Almost 50% of the glaucoma patient population in the US remains untreated, which signifies a vast market for medicines to treat the disease, according to new forecasts.

Glaucoma is the second leading cause of blindness in the US, and this presents makers of drugs to treat the disease with a significant opportunity to fulfill unmet medical needs, says the report, from Frost & Sullivan. As glaucoma is an adult disease, the patient pool will expand as the population ages, it notes, and forecasts that market revenues will grow from a value of around $2.19 billion in 2010 to some $2.25 billion in 2016.

Given that almost 50% of the US glaucoma patient population is currently underdiagnosed and underserved with available pharmacotherapy options, products which offer effective treatment, improved drug delivery and higher disease awareness through patient education will be "immensely successful," says the study. 

Moreover, it adds that patients suffering from glaucoma, whether they are aware of the disease or not, need better therapies than the numerous pharmacotherapy options which are currently available.

"The underserved population of patients is not achieving therapy goals and demonstrates poor patient compliance with daily eye drops," comments Debbie Toscano, an industry analyst at Frost & Sullivan. 

"There is considerable need for more effective therapies that go beyond targeting intraocular pressure to preserve option nerve function, as well as for innovations in delivery to improve patient compliance and clinical outcomes," she adds.

Currently, the availability of a number of generic medications, including a generic version of Pfizer's gold-standard prostaglandin analog (PA) Xalatan (latanoprost), may be reducing the attractiveness of this market to potential participants, the report suggests. As glaucoma requires lifelong therapy, there is a huge demand for low-cost therapeutic options, and this slows down innovation in the market. In addition, increasing economic pressures are expected to compel payers and prescribers to encourage the use of generics.

However, the study also sees a substantial need for innovation in drug delivery and alternatives to daily eye drops. For example, many patients - and particularly the elderly - have difficulty in self-administering eye drops. These products also involve other challenges such as high frequency of administration, wastage of drops and inability to last for the duration of prescription, leading to non-compliance and undertreatment.

Innovative pharmaceutical and biotechnology companies seeking to tap into this market have to offer improved therapies which exhibit novel mechanisms and/or deliver methods, the report advises. Novelty in mechanisms that address the underlying causes of glaucoma and provide additional clinical benefit such as neuroprotection is vital to improve patient outcomes and prevent blindness, it adds.

"The heterogeneous nature of the pathophysiology of glaucoma and the variable patient response to therapy drive the need for multiple effective therapeutic choices," comments Ms Toscano. "Currently, PAs dominate the market with 59.8% of the total share, due to their superior efficacy, tolerability and convenience profiles. The introduction of this class to the market has significantly raised the bar for new entrants," she adds.