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1 Dysport - MB - November 2007. Dysport MB - in adult spasticity, secondary to stroke and juvenile cerebral palsy Kungsbacka in November 2007 SIFO Research.

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Presentation on theme: "1 Dysport - MB - November 2007. Dysport MB - in adult spasticity, secondary to stroke and juvenile cerebral palsy Kungsbacka in November 2007 SIFO Research."— Presentation transcript:

1 1 Dysport - MB - November 2007

2 Dysport MB - in adult spasticity, secondary to stroke and juvenile cerebral palsy Kungsbacka in November 2007 SIFO Research International Navigare

3 3 Dysport - MB - November 2007 Background and Objectives In Sweden, unlike the rest of Europe Botox is the market leader among Botulinum toxins with approx 90-95% market share. This market description study is conducted in order to evaluate the Swedish market of botulinum toxins and find the attitudes towards Botox vs Dysport. Other important issues are prescription habits, who takes the decisions regarding the choice of Btx and to find out what is required to switch Botox for Dysport. Method The interviews were carried out during October and November 2007 and were performed as pre- arranged telephone interviews with 24 specialists. The interviews took approximately minutes and were performed by medically trained interviewers. AS a member of ESOMAR (European Society for Opinion and Market Research) Navigare follows the ethical rules for marketing research. Among other things these rules mean that the respondents are guaranteed full anonymity.

4 4 Dysport - MB - November 2007 Patient Flow and Frequencies

5 5 Dysport - MB - November 2007 Source: QXa Base: All Drs

6 6 Dysport - MB - November 2007 Source: Q1a Base: All Drs

7 7 Dysport - MB - November 2007 Source: Q1aa Base: All Drs

8 8 Dysport - MB - November 2007 Source: Q1b Base: All Drs

9 9 Dysport - MB - November 2007 Source: Q2 Base: All Drs

10 10 Dysport - MB - November 2007 Source: Q3a Base: All Drs Choice of Treatment - Initiation Initiation of Adult Spasticity and Juvenile Cerebral Palsy - Share of Patients Treated with Botulinum Toxins none don't know adult spasticity (n=18) juvenile cerebral palsy (n=9) % Drs adult spasticity (n=18) juvenile cerebral palsy (n=9) mean 51,756,9 median 50,0 min 0,033,0 max 100,0

11 11 Dysport - MB - November 2007 Initiation of Adult Spasticity and Juvenile Cerebral Palsy - Treatment Alternatives to Botulinum Toxins physiotherapybaclofendiazepamgabapentinsurgeryother adult spasticity (n=18) juvenile cerebral palsy (n=9) % Drs Source: Q3b+4b Base: All Drs

12 12 Dysport - MB - November 2007 Source: Q3c+4c Base: All Drs

13 13 Dysport - MB - November 2007 Source: Q3c+4c Base: All Drs

14 14 Dysport - MB - November 2007 Source: Q3d+4d Base: All Drs

15 15 Dysport - MB - November 2007 Source: Q3d Base: All Drs

16 16 Dysport - MB - November 2007 Source: Q4d Base: All Drs

17 17 Dysport - MB - November 2007 Source: Q5 Base: All Drs

18 18 Dysport - MB - November 2007 Source: Q5 Base: All Drs

19 19 Dysport - MB - November 2007 Source: Q5 Base: All Drs

20 20 Dysport - MB - November 2007 Source: Q6a Base: All Drs

21 21 Dysport - MB - November 2007 Source: Q6a Base: All Drs

22 22 Dysport - MB - November 2007 Source: Q6b Base: All Drs

23 23 Dysport - MB - November 2007 Source: Q6b Base: All Drs

24 24 Dysport - MB - November 2007 Source: Q6b Base: All Drs

25 25 Dysport - MB - November 2007 Source: Q7a Base: Adult spasticity Adult Spasticity

26 26 Dysport - MB - November 2007 Source: Q7b Base: Adult spasticity

27 27 Dysport - MB - November 2007 Source: Q8 Base: All Drs

28 28 Dysport - MB - November 2007 Source: Q9a Base: All Drs Switch Treatment

29 29 Dysport - MB - November 2007 Source: Q9bBase: Drs who switched treatment adult spasticity (n=9) juvenile cerebral palsy (n=3) mean 4,613,3 median 0,010,0 min 0,0 max 30,0 * Note low number of respondents * *

30 30 Dysport - MB - November 2007 Source: Q9c+d+eBase: Drs who switched treatment

31 31 Dysport - MB - November 2007 Source: Q9f Base: All Drs

32 32 Dysport - MB - November 2007 Source: Q9g+hBase: Drs who switched treatment

33 33 Dysport - MB - November 2007 Source: Q10a Base: All Drs

34 34 Dysport - MB - November 2007 Source: Q11 Base: All Drs Opinion About Botulinum Toxins

35 35 Dysport - MB - November 2007 Source: Q12a Base: All Drs

36 36 Dysport - MB - November 2007 Source: Q12a Base: All Drs

37 37 Dysport - MB - November 2007 Source: Q12a Base: All Drs

38 38 Dysport - MB - November 2007 Source: Q12b Base: All Drs

39 39 Dysport - MB - November 2007 Source: Q13a Base: All Drs

40 40 Dysport - MB - November 2007 Source: Q13b Base: All Drs

41 41 Dysport - MB - November 2007 Source: Q13b Base: All Drs

42 42 Dysport - MB - November 2007 Source: Q13b Base: All Drs

43 43 Dysport - MB - November 2007 Source: Q14a Base: All Drs

44 44 Dysport - MB - November 2007 Source: Q14a Base: All Drs

45 45 Dysport - MB - November 2007 Source: Q14a Base: All Drs

46 46 Dysport - MB - November 2007 Source: Q15a Base: All Drs

47 47 Dysport - MB - November 2007 Source: Q15a Base: All Drs

48 48 Dysport - MB - November 2007 Source: Q15a Base: All Drs

49 49 Dysport - MB - November 2007 Source: Q15b Base: All Drs

50 50 Dysport - MB - November 2007 Source: Q15b Base: All Drs

51 51 Dysport - MB - November 2007 Source: Q15b Base: All Drs

52 52 Dysport - MB - November 2007 Source: Q16a Base: All Drs adult spasticity (n=18) juvenile cerebral palsy (n=9) mean 3,13,3 median 3,0 min 1,0 max 5,0

53 53 Dysport - MB - November 2007 Source: Q16b Base: All Drs

54 54 Dysport - MB - November 2007 Source: Q16b Base: All Drs

55 55 Dysport - MB - November 2007 Source: Q17a Base: All Drs

56 56 Dysport - MB - November 2007 Source: Q17b Base: Drs who prescribe “off-label”

57 57 Dysport - MB - November 2007 Source: Q18a+c Base: All Drs

58 58 Dysport - MB - November 2007 Source: Q18b Base: All Drs

59 59 Dysport - MB - November 2007 Source: Q18d Base: All Drs

60 60 Dysport - MB - November 2007 Source: Q19a Base: All Drs Company

61 61 Dysport - MB - November 2007 Source: Q19b Base: All Drs

62 62 Dysport - MB - November 2007 Source: Q19c Base: All Drs

63 63 Dysport - MB - November 2007 Source: Q19c Base: All Drs

64 64 Dysport - MB - November 2007 Source: Q19c Base: All Drs

65 65 Dysport - MB - November 2007 Source: Q19c Base: All Drs

66 66 Dysport - MB - November 2007 Source: Q19c Base: All Drs

67 67 Dysport - MB - November 2007 Source: Q19c Base: All Drs

68 68 Dysport - MB - November 2007 Source: Q19d Base: All Drs

69 69 Dysport - MB - November 2007 Source: Q19d Base: All Drs

70 70 Dysport - MB - November 2007 Source: Q19d Base: All Drs

71 71 Dysport - MB - November 2007 Source: Q19d Base: All Drs

72 72 Dysport - MB - November 2007 Source: Q19d Base: All Drs

73 73 Dysport - MB - November 2007 Source: Q19d Base: All Drs

74 74 Dysport - MB - November 2007 Patient flows and frequencies  1 Specialist involved in the care of patients with adult spasticity (AS) are, median figure, responsible for 40 patients and specialist in care of pats with juvenile cerebral palsy (JCP) are in care of 60 patients. Total amount of pats on Btx are for AS-drs 50 and 150 for JCP-drs. Drs in care of AS have 8 new patients per month and drs in care of pats with JCP have 2 new pats. Drs in care of JCP pats named possible Btx treatment for 90% of their patients and AS drs named possible treatment for 30% of their patients (median figures). (p 5-9) Choice of treatment – Initiation  2 Share of patients initiated with Btx is 50% for both specialist groups (median figure). (p 10)  3 A great majority, approx 90% of AS- and JCP- drs mention that in initiation treatment they use physiotherapy. 67% of AS-drs named that they use baclofen and specialists in care of JCP-pats use baclofen to 44% of their patients. (n=11)  4 When asked for allocation of treatment approx 100 % of both patient groups are treated with physiotherapy. (p 12)  5 Drs initiate with Btx mainly to increase patients’ function and when insufficient efficacy of physiotherapy/baclofen. 22% of JCP drs use Btx as soon as possible. (p 14) Summary

75 75 Dysport - MB - November 2007 Choice of treatment – Initiation  6 Four out of nine drs in care of JCP patients mentioned insufficient efficacy as the main reason for patients not receiving treatment with Btx. Drs in care of AS- patients named limited personnel resources and price. Note that 5 AS-drs and 3 JCP-drs named that all pats receive treatment with Btx. (p17)  7 98 % of new AS patients and 96% of JCP patients receive Botox. Only 2% of new AS-patients and 4% JCP patients receive Dysport. (p 20)  8 Main reason for choosing Botox more often than Dysport is experience/tradition/habit, mentioned by 67% of AS-drs and 78% of JCP drs. Adult spasticity secondary to stroke  9 In median figure, patients with adult spasticity receive treatment with Btx after one year. The median age of that patient is 59 years. (p 25-26) Present treatment with Botulinum toxins  10 A great majority of patients with AS and JCP are treated with Botox 96% vs 93%. 4% of AS-pats and 7% of JCP are treated with Dysport. Xiomin is also named. (p 27) Summary

76 76 Dysport - MB - November 2007 Switch treatment  11 Half of the drs in care of AS patients mentioned that they have switched treatment from one Btx to another Btx. 1/3 of drs in care of AS patients have switch treatment, (p 28). In average 5 AS patients are switched from one Btx to another while drs in care of JCP pats mentioned 13 pats. Dysport is mainly switched in. (p 29)  12 When drs have switched from Btx, in this case Botox, to other treatment it has mainly been due to insufficient efficacy. Mainly switched in treatments are baclofen, surgery and physyotherapy. (p 31-32)  13. People who influence the choice of Btx are primarily drs but also physiotherapists in a lower extent. (p 33) Opinion of Botulinum toxins  14. A majority of the drs do not have any opinion or seem that the products are equal. 17% of AS drs and 22% of JCP drs perceive Botox as more effective. 1 AS dr perceive Dysport as more effective. (p 34)  15. The main perceived advantages of Botox are experience, administration and the company’s education/service. The main advantage of Dysport is price. Note that half of the drs mentioned that they do not know Dysport’s advantage. (p 35-38) Summary

77 77 Dysport - MB - November 2007 Switch treatment  16. Price is named as the main disadvantage with Botox compared to Dysport, mentioned by 50% of AS drs and 44% of drs in care of JCP patients. Half of the AS drs named administration as Dysport’s main disadvantage followed by lack of experience and diffusion. 44% of the drs in care of JCP patients mentioned lack of exp and 33% administration. (p 39-42)  17. AS drs: Patients mainly treated with Botox are those with spasticity (sec to stroke), dystonia and MS patients. JCP drs mentioned patients with JCP, children with spasticity and pats with moving toes. (p 43-45) Dysport  18. Both groups of drs mentioned price and insufficient efficacy as possible reasons to switch from Botox to Dysport. Information is also named by JCP drs. (p 46-48)  19. Considerable differences in drs’ answers about dosage proportion. (p 49)  20 Median figure 3 for importance evaluation about Dysport’s lower price, 28 % of AS drs vs 44% of JCP say that it is very important (p 52)  21 Doctors do not see ay reason for prescribe or increase prescription of Dysport. (p 57) Information and education are the factors demanded to influence prescription of Dysport. (p 58) Summary

78 78 Dysport - MB - November 2007 Retain  Low Price Aim to  Leverage of Dysport efficacy (product group /Dysport is the best)  Leverage of Education, support and service  Leverage of pedagogical dosage schedule  Increase awareness of low risk for diffussion and antibody formation  Increase knowledge about Dysport – reps  Increase of emotional dimensions  Work with physiotherapists and clinical chiefs/buyers. Payers? Key Findings Positioning ? Messages  Dysport effective Btx mild side effects easy administration?

79 79 Dysport - MB - November 2007


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