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REFERENCE CODE GDHC87PIDR | PUBLICATION DATE FEBRUARY 2015
ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS
TO 2023
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Executive Summary
Table below provides the key metrics for atrial
fibrillation (AF) in the eight major pharmaceutical
markets (8MM) (US, France, Germany, Italy,
Spain, UK, Japan, and Canada) covered in this
report, from 2013 to 2023.
AF: Key Metrics in the 8MM, 2013−2023 2013 Epidemiology
Prevalent population 10.1 million
Treated population 8.7 million
2013 Market Sales
US $2.7bn
5EU $1.4bn
Japan $258m
Canada $243m
Total $4.6bn
Pipeline Assessment
Number of drugs in Phase I–III 10
Number of first-in-class drugs 1
Most Promising Pipeline Drug Peak-Year Sales
Gilead’s ranolazine/dronedarone $315m
Key Events (2014–2023) Level of Impact
Launch of Daiichi Sankyo’s Savaysa* (edoxaban) in 2014 and 2015 ↑↑
Portola Pharmaceuticals launches the factor Xa inhibitor antidote, andexanet alfa, in 2017 ↑↑
Boehringer Ingelheim launches the Pradaxa antidote, idarucizumab, in 2018 ↑↑
Boehringer Ingelheim’s Pradaxa (dabigatran) loses US patent protection in 2018 ↓↓↓
Gilead launches ranolazine/dronedarone in 2022 ↑↑
2023 Market Sales
US $2.4bn
5EU $2.5bn
Japan $535m
Canada $255m
Total $5.7bn
Source: GlobalData *Edoxaban is marketed as in Japan under the brand name Lixiana. 5EU = France, Germany, Italy, Spain, and the UK, 8MM = US, France, Germany, Italy, Spain, UK, Japan, and Canada
Atrial Fibrillation Market Will Peak at $9.4bn in 2020
GlobalData estimates the 2013 sales for AF at
approximately $4.6 billion across the 8MM. The US
dominates the overall size of the AF market,
generating an estimated $2.7 billion in 2013 and
accounting for 59% of the overall size of the
market. This is mainly due to the large prevalent
AF population in the US, early adoption of the new
oral anticoagulants (NOACs), and higher prices for
AF medications in this market.
Since the launch of the first of the NOACs in 2010,
this drug class has experienced substantial uptake,
accounting for $3.2 billion − approximately 70% −
of all AF sales revenue across the 8MM in 2013.
GlobalData anticipates that NOAC uptake will
continue to increase, and will be the main driver in
the growth of the AF market. This growth will be
driven further by the recent launch of a fourth
NOAC, Daiichi-Sankyo’s Savaysa, which now
provides further anticoagulant treatment options for
patients with AF. GlobalData forecasts that the AF
drug market will grow at a Compound Annual
Growth Rate (CAGR) of 2.1% over the 10-year
forecast, resulting in a market value of $5.7 billion
by 2023. However, it is expected that peak sales
will be reached prior to this date, in 2020, when the
AF market will be valued at $9.4 billion. A
subsequent decline in the overall size of the AF
market from this date will be related to the entry of
the first generic versions of the NOACs, starting
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Executive Summary
with Boehringer Ingelheim’s anticipated loss of US
patent protection for Pradaxa in 2018.
The antiarrhythmic drugs ranolazine/dronedarone,
developed by Gilead, and Laguna
Pharmaceuticals’ vanoxerine are also forecast to
launch late in the forecast period. However, neither
will reach peak sales by 2023, with only
ranolazine/dronedarone making an early impact as
a potential drug candidate for the maintenance of
sinus rhythm.
Major drivers for the growth of the AF market over
the forecast period will include:
The continued uptake of the NOACs for the
prevention of stroke in patients with AF. Due to
the advances that the NOACs provide in terms
of improved safety and the lack of a need for
routine monitoring, NOAC uptake will continue
to increase, taking market share away from
warfarin.
A shift in AF treatment guidelines to using the
CHA2DS2-VASc score instead of the CHADS2
score for assessing stroke risk, which will
cause a larger proportion of lower risk patients
to receive anticoagulant treatment. (See Table 13 and Table 14 for descriptions of the
CHADS2 and CHA2DS2-VASc abbreviations,
respectively.)
The approval and launch of the first antidotes
for the NOACs will alleviate physician and
patient concerns regarding a lack of a reversal
agent in the event of uncontrolled bleeding,
thereby increasing overall uptake.
Major barriers to the growth of the AF market over
the forecast period will include:
Generic erosion of the NOACs, starting with
Boehringer Ingelheim’s Pradaxa, which will
lose US patent protection in 2018.
Large, costly, and comprehensive clinical trials
required to support regulatory approval of
cardiovascular drugs, which will deter drug
developers wanting to enter the AF market.
Widely available generic antiarrhythmic drugs,
which will make it difficult for any novel rhythm
control agents to gain reimbursement and
wider uptake.
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Executive Summary
Figure below provides the sales for AF in the 8MM
from 2013 to 2023.
Sales for AF by Region, 2013–2023
59%
4%
12%
4%
7%
3%6%
5%
2013 Total: $4.6bn
US
France
Germany
Italy
Spain
UK
Japan
Canada
42%
8%15%
7%
10%
4%
9%5%
2023 Total: $5.7bn
Source: GlobalData
The New Oral Anticoagulants Will Drive the Growth and Size of the Atrial Fibrillation Market
Antithrombotic therapy has an important role in the
prevention of stroke in patients with AF, with
vitamin K antagonists such as warfarin historically
being the most widely prescribed drugs and with
antiplatelet drugs playing a more minor role.
However, since 2010, and the launch of the first of
the NOACs, a shift in the treatment of patients with
AF has occurred. There are now four NOACs on
the market indicated for the prevention of AF,
which include Boehringer Ingelheim’s Pradaxa
(dabigatran), Bayer/Janssen’s Xarelto
(rivaroxaban), Bristol-Myers Squibb/Pfizer’s Eliquis
(apixaban), and a fourth NOAC which was only
approved in the US early in 2015, Daiichi-Sankyo’s
Savaysa (edoxaban).
The NOACs represent important advances over
warfarin because they have predictable
pharmacological profiles and do not require routine
blood monitoring or dose adjustments, have fewer
drug–drug interactions, an absence of major
dietary effects, and in terms of efficacy and safety,
have proven to be non-inferior, if not superior,
compared with warfarin, particularly with regard to
a reduced risk of major bleeding. However, uptake
of the NOACs has been slowed due to the
associated cost of these drugs, which are
substantially higher than that of generically
available warfarin and other vitamin K antagonists.
In addition, the lack of an antidote that can be used
in the case of excessive bleeding with NOACs has
also limited their widespread use. GlobalData
believes that as physician familiarity with these
drugs increases, and experience is gained in
selecting the appropriate NOAC based on a
patient’s risk profile, further NOAC uptake will
occur across all markets. The anticipated arrival of
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Executive Summary
NOAC reversal agents (antidotes) from 2017 on
are also expected to ease remaining physician and
patient concerns regarding the treatment of
uncontrolled bleeding.
GlobalData anticipates that the NOACs will have
the greatest impact on the AF market within the
forecast period. It is anticipated that the strong
safety and efficacy profile of Eliquis, as
demonstrated in pivotal Phase III clinical trials, will
drive uptake of the drug, despite it being positioned
as the third NOAC to enter the market. It is
forecast that sales of Eliquis will exceed Xarelto by
2018 replacing it as the market leader of the
NOACs. In contrast, the impact of the launch of
Savaysa in the US is expected to be more limited
than initially anticipated, after the US Food and
Drug Administration (FDA) decided that Savaysa
will carry a boxed warning stating that the drug
should not be used in patients with normal renal
function. With the anticoagulant space for the
prevention of stroke becoming increasingly
crowded, it is forecast that Pradaxa will be the
NOAC to lose the most market share as physicians
and patients opt for one of the other NOACs such
as Xarelto and Eliquis, which not only have strong
safety profiles, but also less restrictions on their
use.
Companies Focus on Label Expansion and Intensive Marketing to Differentiate Their Products
Companies attempting to penetrate the AF market
and differentiate their products, particularly those
companies that market NOACs, are doing so with
two main strategies: label expansion to increase
physician brand familiarity, and intensive marketing
to disseminate clinical trial results. Gaining
approval for additional cardiovascular indications
has been a strategy that has worked very well for
Bayer and Janssen, the two companies that jointly
developed and market Xarelto. Positioned as the
second-to-market NOAC, after Pradaxa, Xarelto’s
marketing companies rapidly conducted clinical
trials and filed for regulatory approval for non-AF
indications, such as the treatment and reduction in
risk of recurrent deep vein thrombosis (DVT),
pulmonary embolism (PE), and acute coronary
syndrome (ACS), thereby initially garnering the
approval for more indications than any of the other
NOACs. Boehringer Ingelheim, Bristol-Myers
Squibb, and Pfizer have tried to follow suit, but
have been much slower at expanding the labels of
their own respective NOACs. The competing
companies have had difficulty in keeping up with
the marketers of Xarelto, and Bayer and Janssen
are now also pursuing Xarelto’s approval for
additional patient populations such as chronic
heart failure, and the prevention of symptomatic
venous thromboembolism (VTE) and VTE-related
death in high-risk, medically ill patients.
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Executive Summary
In addition to label expansion, marketing has also
played a strong role in the success of certain
NOACs. Bayer and Janssen, for example, heavily
invested in advertising by utilizing journal articles
and direct-to-consumer advertising as a means to
reach physicians and patients, while Bristol-Myers
Squibb and Pfizer have also reported that they
have initiated marketing and outreach campaigns
to disseminate the positive results from the pivotal
Phase III clinical trials with Eliquis. Furthermore,
some companies are using the results from
additional clinical trials or subanalysis studies to
differentiate their NOACs. Bayer and Janssen are
the only companies to have conducted a clinical
trial for a NOAC solely in a Japanese population
(with the J-ROCKET AF study); the companies
have strongly publicized this information, thereby
giving Xarelto an advantage in Japanese clinical
practice. Companies such as Bayer, Janssen, and
Daiichi Sankyo are also conducting studies in
subgroups of the AF population, such as patients
scheduled for cardioversion or catheter ablation, as
a way of differentiating their NOACs and
cementing them as part of the standard of care in
the anticoagulation of patients with AF.
Figure below provides a gap analysis of the major
players in the AF market during the forecast period
Company Portfolio Gap Analysis in AF, 2013–2023
Strength of Pipeline
Low High
Hig
hLo
wStre
ngth
of M
arke
ted
Pro
duct
s
Strength of Pipeline
Source: GlobalData
Safer Antiarrhythmic Drugs Remains Biggest Unmet Need in Atrial Fibrillation Treatment
The overall level of unmet need in the AF market is
moderate, with a number of generics available for
the management of heart rate control, and the
recent arrival and anticipated the launch of several
NOACs for the prevention of stroke. However,
even though there is now adequate therapeutics
available for most AF management strategies, the
biggest unmet need lies in safer antiarrhythmic
drugs for the maintenance of sinus rhythm. Despite
the restoration and maintenance of sinus rhythm
being a common practice in the management of
AF, the antiarrhythmic drugs that are available are
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Executive Summary
of modest efficacy and have unfavorable safety
profiles. For example, amiodarone is a widely used
generic antiarrhythmic drug, and even though it is
considered the most effective agent available for
heart rhythm control, it has a number of side
effects, including proarrhythmia as well as thyroid,
liver, skin, and pulmonary complications.
Subsequently, Sanofi’s Multaq (dronedarone) was
developed in the hope it would be an effective and
safer alternative to amiodarone, but it was found to
increase the risk of death in patients with
permanent AF and some subtypes of heart failure.
Antiarrhythmic drug development has been very
slow and there are very few drugs in the current
pipeline that are expected to address this unmet
need during the forecast period. At present, there
are no antiarrhythmic drugs in Phase III clinical
trials; however, there are six drugs in Phase II
development and one drug in Phase I. Of these
agents, the furthest in development is Gilead’s
fixed-dose combination (FDC) of ranolazine and
low-dose dronedarone, which recently completed
Phase II clinical trials for paroxysmal AF. Part of
the reason for the low level of activity in the
pipeline is due to the high risk involved in
developing an antiarrhythmic drug. Large and
costly clinical trials are required to demonstrate
that a drug is safe and effective, and the track
record for those antiarrhythmic drugs that have
reached the market in the past decade has been
disappointing. It is also expected that the
availability of cheaper generic alternatives and the
continuing cost constraints faced by national health
authorities will also make it difficult for drugs to
obtain reimbursement and subsequent addition to
hospital formularies.
Outside of rhythm control strategies, the other key
unmet needs that still exist are related to barriers
to NOAC uptake, which include: antidotes that can
successfully reverse the anticoagulant effect of the
NOACs; improved access and reimbursement of
the NOACs; and increased patient awareness and
physician education on the clinical benefits of
stroke prevention with these drugs.
New Oral Anticoagulant Market Becomes Increasingly Crowded as Antiarrhythmic Drug Pipeline Remains Sparse
The AF therapeutics pipeline can be divided into
two categories of drugs: anticoagulants in
development for the prevention of stroke in
patients with AF, and antiarrhythmic drugs that can
be used for the maintenance of normal sinus
rhythm or to cardiovert patients with AF back to
sinus rhythm. In the anticoagulant market, Daiichi-
Sankyo’s Savaysa (edoxaban) was approved for
stroke prevention in Japan and the US, in
September 2014 and January 2015, respectively,
with regulatory approval in Europe still pending;
making it the fourth NOAC to enter this space.
However, Savaysa will encounter competition from
established brands, such as Pradaxa, Xarelto, and
Eliquis, which for some, have had several years to
increase brand familiarity through indication
expansion, marketing, and a larger collection of
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Executive Summary
supportive clinical trial data. Even though, the
Savaysa clinical trials produced solid results that
confirmed its non-inferior efficacy to warfarin, and
significantly reduced bleeding rates, which have
become critical components for advancing a
“warfarin replacement” product to market,
Savaysa’s future in the AF market is now
uncertain. GlobalData initially believed the drug
would be well positioned for those AF patients with
a previous history of bleeding events, as its various
dosages would allow for dose adjustments. In
addition, Savaysa’s convenient once-daily dosing
also made it a very attractive patient option.
However, the FDA’s decision that Savaysa should
not be used in patients with normal renal function
has severely restricted the drug’s patient potential.
GlobalData now believes that Savaysa will struggle
to capture a significant share of the anticoagulant
market. With no other drug candidates presently in
Phase III development for stroke prevention in AF,
GlobalData does not anticipate any major
developments to occur in the anticoagulant
treatment landscape during the forecast period.
In terms of antiarrhythmic drugs, two drug
candidates are forecast to enter the market within
the next decade: Gilead’s FDC of
ranolazine/dronedarone and Laguna
Pharmaceuticals’ vanoxerine, which have both
completed Phase II clinical trials. Based on the
clinical trials required to bring Sanofi’s Multaq
(dronedarone) to market, for Gilead to gain
regulatory approval for ranolazine/dronedarone, it
is expected that an extensive series of Phase III
clinical trials will be required to provide evidence to
support its rhythm control properties and potentially
superior safety profile over existing therapies.
Laguna Pharmaceuticals, on the other hand, is a
very small spin-off company of the pharmaceutical
testing firm, ChanTest, and will require substantial
outside investment in the form of venture capital or
a partnership agreement, if it is to succeed in
bringing its cardioversion drug candidate to market.
Both drug candidates are expected to launch late
in the forecast period and will not reach peak sales
until after 2023.
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Executive Summary
Figure below provides a competitive assessment of
the late-stage pipeline agents for AF during the
forecast period.
Competitive Assessment of Late-Stage Pipeline Agents for AF, 2013–2023
Clinical Attributes
Low High
Hig
hLo
w
Com
mer
cial
Attr
ibut
es
Note: Bubble size corresponds to projected sales during peak years.
Gilead’s ranolazine/dronedarone
Laguna Pharmaceuticals’ vanoxerine
Source: GlobalData
What Do the Physicians Think?
Key Opinion Leaders (KOLs) interviewed by
GlobalData highlighted the advancement the
NOACs offer in the anticoagulation of patients for
stroke prevention in AF. It is expected that the
continued uptake of the NOACs will be the main
driver in the growth of the AF market.
“Antithrombotic drugs are certainly the most rapidly
evolving field, because we have several new
drugs, the NOACs, that have come or are coming
into the market and they are revolutionizing the
entire area.”
EU Key Opinion Leader
“I think the NOACs are definitely an advance.
Patients are happy that they do not have to worry
about getting needle pricks, they do not have to
worry about dieting restrictions, and of course, they
can travel. I make sure that they understand that
there is a bleeding risk, but it is not likely that there
is one. In my opinion, there is more bleeding with
warfarin than with the NOACs.”
US Key Opinion Leader
“They are all at least as effective as vitamin K
antagonists and they all are safer; this is why
vitamin K antagonists should no longer be used.”
EU Key Opinion Leader
“I believe the antidotes or the availability of an
antidote would increase the use of NOACs. Further
education of physicians will also play a good part in
increasing NOAC use. So, there are lots of things
which need to be done in the upcoming years to
make the NOACs the number one therapy for
stroke prevention. But, I do believe the drugs do
have the potential for this.”
EU Key Opinion Leader
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Executive Summary
KOLs interviewed by GlobalData believe there is
limited clinical need for NOAC antidotes, but that
the significant media attention surrounding the risk
of uncontrolled bleeding events and a lack of
clinical knowledge about the NOACs have fueled
the interest and investment in their development.
“I do think that this desire for a reversal agent is a
little bit overstated, because I do think that we will
end up using antidotes a lot less than people think
we need to.”
US Key Opinion Leader
“Antidotes are required more to reassure the
physician and patient, rather than an actual unmet
need in clinical practice. In fact, you don’t need an
antidote, that’s what the big randomized clinical
trials tell us.”
EU Key Opinion Leader
“I think it makes sense to have an antidote. The
reason that there are no antidotes was a mistaken
concept from the pharma industry. They thought
that these drugs would be so safe that antidotes
would not be necessary. I think that most people
are concerned about bleeds that will not stop and
would like to have specific antidotes that will stop
bleeding. I don’t think there is much of a need to
use such antidotes very often and it might not
actually be justifiable to develop antidotes, but they
are being developed because most people say
they want them.”
EU Key Opinion Leader
“I am not sure if antidotes will be largely used, but
it’s important and very necessary to have these
antidotes to reassure people who are
anesthesiologists, emergency doctors, and
surgeons – because most of them are telling
everyone that these drugs are dangerous, because
there is no antidote.”
EU Key Opinion Leader
KOLs interviewed by GlobalData agreed that the
biggest unmet need in the management of AF is
safer antiarrhythmic drugs for rhythm control;
however, they state the reason for the low level of
activity in the pipeline is due to the high risk
involved in developing an antiarrhythmic drug.
Large and costly clinical trials are required to
demonstrate that a drug is safe and effective, and
the track record for those antiarrhythmic drugs that
have reached the market has been disappointing.
“I strongly believe that we need better
antiarrhythmic drugs for rhythm control.”
EU Key Opinion Leader
“Of course, for antiarrhythmic drugs, there are still
unmet needs because it’s clear that most [AF]
patients will sometime in their lives be on
antiarrhythmic drugs. But, the problem is that most
companies don’t want to take the risk of developing
an antiarrhythmic drug because they all have been
a failure.”
EU Key Opinion Leader
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Executive Summary
“We have had no new antiarrhythmic drugs for
something like 25 years. The last one was
flecainide. We had dronedarone [Multaq], but the
rate of prescription of dronedarone in Europe
remains very low because many countries have
refused to reimburse the drug.”
EU Key Opinion Leader
“To treat AF patients we could use safer rhythm
control drugs, if such a thing could ever exist. We
thought for a long time that dronedarone [Multaq]
was the one, but it turned out that in certain
groups, it will increase the risk of death. So, that
did not work out.”
US Key Opinion Leader
“Very few companies want to take risk of
developing an antiarrhythmic drug, because that
means a huge cost for development.”
EU Key Opinion Leader
“It is a market which has a large number of AF
patients, but it’s so difficult to demonstrate
something [in a clinical trial]. The problem with AF
is that, of course, it’s a disease with an increased
risk for [shortened] life expectancy, but fortunately,
the rate of complication is very low. So, if you want
to demonstrate something, for example in
anticoagulation, you have to make huge trials with
something like 15,000 patients. So, it’s a huge cost
and it’s too difficult to do. It’s one of the main
reasons why there are no new developments with
antiarrhythmic drugs. And then there is still the
history of dronedarone; it was a failure.”
EU Key Opinion Leader
“I do think that an antiarrhythmic therapy that is
very safe and very effective is needed, it’s just I’m
not optimistic. There has never been a drug that’s
been particularly effective or safe. So, if there
happens to be one, I think that’s great; but I don’t
think that there are very many people in the field
who think that a new great blockbuster
antiarrhythmic drug is around the corner. I don’t
think anyone is holding their breath.”
US Key Opinion Leader
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Table of Contents
ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
1 Table of Contents
1 Table of Contents ..................................................................................................................... 12
1.1 List of Tables .................................................................................................................... 20
1.2 List of Figures ................................................................................................................... 25
2 Introduction ............................................................................................................................... 27
2.1 Catalyst ............................................................................................................................. 27
2.2 Related Reports ................................................................................................................ 28
2.3 Upcoming Related Reports ............................................................................................... 28
3 Disease Overview ..................................................................................................................... 29
3.1 Etiology and Pathophysiology ........................................................................................... 29
3.1.1 Etiology ......................................................................................................................... 29
3.1.2 Pathophysiology ............................................................................................................ 30
3.2 Symptoms ......................................................................................................................... 31
3.3 Classification of Atrial Fibrillation ....................................................................................... 32
3.4 Prognosis .......................................................................................................................... 32
4 Epidemiology ............................................................................................................................ 34
4.1 Disease Background ......................................................................................................... 34
4.2 Risk Factors and Comorbidities ........................................................................................ 35
4.3 Global Trends ................................................................................................................... 37
4.4 Forecast Methodology ....................................................................................................... 39
4.4.1 Sources Used................................................................................................................ 41
4.4.2 Forecast Assumptions and Methods ............................................................................. 47
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Table of Contents
ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
4.4.3 Sources Not Used ......................................................................................................... 52
4.5 Epidemiological Forecast for Atrial Fibrillation (2013–2023) .............................................. 53
4.5.1 Diagnosed Prevalent Cases of Atrial Fibrillation ............................................................ 53
4.5.2 Age-Specific Diagnosed Prevalent Cases of Atrial Fibrillation ....................................... 54
4.5.3 Sex-Specific Diagnosed Prevalent Cases of Atrial Fibrillation ....................................... 56
4.5.4 Age-Standardized Diagnosed Prevalence of Atrial Fibrillation ....................................... 58
4.5.5 Diagnosed Prevalent Cases of Atrial Fibrillation by Clinical Subtypes ........................... 60
4.6 Discussion ........................................................................................................................ 61
4.6.1 Epidemiological Forecast Insight ................................................................................... 61
4.6.2 Limitations of the Analysis ............................................................................................. 63
4.6.3 Strengths of the Analysis ............................................................................................... 64
5 Disease Management ............................................................................................................... 65
5.1 Diagnosis and Treatment Overview .................................................................................. 65
5.1.1 Diagnosis ...................................................................................................................... 65
5.1.2 Treatment Guidelines and Leading Prescribed Drugs ................................................... 67
5.1.3 Clinical Practice ............................................................................................................. 69
5.2 US..................................................................................................................................... 83
5.3 France .............................................................................................................................. 85
5.4 Germany ........................................................................................................................... 87
5.5 Italy ................................................................................................................................... 89
5.6 Spain ................................................................................................................................ 91
5.7 UK..................................................................................................................................... 93
5.8 Japan ................................................................................................................................ 95
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Table of Contents
ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
5.9 Canada ............................................................................................................................. 98
6 Competitive Assessment ........................................................................................................ 100
6.1 Overview ......................................................................................................................... 100
6.2 Product Profiles – Major Brands, Anticoagulant Agents .................................................. 105
6.2.1 Warfarin (Widely Genericized) ..................................................................................... 105
6.2.2 Pradaxa (dabigatran)................................................................................................... 115
6.2.3 Xarelto (rivaroxaban) ................................................................................................... 129
6.2.4 Eliquis (apixaban) ........................................................................................................ 142
6.2.5 Savaysa (edoxaban) ................................................................................................... 155
6.3 Product Profiles – Major Brands, Antiarrhythmic Drugs ................................................... 167
6.3.1 Multaq (dronedarone) .................................................................................................. 167
6.3.2 Brinavess (vernakalant) ............................................................................................... 179
6.4 Other Therapeutic Classes.............................................................................................. 191
6.4.1 Vitamin K Antagonists Other than Warfarin (Widely Genericized) ................................ 192
6.4.2 Antiplatelets – Aspirin (Widely Genericized) ................................................................ 194
6.4.3 Beta-Blockers – Atenolol, Metoprolol, Propranolol (Widely Genericized) ..................... 195
6.4.4 Calcium Channel Blockers – Diltiazem, Verapamil (Widely Genericized) .................... 196
6.4.5 Cardiac Glycosides − Digoxin (Widely Genericized) .................................................... 197
6.4.6 Potassium Channel Blockers – Amiodarone, Sotalol, Dofetilide (Widely Genericized) . 198
6.4.7 Sodium Channel Blockers – Flecainide, Propafenone (Widely Genericized) ............... 200
7 Unmet Need and Opportunity ................................................................................................. 202
7.1 Overview ......................................................................................................................... 202
7.2 Safer Antiarrhythmic Drugs for the Maintenance of Sinus Rhythm .................................. 203
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7.2.1 Unmet Need ................................................................................................................ 203
7.2.2 Gap Analysis ............................................................................................................... 204
7.2.3 Opportunity ................................................................................................................. 205
7.3 Effective and Rapid Acting Cardioversion Drugs ............................................................. 206
7.3.1 Unmet Need ................................................................................................................ 206
7.3.2 Gap Analysis ............................................................................................................... 207
7.3.3 Opportunity ................................................................................................................. 208
7.4 Antidotes for the New Oral Anticoagulants ...................................................................... 209
7.4.1 Unmet Need ................................................................................................................ 209
7.4.2 Gap Analysis ............................................................................................................... 210
7.4.3 Opportunity ................................................................................................................. 212
7.5 Improved Access to and Reimbursement of the New Oral Anticoagulants ...................... 213
7.5.1 Unmet Need ................................................................................................................ 213
7.5.2 Gap Analysis ............................................................................................................... 216
7.5.3 Opportunity ................................................................................................................. 218
7.6 Increased Physician Education on the Clinical Benefits of the NOACs ............................ 219
7.6.1 Unmet Need ................................................................................................................ 219
7.6.2 Gap Analysis ............................................................................................................... 220
7.6.3 Opportunity ................................................................................................................. 221
7.7 Increased Patient Awareness on the Clinical Benefits of the NOACs .............................. 222
7.7.1 Unmet Need ................................................................................................................ 222
7.7.2 Gap Analysis ............................................................................................................... 223
7.7.3 Opportunity ................................................................................................................. 223
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8 Pipeline Assessment............................................................................................................... 225
8.1 Overview ......................................................................................................................... 225
8.2 Clinical Trial Mapping ...................................................................................................... 226
8.2.1 Clinical Trials by Country ............................................................................................. 226
8.2.2 Clinical Trials by Phase and Trial Status ..................................................................... 227
8.3 Promising Drugs in Clinical Development ........................................................................ 228
8.3.1 Ranolazine/Dronedarone ............................................................................................ 230
8.3.2 Vanoxerine .................................................................................................................. 240
8.4 Other Drugs in Development ........................................................................................... 250
8.4.1 Early-Stage Anticoagulant Pipeline ............................................................................. 250
8.4.2 Early-Stage Antiarrhythmia Pipeline ............................................................................ 256
9 Current and Future Players ..................................................................................................... 261
9.1 Overview ......................................................................................................................... 261
9.2 Trends in Corporate Strategy .......................................................................................... 263
9.3 Company Profiles ............................................................................................................ 265
9.3.1 Boehringer Ingelheim .................................................................................................. 265
9.3.2 Bayer .......................................................................................................................... 268
9.3.3 Janssen (Johnson & Johnson) .................................................................................... 271
9.3.4 Bristol-Myers Squibb ................................................................................................... 274
9.3.5 Pfizer ........................................................................................................................... 277
9.3.6 Daiichi-Sankyo ............................................................................................................ 280
9.3.7 Gilead.......................................................................................................................... 283
10 Market Outlook ....................................................................................................................... 287
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10.1 Global Markets ................................................................................................................ 287
10.1.1 Forecast ...................................................................................................................... 287
10.1.2 Drivers and Barriers – Global Issues ........................................................................... 296
10.2 United States .................................................................................................................. 301
10.2.1 Forecast ...................................................................................................................... 301
10.2.2 Key Events .................................................................................................................. 307
10.2.3 Drivers and Barriers .................................................................................................... 307
10.3 France ............................................................................................................................ 310
10.3.1 Forecast ...................................................................................................................... 310
10.3.2 Key Events .................................................................................................................. 314
10.3.3 Drivers and Barriers .................................................................................................... 314
10.4 Germany ......................................................................................................................... 318
10.4.1 Forecast ...................................................................................................................... 318
10.4.2 Key Events .................................................................................................................. 323
10.4.3 Drivers and Barriers .................................................................................................... 323
10.5 Italy ................................................................................................................................. 325
10.5.1 Forecast ...................................................................................................................... 325
10.5.2 Key Events .................................................................................................................. 330
10.5.3 Drivers and Barriers .................................................................................................... 330
10.6 Spain .............................................................................................................................. 333
10.6.1 Forecast ...................................................................................................................... 333
10.6.2 Key Events .................................................................................................................. 337
10.6.3 Drivers and Barriers .................................................................................................... 337
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10.7 United Kingdom .............................................................................................................. 339
10.7.1 Forecast ...................................................................................................................... 339
10.7.2 Key Events .................................................................................................................. 344
10.7.3 Drivers and Barriers .................................................................................................... 344
10.8 Japan .............................................................................................................................. 347
10.8.1 Forecast ...................................................................................................................... 347
10.8.2 Key Events .................................................................................................................. 352
10.8.3 Drivers and Barriers .................................................................................................... 352
10.9 Canada ........................................................................................................................... 355
10.9.1 Forecast ...................................................................................................................... 355
10.9.2 Key Events .................................................................................................................. 359
10.9.3 Drivers and Barriers .................................................................................................... 359
11 Appendix................................................................................................................................. 362
11.1 Bibliography .................................................................................................................... 362
11.2 Abbreviations .................................................................................................................. 383
11.3 Methodology ................................................................................................................... 388
11.4 Forecasting Methodology ................................................................................................ 388
11.4.1 Diagnosed Atrial Fibrillation Patients ........................................................................... 388
11.4.2 Percent Drug-Treated Patients .................................................................................... 389
11.4.3 Drugs Included in Each Therapeutic Class .................................................................. 389
11.4.4 Launch and Patent Expiry Dates ................................................................................. 390
11.4.5 General Pricing Assumptions ...................................................................................... 391
11.4.6 Individual Drug Assumptions ....................................................................................... 392
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11.4.7 Generic Erosion .......................................................................................................... 401
11.4.8 Pricing of Pipeline Agents............................................................................................ 401
11.5 Physicians and Specialists Included in this Study ........................................................... 402
11.6 About the Authors ........................................................................................................... 404
11.6.1 Analyst ........................................................................................................................ 404
11.6.2 Therapy Area Director ................................................................................................. 404
11.6.3 Epidemiologist ............................................................................................................. 405
11.6.4 Global Head of Healthcare .......................................................................................... 405
11.7 About GlobalData ............................................................................................................ 406
11.8 Disclaimer ....................................................................................................................... 406
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1.1 List of Tables
Table 1: Common Cardiac and Non-Cardiac Causes of AF ....................................................................... 30
Table 2: Classification of AF...................................................................................................................... 32
Table 3: Clinical Subtypes of AF ............................................................................................................... 34
Table 4: Risk Factors and Comorbidities for AF ......................................................................................... 36
Table 5: Diagnosed Prevalence (%) of AF in the 6MM,* as Reported in Epidemiological Studies ............... 37
Table 6: Total Prevalence (%) of AF in the 7MM,* as Reported in Epidemiological Studies ........................ 38
Table 7: 8MM, Sources of Prevalence Data Used to Forecast the Diagnosed Prevalent Cases of AF ........ 40
Table 8: 8MM, Sources of AF Subtype Data Used to Forecast the Diagnosed Prevalent Cases of AF by
Subtypes ..................................................................................................................................... 41
Table 9: 8MM, Diagnosed Prevalent Cases of AF, Ages ≥40 Years, Both Sexes, N, 2013–2023 ............... 53
Table 10: 8MM, Diagnosed Prevalent Cases of AF, by Age, Both Sexes, N (Row %), 2013......................... 55
Table 11: 8MM, Diagnosed Prevalent Cases of AF, by Sex, Ages ≥40 Years, N (Row %), 2013 .................. 57
Table 12: 8MM, Diagnosed Prevalent Cases of AF, by Clinical Subtypes, Both Sexes, N (Row %), 2013 .... 60
Table 13: CHADS2 Index for Stroke Risk Assessment ................................................................................. 67
Table 14: CHA2DS2-VASc Index for Stroke Risk Assessment ...................................................................... 67
Table 15: Treatment Guidelines for Atrial Fibrillation by Country .................................................................. 68
Table 16: Most Prescribed Drugs or Drug Classes for AF by Country, 2014 ................................................ 69
Table 17: Country Profile − US.................................................................................................................... 84
Table 18: Country Profile − France.............................................................................................................. 86
Table 19: Country Profile – Germany .......................................................................................................... 88
Table 20: Country Profile − Italy .................................................................................................................. 90
Table 21: Country Profile − Spain ............................................................................................................... 92
Table 22: Country Profile − UK.................................................................................................................... 94
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Table 23: Country Profile − Japan ............................................................................................................... 97
Table 24: Country Profile − Canada ............................................................................................................ 99
Table 25: Leading Treatments and Branded Drugs for AF, 2014 ............................................................... 104
Table 26: Product Profile – Warfarin (Widely Genericized) ........................................................................ 108
Table 27: Warfarin (Widely Genericized) SWOT Analysis, 2014 ................................................................ 113
Table 28: Global Sales Forecasts ($m) for Warfarin, 2013–2023 ............................................................... 115
Table 29: Product Profile – Pradaxa (dabigatran) ...................................................................................... 119
Table 30: Pradaxa (dabigatran) SWOT Analysis, 2014 .............................................................................. 126
Table 31: Global Sales Forecasts ($m) for Pradaxa, 2013–2023 ............................................................... 129
Table 32: Product Profile – Xarelto (rivaroxaban) ...................................................................................... 133
Table 33: Xarelto (rivaroxaban) SWOT Analysis, 2013 .............................................................................. 139
Table 34: Global Sales Forecasts ($m) for Xarelto, 2013–2023 ................................................................. 141
Table 35: Product Profile – Eliquis (apixaban) ........................................................................................... 146
Table 36: Eliquis (apixaban) SWOT Analysis, 2014 ................................................................................... 152
Table 37: Global Sales Forecasts ($m) for Eliquis, 2013–2023 .................................................................. 154
Table 38: Product Profile – Savaysa (edoxaban) ....................................................................................... 158
Table 39: Savaysa (edoxaban) SWOT Analysis, 2014............................................................................... 164
Table 40: Global Sales Forecasts ($m) for Savaysa, 2013–2023 ............................................................... 167
Table 41: Product Profile – Multaq (dronedarone) ..................................................................................... 170
Table 42: Overview of the Pivotal Clinical Trials for Multaq ........................................................................ 171
Table 43: Efficacy of Multaq in Patients with Paroxysmal or Persistent AF/AFL in the ATHENA Study ....... 173
Table 44: Efficacy of Multaq in Patients with Permanent AF in the PALLAS Study ..................................... 175
Table 45: Multaq (dronedarone) SWOT Analysis, 2014 ............................................................................. 177
Table 46: Global Sales Forecasts ($m) for Multaq, 2013–2023 .................................................................. 179
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Table 47: Product Profile – Brinavess (vernakalant) .................................................................................. 184
Table 48: Efficacy of Intravenous Brinavess in Pivotal Late-Stage Clinical Trials ....................................... 185
Table 49: Brinavess (vernakalant) SWOT Analysis, 2014 .......................................................................... 189
Table 50: Global Sales Forecasts ($m) for Brinavess, 2013–2023 ............................................................. 191
Table 51: Summary of Widely Genericized Therapeutic Classes, 2014 ..................................................... 192
Table 52: Commonly Used Genericized Vitamin K Antagonists (Excluding Warfarin), by Region* .............. 193
Table 53: Unmet Need and Opportunity in Atrial Fibrillation ....................................................................... 202
Table 54: AF – Clinical Trials by Phase and Status, 2014 .......................................................................... 228
Table 55: Late-Stage Pipeline for AF, 2014 ............................................................................................... 228
Table 56: Therapeutic Classes in Late-Stage Development for AF, 2014................................................... 229
Table 57: Product Profile – Ranolazine/Dronedarone ................................................................................ 233
Table 58: Ranolazine/Dronedarone SWOT Analysis, 2014 ........................................................................ 238
Table 59: Global Sales Forecasts ($m) for Ranolazine/Dronedarone, 2013–2023 ..................................... 240
Table 60: Product Profile – Vanoxerine ..................................................................................................... 243
Table 61: Efficacy of Vanoxerine in Patients with AF/AFL in the Phase IIb COR-ART Study ...................... 244
Table 62: Safety of Vanoxerine in Patients with AF/AFL in the Phase IIb COR-ART Study ........................ 246
Table 63: Vanoxerine SWOT Analysis, 2014 ............................................................................................. 248
Table 64: Global Sales Forecasts ($m) for Vanoxerine, 2013–2023 .......................................................... 250
Table 65: Early-Stage Pipeline Products for Atrial Fibrillation – Anticoagulant Agents ................................ 251
Table 66: Early-Stage Pipeline Products for Atrial Fibrillation – Antiarrhythmic Drugs ................................ 257
Table 67: Key Companies in the AF Market, 2014 ..................................................................................... 262
Table 68: Boehringer Ingelheim’s AF Portfolio Assessment, 2014 ............................................................. 267
Table 69: Boehringer Ingelheim SWOT Analysis, 2014 ............................................................................. 268
Table 70: Bayer’s AF Portfolio Assessment, 2014 ..................................................................................... 270
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Table 71: Bayer SWOT Analysis, 2014 ..................................................................................................... 271
Table 72: Janssen’s AF Portfolio Assessment, 2014 ................................................................................. 273
Table 73: Janssen SWOT Analysis, 2014 ................................................................................................. 274
Table 74: Bristol-Myers Squibb’s AF Portfolio Assessment, 2014 .............................................................. 276
Table 75: Bristol-Myers Squibb SWOT Analysis, 2014 .............................................................................. 277
Table 76: Pfizer’s AF Portfolio Assessment, 2014 ..................................................................................... 279
Table 77: Pfizer SWOT Analysis, 2014 ..................................................................................................... 280
Table 78: Daiichi-Sankyo’s AF Portfolio Assessment, 2014 ....................................................................... 282
Table 79: Daiichi-Sankyo SWOT Analysis, 2014 ....................................................................................... 283
Table 80: Gilead’s AF Portfolio Assessment, 2014 .................................................................................... 285
Table 81: Gilead SWOT Analysis, 2014 .................................................................................................... 286
Table 82: Global* Sales Forecasts ($m) for AF, 2013–2023 ...................................................................... 289
Table 83: Global AF Market – Drivers and Barriers, 2014 .......................................................................... 296
Table 84: Sales Forecasts ($m) for AF in the US, 2013–2023 ................................................................... 304
Table 85: Key Events Impacting Sales for AF in the US, 2014 ................................................................... 307
Table 86: AF Market – Drivers and Barriers in the US, 2013–2023 ............................................................ 307
Table 87: Sales Forecasts ($m) for AF in France, 2013–2023 ................................................................... 312
Table 88: Key Events Impacting Sales for AF in France, 2014................................................................... 314
Table 89: AF Market – Drivers and Barriers in France, 2013–2023 ............................................................ 314
Table 90: Sales Forecasts ($m) for AF in Germany, 2013–2023 ................................................................ 320
Table 91: Key Events Impacting Sales for AF in Germany, 2014 ............................................................... 323
Table 92: AF Market – Drivers and Barriers in Germany, 2013–2023 ........................................................ 323
Table 93: Sales Forecasts ($m) for AF in Italy, 2013–2023........................................................................ 327
Table 94: Key Events Impacting Sales for AF in Italy, 2014 ....................................................................... 330
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Table 95: AF Market – Drivers and Barriers in Italy, 2013–2023 ................................................................ 330
Table 96: Sales Forecasts ($m) for AF in Spain, 2013–2023 ..................................................................... 334
Table 97: Key Events Impacting Sales for AF in Spain, 2014 .................................................................... 337
Table 98: AF Market – Drivers and Barriers in Spain, 2013–2023 .............................................................. 337
Table 99: Sales Forecasts ($m) for AF in UK, 2013–2023 ......................................................................... 341
Table 100: Key Events Impacting Sales for AF in the UK, 2014 ................................................................... 344
Table 101: Asthma Market – Drivers and Barriers in the UK, 2013–2023 ..................................................... 344
Table 102: Sales Forecasts ($m) for AF in Japan, 2013–2023 .................................................................... 349
Table 103: Key Events Impacting Sales for AF in Japan, 2014 .................................................................... 352
Table 104: AF Market – Drivers and Barriers in Japan, 2013–2023 ............................................................. 352
Table 105: Sales Forecasts ($m) for AF in Canada, 2013–2023 .................................................................. 357
Table 106: Key Events Impacting Sales for AF in Canada, 2014 ................................................................. 359
Table 107: AF Market – Drivers and Barriers in Canada, 2013–2023 .......................................................... 359
Table 108: Key Launch Dates ..................................................................................................................... 390
Table 109: Key Patent Expiries ................................................................................................................... 390
Table 110: High-Prescribing Physicians (non-KOLs) Surveyed, By Country ................................................ 403
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1.2 List of Figures
Figure 1: 8MM, Diagnosed Prevalent Cases of AF, Ages ≥40 Years, Both Sexes, N, 2013–2023 ............... 54
Figure 2: 8MM, Diagnosed Prevalent Cases of AF, by Age, Both Sexes, N, 2013 ....................................... 56
Figure 3: 8MM, Diagnosed Prevalent Cases of AF, by Sex, Ages ≥40 Years, N, 2013 ................................ 58
Figure 4: 8MM, Age-Standardized Diagnosed Prevalence (%) of AF, by Sex, Ages ≥40 Years, 2013 ......... 59
Figure 5: 8MM, Diagnosed Prevalent Cases of AF, by Clinical Subtypes, Both Sexes, N, 2013 .................. 61
Figure 6: ESC Guideline Recommendations for Choosing an Anticoagulant ............................................... 72
Figure 7: JCS Guideline Recommendations for Choosing an Anticoagulant ................................................ 74
Figure 8: CCS Guideline Recommendations for Choosing an Anticoagulant ............................................... 75
Figure 9: AHA Guideline Recommendations for Drug Therapy for Ventricular Rate Control ........................ 77
Figure 10: AHA Guideline Recommendations for Rhythm Control in Patients with Paroxysmal and Persistent
AF ............................................................................................................................................... 79
Figure 11: ESC Guideline Recommendations for Rhythm Control According to Underlying Pathology .......... 81
Figure 12: JCS Guideline Recommendations for Rhythm Control ................................................................. 82
Figure 13: Site of Action of the New Oral Anticoagulants in the Anticoagulation Cascade ........................... 101
Figure 14: AF Therapeutics – Clinical Trials by Country, 2014 .................................................................... 226
Figure 15: Competitive Assessment of Late-Stage Pipeline Agents for AF, 2013–2023 .............................. 229
Figure 16: Company Portfolio Gap Analysis in AF, 2013–2023 ................................................................... 263
Figure 17: Global Sales for AF by Country, 2013–2023 .............................................................................. 291
Figure 18: Annual Global Sales for AF by Region, 2013–2023.................................................................... 292
Figure 19: Global* AF Sales by Drug Class, 2013–2023 ............................................................................. 293
Figure 20: Annual Global* Sales for AF by Drug Class, 2013–2023 ............................................................ 294
Figure 21: Annual Global* Sales for the Novel Oral Anticoagulants, 2013–2023 ......................................... 295
Figure 22: Sales for AF in the US by Drug Class, 2013–2023 ..................................................................... 306
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Figure 23: Sales for AF in France by Drug Class, 2013–2023 ..................................................................... 313
Figure 24: Sales for AF in Germany by Drug Class, 2013–2023 ................................................................. 322
Figure 25: Sales for AF in Italy by Drug Class, 2013–2023 ......................................................................... 329
Figure 26: Sales for AF in Spain by Drug Class, 2013–2023 ....................................................................... 336
Figure 27: Sales for AF in the UK by Drug Class, 2013–2023 ..................................................................... 343
Figure 28: Sales for AF in Japan by Drug Class, 2013–2023 ...................................................................... 351
Figure 29: Sales for AF in Canada by Drug Class, 2013–2023 ................................................................... 358
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Introduction
2 Introduction
2.1 Catalyst
Various therapeutic options are available to treat patients with atrial fibrillation (AF), and most
patients will receive some form of antithrombotic therapy, a heart rate control agent, and
potentially, an antiarrhythmic drug for rhythm control. All sectors of the AF market have historically
been saturated with generics, with the vitamin K antagonists such as warfarin playing an important
role in stroke prevention in AF. However, since 2010, and the launch of the first of the new oral
anticoagulants (NOACs), a shift in the treatment of patients with AF has occurred. The NOACs
offer a significant advancement in anticoagulation and their continued uptake will be the main driver
of growth in the AF market over the next 10 years.
There are now four NOACs on the market; these include Boehringer Ingelheim’s Pradaxa
(dabigatran), Bayer/Janssen’s Xarelto (rivaroxaban), Bristol-Myers Squibb/Pfizer’s Eliquis
(apixaban), and Daiichi-Sankyo’s Savysa (edoxaban).
In September 2014, Daiichi-Sankyo gained label expansion in Japan for edoxaban to include
the treatment of patients with AF, and it was also approved and launched in the US early in
2015 under the brand name Savaysa.
All major treatment guidelines for the management of AF now include the NOACs as a
treatment option for the anticoagulation of patients with AF, with some giving preference to the
NOACs over vitamin K antagonists. Treatment guidelines also give more focus to identifying
and treating patients with AF that have a low risk of stroke.
The anticipated arrival of NOAC antidotes from 2017 onwards is also forecast to be a major
driver of further NOAC uptake. The availability of NOAC antidotes is expected to ease
remaining physician and patient concerns surrounding the risk of uncontrolled bleeding events.
In contrast, despite a great unmet need for safer antiarrhythmic drugs, developments in this field
are expected to be much slower.
Two potential antiarrhythmic drugs are forecast to enter the market within the next decade:
Gilead’s fixed-dose combination (FDC) of ranolazine and low-dose dronedarone, and Laguna
Pharmaceuticals’ vanoxerine, both of which have completed Phase II clinical trials. Both drug
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ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
Introduction
candidates are expected to launch late in the forecast period and will not reach peak sales until
after 2023.
The low level of activity in the pipeline is expected to continue due to the high risk involved in
developing antiarrhythmic drugs.
2.2 Related Reports
GlobalData (2014). Acute Coronary Syndrome − Global Drug Forecast and Market Analysis to
2023, July 2014, GDHC69PIDR
2.3 Upcoming Related Reports
GlobalData (2015). Dyslipidemia − Global Drug Forecast and Market Analysis to 2023,
GDHC110PIDR
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Appendix
ATRIAL FIBRILLATION – GLOBAL DRUG FORECAST AND MARKET ANALYSIS TO 2023
11.7 About GlobalData
GlobalData is a leading global provider of business intelligence in the healthcare industry.
GlobalData provides its clients with up-to-date information and analysis on the latest developments
in drug research, disease analysis, and clinical research and development. Our integrated business
intelligence solutions include a range of interactive online databases, analytical tools, reports, and
forecasts. Our analysis is supported by a 24/7 client support and analyst team.
GlobalData has offices in New York, San Francisco, Boston, London, India, Korea, Japan,
Singapore, and Australia.
11.8 Disclaimer
All Rights Reserved.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any
form by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior
permission of the publisher, GlobalData.