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Report: Tecfidera Becoming Key Player on MS Scene

Drug captures almost half of second-line share among newly diagnosed patients

Decision Resources Group, a health care research firm located in Burlington, Mass., finds that, according to U.S. patient-level claims data, Tecfidera (dimethyl fumarate, Biogen Idec), the third-to-market oral disease-modifying therapy (DMT) for patients with multiple sclerosis (MS), captured nearly half of second-line share and 7% of first-line share among newly diagnosed patients whose prescription drug use was tracked for 1 year.

With Tecfidera not being available until April 2013, these findings attest to the rapid and broad incorporation of the drug into the MS treatment algorithm in the U.S., the report says.

Analyst Emma McFadden, PhD, remarked: “Among newly diagnosed patients who were treated with Tecfidera as a first- or second-line treatment, few patients progressed to later lines of therapy within a year of diagnosis. This finding suggests that, more often than not, patients are able to effectively manage tolerability issues, such as flushing and gastrointestinal events, that can be associated with the product.”

Among all patients who filled a DMT prescription in the fourth quarter of 2013, Copaxone (glatiramer acetate injection, Teva) and the interferon (IFN) beta drug class — primarily Avonex (IFN beta-1a, Biogen Idec) and Rebif (IFN beta-1a, EMD Serono/Pfizer) — claimed nearly two-thirds of the patient share. The continued reliance on these platform-injectable DMTs can be attributed to neurologists’ preference for time-tested products with long-term safety data, the report suggests. However, a quarterly trend analysis showed that the rapid uptake of Tecfidera has affected prescribing of these DMTs, as well as prescribing of Tysabri (natalizumab, Biogen Idec), with shares consistently declining since Tecfidera’s launch.

The oral DMTS, including Tecfidera, Aubagio (teriflunomide, Genzyme), and Gilenya (fingolimod, Novartis), captured more than one-quarter of share among recently treated patients, with each therapy experiencing at least some growth compared with previous quarters. However, confirming that Tecfidera is emerging as the preferred oral DMT, its share already surpasses the combined share of the earlier oral DMTs within 9 months of its launch.

“In our analysis, persistency was highest for Novartis’s Gilenya, the first oral DMT to reach the MS market,” McFadden said. “Although neurologists occasionally report difficultly starting patients on Gilenya due to first-dose monitoring requirements, this finding suggests that once initiated on Gilenya, patients tend to remain on the DMT, likely due to its favorable efficacy and tolerability profile.”

Source: Decision Resources Group; November 24, 2014.

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