Angina Pectoris – Global Drug Forecast and Market Analysis to 2028

Pages: 148 Published: April 30, 2020 Report Code: GDHC197PIDR

Angina pectoris, or angina for short, refers to chest pain or discomfort caused by insufficient blood supply to the heart muscle, known as myocardial ischemia, when myocardial oxygen demand exceeds oxygen supply. In chronic forms of angina, ischemia of the myocardium can be caused by fixed epicardial coronary artery atherosclerotic obstruction, by microvascular dysfunction (MVD) involving the smaller vessels of the heart, or coronary artery spasm. This report focuses on the following forms of angina: stable angina (atherosclerotic obstruction), microvascular, and variant (also called vasospastic or Prinzmetal angina).

New therapies entering the market will be the main drivers of growth, with one gene-based therapy, Generx (Ad5FGF-4), and two cell-therapy treatments, CLBS16 and CLBS14 expected to launch in the US during the forecast period. Other major drivers for the angina market are the aging global population, enhanced survival after an MI, and the increasing prevalence of obesity, diabetes, and hypertension. Based on epidemiological analysis by GlobalData, the number of diagnosed prevalent cases of stable angina will grow by 16.09% over the forecast period at an AGR of 1.60% from 11,853,368 cases in 2018 to 13,761,123 cases by 2028 in the seven major pharmaceutical markets (7MM) covered in this report, the US, 5EU (France, Germany, Italy, Spain, and UK) and Japan. Diagnosed prevalent cases of microvascular angina will grow by 16.25% from 3,886,426 cases in 2018 to 4,518,109, while variant angina will grow by 16.23% from 49,258 cases in 2018 to 57,255 cases by 2028.

GlobalData projects the antianginal drug marketplace for stable, microvascular and variant angina within the 7MM will grow from $2.5B in 2018 at a modest compound annual growth rate (CAGR) of 2.6% to $3.2B by 2028. In particular, GlobalData expects the US the US market will contribute the most to the antianginal market’s growth, contributing $1.8B sales in 2018 (72% of the global antianginal market) and $2.5B in 2028 (78% of the global antianginal market).

In terms of the current treatment landscape, the consensus among interviewed physicians was that they have a number of efficacious treatment options at their disposal though there are still patients that are ineffectively managed, and therefore notable unmet needs remain. KOLs interviewed by GlobalData highlighted the lack of treatment options targeting refractory patients to be an extremely important unmet need. Another major issue mentioned was the lack of efficacious, evidence-based therapies for microvascular angina. In addition, patients with variant angina also lack treatments tailored to this type of angina, mainly attributed to the knowledge gap in the underlying pathophysiology. Despite a number of drugs currently in development, GlobalData’s research suggests that the future level of attainment of these unmet needs will be modest, and a relatively high level of opportunity exists for drug developers to enter the angina market.

KEY QUESTIONS ANSWERED

Despite the existence of numerous well-established treatment options in the angina space, a few—yet significant—unmet needs remain.

• Which unmet needs are the most pressing in the 7MM?

• Where should pharmaceutical companies focus drug development efforts in order to become a significant player in the space?

The angina market has been overlooked by drug developers for many years, though more recently, clinical development activity has picked up.

• What are the most promising late-stage candidates and how much they expected to generate over the forecast period?

• What do KOLs say about their clinical and commercial positioning?

Although angina is a prevalent condition, it remains a niche indication on the industry level.

• Which have been historically the companies leading the way?

• What new companies are emerging in the space?

Scope

Overview of chronic forms of angina pectoris (stable, microvascular, variant) including epidemiology, disease etiology and management.

Topline angina pectoris drugs market revenue (including antianginals and drugs used for secondary prevention of CV events), annual cost of therapy, and anticipated sales for major late-stage pipeline drugs.

Key topics covered include assessment of current and pipeline therapies, unmet needs, current and future players and market outlook for the US, 5U and Japan over the 10-year forecast period.

Pipeline analysis: Emerging novel trends under development, and detailed analysis of late-stage pipeline drugs.

Analysis of the current and future market competition in the global angina pectoris therapeutics market. Insightful review of the key industry drivers, restraints and challenges.

Key Highlights

The proportion of people at risk of developing angina is expected to increase over the 10-year forecast period due to the growing aging population, increased survival after myocardial infarction (MI), and the rise in the prevalence of obesity and diabetes.

The potential launch of four late-stage pipeline agents will increase the number of patients who can be offered pharmacological treatment options. In addition, three of these drugs in late-stage development are expected to have a high annual cost of therapy (ACOT), a factor that will contribute to notable profitability.

Microvascular angina is being increasingly recognized in clinical practice and there has been a renewed interest among the medical community to understand the pathophysiological mechanisms underpinning its pathogenesis.

Despite the plethora of therapies currently available to angina patients, there is still room for improvement within the treatment space. The most recognizable is the need for novel treatment options for refractory patients.

Reasons to Buy

The report will enable you to:

Develop and design your in-licensing and out-licensing strategies, using a detailed overview of current pipeline products and technologies to identify companies with the most robust pipelines.

Develop business strategies by understanding the trends shaping and driving the global angina pectoris therapeutics market.

Drive revenues by understanding the key trends, innovative products and technologies, market segments, and companies likely to impact the global angina pectoris market in the future.

Formulate effective sales and marketing strategies by understanding the competitive landscape and by analyzing the performance of various competitors.

Identify emerging players with potentially strong product portfolios and create effective counter-strategies to gain a competitive advantage.

Track drug sales in the global angina pectoris therapeutics market from 2018-2028.

Organize your sales and marketing efforts by identifying the market categories and segments that present maximum opportunities for consolidations, investments and strategic partnerships.

Key Players

Gilead

Menarini Group

Ono Pharmaceutical

Les Laboratoires Servier

Caladrius Biosciences

Angionetics

Milestone Pharmaceuticals

Imbria Pharmaceuticals

Astrazeneca

Bristol-Myers Squibb

NHS Greater Glasgow and Clyde

Table of Contents

1 Table of Contents

1.1 List of Tables

1.2 List of Figures

2 Angina Pectoris: Executive Summary

2.1 Moderate Growth in the Angina Market Is Expected to Be Driven by US Sales

2.2 Small Biotech Companies Pursuing Therapeutic Angiogenesis

2.3 Various Unmet Needs Remain in Refractory, Microvascular, and Variant Angina

2.4 Gene and Cell-Based Therapies Will Face Difficulties Penetrating the Market

2.5 What Do Physicians Think?

3 Introduction

3.1 Catalyst

3.2 Related Reports

3.3 Upcoming Related Reports

4 Disease Overview

4.1 Etiology and Pathophysiology

4.1.1 Etiology

4.1.2 Pathophysiology

4.2 Classification or Staging Systems

5 Epidemiology

5.1 Disease Background

5.2 Risk Factors and Comorbidities

5.3 Global and Historical Trends

5.4 Forecast Methodology

5.4.1 Sources Used

5.4.2 Forecast Assumptions and Methods

5.4.3 Diagnosed Incident Cases of Angina Pectoris

5.4.4 Diagnosed Prevalent Cases of Angina Pectoris

5.4.5 Comorbidities of Diagnosed Incident and Diagnosed Prevalent Cases of Angina Pectoris

5.4.6 Diagnosed Prevalent Cases of Refractory Angina

5.5 Epidemiological Forecast for Angina Pectoris, 2018–2028

5.5.1 Diagnosed Incident Cases of Angina Pectoris

5.5.2 Age-Specific Diagnosed Incident Cases of Angina Pectoris

5.5.3 Diagnosed Incident Cases of Stable Angina

5.5.4 Diagnosed Incident Cases of Unstable Angina

5.5.5 Diagnosed Incident Cases of Prinzmetal Angina

5.5.6 Diagnosed Incident Cases of Microvascular Angina

5.5.7 Diagnosed Incident Cases of Angina Pectoris by Comorbidities

5.5.8 Diagnosed Prevalent Cases of Angina Pectoris

5.5.9 Age-Specific Diagnosed Prevalent Cases of Angina Pectoris

5.5.10 Diagnosed Prevalent Cases of Stable Angina

5.5.11 Diagnosed Prevalent Cases of Unstable Angina

5.5.12 Diagnosed Prevalent Cases of Prinzmetal Angina

5.5.13 Diagnosed Prevalent Cases of Microvascular Angina

5.5.14 Comorbidities of Diagnosed Prevalent Cases of Angina Pectoris

5.5.15 Diagnosed Prevalent Cases of Refractory Angina

5.6 Discussion

5.6.1 Epidemiological Forecast Insight

5.6.2 Limitations of the Analysis

5.6.3 Strengths of the Analysis

6 Disease Management

6.1 Diagnosis Overview

6.1.1 Stable Angina

6.1.2 Microvascular Angina

6.1.3 Variant Angina

6.2 Treatment Overview

6.2.1 Antianginals

6.2.2 Secondary Prevention of CV Events

6.3 Clinical Practice

6.3.1 US

6.3.2 5EU

6.3.3 Japan

7 Competitive Assessment

7.1 Overview

8 Unmet Needs and Opportunity Assessment

8.1 Overview

8.2 Novel Treatment Options for Refractory Patients

8.3 Targeting the Varying Pathophysiological Mechanisms of Microvascular Angina

8.4 Solid Understanding and Suitable Management of Variant Angina

8.5 Increased Physician Recognition of Microvascular Angina

8.6 Accurate Diagnosis of Variant Angina

9 Pipeline Assessment

9.1 Overview

9.2 Promising Drugs in Clinical Development

9.2.1 CLBS14

9.2.2 CLBS16

9.2.3 Generx (alferminogene tadenovec, Ad5FGF-4)

9.2.4 Zibotentan

10 Current and Future Players

10.1 Overview

10.2 Trends in Corporate Strategy

10.3 Company Profiles

10.3.1 Gilead Sciences/Menarini Group

10.3.2 Les Laboratoires Servier

10.3.3 AstraZeneca

10.3.4 Bristol-Myers Squibb

10.3.5 Caladrius Biosciences

10.3.6 Angionetics

10.3.7 XyloCor Therapeutics

10.3.8 Milestone Pharmaceuticals

10.3.9 Imbria Pharmaceuticals

11 Market Outlook

11.1 Global Markets

11.1.1 Forecast

11.1.2 Drivers and Barriers – Global Issues

11.2 US

11.2.1 Forecast

11.2.2 Key Events

11.2.3 Drivers and Barriers

11.3 5EU

11.3.1 Forecast

11.3.2 Key Events

11.3.3 Drivers and Barriers

11.4 Japan

11.4.1 Forecast

11.4.2 Key Events

11.4.3 Drivers and Barriers

12 Appendix

12.1 Bibliography

12.2 Abbreviations

12.3 Methodology

12.3.1 Forecasting Methodology

12.3.2 Diagnosed Patients

12.3.3 Percent Drug-Treated Patients

12.3.4 Drugs and Drug Classes Included

12.3.5 Launch and Patent Expiry Dates

12.3.6 General Pricing Assumptions

12.3.7 Individual Drug Assumptions

12.3.8 Generic Erosion

12.3.9 Pricing of Pipeline Agents

12.4 Primary Research – KOLs Interviewed for This Report

12.4.1 KOLs

12.5 Primary Research – Prescriber Survey

12.6 About the Authors

12.6.1 Analyst

12.6.2 Therapy Area Director

12.6.3 Therapy Area Associate Director

12.6.4 Epidemiologist

12.6.5 Reviewers

12.6.6 Global Director of Therapy Analysis and Epidemiology

12.6.7 Global Head and EVP of Healthcare Operations and Strategy

12.7 About GlobalData

12.8 Contact Us

12.9 Disclaimer

List of Tables

Table 1: Angina Pectoris: Key Metrics in the 7MM

Table 2: Classification for Angina Pectoris

Table 3: Risk Factors and Comorbidities for Angina Pectoris

Table 4: Treatment Guidelines for Angina Pectoris

Table 5: Country Profile – US

Table 6: Country Profile – 5EU

Table 7: Country Profile – Japan

Table 8: Leading Treatments for Angina Pectoris

Table 9: Comparison of Therapeutic Classes in Development for Angina Pectoris, 2018–2028

Table 10: Gilead’s Portfolio Assessment

Table 11: Les Laboratoires Servier’s Portfolio Assessment

Table 12: AstraZeneca’s Portfolio Assessment

Table 13: Bristol-Myers Squibb’s Portfolio Assessment

Table 14: Caladrius Biosciences’ Portfolio Assessment

Table 15: Angionetics’ Portfolio Assessment

Table 16: XyloCor’s Portfolio Assessment, 2020

Table 17: Milestone Pharmaceuticals’ Portfolio Assessment

Table 18: Imbria Pharmaceuticals’ Portfolio Assessment

Table 19: Angina Market – Global Drivers and Barriers, 2018–2028

Table 20: Key Events Impacting Sales for Angina in the US, 2018–2028

Table 21: Angina Market – Drivers and Barriers in the US, 2018–2028

Table 22: Key Events Impacting Sales for Angina in the 5EU, 2018–2028

Table 23: Angina Market – Drivers and Barriers in the 5EU, 2018–2028

Table 24: Key Events Impacting Sales for Angina in Japan, 2018–2028

Table 25: Angina Market – Global Drivers and Barriers in Japan, 2018–2028

Table 26: Key Historical and Projected Launch Dates for Angina

Table 27: Key Historical and Projected Expiry Dates for Angina

Table 28: High-Prescribing Physicians (non-KOLs) Surveyed, By Country

List of Figures

Figure 1: Global Sales Forecast by Region (Antianginals and Drugs for Secondary Prevention of CV Events) in 2018 and 2028

Figure 2: Analysis of the Company Portfolio Gap in Angina Pectoris During the Forecast Period

Figure 3: Competitive Assessment of the Late-Stage Pipeline Agents That GlobalData Expects to Be Licensed for the Treatment of Angina During the Forecast Period

Figure 4: Mechanisms of the Various Angina Types

Figure 5: 7MM, Diagnosed Incidence of Angina Pectoris, Both Sexes, Ages ≥18 Years, Cases per 100,000 Population, 2018

Figure 6: 7MM, Diagnosed Prevalence of Angina Pectoris, Both Sexes, Ages ≥18 Years, %, 2018

Figure 7: 7MM, Sources Used to Forecast the Diagnosed Incident Cases of Stable Angina

Figure 8: 7MM, Sources Used to Forecast the Diagnosed Incident Cases and Diagnosed Prevalent Cases of Unstable Angina

Figure 9: 7MM, Sources Used to Forecast the Diagnosed Incident Cases and Diagnosed Prevalent Cases of Prinzmetal Angina

Figure 10: 7MM, Sources Used to Forecast the Diagnosed Incident Cases and Diagnosed Prevalent Cases of Microvascular Angina

Figure 11: 7MM, Sources Used to Forecast the Diagnosed Incident Cases of Angina Pectoris by Comorbidities (Diabetes and Hypertension)

Figure 12: 7MM, Sources Used to Forecast the Diagnosed Incident Cases of Angina Pectoris by Comorbidities (COPD and Chronic Renal Disease)

Figure 13: 7MM, Sources Used to Forecast the Diagnosed Prevalent Cases of Stable Angina

Figure 14: 7MM, Sources Used to Forecast the Diagnosed Prevalent Cases of Refractory Angina

Figure 15: 7MM, Diagnosed Incident Cases of Angina Pectoris, Both Sexes, Ages ≥18 Years, N, 2018

Figure 16: 7MM, Diagnosed Incident Cases of Angina Pectoris by Age, Both Sexes, N, 2018

Figure 17: 7MM, Diagnosed Incident Cases of Stable Angina, Both Sexes, Ages ≥18 Years, N, 2018

Figure 18: 7MM, Diagnosed Incident Cases of Unstable Angina, Both Sexes, Ages ≥18 Years, N, 2018

Figure 19: 7MM, Diagnosed Incident Cases of Prinzmetal Angina, Both Sexes, Ages ≥18 Years, N, 2018

Figure 20: 7MM, Diagnosed Incident Cases of Microvascular Angina, Both Sexes, Ages ≥18 Years, N, 2018

Figure 21: 7MM, Diagnosed Incident Cases of Angina Pectoris by Comorbidities, Both Sexes, Ages ≥18 Years, N, 2018

Figure 22: 7MM, Diagnosed Prevalent Cases of Angina Pectoris, Both Sexes, Ages ≥18 Years, N, 2018

Figure 23: 7MM, Diagnosed Prevalent Cases of Angina Pectoris by Age, Both Sexes, N, 2018

Figure 24: 7MM, Diagnosed Prevalent Cases of Stable Angina, Both Sexes, Ages ≥18 Years, N, 2018

Figure 25: 7MM, Diagnosed Prevalent Cases of Unstable Angina, Both Sexes, Ages ≥18 Years, N, 2018

Figure 26: 7MM, Diagnosed Prevalent Cases of Prinzmetal Angina, Both Sexes, Ages ≥18 Years, N, 2018

Figure 27: 7MM, Diagnosed Prevalent Cases of Microvascular Angina, Both Sexes, Ages ≥18 Years, N, 2018

Figure 28: 7MM, Diagnosed Prevalent Cases of Angina Pectoris by Comorbidities, Both Sexes, Ages ≥18 Years, N, 2018

Figure 29: 7MM, Diagnosed Prevalent Cases of Refractory Angina, Both Sexes, Ages ≥18 Years, N, 2018

Figure 30: Assessment of NOCAD

Figure 31: Level of Use versus Line of Therapy for Currently Marketed Antianginals

Figure 32: Unmet Needs and Opportunities in Angina

Figure 33: Overview of the Development Pipeline in Stable, Refractory, and Microvascular Angina

Figure 34: Key Phase II/III Trials for the Promising Pipeline Agents That GlobalData Expects to Be Licensed for Angina in the 7MM During the Forecast Period

Figure 35: Competitive Assessment of the Late-Stage Pipeline Agents That GlobalData Expects to Be Licensed for the Treatment of Angina During the Forecast Period

Figure 36: Analysis of the Company Portfolio Gap in Angina During the Forecast Period

Figure 37: Global (7MM) Sales Forecast by Region for Angina in 2018 and 2028

Figure 38: Sales Forecast for Antianginals by Drug or Drug Class in the US in 2018 and 2028

Figure 39: Sales Forecast for Antianginals by Drug or Drug Class in the 5EU in 2018 and 2028

Figure 40: Sales Forecast for Antianginals by Drug or Drug Class in Japan in 2018 and 2028

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