Treatment Algorithms: Dyslipidemia – Statin monotherapies dominate the industry but uncontrolled lipid levels remain an issue

• Publication date: May 2012
• Report size: 69 pages

Datamonitor estimates the antidyslipidemic drug-treated population at 73.5 million patients across the seven major industries, with the majority having high cholesterol as opposed to hypertriglyceridemia alone. Statins are the dominant treatment for high cholesterol while fibrates are more used for hypertriglyceridemia. Lipid control is an unmet need in a high proportion of drug-treated patients....

Datamonitor estimates the antidyslipidemic drug-treated population at 73.5 million patients across the seven major industries, with the majority having high cholesterol as opposed to hypertriglyceridemia alone. Statins are the dominant treatment for high cholesterol while fibrates are more used for hypertriglyceridemia. Lipid control is an unmet need in a high proportion of drug-treated patients.Follow patient key market segments and treatment pathways for dyslipidemia across the seven major industries.Gain insight into the most commonly used therapies for pure hypercholesterolemia, pure hypertriglyceridemia, and mixed hyperlipidemia.Understand prescribing trends and their affect on treatment regimens.Identify unmet needs, especially within dyslipidemic sub-populations, which represent industry opportunities.Understand the impact of generic entry on the antidyslipidemic industry .Not all patients are available for drug therapy due to the low diagnosis rate, low compliance rates, and therapeutic lifestyle management as the first line of treatment. Only 43% of dyslipidemia patients are market research report ed diagnosed within the seven major industries.The type of dyslipidemia that a patient is diagnosed with impacts on the treatment regimen used. Statin monotherapy dominates where the target lipid is low-density lipoprotein cholesterol. This is due to statins’ superior proven efficacy in lowering both target lipid levels and cardiovascular disease risk.Three months after the Lipitor went off patent in the US, primary care physicians were prescribing generic drugs to 35% of their atorvastatin-treated patients, with some patients being switched from other branded statin Crestor. Brand erosion is likely to increase with further generic competition.Which antidyslipidemics drug classes and molecules are prescribed for each dyslipidemia subgroup in each of the seven major industry s?What factors influence physician prescribing decisions?What are the highest priority needs in the Dyslipidemia industry ?What impact will generic atorvastatin have on physician prescribing of Lipitor (atorvastatin, Pfizer) and Crestor (rosuvastatin, AstraZeneca)?What co-morbidities and co-indications are prevalent in dyslipidemia patients to impact prescribing decisions?

Pathology Industry

OVERVIEW•Catalyst
•Summary

EXECUTIVE SUMMARY•Datamonitor key findings
•Related reports

TREATMENT ALGORITHMS AND PATIENT PROFILES•Methodology
•Patient profiles: seven major industry s
•Treatment algorithm: seven major industry s

DISEASE DEFINITION AND DIAGNOSIS•Disease definition
•Etiology - Lifestyle is the most common cause of dyslipidemia

•Prognosis - Dyslipidemia is generally asymptomatic, but it can lead to symptomatic cardiovascular disease

•Presentation and diagnosis - As an asymptomatic disease, country-wide screening is recommended to limit cardiovascular risk
- Over half of dyslipidemia patients are undiagnosed

•Treatment rates - Lifestyle management effectiveness is limited by under-prescription and low compliance
- Variations in treatment guidelines affect reported treatment rates
- Reported compliance rates vary considerably across the seven major industry s

PATIENT SEGMENTATION•Segmentation by lipid levels
•Pure hypertriglyceridemia is less common than cholesterol-related dyslipidemias
•High-density lipoprotein cholesterol
•Familial hypercholesterolemia

CURRENT TREATMENT OPTIONS•Overview of the antidyslipidemic drug classes
•Prescribing trends - Prescription trends for specific dyslipidemia subgroups are based on antidyslipidemic class efficacy
- Class usage across the seven industry s is largely consistent

•Prescribing strategies - Therapy switching is most commonly due to insufficient lipid modulation
- Generic antidyslipidemics continue to take industry share from key brands following Lipitor's patent expiry

PRESCRIBING INFLUENCES AND UNMET NEEDS•Prescribing influences - (Untitled sub-section)

•Treatment outcomes: unmet needs - Physicians’ highest priority unmet needs: antidyslipidemics with stronger efficacy at improving lipid deviations

BIBLIOGRAPHY•Journal papers
•Websites
•Datamonitor reports

APPENDIX•Physician data
•Survey questionnaire - Screener
- Summary
- Diagnosis and patient sector ation
- 3.0 Treatment Regimens
- 4. 0 Co-morbidities / compelling indications
- 5 Compliance
- 6.0 Clinical need in dyslipidemia
- 7.0 Pipeline and recently launched drugs
- 8.0 Prescribing influences
- 9.0 Switching therapies
- DEMOGRAPHICS

•Report methodology

TABLES•Table: Common etiologies and risk factors of dyslipidemia and their effect on lipid levels
•Table: An overview of the antidyslipidemic drug classes in the seven major industries, 2012
•Table: Physicians’ clinical needs ranked according to importance, 2012
•Table: The proportion of patients that have uncontrolled lipid levels across the seven major industries, by subtype, 2012
•Table: Survey respondents across the seven major industries, by country, 2012

FIGURES•Figure: Dyslipidemia patient profiles across the seven major industries, 2012
•Figure: Dyslipidemia treatment regimens for the seven major industries, by subgroup, 2012
•Figure: Proportion of patients receiving antidyslipidemics with co-morbidities or compelling indications in the seven major industries, 2012
•Figure: Proportion of patients with the most common compelling indications, diabetes and obesity, across the seven major industries, 2012
•Figure: Diagnosed dyslipidemia patients as a proportion of the prevalent patient population in the seven major industries, 2012
•Figure: Dyslipidemia patients treated with drug therapy as a proportion of the diagnosed patient population in the seven major industries, 2012
•Figure: Compliance rates for pure hypercholesterolemia pharmacotherapy in the seven major industries, by country, 2012
•Figure: Compliance rates for pure hypertriglyceridemia pharmacotherapy in the seven major industries, by country, 2012
•Figure: Compliance rates for mixed hyperlipidemia pharmacotherapy in the seven major industries, by country, 2012
•Figure: The proportion of diagnosed patients within each subgroup (pure hypercholesterolemia, pure hypertriglyceridemia, and mixed hyperlipidemia) across the seven major industries, 2012
•Figure: Proportion of each dyslipidemic subgroup that have also been diagnosed with low HDL-C across the seven major industries, 2012
•Figure: The proportion of diagnosed hypercholesterolemia patients that have familial hypercholesterolemia across the seven major industries, 2012
•Figure: The proportion of patients in each subgroup prescribed antidyslipidemics across the seven major industries, by class, 2012
•Figure: Antidyslipidemic drug class usage in each dyslipidemia subgroup (pure hypercholesterolemia, pure hypertriglyceridemia, and mixed hyperlipidemia) in the US, 2012
•Figure: Antidyslipidemic drug class usage in each dyslipidemia subgroup (pure hypercholesterolemia, pure hypertriglyceridemia, and mixed hyperlipidemia) in Japan, 2012
•Figure: Antidyslipidemic drug class usage in each dyslipidemia subgroup (pure hypercholesterolemia, pure hypertriglyceridemia, and mixed hyperlipidemia) in the five major EU industries, 2012
•Figure: Proportion of patients receiving one or more antidyslipidemic drug, 2012
•Figure: Physician reported patients who were prescribed either the generic of branded forms of atorvastatin in February, 2012
•Figure: Proportion of patients currently receiving Lipitor and Crestor that are expected to switch or have switched to generic atorvastatin following Lipitor's loss of patent exclusivity, 2012
•Figure: Physician-reported prescribing influences, ranked by importance, 2012
•Figure: Factors influencing prescribing decisions when choosing between a fixed-dose combination and a free-dose combination, ranked according to their impact, 2012
•Figure: Mean satisfaction scores given to antidyslipidemic treatments based on their ability to modify specific lipid levels, 2012

Companies mentioned

Abbott Laboratories, First Data Corporation, Hutchison 3G UK Limited, RSA Insurance Group plc, Wolters Kluwer nv