Patients with osteoporosis are at increased risk of suffering fractures due to a loss in bone strength. These fractures, in turn, place a considerable burden on public health systems. The osteoporosis therapy market is maturing, and treatment of the disease is associated with significant unmet need, particularly for therapies that are safer and more efficacious, especially those that can reduce the risk of nonvertebral fractures (e.g., hip fractures). The launch of several key therapies will lead to significant market changes over the 2017-2027 forecast period. In particular, Amgen/UCB/Astellas BioPharma’s romosozumab and Radius Health’s abaloparatide—in both subcutaneous(SC) and transdermal (TD) administration—will energize the market.

Questions Answered:

  • Novel agents—Radius Health’s abaloparatide SC and TD and Amgen/UCB/Astellas BioPharma’s romosozumab—are in late-stage development, registered, or recently launched for the treatment of osteoporosis. What do interviewed thought leaders say about the advantages and disadvantages of each therapy? How do they anticipate using them in the osteoporosis treatment algorithm? Which agents in the current market are most vulnerable to being replaced by these novel therapies, and which ones will constrain uptake of the new drugs?
  • The bisphosphonate drug class (e.g., alendronate, risedronate, ibandronate, zoledronate) is the dominant drug class for the treatment of osteoporosis but is associated with adverse effects, including osteonecrosis of the jaw and an elevated risk of atypical femoral fractures. How much impact will this association have on osteoporosis and osteopenia drug-treatment rates? To what extent will this association adversely affect bisphosphonate sales?
  • Teriparatide and denosumab hold a sizable share of the market. How will the loss of patent protection affect their market share? What effect will the launch of novel agents have on their patient share?


Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, Japan.

Primary research: 19 country-specific interviews with experts.

Epidemiology: Osteopenia, osteoporosis, and total prevalent cases of FRAX high-risk.

Population segments in market forecast: Osteoporosis.

Emerging therapies: Registered: 1 drug; Phase II: 1 drug. Coverage of select preclinical and Phase I products.

Key drugs: Denosumab, teriparatide, abaloparatide SC, abaloparatide TD, alendronate, romosozumab, raloxifene

Table of contents

  • Disease Landscape & Forecast
    • Key Updates
      • November 2018
      • August 2018
      • April 2018
      • November 2017
      • July 2017
      • June 2017
      • March 2017
    • Market Outlook
      • Key Findings
        • Market Overview
      • Market Drivers and Constraints
        • What Factors Are Driving the Market for Osteoporosis?
        • What Factors Are Constraining the Market for Osteoporosis?
      • Drug-Class-Specific Trends
        • Bisphosphonates
        • Selective Estrogen Receptor Modulators
        • Parathyroid Analogues
        • RANKL Inhibitors
        • Calcitonins
        • Sclerostin Inhibitors
        • Strontium Salts
        • Other Therapies
    • Forecast
      • Market-Forecast-Assumptions
      • Market Forecast Dashboard
    • Etiology and Pathophysiology
      • Disease Overview
      • Etiology
        • Primary Osteoporosis
        • Secondary Osteoporosis
        • Risk Factors
        • Osteoporosis: A Risk Factor for Fractures
      • Key Pathways and Drug Targets
        • Anatomy
        • Bone Remodeling and Turnover
        • Immunologic Effects
        • Drug Targets
    • Epidemiology
      • Introduction
      • Epidemiology Populations
        • Total Prevalence of Osteoporosis and Osteopenia
        • FRAX High-Risk
        • Diagnosed Prevalent Cases of Osteoporosis
        • Drug-Treated Cases of Osteoporosis
    • Current Treatment
      • Key Findings
      • Treatment Goals
      • Key Current Therapies
        • Overview
        • Bisphosphonates
        • Selective Estrogen Receptor Modulators
        • Parathyroid Hormone Analogues
        • RANKL Inhibitors
        • Strontium Salts
        • Calcitonins
        • Hormone Replacement Therapy
        • Other Therapies to Treat Osteoporosis
      • Medical Practice
        • Overview
        • Treatment Guidelines
        • Region-Specific Treatment Practices
    • Unmet Need Overview
      • Current and Future Attainment of Unmet Needs in Osteoporosis
    • Emerging Therapies
      • Key Findings
      • Key Emerging Therapies
        • Notable Developments Among Key Emerging Therapies for Osteoporosis
        • Sclerostin Inhibitors
        • Parathyroid Hormone Analogues
      • Early-Phase Pipeline Analysis
        • Notable Developments in the Early-Phase Pipeline for Osteoporosis
      • Key Discontinuations and Failures in Osteoporosis
    • Access & Reimbursement Overview
      • Region-Specific Reimbursement Practices
        • United States
        • EU5
        • Japan
        • Looking for More?
    • Methodology
      • Bottom-Up Forecasting Overview
        • Patient Populations
        • Drug-Specific Assumptions
      • Bottom-Up Forecast Assumptions
        • General Sources of Data
        • General Statements About Pricing
        • Dosing, Days of Therapy, and Compliance
        • Generic Erosion
        • Biosimilar Erosion
        • Out-Year Forecasting
        • Emerging Therapy Prices
      • Primary Market Research
        • Experts Interviewed
    • Appendix
      • Osteoporosis Bibliography
      • Supplemental Epidemiology Bibliography

Author(s): David Rees, Ph.D; Sunali D. Goonesekera, SM

David Rees, , is a Business Insights Analyst with the Cardiovascular, Metabolic, and Renal Disorders team at Decision Resources Group. Prior to joining Decision Resources Group, Dr. Rees was a Postdoctoral Research Associate at Imperial College London, and the Institute of Cancer Research. For his doctoral research, he studied the structures of molecular machines in the Nobel Prize winning laboratory of Prof. Sir John Walker at the University of Cambridge. Dr. Rees earned his undergraduate from the University of Bath.

Sunali Goonesekera is an Associate Epidemiologist at Decision Resources Group. Sunali holds a Master’s degree in Epidemiology from the Harvard School of Public Health and a in Biology (Honors) from Dartmouth College. Prior to joining Decision Resources Group, Sunali conducted epidemiological research and lead authored two manuscripts on racial/ethnic disparities in metabolic diseases at the New England Research Institutes. She has contributed to multiple publications in peer-reviewed journals in epidemiology and in the biological sciences.

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