Heart failure market to surpass $22bn by 2028 as arrival of SGLT inhibitors triggers huge growth

The heart failure (HF) market is expected to grow from $3.7bn in 2018 to $22.1bn in 2028 across the eight major markets (8MM*) at an impressive compound annual growth rate (CAGR) of 19.5%, according to GlobalData, a leading data and analytics company.

The company’s latest report, ‘Heart Failure: Global Drug Forecast and Market Analysis to 2028’, states that the generic-saturated market will experience major growth over the next ten years, which can be attributed to the much anticipated label expansion of well-known anti-diabetic sodium-glucose co-transporter (SGLT) inhibitors and other novel pipeline agents such as Zensun’s Neucardin, Bayer’s vericiguat and Servier’s omecamtiv mecarbil. Many of these strong pipeline contenders will be add on therapies to the generic based standard of care, which will bring overall growth to all aspects of the market.

Heather Farrell, MPharm, Pharma Analyst at GlobalData, says: “The exciting growth seen in the HF market will be largely due to SGLT inhibitors. Their trial results in reducing mortality and risk of hospitalization are unmatched, so far, and the familiarity of the drugs as anti-diabetics will hopefully improve the uptake and optimise dosing strategies. Key opinion leaders across the 8MM are greatly anticipating the launch of these drugs to improve the lives of HF patients despite the considerable price tag.”

Major drivers for the market include the increasing prevalence of chronic HF, due to the aging global population, the increased prevalence of co-morbidities such as diabetes, and improved treatment and survival after a myocardial infarction. GlobalData’s report highlights the unmet needs in diagnosis and prevention of HF alongside this increasing population. Further unmet need is seen in HF with preserved ejection fraction (HF-PEF), and the newly classed HF with mid-range ejection fraction (HF-mrEF). Moreover, the report looks at the opportunities within the various HF populations and the different needs of each.

Historically, many pipeline agents for HF have faced issues during development and in gaining regulatory approval, leading to their discontinuation. GlobalData’s report analyses the obstacles faced by drug developers and the missteps taken in these failed trials with the aim of highlighting these concerns for future drug development in this field.

Farrell concludes: “Currently, Novartis’ Entresto is the only drug to be launched for HF with reduced ejection fraction (HF-REF) in recent years. Entresto faced uptake issues regarding cost, and trial issues which have led to physician doubt. It’s expected that the uptake of current pipeline agents will face less resistance, with the SGLT inhibitors seeing immediate uptake post launch, and even further uptake with their anticipated approval in HF-PEF. Acute HF will also see immediate uptake of two pipeline agents, CXL-1427 and Istaroxime, due to large unmet need, and the post-acute therapy strategy aims to introduce three pipeline agents. The HF space, therefore, will see great developments in treatment regimens and most importantly improved and greater choice for prescribers and patients.”

*8MM = US, France, Germany, Italy, Spain, the UK, Japan and China

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