The neuromyelitis optica spectrum disorder (NMOSD) therapeutics market is highly genericized, with corticosteroids and immunosuppressants currently accounting for the highest portion of prescribed drugs in China. However, the introduction of more innovative and effective classes of therapies is expected to drive increasing sales through 2030 at a compound annual growth rate (CAGR) of 20.9%, according to GlobalData, a leading data and analytics company.

GlobalData’s latest report, ‘Neuromyelitis Optica Spectrum Disorder: Opportunity Assessment and Forecast to 2030’, details that this growth will be driven by the expanding use of monoclonal antibodies (mAbs) and other biologics as preventative therapies, as well as the rising adoption of biosimilars.

Sarah Elsayed, Neurology Analyst at GlobalData, comments: “The anticipated shift towards the use of novel biologics is a result of the emerging clinical evidence of their efficacy in reducing NMOSD attacks coupled with the recent drug pricing reforms carried out by China’s National Medical Products Administration that aim to increase reimbursement of innovative biologic drugs.

“As most therapies used in the current NMOSD treatment algorithm are off-label, lack of indication-specific approval means that the Chinese government’s basic medical insurance (BMI) can refuse to reimburse most therapies, which is a strong limitation for physicians’ use. While a few novel mAbs are currently available for off-label use in some urban hospitals in China, their use is limited to severe cases and/or out-of-pocket payments due to their premium prices and lack of reimbursement by the BMI.”

Roche’s Enspryng is currently the only approved mAb in China for use in Anti-AQP4+ NMOSD, but its initial uptake and hospital availability are still relatively low due to continued lack of coverage.

Ms Elsayed adds: “If Roche reached a deal with the Chinese government and won inclusion of Enspryng in the National Reimbursement Drug List (NRDL), this would strongly boost the drug’s uptake over the next few years. Notably, recent reforms to China’s NRDL and revised pricing agreements with foreign pharma companies have impacted the prices of biologic therapies in several other indications such as breast cancer and Hodgkin’s lymphoma, which has led KOLs to expect that the NMOSD market could follow a similar path in the near future.”

GlobalData anticipates that the launch of biosimilars and continued pricing negotiations by multinational companies to win inclusion in the NRDL could lead to further cost reductions, and therefore these effective treatments could become more accessible to patients.

Ms Elsayed continues: “A few domestic biosimilars are expected to launch in the middle of the forecast period for Soliris (eculizumab), reaching sales of approximately $182m by 2030. The majority of biosimilars in China are developed by local companies meaning that they will likely be more affordable and accessible for patients.”

GlobalData forecasts the entry of three novel biologic therapies from the late-stage NMOSD pipeline through 2030. In order of entry, these products will be Mitsubishi Tanabe’s Uplizna (inebilizumab), RemeGen’s telitacicept, and Alexion’s Ultomiris (ravulizumab). The projected launch of these pipeline agents is expected to coincide with the escalating use of novel mAbs and biosimilars for NMOSD patients in China, which will drive market growth further, reaching estimated total sales of $773m in 2030.