Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that, through 2018 in the acute coronary syndrome drug market, the overall uptake of Eli Lilly/Daiichi Sankyo's Effient in the United States and Europe (where it is marketed as Efient) will be constrained by the widespread use of AstraZeneca's Brilinta, which is expected to launch in 2011.
The Pharmacor 2010 findings from the topic entitled Acute Coronary Syndrome reveals that Effient will likely find greatest use in patient subgroups such as ST-segment elevation myocardial infarction (STEMI) patients, diabetics and patients who are at high risk of stent thrombosis but at modest risk of bleeding. Following last year's launch of Effient, cardiologists now have the option of prescribing an adenosine diphosphate (ADP) receptor antagonist that is more potent than clopidogrel (Bristol-Myers Squibb/Sanofi-Aventis's Plavix/Iscover, generics).
However, the drawbacks of Effient include a high rate of bleeding and lack of reversibility while other emerging agents in the ADP receptor antagonist class such as Brilinta and Novartis's elinogrel offer reversibility. As a result, Brilinta and elinogrel provide greater safety and flexibility in patients who need coronary artery bypass graft (CABG) surgery. Furthermore, Brilinta is supported by a compelling mortality benefit in recently reported data from the PLATO clinical trial.
"Brilinta and elinogrel all have potential advantages over both Effient and Plavix because they are reversible and do not require in vivo activation," said Decision Resources Therapeutic Area Director Nikhil Mehta. "Therefore, patients taking these agents can undergo surgery in a shorter amount of time. Additionally, Brilinta and elinogrel also have a more consistent effect and quicker onset of action than Plavix."
The Pharmacor 2010 findings also reveal that generic erosion of premium-priced branded agents will offset sales of new agents and will cause the acute coronary syndrome market for drugs in the hospital setting to decrease from $800 million in 2008 to $729 million in 2018 in the United States, France, Germany, Italy, Spain, the United Kingdom and Japan.
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