Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a significant public health and financial burden. The availability of non-vitamin K antagonist oral anticoagulants (NOACs) for the treatment and secondary prophylaxis of VTE is addressing the need for more-convenient alternatives to current standards of care, and these agents will drive market growth during the forecast period. However, considerable areas of unmet need exist within the VTE space, such as primary prophylaxis of VTE in acute medically ill patients and management of VTE treatment and risk in cancer patients. The ongoing label expansion program for NOACs and the anticipated launch of new therapies such as IONIS-FXIRx offer potential solutions to these unmet needs.

Questions Answered:

  • How do the different VTE subpopulations contribute to the overall VTE market landscape? What will be the key drivers and deterrents for the VTE market during the 2017-2027 forecast period?
  • How will uptake of newer agents in the market impact current market-leading therapies? Which agents will be the most successful and why?
  • What do thought leaders think of the label expansion programs for NOACs? How do physicians perceive betrixaban, a new NOAC on the market, for managing medically ill patients?
  • Which patient subpopulations have the greatest unmet need and commercial potential? Which drugs under development will fulfill these unmet needs?

Scope:

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

Primary research: 20 country-specific interviews with thought leaders in the field.

Epidemiology: Number of DVT events; number of PE events; number of hospitalization events (orthopedic surgery, major non-orthopedic surgery, nonsurgical) eligible for VTE acute primary prophylaxis; number of prevalent cases of cancer patients eligible for VTE primary prophylaxis.

Population segments in market forecast: Primary prophylaxis indications (major orthopedic surgery, non-orthopedic surgery, nonsurgical patients, cancer patients eligible for prophylaxis); acute DVT treatment and secondary prophylaxis; acute PE treatment and secondary prophylaxis.

Emerging therapies: Phase II: 3 drugs; Phase III: 3 drugs. Coverage of select preclinical and Phase I products.

Table of contents

  • Venous Thromboembolism - Landscape & Forecast - Disease Landscape & Forecast
    • Key Updates
      • October 2018
      • August 2018
      • June 2018
      • February 2018
      • December 2017
      • August 2017
      • June 2017
      • March 2017
    • Market Outlook
      • Key Findings
        • Market Overview
        • Market Share of Venous Thromboembolism Drug Classes in 2017
        • Market Share of Venous Thromboembolism Drug Classes in 2027
        • Venous Thromboembolism SWOT Analysis
      • Market Drivers and Constraints
        • What Factors Are Driving the Market for Venous Thromboembolism?
        • What Factors Are Constraining the Market for Venous Thromboembolism?
        • Key Market Events for Venous Thromboembolism
        • Sales of Venous Thromboembolism Therapies in the Major Pharmaceutical Markets: 2017-2027
        • Major-Market Patient Share by Drug Class in Venous Thromboembolism Primary Prophylaxis: 2017-2027
        • Major-Market Patient Share by Drug Class in Venous Thromboembolism Treatment and Secondary Prophylaxis: 2017-2027
      • Drug-Class-Specific Trends
        • Sales of Novel Oral Anticoagulants for the Treatment of Venous Thromboembolism in the Major Markets: 2017-2027
        • Major-Market Patient Share of the Novel Oral Anticoagulants in Venous Thromboembolism Primary Prophylaxis: 2017-2027
        • Major-Market Patient Share of the Novel Oral Anticoagulants in Venous Thromboembolism Treatment and Secondary Prophylaxis: 2017-2027
        • Estimated Sales of IONIS-FXIRx in the Major Pharmaceutical Markets: 2017-2027
    • Forecast
      • Market Forecast Assumptions
      • Market Forecast Assumptions
      • Market Forecast Dashboard
      • Market Forecast Dashboard
      • Sales of Drugs for VTE Primary Prophylaxis in the Major Pharmaceutical Markets: 2017-2027 (millions of 2017 U.S. dollars)
      • Sales of Drugs for VTE Treatment and Secondary Prophylaxis in the Major Pharmaceutical Markets: 2017-2027 (millions of 2017 U.S. dollars)
    • Etiology and Pathophysiology
      • Disease Overview
        • Development of Deep Vein Thrombosis and Pulmonary Embolism
        • Veins of the Lower Extremities Involved in Deep Vein Thrombosis
      • Disease Pathophysiology
        • Virchow's Triad and Associated Factors
      • Vascular Endothelial Injury
        • Tissue Factor Exposure, Expression, and Localization
      • Venous Stasis
        • Hypercoagulability: Prothrombotic State
          • The Coagulation Process
            • The Cascade Model
            • The Cell-Based Model
            • The Cascade Model of Coagulation
            • The Coagulation Cascade and Mechanism of Action of Anticoagulant Agents
            • The Cell-Based Model of Coagulation
          • VTE Risk Factors
            • Key Pathways and Drug Targets
              • Major Drug Targets of Anticoagulants in Development
          • Epidemiology
            • Key Findings
              • Epidemiology Populations
                • Disease Definition
                • Methods
                • Sources Used to Estimate the Rate of VTE Events
                • Number of Diagnosed Events of VTE: 2017-2027
                • Disease Definition
                • Methods
                • Sources Used to Estimate the Number of Diagnosed Events of VTE Acute Prophylaxis
                • Number of Diagnosed Events of VTE Acute Prophylaxis: 2017-2027
                • Disease Definition
                • Methods
                • Sources Used to Estimate the Number of Diagnosed Events of VTE Prophylaxis in Cancer
                • Number of Diagnosed Events of VTE Prophylaxis in Cancer: 2017-2027
                • Drug-Treated Events of VTE: 2017-2027
            • Current Treatment
              • Key Findings
                • Treatment Goals
                  • Key End Points Used in Clinical Trials for Venous Thromboembolism
                • Key Current Therapies
                  • Overview
                  • Mechanism of Action of Key Current Drug Classes Used for Venous Thromboembolism
                  • Current Treatments Used for Venous Thromboembolism
                  • Market Events Impacting the Use of Key Current Therapies in Venous Thromboembolism
                  • Advantages and Disadvantages of Vitamin K Antagonists
                  • Expert Insight on Vitamin K Antagonists
                  • Advantages and Disadvantages of Unfractionated Heparin
                  • Advantages and Disadvantages of Low-Molecular-Weight Heparin
                  • Expert Insight on Heparins and Heparinoids
                  • Advantages and Disadvantages of Indirect FXa Inhibitors
                  • Expert Insight on Indirect FXa Inhibitors
                  • Advantages and Disadvantages of Rivaroxaban
                  • Key Ongoing Clinical Trials of Rivaroxaban in the Treatment of Venous Thromboembolism
                  • Expert Insight: Rivaroxaban
                  • Advantages and Disadvantages of Apixaban
                  • Ongoing Clinical Development of Apixaban
                  • Key Ongoing Clinical Trials of Apixaban in the Treatment of Venous Thromboembolism
                  • Expert Insight: Apixaban
                  • Advantages and Disadvantages of Edoxaban
                  • Ongoing Clinical Development of Edoxaban
                  • Key Ongoing Clinical Trials of Edoxaban in the Treatment of Venous Thromboembolism
                  • Expert Insight: Edoxaban
                  • Advantages and Disadvantages of Betrixaban
                  • Key Results from Select Clinical Trials Investigating Betrixaban for the Treatment of Venous Thromboembolism
                  • Expert Insight: Betrixaban
                  • Advantages and Disadvantages of Dabigatran Etexilate
                  • Key Ongoing Clinical Trials of Dabigatran Etexilate in the Treatment of Venous Thromboembolism
                  • Expert Insight: Dabigatran Etexilate
                  • Advantages and Disadvantages of Thrombolytics
                  • Key Ongoing Clinical Development of Thrombolytics in the Treatment of Venous Thromboembolism
                  • Expert Insight: Thrombolytics
                • Medical Practice
                  • Overview
                  • Country-Specific Venous Thromboembolism Treatment Guidelines
                  • Factors Influencing Drug Selection in Venous Thromboembolism
                  • Treatment Decision Tree for Venous Thromboembolism: United States
                  • Treatment Decision Tree for Venous Thromboembolism: France
                  • Treatment Decision Tree for Venous Thromboembolism: Germany
                  • Treatment Decision Tree for Venous Thromboembolism: Italy
                  • Treatment Decision Tree for Venous Thromboembolism: Spain
                  • Treatment Decision Tree for Venous Thromboembolism: United Kingdom
                  • Treatment Decision Tree for Venous Thromboembolism: Japan
              • Unmet Need Overview
                • Current and Future Attainment of Unmet Needs in Venous Thromboembolism
                • Top Unmet Needs in Venous Thromboembolism: Current and Future Attainment
                • Expert Insight: Unmet Need in Venous Thromboembolism
              • Emerging Therapies
                • Key Findings
                  • Pipeline Trends in Venous Thromboembolism
                • Key Emerging Therapies
                  • Notable Developments Among Key Emerging Therapies for Venous Thromboembolism
                  • Key Emerging Therapies in Development for Venous Thromboembolism
                  • Estimated Launch Dates of Key Emerging Therapies for the Treatment of Venous Thromboembolism
                  • IONIS-FXIRx Profile
                  • IONIS-FXIRx Clinical Development
                  • Clinical Development Milestones for IONIS FXIRx in the Treatment of Venous Thromboembolism
                  • Likely Uses of IONIS FXIRx for the Treatment of Venous Thromboembolism
                  • Expert Insight: IONIS-FXIRx
                  • Expectations for Launch and Sales Opportunity of IONIS-FXIRx in Venous Thromboembolism
                • Early-Phase Pipeline Analysis
                  • Notable Developments in the Early-Phase Pipeline for Venous Thromboembolism
                  • Select Phase II Compounds in Development for Venous Thromboembolism
                  • Select Phase I and Preclinical Development Programs for Venous Thromboembolism
              • Access & Reimbursement Overview
                • Region-Specific Reimbursement Practices
                  • Key Market Access Considerations in Venous Thromboembolism: United States
                  • Key Market Access Considerations in Venous Thromboembolism: EU5
                  • Key Market Access Considerations in Venous Thromboembolism: Japan
                  • General Reimbursement Environment: Japan
                • Looking for More?
              • Methodology
                • Bottom-Up Forecasting Overview
                  • Patient Populations
                  • Drug-Specific Assumptions
                • Bottom-Up Forecast Assumptions
                  • General Sources of Data
                  • Agents Included in Our Market Analysis
                  • General Statements About Pricing
                  • Sources for Drug Prices
                  • 2017 Exchange Rates
                  • Dosing, Days of Therapy, and Compliance
                  • Generic Erosion
                  • Biosimilar Erosion
                  • Out-Year Forecasting
                  • Emerging Therapy Prices
                • Primary Market Research
                  • Experts Interviewed
              • Appendix
                • Key Abbreviations Related to Venous Thromboembolism
                • Brands, Marketers, and Generic Availability of Key Therapies for Venous Thromboembolism by Market
                • Venous Thromboembolism Bibliography

            Author(s): Shreya Saxena, MBA; Ema Rodrigues, DSc, MPH

            Shreya Saxena is a senior business insights analyst in the Cardiovascular, Metabolic and Renal disorders team at Decision Resources Group.

            She obtained an M.B.A. degree with specializations in Marketing and HR, and a Bachelor's degree in Pharmacy from the GGSIPU University, Delhi, India. Prior to joining DRG, she has worked as a Business Analyst at the research firm Evalueserve. Her role involved in-depth commercial, and scientific secondary research, and competitive intelligence across multiple indications (such as atrial fibrillation, ACS, VTE, heart failure and women’s health), including pipeline analysis, clinical trials assessment, disease landscaping, product and company profiling, and financial assessment and benchmarking.

            Ema is an epidemiologist with expertise in forecasting incident and prevalent populations within oncology, as well as some cardiovascular indications such as venous thromboembolism. She has significant experience with statistical methods such as multivariate linear regression, conditional logistic regression, principal components analysis, mixed models, hierarchical modeling, and path analysis to account for the complex relationships among various predictors of health outcomes, particularly correlated variables.

            She completed her master’s and doctoral degree (MPH, D.Sc.) in Environmental Health at Boston University School of Public Health, where she worked on projects investigating significant predictors of various health outcomes including central nervous system cancer, cognitive function, and birth outcomes.