Novartis' Gilenya has begun to impact established DMAs and market perceptions; report

While physician trialing of Swiss drug major Novartis’ (NOVN: VX) Gilenya (fingolimod), the first oral disease-modifying agent (DMA) for the treatment of multiple sclerosis (MS), has slowed over the past quarter, market share continues to grow as a result of expanded uptake by prescribers, according to Decision Resources BioTrends report.

Teva’s Copaxone (glatiramer acetate) continues to be the market leader, capturing just under one-third of DMA-treated MS patients, with Biogen Idec’s Avonex (interferon beta-1a) also strong among CIS and RRMS patients and Bayer’s Betaseron (interferon beta-1b) and Pfizer/EMD Serono’s Rebif (interferon beta-1a) strong among progressive MS patients. Among RRMS patients, Betaseron appears to be the DMA most negatively impacted by adoption of Gilenya. Despite expanded use, Gilenya is still rarely thought of as a first-line agent; neurologists tend to view it as a second or third line agent, especially following an efficacy failure. Interestingly, while surveyed neurologists claim that the vast majority of their patients prefer an oral formulation, they perceive that a very small percent of patients prefer Gilenya over the other available DMAs.

Perhaps in response to the availability of Gilenya and continued communications related to increased prevalence of PML cases, neurologists report being significantly less comfortable with Biogen and Elan’s Tysabri’s (natalizumab) risk-benefit profile compared to neurologists surveyed in the previous quarter, the report noted.