Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that despite generic erosion of many branded agents -- most notably Novartis's Diovan -- the hypertension drug market will experience only modest decline over the next decade. Through 2013, the market will decrease by 1.4 percent annually and thereafter the annual decline will slow to 1 percent through 2018 in the United States, France, Germany, Italy, Spain, the United Kingdom and Japan.
The new Pharmacor report entitled Hypertension finds that the major contributor to market decline will be the increasing generic availability of antihypertensive agents. By 2018, Diovan alone will lose more than $1 billion in sales, owing to generic erosion of the agent which will begin in 2010 in the U.S., in 2011 in Europe and in 2013 in Japan. Additionally, agents from drug classes that are typically used in first-, second-, and third-line therapy -- such as angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor antagonists (AIIRAs), calcium-channel blockers (CCBs), and diuretics -- will all be subject to generic competition.
The report also finds that near-term opportunity in the hypertension market -- which is saturated with effective, well-established treatments -- lies in the development of therapies that offer greater convenience. Fixed-dose combinations such as CCB/renin-angiotensin-aldosterone system (RAAS) inhibitors and CCB/RAAS/diuretics will capitalize on this opportunity. By 2012, three fixed-dose combinations -- Novartis's Exforge HCT, Daiichi Sankyo's olmesartan/amlodipine/HCT, and Novartis's aliskiren/amlodipine/HCT -- will each be available in the world's major markets. While these agents will offer considerable improvements in convenience over currently available fixed-dose combinations, interviewed experts express differing views on their likely uptake.
"Some experts welcome the greater convenience of these combination therapies which could help reduce patients' pill burden," said Decision Resources Analyst Caroline Gates. "However, others indicate that they prefer to use single agents in order to titrate individual doses on a patient-by-patient basis, especially in cases of advanced hypertension where at least three antihypertensive agents are typically required to control blood pressure."
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