May 2023 saw the world’s first approval of two respiratory syncytial virus (RSV) vaccines, Arexvy by GSK and Abrysvo by Pfizer. However, these vaccines not the only prophylactic treatments hoping to stake a claim in the market ahead of the RSV season in September, with Moderna’s mRNA-1345 and AstraZeneca’s Beyfortus also on the horizon. Driven by these recent developments in preventative measures, sales of RSV drugs are estimated to surpass $9 billion by 2029, a growth of over $8 billion from 2023, according to GlobalData, a leading data and analytics company.

RSV is a common infectious disease of the lungs and respiratory tract that can cause further health problems such as bronchiolitis and pneumonia. Although infections in healthy children and adults are less severe, certain patient groups, such as children with lung disease, the elderly, or the immunocompromised, may experience life-threatening symptoms, with RSV causing up to 10,000 deaths in the US per year.

Jasper Morley, Drugs Intelligence Analyst at GlobalData, comments: “Until recently, there were no approved prophylactic treatments available. Approved by the FDA in 2023, GSK’s Arexvy and Pfizer’s Abrysvo are both subunit vaccines indicated for the prevention of lower respiratory tract disease caused by RSV in individuals aged 60 and over. Including Moderna’s mRNA-1345 and AstraZeneca’s Beyfortus, the four therapies will make up 90% of total forecast sales in 2029 and are the main drivers of the significant increase in the global RSV market.”

Following US and EU approval in May and June 2023, respectively, Arexvy is projected to climb steadily and emerge as a market leader, according to GlobaldData’s Sales and Forecast tool. This vaccine is forecast to retain the top spot over a seven-year forecast, ultimately generating more than a quarter of total global RSV market sales, with just over $2.5 billion in 2029.  Despite receiving US approval in May, Abrysvo is still awaiting EU approval. It is forecast to achieve sales of $1.7 billion, securing third place behind Moderna’s mRNA-1345.

mRNA-1345 is an mRNA-based vaccine that is currently awaiting approval in Australia and the EU for children and adults. The drug is expected to launch in 2024 and experience exponential growth, surpassing Abrysvo, to reach sales of $2.4 billion in 2029.

After receiving EU approval late last year and US approval on July 17, 2023, Astrazeneca’s Beyfortus is set to reach global sales of $1.27 billion. This recombinant monoclonal antibody is the world’s first treatment indicated for disease prevention in infants during their first RSV season.

Morley concludes: “With the leading four RSV treatments all indicated prophylactically and eager to establish themselves before the start of the fall season, the RSV market is poised to become a major pharmaceutical battleground over the next seven years. Fierce rivalry is to be expected, and the prospect of additional drug approvals, including geographical and maternal vaccinations, will grant treatments a competitive edge and a favorable position in the market.”