Idiopathic pulmonary fibrosis (IPF) is one of the most common interstitial lung diseases and is characterized by an irreversible loss of lung function. Roche’s pirfenidone (Esbriet) was the first disease-modifying therapy (DMT) approved for IPF, followed soon after by Boehringer Ingelheim’s nintedanib (Ofev); these therapies set the stage for fierce competition in the IPF therapy market. We explore this evolving space, analyzing the clinical and commercial outlook for pirfenidone and nintedanib. We assess emerging therapies, including FibroGen’s IV-administered pamrevlumab and Galapagos’s oral autotoxin inhibitor GLPG-1690. We also examine current medical practice and identify the areas of pressing unmet need in the treatment of the disease.

QUESTIONS ANSWERED

  • How will the size of the IPF population change through 2029? How large are the key subpopulations? What percentage of the IPF population receives drug treatment?
  • How do interviewed experts view the clinical profiles of Esbriet and Ofev, and what factors drive or constrain their use? What are the most pressing unmet clinical needs in the management of IPF, according to experts?
  • Which emerging therapies do IPF experts consider most promising? If approved, how would emerging therapies influence the management of IPF and the market position of Ofev and Esbriet? What is the commercial potential of pamrevlumab and GLPG-1690?

Table of contents

  • Idiopathic Pulmonary Fibrosis - Landscape & Forecast - Disease Landscape & Forecast
    • COVID-19
      • Commercial Outlook
        • Key Findings
          • Regional Sales of Key Therapies to Treat Idiopathic Pulmonary Fibrosis: 2019 and 2029
          • Idiopathic Pulmonary Fibrosis SWOT Analysis
        • Drivers and Constraints
          • What Factors Are Driving the Market for Idiopathic Pulmonary Fibrosis?
          • What Factors Are Constraining the Market for Idiopathic Pulmonary Fibrosis?
        • Drug-Class-Specific Trends
          • Antifibrotics
          • Tyrosine Kinase Inhibitors
          • Connective Tissue Growth Factor Inhibitors
          • Autotaxin Inhibitors
        • Alternative Market Scenarios
          • Alternative Scenarios for the Idiopathic Pulmonary Fibrosis Market Through 2029
      • Forecast
        • Forecast Sales of Key Therapies in Idiopathic Pulmonary Fibrosis
      • Etiology and Pathophysiology
        • Disease Overview
        • Etiology
          • Key Risk Factors Associated with Idiopathic Pulmonary Fibrosis
          • The Lung in Idiopathic Pulmonary Fibrosis
        • Pathophysiology
          • Role of Inflammation
          • Pathogenesis of Idiopathic Pulmonary Fibrosis
        • Disease Progression
          • Characteristics of Rapid and Slow Progressors
        • Disease Staging
          • The GAP Index
        • Symptoms and Complications
          • Symptoms and Complications of Idiopathic Pulmonary Fibrosis
          • Key Symptoms and Complications of Idiopathic Pulmonary Fibrosis
        • Key Pathways and Drug Targets
          • Key Pathways and Drug Targets in Idiopathic Pulmonary Fibrosis
          • Key Pathways and Drug Targets in Idiopathic Pulmonary Fibrosis
      • Epidemiology Overview
        • Introduction
          • Key Findings
          • Key Updates
        • Epidemiology Populations
          • Disease Definition
          • Methods
          • Sources Used for Diagnosed Prevalent Cases of Idiopathic Pulmonary Fibrosis
          • Number of Diagnosed Prevalent Cases of Idiopathic Pulmonary Fibrosis in the Major Pharmaceutical Markets: 2019-2029
          • Sources Used for Drug-Treated Prevalent Cases of Idiopathic Pulmonary Fibrosis
          • Number of Diagnosed and Drug-Treated Prevalent Cases of Idiopathic Pulmonary Fibrosis: 2019-2029
          • Disease Definition
          • Methods
          • Sources Used for GAP Staging in Idiopathic Pulmonary Fibrosis
          • Number of Diagnosed Prevalent Cases of Idiopathic Pulmonary Fibrosis in the Major Pharmaceutical Markets by GAP Severity: 2019-2029
          • Disease Definition
          • Methods
          • Sources Used for Diagnosed Prevalent Cases by Comorbidity
          • Number of Diagnosed Prevalent Cases of Idiopathic Pulmonary Fibrosis in the Major Pharmaceutical Markets by Comorbidity: 2019-2029
      • Current Treatment Overview
        • Key Findings
          • Diagnosis
            • Diagnosis of Idiopathic Pulmonary Fibrosis
            • Diagnostic Tests and Criteria
            • Diagnostic Criteria for Idiopathic Pulmonary Fibrosis in 2018
            • Comparison of ATS/ERS/JRS/ALAT Recommendations for the Diagnosis of Idiopathic Pulmonary Fibrosis in 2011 and 2018
            • Expert Insight on Diagnosis
          • Treatment Goals
            • Key Endpoints Used in Clinical Trials for Idiopathic Pulmonary Fibrosis
          • Key Current Therapies
            • Overview
            • Mechanism of Action of Current Drugs Used for Idiopathic Pulmonary Fibrosis
            • Current Treatments Used for Idiopathic Pulmonary Fibrosis
            • Market Events Impacting the Use of Current Therapies in Idiopathic Pulmonary Fibrosis
            • Clinical Trial Outcomes for Pirfenidone
            • Key Results from Select Clinical Trials Investigating Pirfenidone for the Treatment of Idiopathic Pulmonary Fibrosis
            • Advantages and Disadvantages of Pirfenidone
            • Ongoing Clinical Development
            • Key Ongoing Trials of Pirfenidone in the Treatment of Idiopathic Pulmonary Fibrosis
            • Expert Insight: Pirfenidone
            • Clinical Trial Outcomes for Nintedanib
            • Key Results from Select Clinical Trials Investigating Nintedanib for the Treatment of Idiopathic Pulmonary Fibrosis
            • Advantages and Disadvantages of Nintedanib
            • Ongoing Clinical Development
            • Key Ongoing Trials of Nintedanib in the Treatment of Idiopathic Pulmonary Fibrosis
            • Expert Insight on Nintedanib
            • Combination of Pirfenidone and Nintedanib
            • Clinical Trial Outcomes for the Combination of Pirfenidone and Nintedanib
            • Key Results from Select Clinical Trials Investigating the Combination of Pirfenidone and Nintedanib for the Treatment of Idiopathic Pulmonary Fibrosis
            • Key Ongoing Trials of the Combination of Pirfenidone and Nintedanib in the Treatment of Idiopathic Pulmonary Fibrosis
            • Expert Insight on the Combination of Pirfenidone and Nintedanib
            • Other Medications Used to Treat Idiopathic Pulmonary Fibrosis
          • Medical Practice
            • Overview
            • Idiopathic Pulmonary Fibrosis Treatment Guidelines
            • Factors Influencing Drug Selection in Idiopathic Pulmonary Fibrosis
            • Treatment Providers
            • Treatment Initiation
            • Treatment of Severe Idiopathic Pulmonary Fibrosis
            • Expert Insight on Approach to Treatment
            • Expert Insight on the Role of Specialty Centers for Idiopathic Pulmonary Fibrosis
            • Generalized Treatment Decision Tree for Idiopathic Pulmonary Fibrosis
        • Unmet Need Overview
          • Current and Future Attainment of Unmet Needs in Idiopathic Pulmonary Fibrosis
          • Top Unmet Needs in Idiopathic Pulmonary Fibrosis: Current and Future Attainment
          • Expert Insight on the Unmet Needs in the Treatment of Idiopathic Pulmonary Fibrosis
        • Emerging Therapies Overview
          • Introduction
            • Key Findings
            • Pipeline Trends in Idiopathic Pulmonary Fibrosis
          • Key Emerging Therapies
            • Estimated Launch Dates of Key Emerging Therapies for the Treatment of Idiopathic Pulmonary Fibrosis
            • Key Ongoing Trials of Pamrevlumab in the Treatment of Idiopathic Pulmonary Fibrosis
            • Pamrevlumab Clinical Development
            • Expert Insight: Pamrevlumab
            • Expectations for Launch and Sales Opportunity of Pamrevlumab in Idiopathic Pulmonary Fibrosis
            • PBI-4050 Profile
            • PBI-4050 Clinical Development
            • Expert Insight
            • Expectations for Launch and Sales Opportunity of PBI-4050 in Idiopathic Pulmonary Fibrosis
            • PRM-151 Profile
            • PRM-151 Clinical Development
            • Expert Insight: PRM-151
            • Expectations for Launch and Sales Opportunity of PRM-151 in Idiopathic Pulmonary Fibrosis
            • GLPG-1690 Profile
            • Key Ongoing Clinical Trials of GLPG-1690 in the Treatment of Idiopathic Pulmonary Fibrosis
            • GLPG-1690 Clinical Development
            • Expert Insight: GLPG-1690
            • Expectations for Launch and Sales Opportunity of GLPG-1690 in Idiopathic Pulmonary Fibrosis
          • Early-Stage Pipeline Analysis
            • Select Compounds in Early-Stage Development for Idiopathic Pulmonary Fibrosis
            • Expert Insight: Select Early-Stage Compounds
          • Symptomatic or Acute Therapies in Development for Idiopathic Pulmonary Fibrosis
            • Select Symptomatic or Acute Therapies in Early-Phase Development for Idiopathic Pulmonary Fibrosis
          • Key Discontinuations and Failures in Idiopathic Pulmonary Fibrosis
            • Key Development Discontinuations and Failures
          • Patient Registries
            • Patient Registries for Idiopathic Pulmonary Fibrosis
            • Prominent Patient Organizations
          • Orphan Drug Designation
          • Access and Reimbursement Overview
            • Region-Specific Reimbursement Practices
              • Key Market Access Considerations in Idiopathic Pulmonary Fibrosis: United States
              • General Reimbursement Environment: United States
              • Key Market Access Considerations in Idiopathic Pulmonary Fibrosis: EU5
              • General Reimbursement Environment: EU5
              • Looking for More?
          • Methodology
            • Bottom-Up Forecasting Overview
              • Patient Populations
              • Drug-Specific Assumptions
            • Bottom-Up Forecast Assumptions
              • General Sources of Data
              • Drug-Treatment Rate Assumptions in Idiopathic Pulmonary Fibrosis
              • Patient-Share Assumptions in Idiopathic Pulmonary Fibrosis
              • General Statements About Pricing
              • Sources for Drug Prices
              • 2019 Exchange Rates
              • Price per Treated Day: 2019-2029
              • Dosing, Days of Therapy, and Compliance
              • Generic Erosion
              • Generic Erosion Assumptions
              • Out-Year Forecasting
              • Emerging Therapy Prices
            • Primary Market Research
              • Experts Interviewed
          • Appendix
            • Key Abbreviations Related to Idiopathic Pulmonary Fibrosis
            • Brands, Marketers, and Generic Availability of Key Therapies for Idiopathic Pulmonary Fibrosis by Market
            • Idiopathic Pulmonary Fibrosis Bibliography

        Author(s): Nuno Tiago Giao Antunes, PhD; Devashri Mukherjee, MPH; Natasha Bardhan, M.Pharm

        Nuno T. Antunes, Ph.D., is senior business insights analyst on the Infectious, Niche, and Rare Diseases team at Decision Resources Group, specializing in antibacterial agents. Previously, he was a Latin America Market Access senior analyst in the Global Market Access Insights Team, where he developed expertise in market access, pricing and reimbursement, health technology assessment, and health policy.

        Nuno holds a Ph.D. in animal health from the Universidad de las Palmas de Gran Canaria, Spain, and a D.V.M. degree from the Universidade de Trás-os-Montes e Alto Douro, Portugal. Prior to joining DRG, he conducted research in antimicrobial resistance and antimicrobial development, and worked in the medical devices industry as a scientist.

        Research enthusiast with a flair for academic writing, member of the DRG family since April 2015 and working from the India office.

        Started off career with a bachelor’s in Dental Surgery followed by a master’s in Public health; having primarily worked in the hospital setting as a Research Consultant prior to DRG and with 10 international publications to my credit.

        Natasha Bardhan is a Research Associate for the Infectious, Niche, & Rare Diseases (INRD) team at Decision Resources.

        Natasha Bardhan holds a bachelor’s degree in Pharmacy from DIPSAR, New Delhi and has completed her master’s in Pharmaceutics from Amity University, Noida. Prior to joining DRG, she worked as a Senior Associate at WNS (Healthcare) for two and a half years. She has worked on multiple client projects involving patents, sales and forecasting, pipeline analysis, keywords research and product/company profiling.


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