New Biologic Treatments Expected to Grow Rheumatoid Arthritis Drug Market to $18.2B

Decisions Resources Group (DRG) released a report which projected an increase in the rheumatoid arthritis (RA) market from $14 billion to $18 billion by 2023. The group attributes this increase to research advances in new alternative biologic treatments, specifically oral Janus kinase (JAK) inhibitors and non tnf-alpha biologics.

RA affects the joints but can also affect the entire body and is characterized as an auto-immune disorder in which the patient’s immune system attacks the body’s tissue.

Traditionally, RA has been treated with disease-modifying antirheumatic drugs (DMARDS), methotrexate being the most common. However, relief for RA sufferers comes at a price. DMARDS must be closely monitored because of potentially lethal side-effects. Additionally, not all cases of RA respond to DMARDS.

A newer generation of biologics has emerged in recent years which are most commonly used in conjunction with traditional treatments to increase efficacy. The current leader in biologic RA treatments is TNF-alpha biologics. These drugs block a chemical called tumor necrosis factor alpha, which plays a major part in joint inflammation.

The DRG anticipates that TNF-alpha’s will continue to hold the lion share of the RA drug market over the next ten years but will experience minimal growth due to the development of biosimilars. Janssen/Merck/Mitsubishi Tanabe’s Remicade and Amgen/Pfizer/Takeda’s Enbrel, and AbbVie/Eisai’s Humira are expected to launch by year’s end.

Additionally, DRG reports that rheumatologists interviewed reported that between 15 and 40 percent of patients do not respond to TNF-alpha or experience diminished efficacy over time. To fill in this gap, researchers have developed the JAK inhibitor, a treatment for patients who do not tolerate DMARDS or TNF-alphas.

 Pfizer’s Xeljanz, the first oral JAK inhibitor, was approved by the FDA in 2012. Unlike the tnf-alpha biologics, JAK inhibitors are taken orally and work inside the cell rather than from the outside, blocking the cell-signaling process that leads to RA symptoms.

Though the EMA has previously rejected Xeljanz for safety concerns, Pfizer anticipates this decision will be revised upon re-examination.

This move, along with the launch of two other similar drugs (Eli Lilly/Incyte’s baricitinib and Vertex’s VX-509), are expected to dramatically change the landscape of the RA drug market.

While increasingly safe and more effective, these biologic treatments are extremely costly. Complex and difficult treatments demand high price tags, and RA accounts for 20 percent of the 52 million arthritis cases in the U.S. These factors combined contribute to the 66 percent growth in the RA market.

According to the DRG report, “Clear market opportunities exist for alternative biologics and oral compounds, especially in the population of patients’ refractory to TNF-alpha inhibitor therapy.”