Although the use of cardiovascular disease treatments is likely to rise significantly over the next decade, the main beneficiaries will be generics firms, not their branded counterparts.

That is the stance taken by the latest report from Datamonitor whose analysts predicts that the CV market will grow from $99 billion in 2008 to $107 billion. It claims that growth in the developed world will be driven by “the increase in patient populations, early diagnosis and early initiation of drug therapy”.
However, big pharma will struggle to capitalise from this surge as the increase in usage “will be concentrated in the generic sector as budget control becomes the key driver in healthcare policy”. Anthony Nealon, report author and senior healthcare analyst at Datamonitor, says the CV market is one of the most mature ones “and the traditional drivers - hypertension and dyslipidaemia - will be heavily impacted by patent expiries and generic competition.”

The two largest drugs “in the entire pharma market”, Pfizer’s Lipitor (atorvastatin) and Sanofi-Aventis/Bristol-Myers Squibb’s Plavix (clopidogrel), are both due to lose patent protection in 2011, while generic competition is also likely to batter other CV blockbusters, such as Merck & Co’s Cozaar (losartan), Novartis’ Diovan (valsartan) and Takeda’s Actos (pioglitazone).

The report goes on to say that weak development pipelines in hypertension and dyslipidaemia will not be able to replace revenues. This is due to the fact, says Dr Nealon, that current drugs offer a wide range of therapy options and “there are no remaining significant clinical unmet needs to spur on development candidates”.

Despite the fall in the overall dyslipidaemia market, Datamonitor forecasts that, over the 2008-2018 period, AstraZeneca will continue to generate strong growth from Crestor (rosuvastatin). The report says the Anglo-Swedish drugmaker “has been highly successful in differentiating Crestor from other drugs”, adding that it has the strongest late-stage CV pipeline with Brilinta (ticagrelor) and Onglyza (saxagliptin), partnered with B-MS.

According to the report, Novo Nordisk is the only other CV company forecast to generate positive sales growth during the 2008-2018 period. “Insulin therapies offer a highly defendable position to generic entries”, claimed Dr Nealon, “due to the high degree of brand and company loyalty”. He concludes that this sets significant barriers to new entrants and Novo is positioned to benefit the most.