Preference, Persistency and Positioning for Lilly’s Taltz in Psoriasis Highlight a Potential Challenge Ahead for Novartis’ Cosentyx in PsO and Psoriatic Arthritis

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Spherix Global Insights has released the results of two independent surveys of dermatologists (n=100) and rheumatologists (n=100) about the evolving practice patterns in the management of psoriasis (PsO) and psoriatic arthritis (PsA).

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Despite positive perceptions, and brand expansion from the current user base in PsA, Cosentyx could be facing some obstacles related to patient persistency. Indeed, rheumatologists report that one-in-five patients initiated on Cosentyx have subsequently discontinued. Furthermore, over half of those discontinuations are cited to be due to lack of efficacy, followed by OOP expense and insurance issues.

With the next IL-17 inhibitor for PsA due this year, in the form of Eli Lilly’s Taltz, what does this mean for Cosentyx and Novartis? Maybe there are clues if we look to psoriasis as a proxy, where both agents are available. Over half of dermatologists surveyed consider the IL-17s to be equivalent in terms of key performance attributes such as tolerability, ease of administration, coverage, and out of pocket costs, and Cosentyx currently holds the advantage over Taltz when dermatologists were pushed to choose just one IL-17 for PsO.

However, a positive indicator for Taltz emerges when looking at the results of dermatologist’s forced choice of only one IL-17. Those who selected Taltz are less likely to prescribe both IL-17s moving forward and more likely to increase only their use of Taltz. Conversely, those who selected Cosentyx are more likely to prescribe both agents in the future, indicating a stronger brand allegiance among Taltz users that could, over time, see brand shift in its favor. Furthermore, one-third believe Taltz has an efficacy advantage over Cosentyx in skin clearance versus only one-tenth attributing the advantage to Cosentyx.

Can we anticipate brand allegiance for Taltz to carry over to PsA once approved? Perhaps the way dermatologists refer and treat PsA patients will play a part. Three-quarters of PsA patients are diagnosed with psoriasis prior to receiving a PsA diagnosis. Additionally, nearly one-third of all PsA patients were referred to their current rheumatologists by a dermatologist, most of whom were biologic and/or Otezla naïve at referral.

However, nearly half of the surveyed rheumatologists agree that dermatologists attempt to treat PsA symptoms and only refer out if they cannot control joint pain, while nearly two-thirds disagree that dermatologists refer patients at the first sign of joint pain. If dermatologists are leaning towards more allegiance to Taltz will this result in an increased number of referrals of patients to rheumatologists already treated with Taltz?

Understanding the referral dynamics and switching in PsA will be further explored in our RealWorld Dynamix™: Biologic and Otezla Switching in PsA US report publishing next month. This study will include details from approximately 200 rheumatologists and 1,000 audited PsA patient charts.

About Spherix Global Insights
Spherix Global Insights is a business intelligence and market research company, specializing in renal, autoimmune, neurologic and rare disease markets. Our aim is to apply our commercial experience and unique relationships within core specialty markets to translate data into insight, enabling our clients to make smarter business decisions.

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Lynn Price, Immunology Franchise Head

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Robbie McCarthy
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