Antihypertensive drugs compose one of the highest-value therapeutic classes in the pharmaceutical sector. This is a relatively mature market, crowded with established drug classes, but it is lucrative and therefore remains fiercely competitive. Hypertension is a new Decision Resources study that examines how competition within and among antihypertensive drug classes will drive shifts in market share, which drugs are likely to emerge as leaders, and how such changes will influence the overall market.

  (Photo: )    New Agents Will Lead the AIIRA Class 

Sales of angiotensin II receptor antagonists (AIIRAs) (used alone, not in combination therapies) will climb from $1.9 billion in 2000 to $3.3 billion in 2010. This growth will be fueled by data that prove their beneficial effects on morbidity and mortality in hypertensive patients, particularly patients with comorbidities such as diabetes and cardiovascular disease. However, market share within the AIIRA class will have changed by 2010, the close of our forecast period. Uptake of valsartan (Novartis's Diovan) will be driven by positive outcome data recently released from the Valsartan Heart Failure (Val- HeFT) trial. We believe this data will persuade physicians to prescribe valsartan preferentially for patients with heart failure instead of other AIIRAs. Irbesartan (Bristol-Myers Squibb's Avapro) will also make gains in our forecast period, supported by data that show its superiority to other AIIRAs in blood pressure reduction.

Omapatrilat Will Erode ACEI Sales

Physicians will continue to favor ACEIs throughout our forecast period, but ACEI market share will decline as best-selling agents lose patent protection and AIIRAs challenge their dominant position. Bristol-Myers Squibb's omapatrilat (Vanlev) will also pose a threat to ACEIs. Experts are extremely enthusiastic about omapatrilat because its dual inhibition of ACE and neutral endopeptidase makes it a particularly powerful antihypertensive. Trial data has already established that omapatrilat is superior to the ACEI lisinopril in patients with heart failure but success in other hypertensive populations will depend on resolving concerns about the side-effect incidence of angioedema. Omapatrilat will compete strongly for market share with other drugs that target the renin angiotensin aldosterone system (RAAS), including AIIRAs and ACEIs. In this fight, AIIRAs will fare better than their ACEI rivals because pharmaceutical companies will market AIIRAs more aggressively to protect their market share.

Beta Blockers and Diuretics in Decline

Despite recommendations by the U.S. Sixth Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) that physicians use diuretics and beta blockers as preferred first-line therapies, physicians in some countries prefer newer agents. However, because diuretics and beta blockers are available in relatively inexpensive generic forms, their decline will not have a great influence on overall market value.

Hypertension offers invaluable market intelligence for competing in this arena. This study is part of Cardium, one of six Pharmacor services that evaluate the commercial potential of drugs in research and development.

Decision Resources, Inc., is a world leader in pharmaceutical research publications, advisory services, and consulting designed to help clients shape strategy, allocate resources, and master their chosen markets. Founded as a subsidiary of Arthur D. Little, Inc., the company has provided strategic information services for 30 years. Visit the Decision Resources Web site at

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SOURCE: Decision Resources, Inc.

Contact: Frank Sama of Decision Resources, Inc., +1-781-296-2553,

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