But it is also a market with unique challenges, and players hoping to succeed in AI need to understand the unique aspects of the business model, including riskier development programs, a high-touch patient-centric commercial model, and the increasing challenge of access.
Estimated market size and projected growth for major Autoimmune indications
1Why is autoimmune such a complex space?
It’s partly technical complexity. Each disease in the space typically has multiple targets, multiple delivery options, and highly variable levels of patient response. But there’s also market complexity: how to use non-traditional service models to meet patient needs, how to deal with access environments that are getting more restrictive in certain therapies, how to manage the risks of treatment through REMS programs, how to address the needs of patients who stop responding to therapy.
2Who’s currently playing in the autoimmune market?
At the moment, Abbott, Roche, J&J, Amgen, and Pfizer have multi-billion-dollar sales and large pipelines in AI. They have invested for the long haul. Another four companies – Biogen Idec, Novartis, Teva, and Merck Serono – are targeted players. They tend to be strong in one area such as multiple sclerosis, with one or two major drugs. The remaining companies in AI – about a dozen of them – have relatively small AI sales but significant pipeline investments and see autoimmune as a significant source of growth.
3You say that companies in AI need a “direct-to-patient” mindset. What’s that?
In AI, pharma companies tend to have a higher level of touch with patients. First, the drugs are expensive, so patients often need assistance to secure reimbursement and initiate therapy. Second, many of these drugs are injectable or infused. For many patients that is a new and scary proposition. They need training and support. Third, there are side effects and lifestyle issues that often require a level of support. Providing that support effectively translates to better patient outcomes.
4What’s the down side?
A lot of companies are investing in AI, and there will be increasing competition over the next few years, plus a higher bar for safety and efficacy. And, frankly, we still don’t understand autoimmune all that well, which makes drug development riskier and less predictable. It’s still an attractive space, but it’s different from almost any area you might have worked in – and you need to understand why.