The emergence of new agents with the potential to affect disease progression will drive fast growth in sales of Alzheimer’s disease (AD) treatments, which are set to more than triple from a value of $4.3 billion in 2009 to $13.3 billion in 2019 overall in seven major markets, says a new study.

This fast growth - in France, Germany, Italy, Japan, Spain, the UK and the US - will be driven primarily by Eli Lilly’s solanezumab and Johnson & Johnson/Pfizer’s bapineuzumab, the first biologic agents to enter the market, according to the report from Decision Resources. These two anti-beta-amyloid monoclonal antibodies (MAbs), which are currently in Phase II development in the US for the treatment of mild to moderate AD, have the potential to slow the rate of neurodegeneration and cognitive decline, and will together earn more than $6.9 billion in the world’s major pharmaceutical markets in 2019, the report forecasts.

Currently, the market for AD therapies is dominated by the acetylcholinesterase inhibitors (AChEIs), which treat only cognitive symptoms without modifying the course of the disease. Experts interviewed for the report indicate that the anti-beta-amyloid MAbs have the most clinical and commercial promise in AD, it says, but adds that continued use of symptomatic agents such as the AChEI donepezil (Eisai/Pfizer’s Aricept, Bracco’s Memac) will help to maintain the AChEI drug class over the next decade.  

“Despite increased generic competition and the launch of more expensive and potentially more efficacious therapies, AChEI sales will be buoyed through 2019,” forecasts Decision Resources director Bethany Kiernan, Bethany Kiernan. “This will be largely due to an overall market expansion driven by increases in the number of drug-treated patients but also, to a lesser extent, by the launch of new formulations of branded AChEIs,” she says.

The World Health Organization (WHO) estimates that 37 million people worldwide are currently living with dementia, with AD causing the majority of cases. The rate of occurrence of AD doubles every five years for people aged between 65 and 85, but if onset were delayed by five years, the number of cases worldwide would be halved, it adds.

Last week, researchers at Oxford University in the UK published study findings which showed that daily tablets of B vitamins can halve the rate of brain atrophy in elderly people who suffer from Mild Cognitive Impairment (MCI). Around half of people with MCI develop dementia, mainly AD, within five years of diagnosis.

“It is our hope that this simple and safe treatment will delay the development of Alzheimer’s disease in many people who suffer from mild memory problems,” said the trial’s co-leader, Professor David Smith.  “Today there are about 1.5 million elderly in UK, five million in USA and 14 million in Europe with such memory problems,” he added.

The results of the trial – called VITACOG – were published on September 8 in the journal PLoS ONE.