Best Medications for Ulcerative Colitis: What are they and why?

best medications for ulcerative colitis

What are the best medications for ulcerative colitis? Looking at the research and listening to gastroenterologists may provide you a quick answer. But in reality, there are many factors that doctors consider when prescribing UC drugs.

Vivisum Partners completed an exhaustive analysis of the ulcerative colitis market and uncovered some interesting insights about how gastroenterologists make their prescription decisions. Below are some of the reasons that gastroenterologists use to rationalize their treatment decisions.

Assessing Clinical Attributes

Each ulcerative colitis drug has its plusses and minuses. Some drugs are more effective than others for a wider percentage of patients; others offer better safety profiles. There are a group of ulcerative colitis drugs that, while effective, may not be tolerated as well by certain patients. All of these factors go into the equation when gastroenterologists look to prescribe the best medications for ulcerative colitis.

Healthcare providers typically need to understand how an individual ulcerative colitis treatment performs relative to a set of clinical attributes. These attributes typically include:

  • Efficacy
  • Safety
  • Dosing
  • Tolerability
  • Access/Insurance coverage
  • Manufacturer support

The best medications for ulcerative colitis will rate highly across these six clinical attributes. It’s a no-brainer that a highly effective drug will grab HCPs’ attention. But if the drug has a poor safety profile, that could serious hamper it’s usage among ulcerative colitis patients. That’s why the combination of these attributes forms the rational basis for why a gastroenterologist is likely to prescribe, or not prescribe, a given ulcerative colitis drug.

For example, Vivisum’s research on the ulcerative colitis market found that, unsurprisingly, efficacy and safety ranked as the top two most important clinical attributes for any drug to be considered as an ideal treatment for ulcerative colitis. Among branded treatments, the two ulcerative colitis drugs that consistently rated highly for efficacy are Entyvio and Remicade. Similarly, the two UC drugs that ranked the highest for safety are Entyvio and Stelara. However, gastroenterologists also rated Remicade among the bottom two drugs for safety. Although Remicade offers high efficacy, it’s perception among gastroenterologists as less safe makes it less likely to be prescribed compared to other ulcerative colitis competitors.

Sometimes the Best Medication for Ulcerative Colitis is the One Patients Can Get

It’s hard for doctors to ignore access and insurance when deciding which medication to prescribe an ulcerative colitis patient. Many treatments that have been available for decades are well-covered by insurance companies. But they may not always work as well and may not be the best fit for a patient’s unique set of needs.

best medications for ulcerative colitis
Photo by Olya Kobruseva

Alternately, emerging biologics offer tremendous benefits, but they come at a high cost and insurance companies often need to see that patients have tried other treatments prior to approving and paying for a biologic.

Access plays a significant role in how gastroenterologists determine the best medication for ulcerative colitis. To continue the Remicade example from earlier, Vivisum found that HCPs’ perceptions of Remicade’s access put it among the top two UC drugs for insurance coverage. This makes sense given that Remicade has been available for decades. A gastroenterologist may determine that a patient needs to switch to a biologic but her insurance will not cover Entyvio, for instance. So Remicade becomes a much more viable option and the best choice for this patient. Although it may not have been the HCP’s first choice, Remicade will still provide high efficacy for the patient and the patient will not face a heavy financial burden for treatment.

Evaluating UC Drugs’ Strengths and Weaknesses

Each ulcerative colitis drug’s strengths and weaknesses will determine whether an HCP is likely to prescribe it to a given patient. If the patient needs a drug that’s more tolerable than its competitors, that will factor into the doctor’s decision. However, it still stands that the more effective and safer an ulcerative colitis drug is, the more likely a gastroenterologist is to prescribe it.  

Vivisum’s research found that Entyvio, who’s top two strengths are safety and efficacy, respectively, currently has the highest patient share among surveyed gastroenterologists. Entyvio’s other primary strength is tolerability, which also helps to keep patients satisfied while on the drug.

On the opposite end of the spectrum are ulcerative colitis drugs whose efficacy or safety are perceived as a significant weakness. Vivisum’s research found that 55% of surveyed gastroenterologists rated safety as Xeljanz biggest weakness. For this reason, Xeljanz patient share is much lower compared to other drugs profiled in the research.

So What is the Best Medication for Ulcerative Colitis?

As far as ideal treatments go, it really is patient dependent. The ideal solution for one ulcerative colitis patient may be intolerable for another. That said, based on the data collected by Vivisum for its Ulcerative Colitis Market Landscape research library, one drug emerged as consistently performing well among the six aforementioned clinical attributes: Entyvio

When asked to rate the top two most ideal ulcerative colitis drugs, 63% of surveyed gastroenterologists included Entyvio. Entyvio’s highly rated safety profile and its efficacy provide gastroenterologists with one of the best medications for ulcerative colitis. And less than one-third of surveyed HCPs rated Entyvio’s access as a weakness. For these reasons, it’s no surprise that Entyvio has grabbed the highest patient share among the eight profiled branded drugs in Vivisum’s analysis.

best medications for ulcerative colitis
Photo by Nataliya Vaitkevich
Elio Evangelista is a Senior Consultant at Vivisum Partners. His experience is based in in market research, benchmarking, marketing, and journalism. Email Elio at elio.evangelista@vivisumpartners.com