Stakeholder Opinions: Autoimmune Disorders in Emerging Markets - Patient Access Limits Market Potential
NEW YORK, Nov. 8, 2010 /PRNewswire/ -- Reportlinker.com announces that a new market research report is available in its catalogue:
Introduction
Autoimmune diseases offer a growth opportunity for companies. Emerging markets are also a key focus, providing a large patient pool and huge potential. However, market potential is not directly proportional to patient potential. Recognizing issues with patient access, cost and affordability are vital to understanding the opportunities.
Scope
*In-depth analysis of epidemiology, including prevalence rates for key autoimmune diseases and estimates of disease populations in the BRICT regions
*Comparison of four year historical IMS sales and volume of the BRICT autoimmune markets, benchmarked against the seven major markets
*Assessment of the leading brands driving growth and top 10 companies active in the autoimmune disease area split by each BRICT region
*Provides a comparative overview of healthcare systems in BRICT, outlining issues with patient access to autoimmune therapies
Highlights
The BRICT autoimmune market generated $644m compared to $25 billion in the seven major markets in 2009. Despite a larger patient potential in BRICT, this does not translate directly to market size due to country-level specific factors, such as diagnosis, cost, patient access and healthcare infrastructure that result in this clear disparity.
Russia outstripped sales growth of its emerging market peers, generating autoimmune disorder sales of $266m in 2009, around 2.5% of Russia's total pharmaceutical market. Russia's high market share and growth rate make it the star of the BRICT autoimmune markets. Datamonitor believes Russia is currently the most attractive BRICT autoimmune market.
Despite differences in access to costly therapies among the BRICT regions, the top six products were high value biologic therapies, which created 70% of the total autoimmune market sales in 2009. Despite being the last anti-TNF to the market, Humira (adalimumab; Abbott) was the fastest growing brand, largely due to significant uptake in Turkey.
Reasons to Purchase
*Understand the relative attractiveness of each of the BRICT autoimmune markets, based on six key factors, including market size and patient potential
*Identify which markets in BRICT are more open to international versus domestic companies
*Gain insight into the autoimmune disorder markets in each region, and understand which products and drug classes are powering sales and volume growth
Overview 1
Catalyst 1
Summary 1
About Datamonitor Healthcare 2
About the Immunology & Inflammation pharmaceutical analysis team 2
Executive Summary 3
Scope of the analysis 3
Datamonitor insight into Autoimmune Diseases in Emerging Markets 3
Related reports 5
Upcoming reports 5
Table of Contents 6
1. Overview 7
Key findings 7
Market definition for this report 8
Indications and markets 8
IMS data 8
Caveats associated with IMS data 9
Hospital versus retail channel split 9
Overview of the BRICT emerging markets 10
Attractiveness of the BRICT autoimmune markets 10
Comparison of total country populations 11
Autoimmune disorder patient population size 13
Tier 1 emerging markets - Brazil, Russia, India, China and Turkey 13
Seven major markets 16
Autoimmune disorder market value 19
High growth rate in the emerging autoimmune markets 19
Notable impact from exchange rates on US$ market value 20
Russia is the star of the BRICT autoimmune emerging markets 23
Autoimmune market in Turkey and Russia is up to 9 times the size of other emerging markets 24
Multiple sclerosis drugs and biologics dominate the top 10 brand positions in the emerging markets 25
Top 10 companies generated 80% of total BRICT autoimmune market value in 2009 27
Cost per patient per year of key autoimmune disorder drugs 29
Anti-TNF brands 29
Multiple sclerosis brands 30
Psoriasis brands 32
Gastrointestinal brands 32
2. Brazil 34
Key findings 34
Current autoimmune disorder market overview 35
Total market sales showed minimal growth and decrease in standard unit volume between 2005 and 2009 35
Antirheumatic agents followed by intestinal anti-inflammatory drugs drove growth 37
Multiple sclerosis drug sales are minimal in Brazil and declining 37
EMS Sigma Pharma's mesalazine has experienced the highest historical growth 38
International companies are important, but there is a large proportion of sales from domestic players 39
Healthcare system 40
Brazil's healthcare system covers the costs of rheumatoid arthritis and other autoimmune disorders 41
Concern about the rising costs of newer therapies sees a shift to drug appraisals 42
Generics and biosimilars 43
Patients can access non-listed drugs through the Brazilian courts 44
Brazil's pharmaceutical market falls under tight price controls 45
Epidemiology overview 45
Rheumatoid arthritis and juvenile idiopathic arthritis 46
Epidemiology 46
Only half of Brazil's rheumatoid arthritis patients are diagnosed 47
Patient follow-up is largely through rheumatologists 48
Use of drugs in the treatment of rheumatoid arthritis 49
Availability of drugs free of charge is the main prescribing factor 49
Majority of rheumatoid arthritis healthcare costs come from drug therapies 49
Methotrexate appears to be the gold-standard rheumatoid arthritis drug in Brazil 50
Infliximab is the most commonly prescribed anti-TNF in rheumatoid arthritis 51
Physicians estimate a third of patients are inadequate responders to methotrexate 52
Ankylosing spondylitis and psoriatic arthritis 53
Psoriasis 54
Systemic lupus erythematosus 54
Crohn's disease and ulcerative colitis 54
Multiple sclerosis 55
Epidemiology 55
Use of disease modifying multiple sclerosis drugs in Brazil 56
3. Russia 58
Key findings 58
Current autoimmune disorder market overview 59
Significant impact from currency devaluation on the autoimmune disorder market from 2008 to 2009 59
Immunosuppressive agents was the only drug class to grow in 2008-09 in US$ terms 61
Overwhelming majority of market value contained within top 10 brands in Russia 62
High level of involvement from international companies in Russian autoimmune disorder market 64
Healthcare system 65
Epidemiology overview 67
Rheumatoid arthritis 68
Epidemiology 68
Rheumatoid arthritis costs 68
Ankylosing spondylitis 70
Psoriasis 70
Multiple sclerosis 70
4. India 71
Key findings 71
Current autoimmune disorder market overview 72
The Indian autoimmune disorder market was largest by volume but second smallest by value in 2009 72
Immunosuppressive agents and specific antirheumatic drugs driving growth in India 73
Enbrel experienced highest short-term growth in Indian autoimmune disorder market 74
India shows the least potential for foreign companies in the autoimmune space 75
Healthcare system 76
Overview 76
Biosimilar monoclonal antibodies are a reality in India 77
Epidemiology overview 78
Rheumatoid arthritis and juvenile idiopathic arthritis 79
Epidemiology 79
Diagnosis rates for key rheumatic diseases in India 80
Most patients visit GPs, but a third seek out rheumatologists directly 81
Drug usage for rheumatoid arthritis in India 81
Low use of biologics due to high cost and subsequent lack of patient affordability 81
Traditional Ayurvedic treatments are used by some patients 84
Rheumatologists in India may be experimenting with treatment gaps to limit direct patient costs 84
Ankylosing spondylitis and psoriatic arthritis 85
Psoriasis 85
Systemic lupus erythematosus 86
Crohn's disease and ulcerative colitis 86
Multiple sclerosis 86
Epidemiology 86
Drug usage for multiple sclerosis in India 87
Natco Pharma launches glatiramer acetate in India 87
5. China 89
Key findings 89
Current autoimmune disorder market overview 90
China was the third largest autoimmune disorder market in the BRICT regions in 2009 90
Remicade sales growth powers China's autoimmune market 92
A mix of international and domestic players operate in the autoimmune market 93
Healthcare system 94
Overview 94
Sweeping healthcare reform plans for 90% coverage by 2011 95
Drug approval system overseen by SFDA, but varies between regions 96
Generics and biosimilars - safety called into question 97
Epidemiology overview 98
Rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis 99
Epidemiology 99
Use of traditional Chinese medicines to treat rheumatoid arthritis 100
Psoriasis 101
Systemic lupus erythematosus 101
Crohn's disease and ulcerative colitis 101
Epidemiology 101
Lack of awareness contributes to the misdiagnosis of inflammatory bowel diseases in China 103
Drug usage for inflammatory bowel disease in China 104
Remicade is the main biologic for inflammatory bowel disease 105
Factors influencing physician choice of therapy - severity, disease location and cost 106
Traditional Chinese medicine is unlikely to be a major threat to Western medications in China/Hong Kong 107
Multiple sclerosis 107
6. Turkey 108
Key findings 108
Current autoimmune disorder market overview 109
Second fastest growing autoimmune disorder market sales after Russia 109
Immunosuppressive agents experience highest sales growth of all autoimmune drug classes 110
Humira took over from Enbrel as second highest selling autoimmune brand in 2009 111
98% of autoimmune sales generated by top 10 companies in 2009 112
Healthcare system 113
Overview 113
Biosimilar legislation as of August 2008 114
Epidemiology overview 115
Rheumatoid arthritis and juvenile idiopathic arthritis 115
Epidemiology 115
Rheumatoid arthritis is well diagnosed in Turkey 116
Turkey follows international guidelines on rheumatoid arthritis management including those from NICE 118
Drug usage for rheumatoid arthritis in Turkey 119
Proportion of patients on biologics in Turkey unlikely to exceed 10% in the next 5 years 122
Rheumatoid arthritis costs 123
Ankylosing spondylitis and psoriatic arthritis 126
Epidemiology 126
Drug usage for ankylosing spondylitis in Turkey 127
Psoriasis 128
Systemic lupus erythematosus 129
Crohn's disease and ulcerative colitis 129
Epidemiology 129
Drug usage for ulcerative colitis in Turkey 131
Multiple sclerosis 133
Bibliography 134
Journals 134
Websites 143
Datamonitor reports 144
Other sources 144
Appendix 145
Epidemiology overview tables 145
Rheumatoid arthritis and juvenile idiopathic arthritis 145
Psoriatic arthritis 146
Ankylosing spondylitis 148
Psoriasis 149
Systemic lupus erythematosus 150
Crohn's disease 151
Ulcerative colitis 152
Multiple sclerosis 153
Price per IMS Standard Unit ($/SU) 153
Anti-TNF drugs 153
Multiple sclerosis drugs 154
Oral gastrointestinal drugs 156
Psoriasis drugs 158
Data definitions, limitations and assumptions 159
Standard units 159
Dosing assumptions 159
Contributing experts 160
Conferences attended 160
Report methodology 161
About Datamonitor 161
About Datamonitor Healthcare 161
About the Immunology & Inflammation analysis team 162
Disclaimer 164
List of Tables
Table 1: Hospital versus retail channels for IMS sales data in the seven major markets and BRICT nations, 2009 10
Table 2: Comparison of the autoimmune population sizes in BRICT and the combined seven major markets, 2010 15
Table 3: Comparison of the autoimmune population sizes in the seven major markets, 2010 17
Table 4: Brazil: key healthcare indicators, 2010 41
Table 5: Brazil: public sector pharmaceutical assistance programs, 2008 42
Table 6: Brazil: methods of patient acquisition of biologic drugs according to rheumatologist perception, 2009 45
Table 7: Brazil: summary of prevalence of key autoimmune diseases and patient populations, 2010 46
Table 8: Brazil: breakdown of diagnosis rate, treatment rate and public versus private sector treatment rates for rheumatoid arthritis patients, 2009 48
Table 9: Brazil: estimates of rheumatoid arthritis patient follow-up according to physician perception, 2009 49
Table 10: Brazil: total annual costs (direct and indirect) related to rheumatoid arthritis patients in an outpatient clinic, Sao Paulo, 2002 50
Table 11: Brazil: most frequently prescribed treatments for rheumatoid arthritis according to the Federal University of Sao Paulo 51
Table 12: Brazil: percentage of patients using each type of biological medication according to rheumatologists' perception, 2009 52
Table 13: Brazil: patient inadequate response rates to various treatment strategies according to rheumatologists' perception, 2009 53
Table 14: Brazil: reasons for noncompliance with biologic use according to the perception of rheumatologists, 2009 53
Table 15: Russia: key healthcare indicators, 2007 67
Table 16: Russia: summary of prevalence of key autoimmune diseases and patient populations, 2010 68
Table 17: Estimated annual cost (euros) of rheumatoid arthritis per patient in Russia, the US and five major EU markets, 2006 69
Table 18: National annual cost (euros m) of rheumatoid arthritis in Russia, the US and five major EU markets, 2006 70
Table 19: India: key healthcare indicators, 2007 77
Table 20: India: summary of prevalence of key autoimmune diseases and patient populations, 2010 79
Table 21: India: diagnosis rates for rheumatic diseases based on key opinion leader estimates, 2010 80
Table 22: Percentage of multiple sclerosis patients receiving disease modifying drugs in each of the BRICT emerging markets, 2008 87
Table 23: China: key healthcare indicators, 2007 95
Table 24: China: summary of prevalence of key autoimmune diseases and patient populations, 2010 99
Table 25: Phenotypes of Chinese Crohn's disease patients according to the Montreal classification in Hong Kong, 1991-2006 102
Table 26: Proportion of Chinese Crohn's disease patients receiving each class of medication in Hong Kong, 2006 104
Table 27: Turkey: key healthcare indicators, 2007 114
Table 28: Turkey: summary of prevalence of key autoimmune diseases and patient populations, 2010 115
Table 29: Turkey: rheumatoid arthritis patients' medical management, 2008 119
Table 30: Turkey: average annual costs (euros)associated with rheumatoid arthritis, 2010 125
Table 31: Estimated annual cost (euros) of rheumatoid arthritis (RA) per patient in Turkey, the US and five major EU markets, 2006 125
Table 32: National annual cost (euros m) of rheumatoid arthritis (RA) in Turkey, the US and five major EU markets, 2006 126
Table 33: Turkey: use of drugs by class in ankylosing spondylitis, 2008 128
Table 34: Turkey: use of DMARD drugs in ankylosing spondylitis, 2008 128
Table 35: Turkey: use of specific molecules in the treatment of ankylosing spondylitis, 2008 128
Table 36: Prevalence of rheumatoid arthritis and juvenile idiopathic arthritis across the seven major markets, 2010 146
Table 37: Psoriatic arthritis prevalence across the seven major markets, 2008 147
Table 38: Ankylosing spondylitis population across the seven major markets, 2008 148
Table 39: Psoriasis prevalence across the seven major markets, 2008 149
Table 40: Systemic lupus erythematosus (SLE) population, split by gender across the seven major markets, 2010 150
Table 41: Prevalence and incidence of Crohn's disease (CD) in the seven major markets by country, 2007 151
Table 42: Prevalence and incidence of ulcerative colitis in the seven major markets by country, 2007 152
Table 43: Prevalence of multiple sclerosis in the seven major markets (000), 2009 153
Table 44: Datamonitor's dosing assumptions for key autoimmune brands, 2010 160
List of Figures
Figure 1: Datamonitor's assessment of attractiveness of the BRICT markets, 2010 11
Figure 2: Overview of total country population size (million) in the BRICT markets and seven major markets, 2010 12
Figure 3: Autoimmune disorder population size (million) compared to autoimmune disorder sales ($ billion) in the BRICT markets compared to the seven major markets, 2010 13
Figure 4: Autoimmune population size shown as a function of the total population in the seven major markets, 2010 18
Figure 5: Sales ($m) and volume (SU million) in the autoimmune market in the combined BRICT markets, 2005-09 20
Figure 6: Impact of a constant exchange rate on the total autoimmune disorder market in the combined BRICT markets, 2005-09 21
Figure 7: Performance of the emerging autoimmune disorder markets in the BRICT markets, 2005-09 22
Figure 8: Sales ($m) and volume (SU million) in the autoimmune market in the combined seven major markets, 2005-09 23
Figure 9: Market share versus market growth in the BRICT autoimmune markets, 2005-09 24
Figure 10: Sales ($m) in the autoimmune market, split by drug class, across the BRICT markets, 2009 25
Figure 11: Performance of the top 10 brands in the BRICT markets, 2005-09 26
Figure 12: Comparison of the sales ($m) of the top 5 brands overall with the top 5 autoimmune brands in the combined BRICT markets , 2009 27
Figure 13: Autoimmune disorder sales ($m) for the top 10 companies in the combined BRICT markets, 2009 28
Figure 14: Autoimmune disorder sales ($m) for the top companies in the individual BRICT markets, 2009 29
Figure 15: Cost per patient per year for Remicade, Humira and Enbrel in the BRICT markets and the seven major markets, 2005-09 30
Figure 16: Cost per patient per year for disease-modifying multiple sclerosis drugs in the BRICT markets and the seven major markets, 2005-09 31
Figure 17: Cost per patient per year for the psoriasis drugs Dovonex (calcipotriol) and Dovobet (calcipotriol + betamethasone) in the BRICT markets and the seven major markets, 2005-09 32
Figure 18: Cost per patient per year for common gastrointestinal drugs for treating inflammatory bowel disease in the BRICT markets and the seven major markets, 2005-09 33
Figure 19: Brazil: sales ($m) and volume (SU million) in the autoimmune market, 2005-09 36
Figure 20: Brazil: performance of the autoimmune drug classes, 2005-09 37
Figure 21: Brazil: sales performance of the top 10 autoimmune brands, 2005-09 39
Figure 22: Brazil: autoimmune disorder sales ($m) for the top 10 autoimmune companies, 2009 40
Figure 23: Brazil: incidence and prevalence of inflammatory bowel disease in São Paulo state, 1986-2005 55
Figure 24: Brazil: proportion of patients with multiple sclerosis, split by type in southern Brazil, 2008 56
Figure 25: Brazil :distribution of use of disease-modifying drugs among multiple sclerosis patients in southern Brazil, 2008 57
Figure 26: Russia: sales ($m) and volume (SU million) in the autoimmune market, 2005-09 60
Figure 27: Russia: impact of a constant exchange rate on the total autoimmune disorder market, 2005-09 61
Figure 28: Russia: performance of the autoimmune drug classes, 2005-09 62
Figure 29: Russia: performance of the top 10 autoimmune brands, 2005-09 63
Figure 30: Number of marketed products included in autoimmune disorder markets compared to percentage of total autoimmune disorder market within top 10 brands in the BRICT and seven major markets, 2009 64
Figure 31: Russia: autoimmune disorder sales ($m) for the top 10 autoimmune companies, 2009 65
Figure 32: India: sales ($m) and volume (SU million) in the autoimmune market, 2005-09 73
Figure 33: India: performance of the autoimmune market, 2005-09 74
Figure 34: India: performance of the top 10 autoimmune brands, 2005-09 75
Figure 35: India: autoimmune disorder sales ($m) for the top 10 autoimmune companies, 2009 76
Figure 36: India: rheumatoid arthritis treatment algorithm, 2010 82
Figure 37: India: use of biologic by line of therapy for rheumatoid arthritis, 2010 84
Figure 38: China: sales ($m) and volume (SU million) in the autoimmune market, 2005-09 91
Figure 39: China: performance of the autoimmune drug classes, 2005-09 92
Figure 40: China: performance of the top 10 autoimmune brands, 2005-09 93
Figure 41: China: autoimmune disorder sales ($m) for the top 10 autoimmune companies, 2009 94
Figure 42: China: market share based on sales of the main mesalazine brands in mild-to-moderately severe ulcerative colitis and Crohn's disease, 2009 105
Figure 43: Turkey: sales ($m) and volume (SU million) in the autoimmune market, 2005-09 110
Figure 44: Turkey: performance of the autoimmune market, 2005-09 111
Figure 45: Turkey: performance of the top 10 autoimmune brands, 2005-09 112
Figure 46: Turkey: autoimmune disorder sales ($m) for the top 10 autoimmune companies, 2009 113
Figure 47: Turkey: distribution of onset types of juvenile idiopathic arthritis, 1994-2004 118
Figure 48: Turkey: Datamonitor's proposed rheumatoid arthritis treatment algorithm , 2010 121
Figure 49: Turkey: comparison of market share based on value and volume for all three anti-TNFs, 2009 122
Figure 50: Turkey: structure of direct costs for rheumatoid arthritis (RA), 2010 124
Figure 51: Turkey: distribution of psoriasis patients who attended a dermatology outpatient clinic split by age range, 1992-99 129
Figure 52: Turkey: prevalence of ulcerative colitis in Trakya split by age range, 1998-2002 131
Figure 53: Turkey: use of medications among Crohn's disease patients in remission, 1993-2007 132
Figure 54: Turkey: use of medications among ulcerative colitis patients in remission, 1993-2007 133
Figure 55: Price per standard unit ($/SU) for leading anti-TNF drugs in BRICT markets, 2005-09 154
Figure 56: Price per standard unit ($/SU) for leading multiple sclerosis drugs in BRICT markets, 2005-09 155
Figure 57: Price per standard unit ($/SU) for leading multiple sclerosis drugs in the US, five major EU markets and Japan, 2005-09 156
Figure 58: Price per standard unit ($/SU) for leading gastrointestinal drugs in BRICT markets, 2005-09 157
Figure 59: Price per standard unit ($/SU) for leading gastrointestinal drugs in the US, five major EU markets and Japan, 2005-09 158
Figure 60: Price per standard unit ($/SU) for leading topical psoriasis drugs in BRICT markets, 2005-09 159
To order this report:
Pathology Industry: Stakeholder Opinions: Autoimmune disorders in emerging markets - Patient access limits market potential
Check our Company Profile, SWOT and Revenue Analysis!
Nicolas Bombourg |
|
Reportlinker |
|
Email: [email protected] |
|
US: (805)652-2626 |
|
Intl: +1 805-652-2626 |
|
SOURCE Reportlinker
Share this article