The Alzheimer’s disease drug market in seven major markets (the USA, France, Germany, Italy, Spain, the UK and Japan) will nearly triple over the next ten years, from $5.4 billion in 2010 to $14.3 billion in 2020.

That is the latest market forecast from Decision Resources which claims that the launch of "novel agents that affect disease progression will transform the AD market, which is currently comprised solely of symptomatic therapies". In particular, the consultants claim that the key drivers of market growth will be the launches of anti-beta-amyloid monoclonal antibodies (MAbs), namely Eli Lilly's solanezumab and Johnson & Johnson/Pfizer's bapineuzumab.

The report says that as the first biological agents and the first potentially disease-modifying therapies, solanezumab and bapineuzumab "are expected to command significant price premiums over currently available agents". The AD market is presently dominated by symptomatic therapies such as acetylcholinesterase inhibitors - eg Eisai/Pfizer's Aricept (donepezil), Shire's Reminyl (galantamine) and Novartis' Exelon (rivastigmine) - and N-methyl-D-aspartate (NMDA) receptor antagonists, namely memantine, sold by Forest Laboratories, Lundbeck and Daiichi Sankyo.

However, DR argues that the latter treatments "have modest effects on the cognitive and functional decline characteristic of the indication but do not affect the underlying disease course". These drugs "will face increasingly stiff generic competition as they continue to lose patent protection across the major markets through 2015".

DR analyst Georgiana Kuhlmann says that “thought leaders are cautiously optimistic that the anti-beta-amyloid MAbswill be able to slow the rate of neurodegeneration and consequently cognitive and functional decline - however, they await evidence from ongoing late-stage clinical trials”. Assuming the MAbs are able to demonstrate such efficacy, "they will have the greatest clinical and commercial promise", she added, although we anticipate that initial uptake of these drugs will be tempered by safety concerns". Nevertheless, DR forecasts that in 2020 solanezumab and bapineuzumab will together earn $8 billion in the major markets.

Still, Ms Kuhlmann believes sales of symptomatic therapies will be largely maintained over the next decade "as these drugs remain central to the treatment of AD, including being used as adjunctive therapies with potentially disease-modifying drugs, coupled with increase in the number of drug-treated patients".