Ocrevus’ Use Continues Rising, with RRMS Patients Receiving the Most Attention

U.S. neurologists are increasingly prescribing Genentech’s Ocrevus (ocrelizumab) to their multiple sclerosis patients, Spherix Global Insights reports.

Another good sign for Genentech is that, in just three months, neurologists have increased by 50 percent their estimate of the numbers of relapsing-remitting MS patients who could benefit from Ocrevus. The estimate of the primary progressive MS patients who could benefit remains about the same.

A dampener on Ocrevus’ use is that it must be administered at special infusion centers, the report said.

Spherix based its report on a survey of 103 neurologists nationwide. It titled its findings “With Ocrevus Uptake in Primary Progressive Multiple Sclerosis a Relative Lock, Genentech and US Neurologists are Increasingly Focused on Ocrevus Positioning in Relapsing Forms of Multiple Sclerosis.”  The report is part of a quarterly series known as RealTime Dynamix: Multiple Sclerosis (US).

One reason some patients have yet to receive Ocrevus is that some doctors are conservative about prescribing new drugs, the report said. A more pressing reason is that the infusion centers that administer the therapy can be far from where patients live, according to the report.

The survey showed that more neurologists are prescribing Ocrevus than three months ago, when the last survey was done.

One reason for the increase may be Genentech’s marketing activities. Neurologists reported having more discussions with the company’s representatives than the previous quarter. The discussions appeared to focus more on Ocrevus’ use in relapsing MS patients than in PPMS patients.

Most neurologists said they view Ocrevus as a second-line treatment for RRMS. Its growing use in this group is likely to take shares from Biogen‘s Tecfidera (dimethyl fumarate) and Tysabri (natalizumab), Novartis‘ Gilenya (fingolimod), and interferon-based therapies, analysts say.

Ocrevus may also affect the use of other antibody-based MS drugs, such as Genentech’s Rituxan (rituximab) and Sanofi Genzyme‘s Lemtrada (alemtuzumab), analysts add.

In contrast, Ocrevus has yet to affect the use of another Sanofi Genzyme therapy, Aubagio (teriflunomide). In fact, neurologists said they believe oral disease-modifying drugs will become increasingly popular in the next six months.

Meanwhile, neurologists who have yet to prescribe Ocrevus said they are unlikely to do so in the next six months. The main reason, they said, was that patients had to go to an infusion center to obtain it. The same neurologists said they were also less likely to prescribe other antibody-based drugs.

Some neurologists said the way to resolve the infusion center problem was for doctors to build their own infusion capabilities. That would likely increase the use of all infused MS disease-modifying therapies, the report said.

In a related development, the launch of Mylan’s generic glatiramer acetate is roiling the MS therapy market. The two doses — 20 mg and the new 40 mg — have already taken about 15 percent of the combined sales of Teva’s Copaxone and Sandoz‘s Glatopa.

Sales of Glatopa, which is available only in 20 mg doses, have been most affected. Health insurers appear to prefer the generics because they’re cheaper, neurologists said.

One reason that Copaxone sales have held up better than Glatopa’s is that some neurologists said they were able to persuade health insurers or pharmacies not to switch to a generic.