Immunology

Specialty therapy area with an expanded access to a variety of biologics which is constrained in lower-income population:

Disparity in Access : Immunology has seen expanded access to a variety of biologics and small molecules, but as a specialty therapy, access is often constrained to broader population. Biologics have been key therapies in this therapy area covering all lines of treatments offering multiple alternatives. In addition to the leading therapies, which treat a range of arthritis, gastrointestinal and dermatological autoimmune conditions, there are many new therapies that continue to bring new treatment options to patients and become more widely adopted. However, there is huge variation in use of biologics across the globe related to differences in reimbursement, medical practice and epidemiology, and this may further increase after products lose exclusivity and biosimilars become available. This gap further widens when it comes to low-income countries and emerging markets where most of the treatments are out-of-pocket and majority of patients are not able to afford these expensive therapies with limited access even after patent expiry.

Relevance for Broader Markets : Immunology diseases are very prevalent across the world including emerging markets but most of the patients are dependent on conventional immuno-suppressants and steroids for treatments with limited options for moderate to severe patients which lead to huge disparity. Biologics, powerful immunosuppressants, weaken patients' immune defences, increasing susceptibility to infections and reactivation of multi-drug resistant infections like tuberculosis. This risk is particularly high in developing tropical countries where such infections are prevalent.

Better Small Molecule Therapies : Small molecule therapies have not been major focus of innovation due to success story in biologics. So, we focus on these alternatives due to faster development cycle, less complicated manufacturing, oral route without hospitalization needs and better safety profile requiring lesser monitoring which is not feasible in low-income countries due to high volume of patients and inferior healthcare infrastructure.