Stakeholder Insight: COPD - Another Reason to Quit

Summary

COPD is a deadly disease of the elderly, with patients suffering years of progressive discomfort and disability with no pharmacological interventions able to slow the progressive decline in lung function. A large, increasing patient population demands the development of truly novel COPD-focused therapies which must be coupled with improved disease awareness and diagnosis.

Highlights

Current treatment practice will continue to diverge from international guidelines, with the most important change being the increased use of long-acting bronchodilators in mild COPD.The use of inhaled corticosteroids will continue to be reserved primarily for late stage disease, until alternative anti-inflammatory agents are available from 2010 onwards.With no revolutionary new drugs in the pipeline, and novel combinations of existing classes of drugs only offering improvements in patient compliance, improvements in smoking cessation and pulmonary rehabilitation offer the greatest hope to COPD patients.

Scope

• Analysis of diagnosis, epidemiology, and treatment of COPD
• Assessment of the extent to which physicians treat COPD severities differently
• Examination of the use of drug classes and brands across the COPD sub-populations
• Evaluation of future prescribing trends and the potential of novel COPD therapies

Reasons to Purchase

• Identify the most lucrative target niche populations for developmental products
• Understand how to position new COPD therapies
• Gain insight into prescribing patterns and physician opinion on current treatment paradigms

Contents

• Chapter 1 Executive Summary
  • Scope
  • Datamonitor insight into the disease market
• Chapter 2 Disease Background
  • COPD is characterized by airflow limitation that is not fully reversible
  • Enigma of COPD pathogenesis
  • Smoking is the primary risk factor
  • Other risk factors
  • Disease severity is based on lung function and symptoms
  • COPD is a disease of the elderly
  • Prognosis is highly variable
  • Acute exacerbations are the most important complication
  • COPD patients have signifiant comorbidities
• Chapter 3 Epidemiology
  • The difficulties in estimating COPD prevalence
  • 28 million patients suffer from COPD
  • COPD population will grow by 14% by 2015
• Chapter 4 Diagnosis
  • Common symptoms may be dismissed as 'just getting older'
  • Gold-standard diagnostic tests are spirometry and reversibility test
  • Smokers do not recognize symptoms
  • Slow onset of COPD delays diagnosis
  • Lack of awareness among the general public
  • Lack of awareness among physicians
  • Patients may be initially diagnosed as asthmatics
  • Under-use of spirometry
  • Half of COPD patients may be undiagnosed
• Chapter 5 Treatment Options
  • COPD market is valued at nearly $5 billion
  • Bronchodilators are mainstay symptomatic treatment
  • Beta2-agonists
  • Anticholinergics
  • Methyl xanthines
  • Combination short-acting anticholinergic/short-acting beta2-agonist products
  • Corticosteroids are the only effective anti-inflammatory
  • Fixed-dose combination inhaled corticosteroid/long-acting beta2-agonist products
  • Leukotriene antagonists
  • Exacerbations are still not preventable
  • Smoking cessation is key to decreasing decline in FEV1
  • Other pharmacological treatments combat infection
  • Non-pharmacological treatments
  • Pulmonary rehabilitation
  • Long-term oxygen therapy
  • Surgery
  • Treatment guidelines are comparable
  • Adherence to guidelines
• Chapter 6 Prescribing Trends
  • Current prescribing trends do not reflect best practice
  • Many patients with mild COPD prescribed long-acting bronchodilators
  • Inhaled corticosteroids are widely prescribed
  • Country prescribing trends are similar
  • Efficacy drives prescribing behaviour
  • Fixed-dose ICS/LABA combinations have the highest efficacy
  • Fixed-dose ICS/LABA combinations are most cost-effective to the payer
  • Patients are most compliant with fixed-dose ICS/LABA combination
• Chapter 7 Future Trends
  • Shortfalls with COPD therapies warrant new approaches
  • Alternatives to inhaled corticosteroids remain elusive
  • Novel combinations: same room, different color
  • Improved smoking cessation thearpies are critical
  • Improving nicotine replacement therapy
  • The high prevalence of COPD demands improved awareness and diagnosis
• Chapter 8 Opinion Leader Transcripts
  • UK opinion leader
  • UK opinion leader
  • US opinion leader
  • Spanish opinion leader
  • Canadian opinion leader
• Appendix A
  • References
  • Weblinks
• Appendix B
  • Physician sample breakdown
  • The survey questionnaire
  • Disclaimer