.

Oral therapies will expand treatment options: Although the perceived lower efficacy of Xeljanz and concerns about the drug’s safety profile will restrict is market potential, Xeljanz will also compete for use in the TNF-alpha-refractory space. Another oral agent, Celgene’s phosphodiesterase-4 inhibitor Otezla, has recently been approved for the treatment of psoriasis (in addition to psoriatic arthritis), and will present an alternative to conventional systemic therapies as an interim step prior to biological therapy.

Thought leaders are particularly interested in the emerging IL-17 inhibitors, which have shown impressive efficacy in late-stage trials, with similar efficacy to the most potent current therapy for psoriasis—Remicade (Janssen/Merck/Mitsubishi Tanabe Pharma). The efficacy and safety of emerging IL-17 inhibitors and IL-23 inhibitors are being evaluated in head-to-head clinical trials with current biologics, which will increase dermatologists’ confidence adopting these new therapies.

Although these agents will initially compete in the TNF-alpha-refractory population and in patients who lose response to Stelara, as their long-term safety profiles become more established, physicians will be comfortable prescribing them earlier—potentially as first-line biologics—in the treatment algorithm.

Source: decisionresources.com

[jiml]

That would be great if they made Stelara a first port of call missing the methotrexate and other damaging drugs as they seem to be drugs very few tolerate but most have to fail on before being considered for stelara. I fear though with the cost of stelara it will still be on the back burner and only used if cheap drugs fail. It is another problem for health systems to juggle funds for
Yes if stelara was a frontline treatment it would save a lot of patients a lot of discomfort going through the current regimes

[Fred]

That would be great if they made Stelara a first port of call missing the methotrexate and other damaging drugs as they seem to be drugs very few tolerate but most have to fail on before being considered for stelara. I fear though with the cost of stelara it will still be on the back burner and only used if cheap drugs fail. It is another problem for health systems to juggle funds for
Yes if stelara was a frontline treatment it would save a lot of patients a lot of discomfort going through the current regimes

Well let's look at it another way.

If the government insist on giving the cheap poison Methotrexate they will end up spending more in the long run as it will fail, you can't stay on it for long, and you will probably end up with a ruined liver.

Once people get to that state, they tend to give up and then it causes issues with the economy. We stop going out to public places spending our money, we take more time off work, we keep throwing are repeat prescriptions away.

The burden to the government of lost hours due to psoriasis is huge, now I'm not saying put everyone on Stelara without trying something else first but it's likely that is where people will end up in a few years down the line so it should be considered in sever cases at least.

Also the governments should fight the pharma's for a better price.

Interesting there was no mention of the DMF's yet they have shown good results.

[jiml]

That would be great if they made Stelara a first port of call missing the methotrexate and other damaging drugs as they seem to be drugs very few tolerate but most have to fail on before being considered for stelara. I fear though with the cost of stelara it will still be on the back burner and only used if cheap drugs fail. It is another problem for health systems to juggle funds for
Yes if stelara was a frontline treatment it would save a lot of patients a lot of discomfort going through the current regimes

Well let's look at it another way.

If the government insist on giving the cheap poison Methotrexate they will end up spending more in the long run as it will fail, you can't stay on it for long, and you will probably end up with a ruined liver.

Once people get to that state, they tend to give up and then it causes issues with the economy. We stop going out to public places spending our money, we take more time off work, we keep throwing are repeat prescriptions away.

The burden to the government of lost hours due to psoriasis is huge, now I'm not saying put everyone on Stelara without trying something else first but it's likely that is where people will end up in a few years down the line so it should be considered in sever cases at least.

Also the governments should fight the pharma's for a better price.

Interesting there was no mention of the DMF's yet they have shown good results.

You are totally correct but I dont think anyone in power looks beyond their term in office and try to save money and pass the worsening problem on to the next incumbents and the economy gets worse .... Oh don't get me started
It seems all the focus is on the IL17 inhibitor drugs and the DMF are on the back burner
Perhaps they will be prescribed ahead of Stelara if the pricing is right

[Caroline]

That would be great if they made Stelara a first port of call missing the methotrexate and other damaging drugs as they seem to be drugs very few tolerate but most have to fail on before being considered for stelara. I fear though with the cost of stelara it will still be on the back burner and only used if cheap drugs fail. It is another problem for health systems to juggle funds for
Yes if stelara was a frontline treatment it would save a lot of patients a lot of discomfort going through the current regimes

Well let's look at it another way.

If the government insist on giving the cheap poison Methotrexate they will end up spending more in the long run as it will fail, you can't stay on it for long, and you will probably end up with a ruined liver.

Once people get to that state, they tend to give up and then it causes issues with the economy. We stop going out to public places spending our money, we take more time off work, we keep throwing are repeat prescriptions away.

The burden to the government of lost hours due to psoriasis is huge, now I'm not saying put everyone on Stelara without trying something else first but it's likely that is where people will end up in a few years down the line so it should be considered in sever cases at least.

Also the governments should fight the pharma's for a better price.

Interesting there was no mention of the DMF's yet they have shown good results.

You view this from the point of a sensible real world vision.
Insurances, doctors and governments are nests of inadequacy, there is probably no possible way to have the insurances have a more than 2 year vision into the future, while you are looking for at least ten years ahead.

Strange they are missing DMF's, seen from the current interest into DMF for MS, it may very well be that the hated MTX will go down the drain and in a few years DMF will be the first to go for, followed by Stelara and the other MAB's.

[Fred]

It may very well be that the hated MTX will go down the drain and in a few years DMF will be the first to go for, followed by Stelara and the other MAB's.

Let's hope so.