Dailypharm Live Search Close
  • Selection dilemma rises in IBD mkt due to increased options
  • by Moon, sung-ho | translator Kang, Shin-Kook | Jun 11, 2024 05:48am
treatment of Inflammatory Bowel Disease
Doctors in the field are struggling to devise a way to position the increasing treatment options
Multinational pharmaceutical companies start competing for sales... Market full of competition period for IBD drugs
With the recent surge in treatment options for inflammatory bowel disease (IBD), which is represented by ulcerative colitis and Crohn's disease, developing an appropriate treatment strategy for IBD is emerging as a rising topic in clinical practice.

This is due to the recent health insurance reimbursement extensions granted for treatments by multinational pharmaceutical companies, which have lowered the burden on site.

#Amid intensifying sales and marketing competition within the industry, the medical community is expected to revise its guidelines on selecting appropriate treatments.

Until now, tumor necrosis factor (TNF) blockers Humira (adalimumab) and Remicade (infliximab) have dominated the field of IBD treatment in Korea.

According to the pharmaceutical industry and medical community on the 8th, the IBD treatment market has been rapidly reshaping with the competitive entry of global pharmaceutical companies’ treatments this year.

First, in the first half of this year, Lilly Korea received approval for its interleukin-23 (IL-23) inhibitor ‘Omvo (mirikizumab) from the Ministry of Food and Drug Safety. This added another IL inhibitor option to ‘Stelara (ustekinumab),’ the only anti-interleukin drug that had been available in the market until then.

As a result, the anti-integrin agent ‘Kynteles (vedolizumab, Takeda),’ and anti-interleukin agent ‘Stelara,’ ‘Omvo,’ and the Janus kinase (JAK) inhibitors ‘Xeljanz (tofacitinib, Pfizer),’ ‘Rinvoq (upadacitinib, AbbVie),’ ‘Jyseleca (filgotinib, Eisai) can now be prescribed for IBD in Korea.

Also, in addition to the JAK inhibitors, which were the only oral treatment options for severe IBD until the first half of this year, the launch and reimbursement approval of ‘Zeposia (ozanimod, BMS),’ a sphingosine-1-phosphate (S1P) receptor modulator broadened the options available on site.

This means that the doctors have more options to use on patients who have failed initial treatment.

In other words, the next treatment they choose can change the direction of each patient’s care.
As such, the choice of IBD therapies, typified by ulcerative colitis (UC), has risen as a hot topic in clinical practice. While clinical research has made it possible to customize treatment for each patient, it has also increased competition between pharmaceutical companies.

A professor of gastroenterology at A University Hospital in Busan said, "Previously, there were no options for IBD other than anti-TNF inhibitors. But many more options have become available in recent years, making the situation more complicated for prescribing clinicians.”

The pharmaceutical industry is also scrambling to prioritize the lines of their treatment amid the various options becoming available. One representative example is BMS's Zeposia, which entered into a co-marketing agreement with Yuhan Corp, which owns strong domestic sales and marketing capabilities.

An industry official said, "In fact, Yuhan Corp’s co-marketing agreement with BMS for Zeposia was considered quite unusual in the field. The collaboration seems to fall in line with the current situation, as the IBD market has recently become more competitive with an increasing number of treatment options and Yuhan had a need to increase its drug lineup."

Also, with the increasing number of therapies available from global pharmaceutical companies, "sequencing" between existing and new drugs has become a hot topic in clinical practice.

In other words, the increase in treatment options to use after initial treatment failure has created a "dilemma" as patients are allowed to switch between drugs, but not immediately.

Another professor of gastroenterology at a university hospital said, "Recently, JAK inhibitors and small molecule drugs have been approved for ulcerative colitis and are being used in practice. However, the issue of side effects needs to be considered as well as benefits. Because complications such as herpes zoster and blood clots can occur when using these drugs, the new drugs are more commonly used on patients that have received shingles vaccinations and relatively young patients."

He added, “In the JAK inhibitor class, Jyseleca is the only JAK inhibitor that can be prescribed directly after azathioprine. In clinical studies, RInvoq has shown promise in ulcerative colitis and Crohn's disease. However, the use of other JAK inhibitors requires azathioprine to be first removed, which is problematic for physicians because they have to remove azathioprine, which they consider effective for the patients.”

In other words, while prioritizing the use of the right treatment for each patient, the sequencing of the treatments is currently being determined at the doctors’ discretion based on clinical research.

As a result, therapies that are deemed to be the most effective based on the clinical studies that support their approval and reimbursement are being placed in the "last line of defense" and used as a last resort in practice.

However, there is an opinion that this approach is not optimal and that prescriptions should be based on a comprehensive analysis of the patient's disease severity and socioeconomic status.

There are also those who believe that they should wait and refer to the revisions made to the guidelines published by the Korean Association for the Study of Intestinal Diseases, which specializes in the disease.

Professor Byong Duk Ye, Professor at the University of Ulsan College and Treasurer of KASID, said, "This is always a problem because there is no right answer. Especially, in the case of Rinvoq, there are opinions that its use should be delayed as much as possible because it is superior in clinical or endoscopic aspects compared to other agents. The drug should be used in combination with the patient's personal disease status and socioeconomic status."

Ye added, "It is not necessarily a good treatment strategy to postpone the use of Rinvoq because it becomes less effective when used in later stages of the disease. It may be better to use it earlier to control inflammation. The final decision should be made in consultation with the patient, and we plan to publish revised KASID guidelines regarding the increased number of IBD treatment options available.”
  • 0
Reader Comment
Anonymity comment Write Operate Rule

댓글 운영방식은

댓글은 실명게재와 익명게재 방식이 있으며, 실명은 이름과 아이디가 노출됩니다. 익명은 필명으로 등록 가능하며, 대댓글은 익명으로 등록 가능합니다.

댓글 노출방식은

댓글 명예자문위원(팜-코니언-필기모양 아이콘)으로 위촉된 데일리팜 회원의 댓글은 ‘게시판형 보기’와 ’펼쳐보기형’ 리스트에서 항상 최상단에 노출됩니다. 새로운 댓글을 올리는 일반회원은 ‘게시판형’과 ‘펼쳐보기형’ 모두 팜코니언 회원이 쓴 댓글의 하단에 실시간 노출됩니다.

댓글의 삭제 기준은

다음의 경우 사전 통보없이 삭제하고 아이디 이용정지 또는 영구 가입제한이 될 수도 있습니다.

  • 저작권·인격권 등 타인의 권리를 침해하는 경우

    상용 프로그램의 등록과 게재, 배포를 안내하는 게시물

    타인 또는 제3자의 저작권 및 기타 권리를 침해한 내용을 담은 게시물

  • 근거 없는 비방·명예를 훼손하는 게시물

    특정 이용자 및 개인에 대한 인신 공격적인 내용의 글 및 직접적인 욕설이 사용된 경우

    특정 지역 및 종교간의 감정대립을 조장하는 내용

    사실 확인이 안된 소문을 유포 시키는 경우

    욕설과 비어, 속어를 담은 내용

    정당법 및 공직선거법, 관계 법령에 저촉되는 경우(선관위 요청 시 즉시 삭제)

    특정 지역이나 단체를 비하하는 경우

    특정인의 명예를 훼손하여 해당인이 삭제를 요청하는 경우

    특정인의 개인정보(주민등록번호, 전화, 상세주소 등)를 무단으로 게시하는 경우

    타인의 ID 혹은 닉네임을 도용하는 경우

  • 게시판 특성상 제한되는 내용

    서비스 주제와 맞지 않는 내용의 글을 게재한 경우

    동일 내용의 연속 게재 및 여러 기사에 중복 게재한 경우

    부분적으로 변경하여 반복 게재하는 경우도 포함

    제목과 관련 없는 내용의 게시물, 제목과 본문이 무관한 경우

    돈벌기 및 직·간접 상업적 목적의 내용이 포함된 게시물

    게시물 읽기 유도 등을 위해 내용과 무관한 제목을 사용한 경우

  • 수사기관 등의 공식적인 요청이 있는 경우

  • 기타사항

    각 서비스의 필요성에 따라 미리 공지한 경우

    기타 법률에 저촉되는 정보 게재를 목적으로 할 경우

    기타 원만한 운영을 위해 운영자가 필요하다고 판단되는 내용

  • 사실 관계 확인 후 삭제

    저작권자로부터 허락받지 않은 내용을 무단 게재, 복제, 배포하는 경우

    타인의 초상권을 침해하거나 개인정보를 유출하는 경우

    당사에 제공한 이용자의 정보가 허위인 경우 (타인의 ID, 비밀번호 도용 등)

  • ※이상의 내용중 일부 사항에 적용될 경우 이용약관 및 관련 법률에 의해 제재를 받으실 수도 있으며, 민·형사상 처벌을 받을 수도 있습니다.

    ※위에 명시되지 않은 내용이더라도 불법적인 내용으로 판단되거나 데일리팜 서비스에 바람직하지 않다고 판단되는 경우는 선 조치 이후 본 관리 기준을 수정 공시하겠습니다.

    ※기타 문의 사항은 데일리팜 운영자에게 연락주십시오. 메일 주소는 dailypharm@dailypharm.com입니다.

recently Agree DisAgree
If you want to see the full article, please JOIN US (click)