|
At the end of September 2000, the global pharmaceutical
market was worth $297.6 billion according to IMS HEALTH's
MIDAS system,
with 37.3% of sales coming from the leading 15 therapy classes.
Cardiovascular disease continues to be the leading cause
of death worldwide - reflected in the success of treatments
for hypertension and triglyceride reduction. Lifestyle trends
and a rise in the ageing population are also influencing
patterns of disease and being reflected in therapy class
growth.
Antiulcerants lead global pharmaceutical sales
The top 15 therapeutic classes together accounted for 37.3%
of global pharmaceutical sales ($297.6 billion) at the end
of the third quarter 2000.
Looking at disease trends, it is not surprising that treatments
for ulcers, heart disease, mental illness and chronic conditions
such as arthritis are among the top 15 therapy classes both
in terms of revenue and prescriptions.
Antiulcerants have maintained their leading sales position
over the past 10 years despite patent expiries, although
in terms of prescriptions they rank third. Cholesterol
and triglyceride reducers have gained a considerable
share of sales over the past 10 years but rank only tenth
in terms of prescriptions.
|
Leading
Therapeutic Classes 1990 to September 2000
|
|
Global
Audited Sales US$
|
|
Therapy
Class (3Q 2000 Rank)
|
%
World 1990
|
%
World 1995
|
%
World 3Q 2000
|
Ranking
by Prescriptions
|
| Antiulcerants |
4.6
|
5.3
|
5.2
|
3
|
| Chol.
& Triglyc. reducers |
*
|
2.7
|
4.5
|
10
|
| Antidepressants |
1.4
|
2.3
|
3.9
|
14
|
| Ca2+
Antagonists (plain) |
3.2
|
3.8
|
3.1
|
4
|
| Non-steroidal
Antirheumatics |
3.7
|
3.7
|
2.8
|
1
|
| Cephalosporins |
4.6
|
3.7
|
2.4
|
7
|
| ACE
Inhibitors (plain) |
2.4
|
2.8
|
2.3
|
11
|
| Non-narcotic
Analgesics |
2.6
|
2.8
|
2.0
|
2
|
| Antipsychotics |
*
|
*
|
1.8
|
*
|
| Oral
Antidiabetics |
*
|
*
|
1.7
|
*
|
| Systemic
Antihistamines |
*
|
*
|
1.7
|
8
|
| Erythropoietin |
*
|
*
|
1.6
|
*
|
| Broad
Spectrum Penicillins |
1.9
|
1.7
|
1.5
|
6
|
| Antiepileptics |
*
|
*
|
1.5
|
*
|
| Macrolides |
*
|
1.4
|
1.4
|
*
|
| *Not
in top 15 that year |
|
|
|
Source:
IMS HEALTH World Review
Considering
the ageing population, it is surprising to see a fall in
the share of non-steroidal antirheumatics and non-narcotic
analgesics. This, however, is due to the lower price of
these products: in prescription terms, they are the two
leading therapeutic classes.
Antipsychotics and EPO products fastest growing
Of the top 15 therapeutic classes, sales of erythropoietin
(EPO) products, used to treat chronic anaemia in dialysis
and cancer patients, and antipsychotics recorded the greatest
increase between 1998 and 1999, despite their ranking outside
the top 15 just five years ago:
- Sales
of erythropoietin products grew 34%, moving the class
up four places in just one year
-
Antipsychotics grew by 26% over 1998, fuelled by sales
of Zyprexa (olanzapine) and Risperdal (risperidone), which
now dominate the class.
Shift
from infectious to non-communicable disease
Disease patterns are influenced by demographic and lifestyle
changes as well as medical advances. On a global basis,
prevention by vaccination,
as well as improvements in treatment, have resulted in shifts
away from infectious disease toward non-communicable disease,
especially in developed countries. According to the World
Health Organization (WHO), non-communicable disease now
accounts for 60% of global mortality.
There are, however, some resurgent markets of infectious
diseases such as new strains of tuberculosis,
which present an unmet need to the pharmaceutical industry.
Leading causes of death
WHO figures show that cardiovascular disease continues to
be the leading cause of death worldwide, followed by cancer
and respiratory disease - mainly chronic obstructive pulmonary
disease (COPD).
Cholesterol and triglyceride reducers ranked second at the
end of the third quarter 2000, with 4.5% of world sales,
up from 2.7% in 1995. This class had strong growth of 23%
in 1999.
Calcium antagonists slipped to 3.1%, down from 3.8% in 1995:
- This
class grew by 6% in 1999 with Pfizer's Norvasc (amlodipine)
continuing as the leading product
- The
Africa, Asia and Australasia region was the most active,
with a growth rate of 23% in 1999, compared with growth
of only 3% in North America
ACE
inhibitors also appear in the top 15, but inexpensive treatments
for hypertension, such as diuretics and beta-blockers, are
not in the top 15 for sales but are for prescriptions. Despite
the reduction in the percentage of the US population affected
by hypertension and high cholesterol (see chart below),
there is still a considerable market for treatment.
Trends
in Hypertension and High Cholesterol in USA (1960 to 1991)
Source: US Center for Disease Control
Cancer
incidence in the USA peaked around 1992 and is now in decline,
although the number of people developing cancer remains
high. In 2000, 1.2 million new cases of cancer are expected
in the USA and 13 million new cases have been diagnosed
since 1990, according to the American Cancer Society.
Not surprisingly, there are over 1,000 cancer treatments
in the R&D pipeline of the world's pharmaceutical and biotechnology
companies, according to IMS HEALTH's drug database, R&Dfocus.
Respiratory disease is a chronic illness that kills
350,000 Americans annually (American Lung Association).
There are currently approximately 30 million Americans living
with chronic respiratory disease.
Between 1982 and 1996 the prevalence rate for asthma in
the USA rose by 58.7%, with the highest rate of increase
in 18-44 year olds (123.4%). COPD increased by 58% between
1982 and 1996, the most prominent forms being emphysema
and chronic bronchitis
Impact of ageing population
Changes in global demographics, such as the growing elderly
population, are also having an impact on disease. While
the global population is growing by 1.7% annually, the over-65
age group increases by 2.5% a year. In Europe, 13.2-17.9%
of individual country populations are over age 65 (WHO).
Proportion of World Population Aged 60+ 1950 to 2050
Source: WHO/United Nations
The
growing elderly population is contributing to a rise in
mental illness such as Alzheimer's
disease and dementia as well as chronic illnesses such
as arthritis.
Non-steroidal antirheumatics remained in the top five therapeutic
classes, with growth of 24% in 1999, driven by the launch
of the COX-2 inhibitors
- Class
sales have declined somewhat since 1995 when they held
3.7% of global sales
- North
America fuelled the growth in this class with a 1999 growth
rate of 55% compared with just 1% growth in Europe
Lifestyle
diseases
Lifestyle trends are strongly influencing the prevalence of
certain diseases in developed countries. High fat diets and
sedentary lifestyles are contributing to the rise in obesity,
especially in the USA.
The consumption of caffeine and alcohol, as well as smoking,
are risk factors for developing ulcers. Increasing urbanization
has contributed to higher levels of stress, which in turn
plays a role in rising rates of depression
and anxiety disorders as well as being a further risk factor
for ulcers.
Antiulcerants continued to top the global pharmaceutical
market with 5.2% of $337 billion in sales. This class share
has risen slowly over the last ten years, up from 4.6% in
1990 - Losec (omeprazole) was the leading antiulcerant in
1999, having surpassed Zantac (ranitidine) in 1996
Antidepressants held 3.9% of the world market, having
risen considerably from 1.4% in 1990. North America has been
responsible for this success, accounting for over 70% of world
sales. Prozac (fluoxetine) was the leading product in 1999,
but this looks set to change as Prozac
loses patent protection in the US market in 2001. |
