Sales of Amgen/Stiefel/Pfizer/Takeda's Enbrel will continue to decline, from just under one-third of total Psoriasis sales in 2011 to less than one-eighth of sales in 2021, according to findings from decision resources.
Decision Resources finds that, for the treatment of psoriasis, Abbott/Eisai's Humira has displaced Amgen/Stiefel/Pfizer/Takeda's Enbrel as the preferred first-line biologic in several markets and Humira became the leading agent in 2011 with sales of more than $1.4 billion in the United States, France, Germany, Italy, Spain, the United Kingdom and Japan. However, while Humira will maintain its patient-share dominance among biologics through 2021, sales of the agent will start to decline in 2018 owing to deeper penetration of Janssen Biotech/Janssen Cilag's Stelara, intensified competition from emerging agents, and to a lesser extent, the market entry of biosimilars. Meanwhile, sales of Enbrel will continue to decline, from just under one-third of total psoriasis sales in 2011 to less than one-eighth of sales in 2021.
The Pharmacor advisory service entitled Psoriasis also finds that Stelara has experienced healthy uptake since its launch for psoriasis in 2009. Contingent on the continued accumulation of favorable postmarketing safety data and its expected near-term approval in psoriatic arthritis, Decision Resources forecasts that, through 2021, Stelara will see some first-line biologic use ahead of the TNF-alpha inhibitors and will surpass Humira to become the sales leader in 2018.
Driven primarily by factors that include the uptake of Stelara, the launch and prescribing of emerging agents, including Pfizer's oral Janus kinase inhibitor tofacitinib and three IL-17 inhibitors--Novartis's secukinumab, Eli Lilly's ixekizumab and Amgen/AstraZeneca/Kyowa Hakko Kirin's brodalumab--the market for prescription psoriasis therapies will increase by approximately $3.6 billion from 2011 to 2021. The findings also reveal that competition for patient share in the TNF-alpha-refractory space of the moderate-to-severe psoriasis market will intensify starting in 2014 with the anticipated launches of tofacitinib and secukinumab, which will be followed by ixekizumab and brodalumab.
"The efficacy of the anti-IL-17 agents in their Phase II clinical trials appears comparable to that of infliximab (Janssen Biotech/Merck/Mitsubishi Tanabe's Remicade), the most efficacious biologic currently marketed for psoriasis," said Decision Resources Bingnan Kang, Ph.D. "However, until satisfactory postmarketing safety records have been established, these agents will likely be used in patients who have already failed a TNF-alpha inhibitor and Stelara."