Published Research: How Johnson & Johnson Innovative Medicine Used Patient-centric Intelligence in Japan to Understand Care Advancements for Pulmonary Arterial Hypertension

A recent study by Johnson & Johnson Innovative Medicine Asia Pacific, in collaboration with Prospection, utilised patient-centric intelligence (PCI) in Japan to evaluate the persistence of endothelin receptor antagonists in pulmonary arterial hypertension (PAH) treatment.

In pulmonary arterial hypertension (PAH) treatment, understanding of the comparative effectiveness of endothelin receptor antagonists (ERAs; macitentan, bosentan, ambrisentan) has often been limited in Asian countries. This is why Johnson & Johnson Innovative Medicine (J&J, formerly Janssen) Asia Pacific conducted a study to evaluate the persistence of these ERAs before and after macitentan approval in Japan (2015).

In collaboration with Prospection, J&J’s team leveraged patient-centric intelligence in Japan to understand treatment compliance and persistence for macitentan. The results of this study—conducted by Omura et al.—were recently published in Pulmonary Therapy, “Comparative Treatment Persistence and Adherence to Endothelin Receptor Antagonists Among Patients with Pulmonary Arterial Hypertension in Japan: A Real-world Administrative Claims Database Study.

The full, downloadable paper is available via open access on Springer Link. Here is a recap of the paper’s abstract:


We used real-world data from the Japanese Medical Data Vision administrative claims database between April 2008 and November 2020. Patients with PAH were identified from the dataset. Persistence to ERA treatment before and after approval of macitentan in Japan was defined as the time between start of the index ERA and treatment discontinuation or death. Propensity score adjustment was applied to minimize confounding effects among treatment groups.


In the pre-macitentan approval cohort, 153 and 51 patients received bosentan and ambrisentan, respectively. In the post macitentan approval cohort, 331, 284, and 91 patients received macitentan, bosentan, and ambrisentan, respectively. Unadjusted median  persistence for ambrisentan- and bosentan treated patients was 19 and 10 months, respectively (adjusted HR 0.87 [95% CI 0.61–1.24]; P = 0.434 [bosentan as reference]). In the post macitentan approval cohort, unadjusted median persistence was 18 months for macitentan-treated patients versus 6 and 8 months for ambrisentan- and bosentan-treated patients, respectively. Adjusted HRs for ambrisentan and bosentan were 1.48 (95% CI 1.12–1.95; P = 0.006) and 1.63 (95% CI 1.30–2.04; P < 0.001 [macitentan as reference]), respectively.


Real-world data for Japanese patients with PAH showed that persistence was significantly higher for macitentan, versus ambrisentan and bosentan, since its approval.

Care and Commercial Implications: How Brand Leaders Can Leverage Real-world Evidence (RWE)

This type of study, rooted in rich patient-level Japanese data, highlights significant patient care and commercial implications. Some of the ways we see our life sciences customers leverage this type of RWE research, include:

  • Shaping Treatment Strategies: Evidence supporting longer persistence in real-world scenarios can position a drug as a promising choice for treatment. An insight like this can be used by brand teams to refine marketing strategies, emphasizing the drug’s efficacy and improved patient adherence.
  • Market Access Optimization: Understanding the real-world effectiveness of a drug opens doors for optimizing market access strategies. Prospection’s expertise in patient data analytics allows for a comprehensive evaluation of the market landscape, helping pharmaceutical companies quantify unmet need pre-launch, to find patient cohorts for indication expansion opportunities or better acceptance of in-market medicines.
  • Product Positioning and Differentiation: The ability to position products effectively in a competitive market is crucial. Prospection’s data-driven insights provide a solid foundation for differentiating a treatment; for example, emphasizing a superior tolerability profile and extended persistence. This can be a key differentiator.
  • Collaboration Opportunities: Pharmaceutical companies can enhance collaboration with hospitals and healthcare providers, especially those identified as expert centers, through Prospection’s patient-centric intelligence. By using RWE to help guide treatment decisions, providers can ensure that their clinical practices align with the latest research, fostering a patient-centric approach and enhancing their reputation in the field.
  • Patient Outcomes and Long-term Success: Often a conclusion of RWE studies is that additional research is needed to see the impact on improving long-term outcomes in the real-world setting. Prospection’s continuous monitoring and analysis of longitudinal patient data and outcomes can contribute to ongoing research, providing pharmaceutical companies and healthcare providers with RWE on the long-term success and tolerability of treatments.

Prospection stands at the forefront of transforming scientific insights into actionable commercial strategies. Our expertise in patient-centric intelligence, coupled with a collaborative customer approach, allows us to assist healthcare providers and pharmaceutical companies to uplift patient care and market share. 

The implications of RWE studies like this one extend beyond clinical findings, presenting a range of opportunities for commercial success and improved patient outcomes. By partnering with Prospection, pharmaceutical companies can navigate an evolving treatment landscape, ensuring that their strategies align with the demonstrated real-world effectiveness of medicines.


Prospection has been providing solutions and services to pharma analytics and commercial teams for more than 10 years. Its proprietary Patient-centric Intelligence Core transforms RWD into intelligence, and powers a range of solutions including the flagship brand management platform, Prospection AI. 

Contact us to learn how patient-centric intelligence can become core to your business.

Related Resources