The asthma market consists of many well-established therapies, including inhaled agents (e.g., GlaxoSmithKline’s Advair / Seretide, AstraZeneca’s Symbicort, Boehringer Ingelheim’s Spiriva), oral drugs (e.g., montelukast), and biologics (e.g., Roche / Novartis’s Xolair, GlaxoSmithKline’s Nucala). However, market dynamics are evolving as branded generic and generic alternatives to inhaled blockbuster agents continue to launch and new biologics targeting niche populations within the severe asthma segment are approved. These events have increased—and will continue to increase—competition in this lucrative market. With the impending entry of an additional biological therapy, the launch of branded generic and generic inhaled drugs in new markets, and the potential launch of LABA/LAMA/ICS combination agents, the asthma market is poised to experience change over the next decade.

Questions Answered:

  • What are KOLs’ insights on current inhaled branded, branded generic, and generic treatment options? What is / will be the market impact of branded generic and generic inhaled therapies?
  • What are KOLs’ perceptions of the currently marketed asthma biologics (Xolair, Nucala, Teva’s Cinqair / Cinqaero, AstraZeneca’s Fasenra)? Where in the treatment algorithm do physicians fit these drugs? What drives physicians’ choice of a biologic in severe, refractory asthma patients?
  • How will the market evolve over the next ten years given the launch of additional inhaled, oral, and biological products? Will the entry of triple LABA/LAMA/ICS combination agents and SABA/ICS combination agents have a substantial effect on the sales and patient share of currently marketed asthma therapies? Where do physicians see these combination therapies fitting in the treatment algorithm?

Scope:

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

Primary research: 39 country-specific interviews with thought leaders.

Epidemiology: Number of diagnosed and drug-treated prevalent cases of asthma; number of diagnosed and drug-treated prevalent cases of intermittent / mild persistent and moderate / severe persistent asthma.

Emerging therapies: Preregistered: 2 drug; Phase III: 8 drugs; Phase II: 11 drugs; coverage of 1 select Phase I product.

Table of contents

  • Asthma - Landscape & Forecast - Disease Landscape & Forecast
    • COVID-19
      • Key Findings
        • Key Updates
          • September 2020
          • June 2020
          • November 2019
          • September 2019
        • Market Outlook
          • Key Findings
            • Market Overview
            • Market Share of Drug Classes for Asthma: 2018
            • Market Share of Drug Classes for Asthma: 2028
            • Asthma SWOT Analysis
          • COVID-19: Areas of Potential Forecast Impact
            • Market Drivers and Constraints
              • What Factors Are Driving the Market for Asthma?
              • What Factors Are Constraining the Market for Asthma?
              • Market Share of Drug Classes in the Moderate / Severe Asthma Population: 2018
              • Market Share of Drug Classes in the Moderate / Severe Asthma Population: 2028
              • Market Share of Asthma Therapies by Region: 2018, 2023, 2028
              • Major-Market Sales in Intermittent / Mild and Moderate / Severe Asthma Populations: 2018-2028
              • Major-Market Patient Share of Biologics in the Moderate / Severe Asthma Population: 2018-2028
            • Drug-Class-Specific Trends
              • Major-Market Sales of Inhaled Corticosteroids in Asthma: 2018-2028
              • Market Share of Inhaled Corticosteroids Within the ICS Drug Class: 2018
              • Market Share of Inhaled Corticosteroids Within the ICS Drug Class: 2028
              • Major-Market Sales of Inhaled Corticosteroids in Intermittent / Mild and Moderate / Severe Asthma Populations: 2018-2028
              • Major-Market Sales of LABA/ICS FDCs in Asthma: 2018-2028
              • Major-Market Sales and Treated Patient Population of Salmeterol / Fluticasone Propionate in Asthma by Brand and Generic Formulations: 2018-2028
              • Major-Market Sales and Treated Patient Population of Formoterol / Budesonide in Asthma by Brand and Generic Formulations: 2018-2028
              • Major-Market Sales of LABA/ICS FDCs in the Intermittent / Mild and Moderate / Severe Asthma Populations: 2018-2028
              • Major-Market Sales of LAMAs in Asthma: 2018-2028
              • Major-Market Sales and Treated Patient Population of LABA/LAMA/ICS FDCs in Asthma: 2018-2028
              • Major-Market Sales of Xolair by Region: 2018-2028
              • Major-Market Sales of Anticytokines in Asthma: 2018-2028
              • Major-Market Patient Share of Anticytokines in the Moderate / Severe Asthma Population: 2018-2028
              • Major-Market Sales and Treated Patient Population of Anticytokines in Asthma by MOA: 2018-2028
          • Forecast
            • Market Forecast Assumptions
            • Market Forecast Dashboard
          • Etiology and Pathophysiology
            • Disease Overview
              • Etiology
                • Atopic vs. Nonatopic Asthma
                • Environmental vs. Genetic Risk Factors
                • Models for Asthma Caused by Environmental Risk Factors
                • Effect of the Allergic Cascade in Asthma
              • Disease Pathophysiology
                • Pathophysiology and Phenotypes
                • Allergen-Induced Inflammation Process
              • Key Pathways and Drug Targets
                • Mechanism of Action of Biological Therapies in Asthma
            • Epidemiology
              • Key Findings
                • Note About Our Epidemiology Estimates
              • Epidemiology Populations
                • Disease Definition
                • Methods
                • Sources Used for Diagnosed Symptomatic or Medically Controlled 12-Month Prevalent Cases of Asthma
                • Diagnosed Symptomatic or Medically Controlled 12-Month Prevalent Cases of Asthma : 2019-2029 (thousands)
                • Disease Definition
                • Methods
                • Severity Populations Used in the Market Forecast
                • Sources Used for Diagnosed Symptomatic or Medically Controlled 12-Month Prevalent Cases of Asthma by Severity
                • Diagnosed Symptomatic or Medically Controlled 12-Month Prevalent Cases of Asthma by Severity: 2019-2029 (Thousands)
                • Diagnosed Symptomatic or Medically Controlled Drug-Treated 12-Month Prevalent Cases of Intermittent/Mild Asthma: 2019-2029 (thousands)
                • Diagnosed Symptomatic or Medically Controlled Drug-Treated 12-Month Prevalent Cases of Moderate/Severe Asthma: 2019-2029 (thousands)
            • Current Treatment
              • Key Findings
                • Treatment Goals
                  • Key Endpoints Used in Clinical Trials for Asthma
                • Key Current Therapies
                  • Overview
                  • Mechanism of Action of Key Current Drug Classes Used for Asthma
                  • Key Current Treatments Used for Asthma
                  • Market Events Impacting the Use of Key Current Therapies in Asthma
                  • Advantages and Disadvantages of ICSs
                  • Expert Insight: Inhaled Corticosteroids
                  • Advantages and Disadvantages of LABAs
                  • LABA/ICS Fixed-Dose Combinations
                  • Advantages and Disadvantages of LABA/ICS Fixed-Dose Combinations
                  • Expert Insight: LABA/ICS Fixed-Dose Combinations
                  • Advantages and Disadvantages of Salmeterol / Fluticasone Propionate
                  • Advantages and Disadvantages of Formoterol / Budesonide
                  • Advantages and Disadvantages of Foster / Fostair
                  • Advantages and Disadvantages of Dulera
                  • Advantages and Disadvantages of Flutiform / Abriff
                  • Advantages and Disadvantages of Breo / Relvar
                  • Atectura Breezhaler / Bemrist Breezhaler (Indacaterol / Mometasone)
                  • Advantages and Disadvantages of Atectura Breezhaler / Bemrist Breezhaler
                  • Advantages and Disadvantages of Montelukast
                  • Long-Acting Muscarinic Antagonists
                  • Advantages and Disadvantages of Spiriva
                  • Expert Insight: LAMAs
                  • Enerzair Breezhaler (Indacaterol / Glycopyrronium / Mometasone)
                  • Advantages and Disadvantages of Enerzair Breezhaler
                  • Expert Insight: LABA/LAMA/ICS Fixed-Dose Combinations
                  • Advantages and Disadvantages of Xolair
                  • Expert Insight: Xolair
                  • Advantages and Disadvantages of IL-5 Antagonists
                  • Expert Insight: IL-5 Antagonists
                  • Advantages and Disadvantages of Nucala
                  • Advantages and Disadvantages of Cinqair / Cinqaero
                  • Ongoing Clinical Development of Cinqair / Cinqaero
                  • Fasenra (Benralizumab)
                  • Advantages and Disadvantages of Fasenra
                  • Ongoing Clinical Development of Fasenra
                  • Dupixent (Dupilumab)
                  • Advantages and Disadvantages of Dupixent (Dupilumab)
                  • Ongoing Clinical Development of Dupixent
                  • Expert Insight: Dupixent
                  • Advantages and Disadvantages of Short-Acting Beta2 Agonists
                • Medical Practice
                  • Overview
                  • Treatment Guidelines
                  • Country-Specific Asthma Treatment Guidelines
                  • Factors Influencing Drug Selection in Asthma
                  • Inhaler Devices for Asthma
                  • Expert Insight: Inhaler Devices
                  • Treatment Decision Tree for Asthma: United States
                  • Treatment Decision Tree for Asthma: Europe
                  • Treatment Decision Tree for Asthma: Japan
              • Unmet Need Overview
                • Current and Future Attainment of Unmet Needs in Asthma
                • Top Unmet Needs in Asthma: Current and Future Attainment
                • Expert Insight: Unmet Need in Asthma
              • Emerging Therapies
                • Key Findings
                  • Pipeline Trends for Asthma
                • Key Emerging Therapies
                  • Key Therapies in Development for Asthma
                  • Estimated Launch Dates of Key Emerging Therapies for the Treatment of Asthma
                  • Tezepelumab
                  • Tezepelumab Profile
                  • Analysis of the Clinical Development Program for Tezepelumab
                  • Expert Insight: Tezepelumab
                  • Expectations for Launch and Sales Opportunity for Tezepelumab in Asthma
                  • Key Results from Select Clinical Trials Investigating QMF-149 for the Treatment of Asthma
                  • Analysis of the Clinical Development Program for QMF-149
                  • Expert Insight: QMF-149
                  • Expectations for Launch and Sales Opportunity of QMF-149 in Asthma
                  • Profile of LABA/LAMA/ICS FDCs
                  • Analysis of the Clinical Development Program for LABA/LAMA/ICS FDCs
                  • Expert Insight: LABA/LAMA/ICS FDCs
                  • Expectations for Launch and Sales Opportunity of LABA/LAMA/ICS FDCs in Asthma
                  • PT-027
                  • Key Ongoing Clinical Trials of PT-027 in the Treatment of Asthma
                  • Analysis of the Clinical Development Program for PT-027
                  • Expectations for Launch and Sales Opportunity of PT-027 in Asthma
                • Early-Phase Pipeline Analysis
                  • Select Compounds in Early-Phase Development for Asthma
                • Key Discontinuations and Failures in Asthma
                • Access and Reimbursement Overview
                  • Region-Specific Reimbursement Practices
                    • Key Market Access Considerations in Asthma: United States
                    • General Reimbursement Environment: United States
                    • Key Market Access Considerations in Asthma: EU5
                    • General Reimbursement Environment: EU5
                    • Key Market Access Considerations in Asthma: Japan
                    • General Reimbursement Environment: Japan
                • Appendix
                  • Key Abbreviations Related to Asthma
                  • Brands, Marketers, and Generic Availability of Key Therapies for Asthma by Market
                  • Asthma Bibliography

              Author(s): Shubhendu Ghosh, PhD; Stephanie Niquita

              Shubhendu Ghosh, Ph.D., is a Business Insights Analyst on the Immune and Inflammatory Disorders team at Decision Resources Group, with a primary focus on asthma.

              Prior to joining DRG, Shubhendu was an Associate Editor at Nature Structural & Molecular Biology and a Copy Editor at Nature Medicine. He was also a Scientific and Developmental Editor at Nature Research Editing Service. Shubhendu received his Ph.D. in Biomedical Sciences from the University of Massachusetts Medical School after completing a B. Sc. in Microbiology from Delhi University and an M. Sc. In Biotechnology from Madurai Kamaraj University.

              Stephanie Niquita works as an associate epidemiologist at Decision Resources Group. Stephanie holds a masters in public health specializing in epidemiology from TISS, Mumbai and a medical degree from Hubei University of Chinese Medicine, People’s Republic of China. She has been trained as a community physician and has also supervised and coordinated various governmental and non-governmental public health projects.


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