Sales of drugs to treat Alzheimer’s disease are set to more than triple by 2023, reaching nearly $12 billion in seven major markets by that date, say new forecasts.

This fast growth will be largely the result of expected launches of the first disease-modifying therapies (DMTs), which will earn sales of $7 billion in 2023 combined in the US, UK, France, Germany, Italy, Spain and Japan, according to the research, from Decision Resources.

These novel, premium-priced agents include two anti-beta-amyloid monoclonal antibodies – Eli Lilly’s solanezumab and Roche’s gantenerumab – as well as Roche/Chugai/MorphoSys’ beta-secretase (BACE) inhibitor MK-8931.

However, the research also expects that the AD drugs in current use to stay relevant. It forecasts that the acetylcholinesterase inhibitors (AChEIs) will continue to capture over 70% total patient share across all AD subpopulations in 2023, and that the N-metyl-D-aspartate (NMDA) receptor antagonist products, including Forest’s Namenda/Namenda XR, are likely to continue capturing approximately 35% patient share.

While current treatments deliver only modest symptomatic efficacy and do not affect disease progression, they will remain the foundation of treatment during the forecast period, aided in part by growing generic availability, it says, 

Also, a new symptomatic alternative – Lundbeck/Otsuka’s novel 5HT-6 receptor antagonist Lu-AE58054 – will launch as an adjunctive symptomatic treatment for AD and achieve blockbuster sales within the forecast period, capturing nearly 10% of major-market sales in 2023.

“The projected launch of Eli Lilly’s solanezumab, potentially the first ever DMT approved for the treatment of AD, will be a transformative event affecting the AD market as early as 2018,” comments DR group analyst Alana Simorellis. 

“Commensurate with ongoing developing and the views of experts in the field, we expect that future DMTs will most like]y see the greatest uptake in the pre-AD and mild AD populations. Moreover, experts interviewed note that new symptomatic options are also sorely needed – Lundbeck/Otsuka’s Lu-AE58054 and potentially others could partially address this need, beginning in 2017,” she adds.

Dr Simorellis also points out that while AD drug development is focused on disease modification, there is also an important area of additional unmet need for safer and more effective symptomatic therapies that can control the behaviour disturbances associated with later-stage AD.

“Development in this area is underway, with clinical trials assessing promising agents like Lundbeck/Otsua’s brexpiprazole for AD-associated agitation,” she says.