Diagnosed prevalent cases of atherothrombotic disease are set to increase steadily, driving the market to increase from $36 billion in 2012 to $47 billion in 2022, according to new forecasts.
The market - which incorporates pharmacotherapies for the treatment of coronary heart disease, peripheral arterial disease and ischaemic stroke and transient ischaemic attack - will see the introduction of numerous add-on therapies over the forecast period. In addition, the launch of a number of premium-priced therapies will offset the generic erosion of key brands and drive significant market growth during the second half of period, from 2017 to 2022, according to the report, from Decision Resources.
The much-anticipated arrival of two antidyslipidemic drug classes - the cholesteryl ester transfer protein (CETP) inhibitors and the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors - is expected to begin in 2017, with the launch of Eli Lilly’s CETP inhibitor evacetrapib. With morbidity and mortality data available at launch, the report is expecting rapid uptake of these agents as add-on therapies, particularly in high-risk patients, which will contribute significantly to market growth during 2017-22.
“Interviewed thought leaders are very excited about the potential of the emerging PCSK9 inhibitor class,” comments Decision Resources senior director Conor Walsh. “The clinical profile from Phase II data has been promising, combining strong reductions in LDL-C [low-density lipoprotein] on top of statin therapy with an apparently good safety and tolerability profile. Although their injectable status and anticipated high price will limit widespread use, we believe blockbuster status is achievable,” adds Dr Walsh.
Despite the reductions in risk resulting from improved public health measures and primary prophylaxis, the number of diagnosed prevalent cases of atherothrombotic disease is set to rise steadily during the forecast period, driven by improvements in post-acute coronary syndrome and post-stroke survival, plus a greater proportion of cases being diagnosed and aging populations, says the study. Along with the launch of high-priced add-on therapies, this will boost market value.
The report also finds that the overall value of the antithrombotic agent market segment will benefit from the expansion of current, premium-priced oral agents, such as Astra/Zeneca’s Brilinta/Brilique (ticagrelor) and Bayer/Janssen’s Xarelto (rivaroxiban), into new indications, further eroding the dominance of Bristol-Myers Squibb/Sanofi’s Plavix/Iscover (clopidogrel) and its generic versions. Further support will come from the launch of Merck’s vorapaxar for the treatment of post-myocardial infarction patients, it adds.