JAK inhibitors to make up 80% of US alopecia areata pharmaceutical treatment sales by 2028 despite being 35 times more expensive than alternatives, says GlobalData

Janus kinase (JAK) inhibitors could make up more than 80% of the US alopecia areata (AA) pharmaceutical treatment sales by 2028 even though they are 35 times more expensive than alternative therapy types, says GlobalData, a leading data and analytics company.

Patrick Aiyes, Pharmaceutical Analyst at GlobalData, commented, “JAK inhibitors have unrivalled efficacy compared to other medications in the treatment paradigm for AA, with case studies showing promising results. GlobalData forecasts that the first approved JAK-inhibitor therapy for AA will likely be available in 2022.’’

However, the annual cost of therapy (ACOT) in the US will be approximately $50,000. This is substantially more than the $1,400 annual price tag of immunosuppressant cyclosporine, which is one of the more expensive therapies for AA.

In addition, JAK inhibitors are a chronic therapy, so patients may experience a relapse once treatment is stopped. As JAKs do not provide a cure for the disease, patients could instead opt for a scalp prosthesis as a cheaper and safer alternative.

Aiyes continued, “Although some key opinion leaders have been critical of the cost of therapy and related side-effects of JAK inhibitors, most have suggested that an efficacious oral therapy would change the treatment landscape for patients with severe AA.”

The efficacy of JAK inhibitors has been demonstrated in Phase III clinical trials. In one open-label study, 66 patients were administered 5mg of Xeljanz twice per day. Hair regrowth was assessed using the Severity of Alopecia Tool (SALT). Of the treated subjects, 32% had a reduction of more than 50% in the SALT score after three months.
Upcoming Phase III trials of drugs such as Eli Lilly’s Olumiant and Pfizer’s PF-06651600 will further support the use of JAK inhibitors in patients with severe AA.

Aiyes adds: “JAK inhibitors are the most advanced therapies in the pipeline for the treatment of AA patients. JAK signal transducers and activators of transcription (STAT) pathway play a significant part in the pathophysiology of AA because it controls the CD8 and NKG2D T-cell, which are both key components in AA.”

Through the inhibition of the JAK-STAT pathway, it is possible to suppress the inflammatory response and these targets.

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