ChangeWave Research: Cardiac Care – Trends and Treatments
ChangeWave Research Report:
Cardiac Care Trends and Treatments – 2006
Overview: During the week of December 7 – 12, 2005, we surveyed Alliance healthcare industry members on current and future trends in the cardiac care marketplace. A total of 177 healthcare members participated including 71 doctors who treat – or who work in a practice that treats – patients with heart disease and/or stroke.
Bottom Line: Doctors see “Blood Lipid Lowering Agents” as having experienced the largest increase in popularity among healthcare providers over the past year, followed by “ACE Inhibitors.” Looking out 1-2 years, doctors say “Artery/Vein/ Plaque Cleaning Drugs” is the treatment category most likely to result in successful therapies getting to market.
In terms of recently approved and Phase II/Phase III Heart Disease and Stroke drugs, Integrilin (Millennium) and TNKase (Genentech) showed some momentum among doctor respondents.
Among the plethora of heart diagnostic tests available, doctors recommended Blood Tests, Electrocardiograms and Echocardiograms most often in the past 12 months. Blood Tests are likely to remain the most popular Heart Disease diagnostic tool during 2006.
(A) Drug Therapies
· Most Popular Heart Drugs. Among drugs to treat heart attacks and stroke, doctors see “Blood Lipid Lowering Agents” (68%) as having experienced the largest increase in popularity among healthcare providers during 2005, followed by “ACE Inhibitors” (37%).
On the downside, “Antianginal Agents” and “Antiarrhythmic Agents” are seen as having experienced the largest decreases in popularity.
· Newly Emerging Drugs in Trial. We also asked respondents about the marketplace prospects of recently approved or Phase II/Phase III Heart Disease and Stroke drugs –and Integrilin (Millennium; Net Difference Score = +12) and TNKase (Genentech; +9) were the two drugs showing some momentum among doctor respondents.
· Successful New Drug Therapies – Next 1-2 years. “Artery/Vein/Plaque Cleaning Drugs” (46%) is the treatment category doctors believe is most likely to result in successful new drug therapies getting to market in the next 1-2 years.
· Good Cholesterol Boosting Drugs. Of the two drugs currently on the market that raise good cholesterol, Niaspan has been prescribed/recommended by 35% of doctors and Advidor by 13%. Moreover, a third of doctors (34%) think their practice will increase the number of prescriptions for Niacin-based good cholesterol boosting drugs in 2006. The number jumps to 71% if the side effect of “niacin flashes” can be eliminated.
· Torcetrapib + Lipitor. If it is shown to raise good cholesterol while lowering bad cholesterol, 82% of doctors say their practice would be likely to prescribe the combination of Torcetrapib and Lipitor instead of Lipitor alone.
· BiDil Prescriptions. Among our doctor respondents, a total of 21% say they are likely to prescribe or recommend BiDil to their African American patients with heart failure over the next 6 months.
(B) Diagnostic Testing
· Past 12 Months – Most Administered Heart Disease Tests. Doctors say Blood Tests (76%) and Electrocardiograms (76%) were the most administered and/or recommended diagnostic tests for heart disease at their practice over the past 12 months, followed by Echocardiograms (73%).
· Next 12 Months – Most Popular Diagnostic Tests. Blood Tests (Net Difference Score = +17) look to remain the most popular method for diagnosing Heart Disease over the next 12 months.
· Triage BNP Testing for Heart Failure. A total of 9% of doctors say their practice currently uses Triage BNP, and another 6% plan on adding it over the next 6 months.
· Biosite’s Test for Ischemic Stroke. A third of doctors (34%) say their practice would be likely to use Biosite’s new diagnostic test for ischemic stroke if it gets FDA approval, even if it’s not 100% accurate.
Summary of Key Findings
The ChangeWave Alliance is a group of 6,000 highly qualified business, technology, and medical professionals in leading companies of select industries—credentialed professionals who spend their everyday lives working on the frontline of technological change. ChangeWave surveys its Alliance members on a range of business and investment research and intelligence topics, collects feedback from them electronically, and converts the information into proprietary quantitative and qualitative reports.
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Table of Contents
Summary of Key Findings 2
The Findings 4
(A) Drug Therapies 4
(B) Diagnostic Testing 15
ChangeWave Research Methodology 19
About ChangeWave Research 20
I. The Findings
Introduction
During the week of December 7 – 12, 2005, we surveyed Alliance healthcare industry members on current and future trends in the cardiac care marketplace. A total of 177 healthcare members participated, including 71 doctors who treat – or who work in a practice that treats – patients with heart disease and/or stroke.
Doctors who treat – or who work in a practice that treats – patients with heart disease and/or stroke (n = 71)
Total Respondents (n = 177)
(A) Drug Therapies
(1A) Question Asked: Focusing on the healthcare community's use of drugs to treat heart attacks and heart disease, which of the following drug categories would you say has experienced the largest increase in popularity among healthcare providers over the past year? (Choose No More Than Two)
Doctors / TotalRespondents
Blood Lipid-Lowering Agents / 68% / 64%
ACE Inhibitors (Angiotensin Converting Enzyme) / 37% / 32%
Antithrombotic Agents / 23% / 19%
Good Cholesterol Boosting Drugs / 13% / 15%
Drugs Used to Treat Congestive Heart Failure / 11% / 10%
Antianginal Agents / 1% / 1%
Antiarrhythmic Agents / 1% / 3%
Don't Know / 6% / 7%
Other / 1% / 2%
(1B) Question Asked: And over the past year, which of the following drug categories would you say have experienced the largest decrease in popularity among health care providers? (Choose No More Than Two)
Doctors / TotalRespondents
Antianginal Agents / 25% / 21%
Antiarrhythmic Agents / 24% / 21%
Drugs Used to Treat Congestive Heart Failure / 11% / 12%
ACE Inhibitors (Angiotensin Converting Enzyme) / 8% / 8%
Antithrombotic Agents / 6% / 3%
Good Cholesterol Boosting Drugs / 6% / 6%
Blood Lipid-Lowering Agents / 1% / 5%
Don't Know / 34% / 37%
Other / 8% / 3%
Net Difference Score – Doctors Current Survey (December 2005)
Increase in Popularity / Doctors
Decrease in Popularity / Doctors
Net Difference
Score
Blood Lipid-Lowering Agents / 68% / 1% / +67
ACE Inhibitors (Angiotensin Converting Enzyme) / 37% / 8% / +29
Antithrombotic Agents / 23% / 6% / +17
Good Cholesterol Boosting Drugs / 13% / 6% / +7
Drugs Used to Treat Congestive Heart Failure / 11% / 11% / 0
Antiarrhythmic Agents / 1% / 24% / -23
Antianginal Agents / 1% / 25% / -24
Most Popular Heart Drugs. Among drugs to treat heart attacks and stroke, doctors see “Blood Lipid Lowering Agents” (68%) as having experienced the largest increase in popularity among healthcare providers during 2005, followed by “ACE Inhibitors” (37%).
On the downside, “Antianginal Agents” and “Antiarrhythmic Agents” are seen as having experienced the largest decreases in popularity.
*Note: The following questions were only asked of Doctors who treat – or who work in a practice that treats – patients with heart disease and/or stroke. (n = 71)
(2) Question Asked: Let's focus on some newly emerging drug therapies for heart disease and stroke that have recently been approved or are in Phase II / III trials. Which of the following heart disease and stroke drugs are you familiar with? (Check All That Apply)
DoctorsIntegrilin (Millennium) / 41%
TNKase (Genentech) / 35%
Aggastat (Guildford) / 25%
Activas (Genetech) / 15%
AGI-1067 (AtheroGenics) / 14%
AngioMax (The Medicines Company) / 14%
Prosugrel (Eli Lilly) / 11%
Ranexa (CV Therapeutics) / 10%
Cerovive (AstraZeneca) / 6%
Citicoline (Indevus Pharma) / 6%
Viprinex (Neurobiological Tech) / 3%
Cleactor (ZymoGenetics) / 0%
Don't Know / 37%
Other / 4%
(2A) Question Asked: Which of the following do you think have the best/least chance of succeeding in the marketplace? (Choose No More Than Three)
Net Difference Score – Doctors Current Survey (December 2005)
DoctorsBest
Chance / Doctors
Least
Chance / Doctors
Net
Difference
Score
Integrilin (Millennium) / 13% / 1% / +12
TNKase (Genentech) / 10% / 1% / +9
Activas (Genetech) / 7% / 0% / +7
Aggastat (Guildford) / 8% / 1% / +7
AGI-1067 (AtheroGenics) / 6% / 0% / +6
Cerovive (AstraZeneca) / 3% / 0% / +3
Ranexa (CV Therapeutics) / 3% / 1% / +2
AngioMax (The Medicines Company) / 4% / 3% / +1
Cleactor (ZymoGenetics) / 1% / 0% / +1
Prosugrel (Eli Lilly) / 1% / 0% / +1
Citicoline (Indevus Pharma) / 0% / 0% / 0
Viprinex (Neurobiological Tech) / 1% / 3% / -2
Newly Emerging Drugs in Trial. We also asked respondents about the marketplace prospects of recently approved or Phase II/Phase III Heart Disease and Stroke drugs –and Integrilin (Millennium; Net Difference Score = +12) and TNKase (Genentech; +9) were the two drugs showing some momentum among doctor respondents.
These next few questions were on drugs that may raise good cholesterol.
(3) Question Asked: There are two drugs currently on the market that raise good cholesterol – both of them variations on Niacin – called Niaspan and Advicor. Are you familiar with these drugs? (Check All That Apply)
DoctorsYes, and I/My Practice have prescribed or recommended Niaspan / 35%
Yes, and I/My Practice have prescribed or recommended Advicor / 13%
Yes, I/My Practice am familiar with but have not prescribed or recommended them / 46%
No / 14%
(3A) Question Asked: Over the next 12 months at your practice/work environment, do you think the number of prescriptions written for Niaspan and/or Advicor will increase, decrease, or remain the same compared to the previous 12 months?
Increase in Niaspan and/or Advicor Prescriptions / 34%
Decrease in Niaspan and/or Advicor Prescriptions / 0%
Remain the Same / 28%
Don't Know / 20%
Not Applicable / 11%
No Answer / 7%
(3B) Question Asked: One side effect of this class of drugs is niacin flashes. If this side effect could be eliminated, how do you think it would affect the number of prescriptions written at your practice/work environment for niacin-based, good cholesterol raising drugs?
DoctorsSignificant Increase in the number of prescriptions / 34%
Slight to Moderate Increase in the number of prescriptions / 37%
No Effect / 10%
Don't Know / 10%
Not Applicable / 8%
No Answer / 1%
Good Cholesterol Boosting Drugs. Of the two drugs currently on the market that raise good cholesterol, Niaspan has been prescribed/recommended by 35% of doctors and Advidor by 13%. Moreover, a third of doctors (34%) think their practice will increase the number of prescriptions for Niacin-based good cholesterol boosting drugs in 2006. The number jumps to 71% if the side effect of “niacin flashes” can be eliminated.
(4) Question Asked: Pfizer is currently testing torcetrapib, a drug that combined with Lipitor may be able to raise good cholesterol and lower bad cholesterol. Are you familiar with torcetrapib?
DoctorsYes / 38%
No / 61%
No Answer / 1%
(4A) Question Asked: If the combo drug proves to materially raise good cholesterol while providing the same cholesterol lowering qualities as Lipitor, how likely is it that you/your practice would prescribe it to patients instead of Lipitor?
Very Likely / 52%
Somewhat Likely / 30%
Unlikely / 1%
I/My Practice Do Not Prescribe Lipitor / 8%
Don't Know / 7%
No Answer / 1%
Torcetrapib + Lipitor. If it is shown to raise good cholesterol while lowering bad cholesterol, 82% of doctors say their practice would be likely to prescribe the combination of Torcetrapib and Lipitor instead of Lipitor alone.
(5) Question Asked: Looking ahead 1 to 2 years, which of the following drug treatment categories do you think are most likely to result in successful new drug therapies getting to market? (Choose No More Than Two)
DoctorsArtery/Vein/Plaque Cleaning Drugs / 46%
Combinational Drugs to Lower Cholesterol and Hypertension / 32%
Good Cholesterol Boosting Drugs / 30%
Anti-Clogging Drugs / 24%
Neurological Based Anti-Stroke Drugs / 23%
Cholesterol Lowering Drugs / 4%
ACE Inhibitors (Angiotensin Converting Enzyme) / 0%
None of the Above / 1%
Don't Know / 8%
Other / 0%
Successful New Drug Therapies – Next 1-2 years. “Artery/Vein/Plaque Cleaning Drugs” (46%) is the treatment category doctors believe is most likely to result in successful new drug therapies getting to market in the next 1-2 years.
(5A) Question Asked: Why?
(i) Artery/Vein/Plaque Cleaning Drugs (46%)
· Doctor HEN47474 writes, "If you can clear the arteries then you have cured the pathology of strokes and coronary disease.”
· Doctor ARN0176 writes, "Emphasis on preventing plaque rupture- healing plaques.”
· Doctor AME32029 writes, "Plaque cleaning drugs will lessen need for surgical intervention and reduce cost.”
· Doctor FSC4718 writes, "Newer medications to reduce cholesterol build-up.”
· Doctor TEI15756 writes, "They will fill a niche that is not addressed at this point.”
· Doctor LEO7024 writes, "There is an evolution of non-surgical therapy gathering steam and these therapies offer the best chance of patient acceptance.”
· Doctor MAX21846 writes, "Statins help prevent new plaque formation, but because existing plaque is calcified it is very difficult to remove which is why stents were developed to keep arteries open. Any drug that could really clean or remove any type of plaque (hard or soft) with or without statins would save many more lives. I recall that there is a drug under development that increases HDL (good) cholesterol and that early studies with statins were successful, but do not know if it improved plaque removal.”
· Doctor MIM3324 writes, "Artery cleaning drugs like agents to increase HDL would clean up arteries and reverse coronary disease rather than prevent progression.”
· Doctor MIN9289 writes, "These categories of drugs have the property of beneficially reducing the risk of a multitude of different disease entities, i.e. stroke, heart disease, vascularly-mediated kidney disease, diabetes, etc.”
· Doctor OCE43646 writes, "Recombinant Apolipoprotein A1 (Milano) has a lot of promise to cause regression of atherosclerotic plaques noninvasively. If proven effective in removing significant amounts of plaque, this would be a revolutionary tool in heart disease.”