Congestive heart failure (CHF), a major growing health problem in industrialized countries, is the subject of a forthcoming study to be published by Decision Resources, Inc. The incidence and prevalence of CHF is increasing in all seven markets under review (United States, France, Germany, Italy, Spain, United Kingdom, and Japan). We estimate that the number of diagnosed prevalent cases in these major markets will increase from 9.8 million in 1999 to 11.1 million in 2009, while the incidence of newly diagnosed CHF cases will increase from 3.6 million in 1999 to 4.1 million in 2009.

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Recent large, multicenter trials have shown that drugs such as angiotensin-converting enzyme (ACE) inhibitors (also known as ACEIs) and beta blockers-both relatively inexpensive therapies-can significantly improve the life expectancy of CHF patients. A major hurdle in all countries under study, however, is to persuade family doctors and general practitioners to adopt these therapies, and this process is proving to be laborious, according to experts interviewed. Thus, we do not foresee dramatic changes to current medical practice for CHF. We do, however, anticipate growing acceptance of beta blockers and spironolactone, a potassium-sparing diuretic, and increased usage of ACEIs by noncardiologists. Angiotensin II receptor antagonists (AIIRAs) are increasingly likely to be used in patients who cannot tolerate ACEIs, but AIIRAs will not likely surpass ACEI therapy in usage, though future trials may show that both classes of agents can be combined synergistically. The greatest challenge to maintaining ACEI sales over the 1999-2009 study period will come from the new generation of vasopeptidase inhibitors, led by omapatrilat (Bristol-Myers Squibb's Vanlev). Generic substitution will also erode ACEI sales.

Several factors will drive the CHF market to grow by approximately 8% per year to almost $3.4 billion by 2009:

  -- An increase in the population aged 65 and older will expand the      diagnosed population by 1.3% per year.   -- Greater usage of accepted therapies (e.g., ACEIs, beta blockers, and      spironolactone), particularly by noncardiac specialists, will help      offset the use of discounted generic drugs. Continued use of other      established therapies, such as digoxin and diuretics, will stabilize      this segment of the market.   -- Premium-priced agents (e.g., omapatrilat and eplerenone) will be      introduced, and AIIRA usage will increase.   -- The introduction of highly expensive biologic agents, such as      etanercept (Immunex's Enbrel), could significantly accelerate market      growth, even if used in a small proportion of patients.  

Congestive Heart Failure is part of Cardium, a multiclient service that evaluates the commercial potential of cardiac drugs in research and development.

Contact: Frank Sama, 781.487.3753 (telephone), 781.487.5750 (fax), or (e-mail). In Europe, contact Ms. Francoise Bidart, +32.2.351.4082 (telephone), +32.2.351.2347 (fax), or (e-mail). In Japan, contact Ms. Makiko Yoshimoto, +81.3.5401.2615 (telephone), +81.3.5401.2617 (fax), or (e-mail).

Decision Resources, Inc., is a world leader in 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, assessing industry trends in the international health care and pharmaceutical industries.


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SOURCE: Decision Resources, Inc.

Contact: Frank Sama of Decision Resources, Inc., 781-487-3753,

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