Using RWE to differentiate TYK2 inhibitors in a crowded psoriasis market

A leading pharmaceutical manufacturer sought Symphony Health, an ICON plc company’s consulting support to inform launch and promotional strategy for an oral allosteric TYK2 inhibitor entering the psoriasis (PsO) market. The brand team aimed to better understand market expansion potential, free drug program dynamics, treatment discontinuation, and prescribing behaviour—especially among non-physician prescribers such as nurse practitioners (NPs) and physician assistants (PAs). As the competitive landscape included both biologics and oral therapies like apremilast, insights from real-world evidence were critical to informing differentiated positioning and targeting strategies.

The client faced a fragmented understanding of how patients accessed therapy (including through free goods programs), what was driving treatment selection, and why patients discontinued treatment altogether. Additionally, there was limited visibility into the value and behaviour of NPs/PAs in the prescribing landscape—particularly around oral non-biologics. The brand also needed to understand how Apremilast expanded the market and whether similar opportunities existed for the TYK2 inhibitor. 

Key challenges included: 

• Lack of clarity around free drug program duration and patient profiles
• Uncertainty in treatment discontinuation triggers
• Need to characterise market growth segments, particularly topical-only patients
• Limited insight into NP/PA prescribing autonomy and volume
• Understanding of drivers behind treatment choice in the absence of clinical lab data and primary research

Symphony Health used its Integrated Dataverse (IDV®) to create a longitudinally linked PsO patient cohort across the prior 12-month period. Patients were mapped back to their prescribing healthcare professionals HCPs to establish patterns in product adoption and prescriber behaviour. The approach included: 

• Identifying PsO patients and their full treatment journey
• Segmentation of prescribers (NPIs) by behaviour: Total Rxs, NBRx, Early Adoption of TYK2s
• Analysis of access pathway, including use and duration of free drug programs
• Comparison of treatment discontinuers to active patients, including demographics, time on therapy, and access barriers
• Profiling of patients treated only with topicals prior to escalation
• Deep dive into NP/PA prescribing volume, treatment type, and alignment with dermatologist treatment behaviour 

The resulting insights illuminated payer, patient, and provider dynamics critical to informing targeted go-to-market planning

• Commercial payer segments offer the most promising opportunities, particularly among patients previously stabilised on topicals.
• No strong quantitative predictors of discontinuation emerged; qualitative follow-up (e.g., patient interviews or PROs) is recommended to understand drop-off rationale.
• NPs and PAs represent high-value targets; they are primary prescribers of topicals and are positioned to escalate treatment—especially in community dermatology settings.
• There is significant potential in targeting L1 (first-line) topical patients who may be ready to advance to oral systemic therapies.
• Apremilast’s success in growing the market came largely from engaging treatment-naïve or topically managed patients. A similar market expansion strategy could be deployed.
• A two-tier targeting strategy is recommended:
  • Primary Target: NP/PAs writing topicals and initiating oral therapies
  • Secondary Target: Dermatologists and rheumatologists flagged as early adopters

• Enabled precision targeting and optimised launch strategy by identifying high-value prescribers (NP/PAs, early adopter derms) and quantifying market expansion opportunities through topical-tosystemic patient transitions.
• Delivered actionable real-world insights on access dynamics, treatment discontinuation, and competitive positioning (e.g., Apremilast growth pathway), supporting differentiated value messaging and sustained market engagement.