PharmaPoint: Acute Coronary Syndrome – Global Drug Forecast and Market Analysis to 2025

Cardiovascular diseases (CVD), including ischemic heart disease and stroke, are the leading causes of mortality in the world. The term acute coronary syndrome (ACS) applies to a spectrum of acute CVD states that are precipitated by coronary artery occlusion (stenosis) that results in ischemia (a reduction or loss of blood flow to tissue) and the necrosis of myocardial tissue .In the most modern use of the term, ACS strictly refers to a range of ischemic cardiovascular events that includes unstable angina (UA), myocardial infarction (MI) and/or death due to myocardial ischemia. In general, these ACS events can be viewed as the culmination of coronary artery disease (CAD), the asymptomatic build-up of atherosclerotic plaque on the walls of the coronary arteries. The triggering of an ACS event stemming from UA or MI initiates the acute phase treatment setting where therapeutic interventions are utilized to reverse and prevent the physiochemical processes that lead to coronary stenosis. Whereas, the chronic phase treatment setting involves secondary preventative measures that are used to avoid recurrent ACS events from occurring.

Scope

Overview of ACS, including epidemiology, etiology, pathophysiology, symptoms, diagnosis, and treatment guidelines.

Annualized ACS therapeutics market revenue, annual cost of therapy and treatment usage pattern data from 2015 and forecast for ten years to 2025.

Key topics covered include strategic competitor assessment, market characterization, unmet needs, clinical trial mapping and implications for the ACS therapeutics market.

Pipeline analysis: comprehensive data split across different phases, emerging novel trends under development, and detailed analysis of late-stage pipeline drugs.

Analysis of the current and future market competition in the global ACS therapeutics market. Insightful review of the key industry drivers, restraints and challenges. Each trend is independently researched to provide qualitative analysis of its implications.

Key Highlights

The new generation antiplatelets, Brilinta and Effient will see a significant increase in patient shares for the treatment ACS against the previous cornerstone, clopidogrel. However, there are considerably high unmet needs within the indication. What are the main unmet needs in this market? Will the drugs under development fulfil the unmet needs of the ACS market?

The PCSK9 inhibitors recently launched into the CV market, and these are predicted to have a notable impact in the ACS space once their CV outcomes data is shown. The most notable candidate in the current late-stage ACS pipeline is ETC-1002, which is vying to target the needed statin intolerant ACS population. Will these newly marketed and late-stage drugs make a significant impact on the ACS market? Which of these drugs will have the highest peak sales at the highest CAGR, and why?

We have seen a notable increase in the ACS population in terms of diagnosed prevalent ACS cases , as well as ACS hospitalisations (incidence and recurrent events). How will epidemiological changes impact the growth of the future market?

Companies mentioned

Amgen

AstraZeneca

Bristol-Myers Squibb

Cerenis Therapeutics

CSL Limited

Daiichi Sankyo

Eli Lilly

Esperion Therapeutics

GlaxoSmithKline

Janssen Pharmaceuticals

(Johnson & Johnson)

The Medicines Company

Merck

Pfizer ...

Amgen

AstraZeneca

Bristol-Myers Squibb

Cerenis Therapeutics

CSL Limited

Daiichi Sankyo

Eli Lilly

Esperion Therapeutics

GlaxoSmithKline

Janssen Pharmaceuticals

(Johnson & Johnson)

The Medicines Company

Merck

Pfizer

Sanofi

Table of Contents

1Table of Contents

1.1List of Tables

1.2List of Figures

2Introduction

2.1Catalyst

2.2Related Reports

2.3Upcoming Related Reports

3Disease Overview

3.1Etiology and Pathophysiology

3.1.1Etiology

3.1.2Pathophysiology

3.2Classification or ...

1Table of Contents

1.1List of Tables

1.2List of Figures

2Introduction

2.1Catalyst

2.2Related Reports

2.3Upcoming Related Reports

3Disease Overview

3.1Etiology and Pathophysiology

3.1.1Etiology

3.1.2Pathophysiology

3.2Classification or Staging Systems

3.3Symptoms

3.4Prognosis

3.5Quality of Life

4Epidemiology

4.1Disease Background

4.2Risk Factors and Comorbidities

4.3Global Trends

4.3.1ACS Diagnosed Prevalence

4.3.2STEMI and NSTEMI Trends

4.3.3ACS Hospitalizations

4.4Forecast Methodology

4.4.1Sources Used

4.4.2Forecast Assumptions and Methods

4.4.3Sources Not Used

4.5Epidemiological Forecast for ACS (2015–2025)

4.5.1Diagnosed Prevalent Cases of ACS

4.5.2Age–Specific Diagnosed Prevalent Cases of ACS

4.5.3Sex-Specific Diagnosed Prevalent Cases of ACS

4.5.4Diagnosed Prevalent Cases of ACS Segmented by STEMI, NSTEMI, and UA

4.5.5Age-Standardized Diagnosed Prevalence of ACS

4.5.6ACS Hospitalizations

4.5.7Sex-Specific ACS Hospitalizations

4.5.8ACS Hospitalizations Segmented by STEMI, NSTEMI, and UA

4.6Discussion

4.6.1Epidemiological Forecast Insight

4.6.2Limitations of the Analysis

4.6.3Strengths of the Analysis

5Disease Management

5.1Diagnosis and Treatment Overview

5.1.1Diagnosis

5.1.2Treatment Guidelines and Leading Prescribed Drugs

5.1.3Clinical Practice

5.2US

5.35EU

5.4Japan

6Competitive Assessment

6.1Overview

6.2Product Profiles – Acute Coronary Syndrome

6.2.1Antihypertensives

6.2.2Anticoagulants

6.2.3Fibrinolytics

6.2.4Antidyslipidemics

6.2.5Antiplatelets

7Unmet Need and Opportunity

7.1Overview

7.2Management of ACS in Elderly Patients

7.2.1Unmet Need

7.2.2Gap Analysis

7.2.3Opportunity

7.3Blood Thinning Agent with Reduced Bleeding

7.3.1Unmet Need

7.3.2Gap Analysis

7.3.3Opportunity

7.4Therapies that Treat Fibrotic Myocardium and Associated Comorbidities

7.4.1Unmet Need

7.4.2Gap Analysis

7.4.3Opportunity

7.5Achieving Guideline-Recommended Levels of LDL-C

7.5.1Unmet need

7.5.2Gap Analysis

7.5.3Opportunity

7.6Optimal Treatment of ACS Patients with Hyperglycemia

7.6.1Unmet Need

7.6.2Gap Analysis

7.6.3Opportunity

8Pipeline Assessment

8.1Overview

8.2Promising Drugs in Clinical Development

8.2.1Bococizumab

8.2.2Anacetrapib

8.2.3CSL-112

8.2.4CER-001

8.2.5LY3015014

8.2.6AMG-899

8.2.7ETC-1002

9Current and Future Players

9.1Overview

9.2Trends in Corporate Strategy

9.3Company Profiles

9.3.1Amgen

9.3.2AstraZeneca

9.3.3Bristol-Myers Squibb

9.3.4Cerenis Therapeutics

9.3.5CSL Limited

9.3.6Daiichi Sankyo

9.3.7Eli Lilly

9.3.8Esperion Therapeutics

9.3.9GlaxoSmithKline

9.3.10Janssen

9.3.11The Medicines Company

9.3.12Merck & Co.

9.3.13Pfizer

9.3.14Sanofi

10Market Outlook

10.1Global Market

10.1.1Forecast

10.1.2Drivers and Barriers – Global Issues

10.2United States

10.2.1Forecast

10.2.2Key Events

10.2.3Drivers and Barriers

10.3France

10.3.1Forecast

10.3.2Key Events

10.3.3Drivers and Barriers

10.4Germany

10.4.1Forecast

10.4.2Key Events

10.4.3Drivers and Barriers

10.5Italy

10.5.1Forecast

10.5.2Key Events

10.5.3Drivers and Barriers

10.6Spain

10.6.1Forecast

10.6.2Key Events

10.6.3Drivers and Barriers

10.7United Kingdom

10.7.1Forecast

10.7.2Key Events

10.7.3Drivers and Barriers

10.8Japan

10.8.1Forecast

10.8.2Key Events

10.8.3Drivers and Barriers

11Appendix

11.1Bibliography

11.2Abbreviations

11.3Methodology

11.4Forecasting Methodology

11.4.1Diagnosed Acute Coronary Syndrome Patients

11.4.2Percent Drug-Treated Patients

11.4.3Drugs Included in Each Therapeutic Class

11.4.4Launch and Patent Expiry Dates

11.4.5General Pricing Assumptions

11.4.6Individual Drug Assumptions

11.4.7Generic Erosion

11.4.8Pricing of Pipeline Agents

11.5Physicians and Specialists Included in this Study

11.6About the Authors

11.6.1Analyst

11.6.2Therapy Area Director

11.6.3Epidemiologist

11.6.4Global Director of Therapy and Epidemiology

11.7About GlobalData

11.8Contact Us

11.9Disclaimer

List of Tables

Table 1: Marketed Antiplatelet Agents that Inhibit Platelet Activation

Table 2: Marketed Anticoagulants that Inhibit the Coagulatory Cascade

Table 3: Antidyslipidemic agents

Table 4: Classifications ...

Table 1: Marketed Antiplatelet Agents that Inhibit Platelet Activation

Table 2: Marketed Anticoagulants that Inhibit the Coagulatory Cascade

Table 3: Antidyslipidemic agents

Table 4: Classifications of ACS

Table 5: Universal Classification of MI

Table 6: Symptoms of Acute Coronary Syndrome

Table 7: Risk Factors and Comorbidities for ACS

Table 8: Global, Crude Total Population Prevalence Percentages of Angina Pectoris and Mean Age of Study Participants

Table 9: 7MM, Sources of Diagnosed Prevalence Data for MI

Table 10: 7MM, Data Sources of STEMI and NSTEMI Proportions Among Diagnosed Prevalent Cases of MI

Table 11: 7MM, Data Sources of ACS Hospitalizations

Table 12: 7MM, Data Sources of STEMI and NSTEMI Proportions Among MI Hospitalizations

Table 13: 7MM, Diagnosed Prevalent Cases of ACS, Ages =25 Years, Both Sexes, N, Select Years, 2015–2025

Table 14: 7MM, Age-Specific Diagnosed Prevalent Cases of ACS, Men and Women, N (Row %), 2015

Table 15: 7MM, Sex-Specific Diagnosed Prevalent Cases of ACS, Ages =25 Years, N (Row %), 2015

Table 16: 7MM, Diagnosed Prevalent Cases of STEMI, NSTEMI, and UA, Ages =25 Years, N (Row %), 2015

Table 17: 7MM ACS Hospitalizations, Ages =25 Years, Both Sexes, N, Select Years, 2015–2025

Table 18: 7MM, Sex-Specific ACS Hospitalizations, Ages =25 Years, N (Row %), 2015

Table 19: 7MM, Diagnosed ACS Hospitalizations Segmented by STEMI, NSTEMI and UA, Ages =25 Years, Both Sexes, N, 2015

Table 20: Most-Prescribed Drugs for ACS by Class in the Global Markets, 2015

Table 21: Treatment Guidelines for Acute Coronary Syndromes (UA, NSTEMI, and STEMI)

Table 22: Country Profile for ACS – US

Table 23: Country Profile for ACS – 5EU

Table 24: Country Profile for ACS – Japan

Table 25: Leading Treatments for ACS, 2015

Table 26: Commonly Used Beta Blockers

Table 27: Product Profile – Beta Blockers

Table 28: Beta Blockers SWOT Analysis, 2015

Table 29: Global ACS Sales Forecasts [$m] for Beta Blockers, 2015–2025

Table 30: Commonly Used ACE Inhibitors

Table 31: Product Profile – ACE Inhibitors

Table 32: ACE Inhibitor?SWOT Analysis, 2015

Table 33 Global ACS Sales Forecasts [$m] for ACE inhibitors, 2015–2025

Table 34: Commonly Used ARBs

Table 35: Product Profile – Angiotensin Receptor Blockers (ARBs)

Table 36: ARB SWOT Analysis, 2015

Table 37: Global ACS Sales Forecasts [$m] for ARBs, 2015–2025

Table 38: Product Profile – Mineralocorticoid Receptor Antagonists (MRAs)

Table 39: MRA SWOT Analysis, 2016

Table 40: Global ACS Sales Forecasts [$m] for MRAs, 2015–2025

Table 41: Product Profile – Warfarin

Table 42: Warfarin SWOT Analysis, 2015

Table 43: Global ACS Sales Forecasts [$m] for Warfarin, 2015–2025

Table 44: Product Profile – Angiomax

Table 45: AngiomaxSWOT Analysis, 2015

Table 46: Global ACS Sales Forecasts [$m] for Angiomax, 2015–2025

Table 47: Product Profile – Fondaparinux

Table 48: Arixtra SWOT Analysis, 2015

Table 49: Global ACS Sales Forecasts ($M) for Fondaparinux, 2015–2025

Table 50: Product Profile – Xarelto (rivaroxaban)

Table 51: Xarelto SWOT Analysis, 2015

Table 52: Global ACS Sales Forecast ($M) for Xarelto, 2015–2025

Table 53: Commonly Used tPAs

Table 54: Product Profile – Tissue Plasminogen Activator (tPA)

Table 55: Fibrinolytics?SWOT Analysis, 2015

Table 56: Global ACS Sales Forecast ($M) for Fibrinolytics, 2015–2025

Table 57: Product Profile – Repatha (Evolocumab)

Table 58: Product Profile – Praluent (Alirocumab)

Table 59: PCSK9 inhibitors SWOT Analysis, 2015

Table 60: Global ACS Sales Forecasts [$m] for Repatha, 2015–2025

Table 61: Global ACS Sales Forecasts [$m] for Praluent, 2015–2025

Table 62: Product Profile – Atorvastatin

Table 63: Product Profile – Simvastatin

Table 64: Lipitor (Atorvastatin) SWOT Analysis, 2015

Table 65: Zocor (Simvastatin) SWOT Analysis, 2015

Table 66: Global ACS Sales Forecasts [$m] for Generic Statins, 2015–2025

Table 67: Product Profile – Crestor (Rosuvastatin)

Table 68: Crestor (Rosuvastatin) SWOT Analysis, 2015

Table 69: Global ACS Sales Forecasts [$m] for Crestor, 2015–2025

Table 70: Product Profile – Clopidogrel

Table 71: Clopidogrel SWOT Analysis, 2015

Table 72: Global ACS Acute Phase Sales Forecast ($M) for Clopidogrel, 2015–2025

Table 73: Global ACS Chronic Phase Sales Forecasts ($M) for Clopidogrel, 2015–2025

Table 74: Product Profile – Brilinta (ticagrelor)

Table 75: Brilinta (ticagrelor) SWOT Analysis, 2015

Table 76: Global Acute Phase ACS Sales Forecast ($M) for Brilinta, 2015–2025

Table 77: Global ACS Chronic Phase Sales Forecast ($M) for Brilinta, 2015–2025

Table 78: Product Profile – Effient (Prasugrel)

Table 79: Effient (Prasugrel) SWOT Analysis, 2015

Table 80: Global Acute Phase ACS Sales Forecast ($M) for Effient, 2015–2025

Table 81: Global ACS Chronic Phase Sales Forecast ($M) for Effient, 2015–2025

Table 82: Product Profile – Integrilin (Eptifibatide)

Table 83: Integrilin (Eptifibatide) SWOT Analysis, 2015

Table 84: Global ACS Sales Forecast ($M) for Integrilin, 2015–2025

Table 85: Product Profile – Cangrelor

Table 86: Kengreal (cangrelor) SWOT Analysis, 2015

Table 87: Global ACS Sales Forecasts ($M) for Kengreal, 2015–2025

Table 88: Product Profile – Zontivity (Vorapaxar)

Table 89: Vorapaxar SWOT Analysis, 2015

Table 90: Global ACS Sales Forecast ($M) for Zontivity, 2015–2025

Table 91: Unmet Need and Opportunity in ACS

Table 92: Comparison of Therapeutic Classes in Development for ACS, 2015

Table 93: Comparison of Therapeutic Classes in Pipeline for ACS, 2016

Table 94: Product Profile – Bococizumab (PF-04950615)

Table 95: Bococizumab (PF-04950615) SWOT Analysis, 2015

Table 96: Global ACS Sales Forecasts [$m] for Bococizumab, 2015–2025

Table 97: Product Profile – Anacetrapib

Table 98: Anacetrapib SWOT Analysis, 2015

Table 99: Global ACS Sales Forecasts [$m] for Anacetrapib, 2015–2025

Table 100: Product Profile – CSL-112

Table 101: CSL-112 SWOT Analysis, 2015

Table 102: Global ACS Sales Forecasts [$m] for CSL-112, 2015–2025

Table 103: Product Profile – CER-001

Table 104: CER-001 SWOT Analysis, 2015

Table 105: Global ACS Sales Forecasts [$m] for CER-001, 2015–2025

Table 106: Product Profile – LY3015014

Table 107: LY3015014 SWOT Analysis, 2015

Table 108 Global ACS Sales Forecasts [$m] for LY3015014 , 2015–2025

Table 109: Product Profile – AMG-899

Table 110: AMG-899 SWOT Analysis, 2015

Table 111: Global ACS Sales Forecasts [$m] for AMG-899, 2015–2025

Table 112: Product Profile – ETC-1002

Table 113: ETC-1002 SWOT Analysis, 2016

Table 114: Global ACS Sales Forecasts [$m] for ETC-1002, 2015–2025

Table 115: Key Companies in the ACS Market, 2016

Table 116: Amgen’s ACS Portfolio Assessment, 2016

Table 117: AstraZeneca’s ACS Portfolio Assessment, 2015

Table 118: BMS’s ACS Portfolio Assessment, 2015

Table 119: Cerenis’ ACS Portfolio Assessment, 2015

Table 120: CSL Limited’s ACS Portfolio Assessment, 2015

Table 121: Daiichi Sankyo’s ACS Portfolio Assessment, 2015

Table 122: Eli Lilly’s ACS Portfolio Assessment, 2015

Table 123: Esperion’s ACS Portfolio Assessment, 2016

Table 124: GlaxoSmithKline’s Acute Coronary Syndrome Portfolio Assessment, 2015

Table 125: Janssen’s ACS Portfolio Assessment, 2015

Table 126: The Medicines Company’s Acute Coronary Syndrome Portfolio Assessment, 2015

Table 127: Merck’s ACS Portfolio Assessment, 2015

Table 128: Pfizer’s ACS Portfolio Assessment, 2015

Table 129: Sanofi’s ACS Portfolio Assessment, 2015

Table 130: Global Sales Forecasts [$m] for Acute Coronary Syndrome, 2015–2025

Table 131: ACS Global market – Drivers and Barriers, 2015–2025

Table 132: Sales Forecasts [$m] for Acute Coronary Syndrome in the US, 2015–2025

Table 133: Key Events Impacting Sales for ACS in the US, 2015–2025

Table 134: US ACS Market – Drivers and Barriers, 2015–2025

Table 135: Sales Forecasts [$m] for Acute Coronary Syndrome in France, 2015–2025

Table 136: Key Events Impacting Sales for ACS in France, 2015–2025

Table 137: France ACS market – Drivers and Barriers, 2015–2025

Table 138: Sales Forecasts [$m] for Acute Coronary Syndrome in Germany, 2015–2025

Table 139: Key Events Impacting Sales for ACS in Germany, 2015–2025

Table 140: Germany ACS market – Drivers and Barriers, 2015–2025

Table 141: Sales Forecasts [$m] for Acute Coronary Syndrome in Italy, 2015–2025

Table 142: Key Events Impacting Sales for ACS in Italy, 2015–2025

Table 143: Italy ACS market – Drivers and Barriers, 2015–2025

Table 144: Sales Forecasts [$m] for Acute Coronary Syndrome in Spain, 2015–2025

Table 145: Key Events Impacting Sales for ACS in Spain, 2015–2025

Table 146: Spain ACS Market – Drivers and Barriers, 2015–2025

Table 147: Sales Forecasts [$m] for Acute Coronary Syndrome in the UK, 2015–2025

Table 148: Key Events Impacting Sales for ACS in the UK, 2015–2025

Table 149: UK ACS market – Drivers and Barriers, 2015–2025

Table 150: Sales Forecasts [$m] for Acute Coronary Syndrome in Japan, 2015–2025

Table 151: Key Events Impacting Sales for ACS in Japan, 2015–2025

Table 152: Japan ACS Market – Drivers and Barriers, 2015–2025

Table 153: Key ACS Launch Dates

Table 154: Key Patent Expiries

Table 155: High-Prescribing Physicians (non-KOLs) Surveyed, By Country

List of Figures

Figure 1: The ACS Timeline and the Scope of GlobalData’s ACS Report and Forecast

Figure 2: Progression of CAD, Atherosclerotic Plaque Rupture, Thrombosis, and ACS ...

Figure 1: The ACS Timeline and the Scope of GlobalData’s ACS Report and Forecast

Figure 2: Progression of CAD, Atherosclerotic Plaque Rupture, Thrombosis, and ACS

Figure 3: Platelet and Coagulatory Factors Implicated in Thrombosis

Figure 4: Electrocardiography in the Diagnosis of ACS

Figure 5: US, Germany, and UK, Crude Diagnosed MI Prevalence in Men and Women, 1990–2008

Figure 6: Global, Crude Total Population Prevalence Percentages of Angina Pectoris (%)

Figure 7: Case Segmentation Map

Figure 8: 7MM, Diagnosed Prevalent Cases of ACS, Ages =25 Years, Both Sexes, N, Select Years, 2015–2025

Figure 9; 7MM, Age-Specific Diagnosed Prevalent Cases of ACS, Men and Women, N, 2015

Figure 10: 7MM, Sex-Specific Diagnosed Prevalent Cases of ACS, Ages =25 Years, N, 2015

Figure 11: 7MM, Diagnosed Prevalent Cases of STEMI and NSTEMI, Ages =25 Years, N, 2015

Figure 12: 7MM, Age-Standardized Diagnosed Prevalence of ACS, Ages =25 Years, 2015

Figure 13: 7MM ACS Hospitalizations, Ages =25 Years, Both Sexes, N, Select Years, 2015–2025

Figure 14: 7MM, Sex-Specific ACS, Ages =25 Years, N, 2015

Figure 15: 7MM, Diagnosed ACS Hospitalizations Segmented by NSTEMI and STEMI, Ages =25 Years, Both Sexes, N, 2015

Figure 16: Company Portfolio Gap Analysis in ACS, 2015–2025

Figure 17: Global Sales for ACS by Region, 2015–2025

Figure 18: Global Sales for ACS by Class, 2015–2025

Figure 19 Global Sales for PCSK9 inhibitors for ACS, 2015–2025

Figure 20: Sales for ACS in the US by Drug Class, 2015–2025

Figure 21: Sales for ACS in France by Drug Class, 2015–2025

Figure 22: Sales for ACS in Germany by Drug Class, 2015–2025

Figure 23: Sales for ACS in Italy by Drug Class, 2015–2025

Figure 24: Sales for ACS in Spain by Drug Class, 2015–2025

Figure 25: Sales for ACS in the UK by Drug Class, 2015–2025

Figure 26: Sales for ACS in Japan by Drug Class, 2015–2025

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