Commercial Insight: Antihypertensives – New ... - Datamonitor

Commercial Insight: Antihypertensives – New challenges for a maturing market
DMHC2178
Introduction
Datamonitor expects the antihypertensive market to exceed $40bn by 2015
across the seven major markets, with novel treatments and the market-leading
ARBs delivering much of this value. However, significant hurdles exist, and
pharmaceutical companies need to carefully design marketing campaigns and
pricing structures for their products.
Key findings and highlights
• The growth rate of the antihypertensive market is declining. These changes reflect the
challenges faced by pharmaceutical companies over the next decade, as brand erosion and
healthcare reforms impact heavily. The slow and declining growth rate does not reflect a
stationary market, but the battle between the drugs that make up the market.
• Cozaar's patent expiry in the US has the potential to alter the structure of the
antihypertensive market dramatically. Threats of generic substitution and money-saving
healthcare strategies which have plagued other markets are now approaching the
successful ARB class, and will have an impact on the whole antihypertensive market.
• Large pharmaceutical companies that have established themselves in the cardiovascular
arena are steering away from development in the antihypertensive market. While still
continuing to enjoy large revenues from its cardiovascular arm, the research and
development of Novartis shows that it is now investing elsewhere.
Reasons to buy
• Quantify the future size and scope of the hypertension market and the potential for new
products
• Analyze options to expand commercial potential through pursuit of new indications
• Formulate successful launch strategies to succeed in a highly competitive market
For more information...
Contact Anne Delaney, R&A DIR
tel: +44 20 7675 7221 fax: +44 20 7675 7016 email: hcmarketing@datamonitor.com

www.datamonitor.com/healthcare
Sample pages from the report
Country Market Assessments
Figure 15:
The tiered co-payment system will lead to greater use of
generics
Average co-payment
of $35-50
Tier 3 – non-preferred brand
Average co-payment
of $20-25
Tier 2 – preferred brand
Country Market Assessments
Average co-payment
Figure of $1012:
Generic companies dominate the US pharmaceutical market in
terms of prescriptions
Tier 1 – generic drugs
Source: Datamonitor (DMHC2192)
D A T A M O N I T O R
In addition, some plans include lifestyle drugs or biological products in an extra fourth
tier. With the reduced co-payment being asked for Tier 1 drugs, it is expected that
Medicare Part D beneficiaries – the older, retired population, most of whom have a
relatively low income as they are no longer working - will increasingly look to fill their
prescriptions with generics. Moreover, this patient population usually has a number of
chronic conditions that require pharmaceutical therapy and, therefore, Note: the NRx – new more
prescriptions
TRx – total prescriptions
products for which they will have to co-pay, the greater will be their desire to receive
lower cost generics.
Source: Teva Investor Lunch Presentation, May 2006
Country Market Assessments
D A T A M O N I T O R
Furthermore, a study into a sample of 35 different Medicare Part D plans has found
that there is a wide variation in the drugs covered by the plans. The study assessed
The third message relates to the restructuring of the diagnostic classification of
It should be noted that the Novartis figures include the prescriptions filled under the
152 generic and branded drugs and found that none of the 35 plans covered all 152
hypertension and has generated some debate among leaders in the field. The
Sandoz division. However, this dominance does not translate into sales value,
drugs. However, 32 of the 35 plans covered the top 10 most commonly prescribed
classification applied to blood pressure levels in JNC6 and JNC7 are displayed in
highlighting the price differential between branded and generic products, with
generic drugs. In addition, only half of the 35 plans covered the top 10 branded drugs,
Figure 9.
substantial discounts usually in place 12 to 18 months after patent expiry
Commercial Insight: Antihypertensives
(Datamonitor, DMHC2178 Benchmarking Best Practice at Patent Expiry in the US, DMHC2055).
© Datamonitor (Published 09/2006) Interestingly, Page several 54 generics companies appear in the top 10 companies
Figure
according
9: JNC6 and JNC7 compared: classification of blood pressure
This report is a licensed product and is not to be photocopied
to total prescriptions filled under the recently rolled-out Medicare Part D reform, as
levels
shown in Table 5. This further highlights the well-established role of generics in
reducing pharmaceutical expenditure in the US.
Commercial Insight: Antihypertensives
DMHC2178
© Datamonitor (Published 09/2006) Page 42
This report is a licensed product and is not to be photocopied
Source: Chobanian et al., 2003 (NIH Publication No. 04-5230)
D A T A M O N I T O R
In a plenary lecture at the American Heart Association (AHA) Scientific Sessions in
November 2005 entitled “Controversies in the management of hypertension”, Dr
William Cushman of the University of Tennessee College of Medicine in Memphis
tried to explain the rationale behind this change. Dr Cushman highlighted that under
the new definition, NHANES data from 1999–2000 showed that 31% of the US
population is pre-hypertensive, and as such is at significant risk of developing Stage 1
and 2 hypertension and experiencing a cardiovascular event, a comment that has
been backed up by many previous studies (e.g. HOPE).
Commercial Insight: Antihypertensives
DMHC2178
© Datamonitor (Published 09/2006) Page 36
This report is a licensed product and is not to be photocopied
“...I am inclined to think there is a class effect for the ARBs. Of course one cannot be
sure of this 100%, but several advantages of ARBs have been shown
for different components of the same class which of course strongly suggest that they
are due to a class effect...”
Key opinion leader, Commercial Insight: Antihypertensives – New challenges for a maturing market

Commercial Insight: Antihypertensives – New challenges for a maturing market
DMHC2178
Table of contents
EXECUTIVE SUMMARY
• Objective of the analysis
• Datamonitor insight into the hypertension market
• Summary of key milestones in the
antihypertensives market
MARKET DEFINITION AND OVERVIEW
- Sales figures definition for this report
- Market definition and overview for this report
- Current pharmaceutical market situation
- Strategic scoping and focus
COUNTRY MARKET ASSESSMENTS
• Global market level assessment, opportunities and
threats
- Market level assessment
- Opportunities
- Threats
• US: market level assessment, opportunities and
threats
- Market level assessment
- Opportunities
- Threats
• Japan: market level assessment, opportunities and
threats
- Market level assessment
- Opportunities
- Threats
• France: market level assessment, opportunities
and threats
- Market level assessment
- Opportunities
- Threats
• Germany: opportunities and threats
- Market level assessment
- Opportunities
- Threats
• Italy: market level assessment, opportunities and
threats
- Market level assessment
- Opportunities
- Threats
• Spain: market level assessment, opportunities and
threats
- Market level assessment
- Opportunities
- Threats
• UK: market level assessment, opportunities and
threats
- Market level assessment
- Opportunities
- Threats
• Summary of environmental issues affecting
antihypertensive market size
FORECAST ANALYSIS
• Assumptions and events
- Increasing market size
- Increasing use of fixed-dose combinations
- Major clinical trials
- New Product Launches
- Additional Indications
- Patent Expiries
• Data definitions, limitations and assumptions
- Standard units
- Japanese market data
- Derivation of sales forecasts and pricing trends
• Forecasts
• Forecast methodology
COMMERCIAL IMPACT AND LIFECYCLE
MANAGEMENT: CASE STUDIES
• Introduction
• Case studies
- Case Study 1: Novartis - future prospects
- Case study 2: The loss of patent protection for
Cozaar (losartan) in the US market; potential
impacts, likely scenarios.
BIBLIOGRAPHY AND REFERENCES
• Bibliography
• References
APPENDIX A - MARKET DATA AND MAJOR BRAND
FACTS
• Global antihypertensive market data
- Segmentation by country
- Segmentation by class
• Major brand facts
- Anatomical Therapeutic Chemical (ATC)
classification
For more information...
Contact Anne Delaney, R&A DIR
tel: +44 20 7675 7221 fax: +44 20 7675 7016 email: hcmarketing@datamonitor.com

www.datamonitor.com/healthcare
APPENDIX B - MARKET FORECAST DATA
• US Forecasts
• Japan Forecasts
• France Forecasts
• Germany Forecasts
• Italy Forecasts
• Spain Forecasts
• UK Forecasts
• Five Major European Markets Forecasts
• Seven Major Markets Forecasts
APPENDIX C
TABLES
Table 1: 7MM sales of the antihypertensive drug
classes, 2005
Table 2: Seven major market sales and market share of
the 10 top-selling antihypertensives, 2005
Table 3: Prevalence of obesity in the seven major
markets by age (000s), 2003 (all totals have
been rounded where applicable)
Table 4: US antihypertensive sales, 2005
Table 5: Five generics companies are among the top 10
companies in terms of prescriptions filled under
Medicare Part D
Table 6: The actual generic fill rate varies between
therapeutic classes
Table 7: Japan antihypertensive sales, 2005
Table 8: An example of the savings to be realized by
using generic drugs
Table 9: France antihypertensive sales, 2005
Table 10: Germany antihypertensive sales, 2005
Table 11: Italy antihypertensive market, 2005
Table 12: Spain antihypertensive market, 2005
Table 13: UK antihypertensive market, 2005
Table 14: The 10 clinical areas of the Quality Outcome
Framework, as outlined in the GMS contract,
2005
Table 15: Summary of macro-environmental issues
affecting the anthypertensive, 2006
Table 16: Patent expiry dates used in forecasting the
antihypertensive market across the seven
major markets
Table 17: Sales of selected Novartis marketed
cardio-metabolic products, 2005
Table 18: Forecasts for Rasilez (aliskiren)
Table 19: Sales forecasts for Exforge (valsartan plus
amlodipine)
Table 20: Kredex: key facts
Table 21: Toprol-XL: key facts
Table 22: Tenormin; key facts
Table 23: Inderal: key facts
Table 24: Norvasc: key facts
Table 25: Plendil: key facts
Table 26: Cardizem LA: key facts
Table 27: Adalat: key facts
Table 28: Altace: key facts
Table 29: Aceon: key facts
Table 30: Accupro: key facts
Table 31: Atacand; key facts
Table 32: Teveten: key facts
Table 33: Avapro: key facts
Table 34: Cozaar: key facts
Table 35: Benicar: key facts
Table 36: Micardis: key facts
Table 37: Diovan: key facts
Table 38: Antihypertensive classifications
Table 39: US antihypertensive sales forecasts
($m; 2005 figures are actuals)
Table 40: Japan antihypertensive sales forecasts
($m; 2005 figures are actuals)
Table 41: France antihypertensive sales forecasts
($m; 2005 figures are actuals)
Table 42: Germany antihypertensive sales forecasts
($m; 2005 figures are actuals)
Table 43: Italy antihypertensive sales forecasts
($m; 2005 figures are actuals)
Table 44: Spain antihypertensive sales forecasts
($m; 2005 figures are actuals)
Table 45: UK antihypertensive sales forecasts
($m; 2005 figures are actuals)
Table 46: Five major markets antihypertensive sales
forecasts ($m; 2005 figures are actuals)
Table 47: Seven major markets antihypertensive sales
forecasts ($m; 2005 figures are actuals)
FIGURES
Figure 1: Key milestones expected to have an impact on
the 7MM antihypertensives market,
2007 - 2015
Figure 2: 7MM pharmaceutical sales, 2004-05
Figure 3: Comparative antihypertensive market share
information for 7MM in terms of sales value and
sales volume, split by country, 2005
Figure 4: Proportion of population aged 20-39 years,
2004 and 2015, and prevalence of
hypertension in this age group in the seven
major markets, 2004
“...I think that the GMS contract for GPs influences their practice, so things like
targets are determined by the GMS contract and not so much by the BHS guidelines,
because that's what they get paid for - their GMS targets...”
Key opinion leader, Commercial Insight: Antihypertensives – New challenges for a maturing market

Commercial Insight: Antihypertensives – New challenges for a maturing market
DMHC2178
Figure 5: Proportion of population aged 40-59 years,
2004 and 2015, and prevalence of
hypertension in this age group in the seven
major markets, 2004
Figure 6: Proportion of population aged 60-79 years,
2004 and 2015, and prevalence of
hypertension in this age group in the seven
major markets, 2004
Figure 7: The growing prevalence of obesity in the US
Figure 8: Generalized distribution chain for parallel
traded pharmaceutical products
Figure 9: JNC6 and JNC7 compared: classification of
blood pressure levels
Figure 10: Compelling indications for individual drug
classes
Figure 11: More than half of all prescriptions dispensed in
the US are generics
Figure 12: Generic companies dominate the US
pharmaceutical market in terms of prescriptions
Figure 13: Generic use in the US is promoted through a
number of channels
Figure 14: The generic fill rates in the US for 2003 varied
considerably by state
Figure 15: The tiered co-payment system will lead to
greater use of generics
Figure 16: Key pressures facing drug developers
Figure 17: The Japanese generic market is
underdeveloped because of a number of
factors
Figure 18: The oncology therapy area accounts for the
highest share of 1,377 projects in clinical
development, from 178 companies.
Figure 19: Novartis's investigational drugs by therapeutic
category
Figure 20: Effects of patent expiry on Cozaar (losartan) in
the US market
Figure 21: Datamonitor forecasts of the effects of Cozaar's
patent expiry on Cozaar (losartan), Diovan
(valsartan) and their respective generics, in the
US market
Figure 22: Segmentation of the antihypertensives market
by country
Figure 23: Segmentation of the antihypertensives market
by class
For more information...
Contact Anne Delaney, R&A DIR
tel: +44 20 7675 7221 fax: +44 20 7675 7016 email: hcmarketing@datamonitor.com

www.datamonitor.com/healthcare
Datamonitor: Your total information solution
Datamonitor is a premium business information company helping 5,000 of the world's leading
companies across the Automotive, Consumer Markets, Energy, Financial Services, Healthcare
and Technology sectors.
Our products and services are specifically designed to support our clients’ key business
processes – from corporate strategy to competitive intelligence. We provide an independent and
trustworthy source of data, analysis and forecasts to improve these processes and ultimately, to
help grow your business.
Corporate Strategy
& Business Planning
Quality
Data
Make more effective strategic
and business decisions
Product Development
& Commercialization
Targeting &
Influencing the Market
Expert
Analysis
Accelerate delivery
of commercial success
Assess and influence your
commercial and market
environment
HELPING
TO GROW
YOUR
BUSINESS
Market &
Competitive Intelligence
Future
Forecasts
Maintain or obtain critical
competitive advantage
Nothing speaks louder than our clients
3M
Abbott
Accenture
Alcon Labs
Allergan
Almirall-Prodesfarma
Altana Pharma AG
Amersham
Amgen
Amrad
Angelini Acraf
Astellas
AstraZeneca
AT Kearney
Baxter
Bayer Healthcare AG
Beaufour Ipsen
Biochemie
Biogen Idec
Boehringer Ingelheim
Boots
Bristol-Myers Squibb
Cantab
Caremark International
Chiesi
Chiron
Chugai
CMC Co
Daiichi
Deutsche Morgan
Grenfell
Elan
Eli Lilly
Esteve
Flamel
Fournier
Gehe
Genzyme
Gilead
Gist Brocades
GlaxoSmithKline
IBM
Immuno AG
Johnson & Johnson
Jouveinal
LEK
Lipha
Lundbeck
Merck KGaA
Merck & Co
Millennium
Pharmaceuticals
Nabi Biopharmaceuticals
Novartis
Novo Nordisk
Pfizer
Pharmachemie
Pierre Fabre
Pliva
Procter & Gamble
Ranbaxy
Recordati
Sankyo
sanofi-aventis
Schering AG
Schering-Plough
Schwarz Pharma AG
Serono
Shire Pharmaceuticals
Solvay Pharmaceuticals
Takeda
TAP Pharmaceutical
Teva
UCB
Uriach
Vernalis
Viatris
Wyeth
“...89% of our clients use Datamonitor research
to develop competitive intelligence...”
Source: Datamonitor Customer Research

Commercial Insight: Antihypertensives – New challenges for a maturing market
DMHC2178
Interested in this topic?
Highlighting latest market trends and new commercial opportunities,
Datamonitor’s Cardiovascular portfolio features detailed analysis of development
pipelines, current and future market dynamics, patient potential, treatment
patterns, and strategic issues.
- Cardiovascular Risk Factors (hypertension, dyslipidemia, secondary prevention)
- Cardiovascular Disease (arrhythmia, heart failure)
- Thrombosis
- Diabetology
Also available in this portfolio
Pipeline Insight: Antihypertensives – Weak pipeline leaves innovation to Novartis
Provides an in-depth, critical evaluation of the key compounds in development for essential
hypertension, assessing the commercial prospects for the launch of new, innovative products
against the level of existing unmet need in the market.
Published: Mar-06
Product code: DMHC2165
Stakeholder Insight: Hypertension – Multiple layers of therapy cover all eventualities
Based on 180 physician interviews across seven major markets, this report analyzes the current
and future trends in the management and treatment of hypertension and four hypertensive subpopulations.
Published: Dec-05
Product code: DMHC2089
Potential for Cross-Risk Factor Combinations: Targeting Hypertension, Dyslipidemia and
Diabetes
The epidemic growth in the three main cardiovascular risk factors i.e. dyslipidemia,
hypertension and type 2 diabetes is resulting in a heavy pill burden on multi-risk patients. One
potential solution is to combine therapies in a single pill.
Published: Dec-03
Product code: BFHC0638
For more information about our products visit www.datamonitor.com/healthcare
Subscribe to Healthcare Monitor
A monthly update of the latest Healthcare products, events, news and special offers from Datamonitor delivered to you
by email. To subscribe email your contact details to hcmonitor@datamonitor.com with subscribe in the subject line.

www.datamonitor.com/healthcare
Place your order now...
Fax back to +44 20 7675 7016 (from Europe), +1 646 365 3362 (from the US)
or +61 2 8705 6901 (from Asia Pacific)
I would like to order:
Product title Product code Price £ / € / $ / ¥ *
__________________________________________________________________ ___________________ __________________
__________________________________________________________________ ___________________ __________________
__________________________________________________________________ ___________________ __________________
__________________________________________________________________ ___________________ __________________
__________________________________________________________________ ___________________ __________________
__________________________________________________________________ ___________________ __________________
__________________________________________________________________ ___________________ __________________
* Please refer to our website www.datamonitor.com for up-to-date prices
Complete your details:
Name
Job Title
Department
Company
Address
State/Province
Post Code/ZIP
Country
Email
Tel
Fax
Sign below to confirm your order:
____________________________________________________________________
Complete payment details:
Please indicate your preferred currency option: UK£ Euro€ US$ Yen¥
I enclose a check payable to Datamonitor plc for _________ (+ p+p $30 UK / $60 rest of world)
Please invoice my company for _______________________ (+ p+p $30 UK / $60 rest of world)
Please debit my credit/charge card
Amex Visa Diners Mastercard
Card No ______________________________________________________________________
Expiry Date _________ / _________ Cardholder Signature ___________________________
Cardholder address____________________________________________________________
Please supply purchase order number here if required by your accounts department:
_____________________________________________________________________________
EU companies (except UK) must supply: VAT / BTW / MOMS / MWST / IVA / FPA number:
___________________________________________________________________________________________
Datamonitor products and services are supplied under Datamonitor’s standard terms and conditions,
copies of which are available on request. Payment must be received within 28 days of receipt of invoice.
I do not want to receive future mailings from Datamonitor and its related companies.
Occasionally, our client list is made available to other companies for carefully selected mailings. Please
check here if you do not wish to receive such mailings.
DMHC2178WEB
From Europe: tel: +44 20 7675 7171 fax: +44 20 7675 7016 email: hcmarketing@datamonitor.com
From the US: tel: +1 212 686 7400 fax: +1 646 365 3362 email: hcmarketing@datamonitor.com
From Asia Pacific: tel: +61 2 9006 1526 fax: +61 2 9006 1559 email: apinfo@datamonitor.com
Contact us to find out more about our products and services