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Summary: Research reveals growing use of exclusive pill therapy among diabetes population in six European countries, fueled by heavy pill use in growing segment of Type 2 diabetes patients |
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For diabetes patients across the Western European countries of France, Germany, Italy, the Netherlands, Spain and the United Kingdom, exclusive pill therapy is increasingly the treatment of choice. And while the proportion of patients receiving no medication continues to decline, the use of insulin within the diabetes population remains relatively stable, according to new research from GfK Market Measures’ Roper Global Diabetes Group.
The proportion of diabetes patients on oral antidiabetic agents (OAA), either exclusively or as part of a combination therapy, has increased to 64 percent in 2008 from 54 percent in 2000, bringing the total number of OAA users in Western Europe to more than 10 million, based on a projected total diagnosed diabetes population of almost 16.5 million. Across the six countries, the proportion of patients on exclusive pill therapy is 55 percent, equivalent to almost 9 million patients, a substantial increase since 2000 when the figure was 48 percent. While the percentages vary by country, with penetration highest in France at 64 percent and lowest in Germany at 46 percent, exclusive pill therapy dominates in all markets. In countries where its share is below average, insulin use increases, which in turn is always higher than the percentage of diabetes patients on no medication.
Less than 15 percent of patients, or 2.5 million people, take no medication for their diabetes, a considerable decrease since 2000 when the figure was 22 percent. Thirty percent of patients use insulin, equivalent to just under 5 million people. Of these patients, two-thirds use insulin exclusively and one-third use insulin in combination with OAAs. Insulin use has remained stable since 2000 when 29 percent of patients reported its use.
GfK’s research shows that some countries are introducing OAAs earlier in the treatment pathway than previously. More than 75 percent of exclusive OAA patients were placed on diabetes pills at diagnosis, and it appears this percentage is gradually increasing in some countries. At 88 percent, the Netherlands has the most patients placed on exclusive pills at diagnosis. In contrast, at 55 percent, the United Kingdom places the fewest on exclusive pills as a first treatment.
Trends among new entrants – patients diagnosed within the past year – also account for increased pill use. The new entrants population in Western Europe has been increasing steadily, accounting for 8.1 percent of the diabetes population in 2008 compared with 4.4 percent in 2000. Likewise, exclusive pill prescribing for new entrants has increased considerably: 51 percent in 2008 compared with 36 percent in 2000.
Biguanides, especially metformin, remain the most popularly prescribed class of OAAs for exclusive pill users. Used by 62 percent of patients in 2008, the market share of biguanides has increased significantly since 2002, when they were used by 48 percent of patients. In direct contrast, sulfonylureas, which were used by 37 percent of patients in 2008, have lost considerable market share since 2002, when they were used by 58 percent of patients.
In terms of switching behavior, just under one-third of exclusive pill users have changed a pill brand within the last two years. While a significant minority of patients switch between brands within the sulfonylurea and biguanide classes, for other classes most patients are switching out of the class.
“The growth in OAA use across Western Europe is being fueled by increased awareness and diagnosis of Type 2 diabetes, as these patients are most likely to be on pills. Also aiding this trend is a move to medicating these patients earlier, in order to help control their diabetes,” said Ian Pike, Director of GfK Market Measures’ Roper Global Diabetes Group based in the United Kingdom. “Type 2 patients often suffer from many other ailments – obesity, cardiovascular disease and sight problems, for example – which impact the quality of their day-to-day lives and compliance with medications. This points to a real opportunity for pharmaceutical companies to develop novel therapies that would address the issues surrounding polypharmacy, especially compliance.”
| Reflecting insights from 3,636 diabetes patients in France, Germany, Italy, the Netherlands, Spain and the United Kingdom, fielded via in-depth telephone interviews from November 2007 through March 2008, GfK Market Measures’ Roper Global Diabetes Group’s 2008 Western European Diabetes Patient Study provides a comprehensive perspective of the region’s diabetes market. The study runs every two years and offers comparable data back to 1994. |
Contact: Ian Pike, Director, Roper Global Diabetes Group
ian.pike@gfk.com
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Summary: Research reveals growing reliance on single drug therapy for patients in early stages of Alzheimer’s disease |
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Both psychiatrists and primary care physicians prescribed combination therapy to a smaller proportion of mild and moderate Alzheimer’s disease patients in the past year. Usage of the Namenda/Aricept combination, in particular, has seen declines by these physicians, though growth in prescribing each drug independently continues as part of trend toward single drug therapy, according to new research by GfK Market Measures.
Comparing figures from GfK’s research last year with psychiatrists and primary care physicians (PCPs), there is evidence of a considerable decline in both specialists’ use of combination therapy to treat patients with mild and moderate Alzheimer’s disease. Overall use of combination therapy by psychiatrists in the last year dropped from 37 percent to 24 percent with mild patients and 54 percent to 45 percent with moderate patients. Comparable figures for PCPs declined from 25 percent to 16 percent for mild patients and 45 percent to 35 percent for moderate patients.
Although combination therapy virtually always includes Namenda, focusing on the most frequently prescribed multiple drug regimen of Namenda/Aricept further demonstrates the significant decline in usage. Use of Namenda/Aricept with mild patients has dropped in the last year from 27 percent to 17 percent among psychiatrists and 18 percent to 10 percent among PCPs. Use with moderate patients saw an even greater decline, moving from 41 percent to 28 percent among psychiatrists and 37 percent to 24 percents among PCPs.
Despite some declines in usage, Aricept continues to maintain universal market penetration among all specialists and is used by more patients at each severity level than any other agent. Namenda is also seeing greater use as monotherapy, prescribed by psychiatrists and PCPs to a greater proportion of patients across all severities. In particular, Namenda’s use by both specialists as a monotherapy with moderate patients doubled in the past year alone, increasing from 5 percent to 10 percent.
“The reality for Namenda is the increased single therapy usage is unlikely to balance the decreased usage of the various combination regimens,” said Kim Lazarus, Vice President and Category Business Leader, Neurology, for GfK Market Measures. “Although our research shows, based on physician recall alone, messaging for Namenda primarily focuses on its use in combination with other agents, PCPs, in particular, are more likely to find the Namenda messages to be believable than the Aricept messaging, which tends to be more diffuse in scope. Should physicians continue to rely more on single drug therapy when treating Alzheimer’s disease in its earlier stages, Forest may need to more strongly tout the increased efficacy benefits of combination therapy, particularly in conversations with psychiatrists. Other messages should address using combination therapy earlier in the moderate stage of the disease.”
| Reflecting insights from 208 physicians, including general and family practitioners, neurologists, psychiatrists and internists fielded via Internet questionnaire in June 2008, GfK Market Measures’ 2008 Alzheimer’s Disease Physician Study provides a comprehensive analysis of the Alzheimer’s disease market from the perspective of treating physicians. |
Contact: Kim Lazarus, VP, Category Business Leader, Neurology
klazarus@gfkmm.com
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