GlobalData on Tuesday said that the Long-acting injectable (LAI) formulations of antipsychotics to treat patients diagnosed with schizophrenia remain under-utilised in the seven major markets (7MM) which include, the US, Japan, France, Germany, Italy, Spain and the UK due to the resistance surrounding the use of these products despite the benefits.
According to GlobalData, patients tend to continue oral antipsychotic treatment, and this leads to a lower than anticipated uptake of LAIs, which are injected every fortnight or in one-to-six-month intervals. According to experts, the discontinuation of or non-adherence to antipsychotic treatment is the most common cause of relapse in patients diagnosed with schizophrenia.
Recently, GlobalData conducted a study and it revealed that the prescription of daily oral aripiprazole, one of the most commonly used atypical antipsychotics, continues to dominate over the use of Otsuka and Lundbeck’s once-monthly LAI formulation Abilify Maintena and Alkermes’ Aristada, which can be administered every six weeks.
The analytics company claimed that this trend was particularly significant in Japan and Germany with 90.2 percent and 82.7 percent of patients using oral aripiprazole, respectively. However, there was significant variability across the 7MM with LAI aripiprazole usage in Spain and the UK reaching 45.4 percent and 47.5 percent, respectively. Overall, throughout the 7MM, the vast majority (70.2 percent) of patients receiving aripiprazole in 2021 were prescribed the oral formulation.
“Patients diagnosed with schizophrenia are typically offered continuous antipsychotic pharmacotherapy to prevent recurring episodes of psychosis. Those who have a history of good response to oral antipsychotics but have adhered poorly to the treatment regimen, resulting in relapse, are eligible to receive LAI therapy. These products provide an efficient method for monitoring treatment adherence, as they must be administered in a clinical setting, allowing for appointment attendance to be tracked. In fact, some key opinion leaders (KOLs) interviewed by GlobalData argued that LAIs should be prescribed even sooner, following first episode psychosis or during early-stage schizophrenia. These experts reasoned that the majority of patients could benefit from the improved adherence and relapse prevention offered by the LAIs. However, despite these benefits, these therapies remain underutilized,” Christie Wong, Pharma Analyst at GlobalData said in a statement on Tuesday.
According to GlobalData, there are many reasons for lingering resistance around the use of LAIs over oral antipsychotics, with individual preferences from both patients and psychiatrists.
“KOLs noted that in an outpatient setting, many psychiatrists are ill-equipped to administer these injectables. This was particularly evident in clinics and practices where they do not have a nurse on staff and the psychiatrist is uncomfortable giving routine injections. Unfortunately, this can cause a barrier to the widespread adoption of LAIs as a standard of care for patients with schizophrenia,” Wong added.
Over the past decade, the development of LAI antipsychotic treatments has been a popular research and development (R&D) strategy for pharma companies, the company claims. GlobalData also stated that with the anticipated patent expiry of Abilify Maintena in France, Germany, Italy, Spain and the UK and US in 2023 and 2024, respectively, Otsuka and Lundbeck look to launch their next-generation aripiprazole reformulation, a LAI dosed once every two months. The aripiprazole two-month LAI will launch in the US and 5EU in 2023, the company predicts.