心臓病の5大危険因子:市場動向と将来展望

The Outlook for Cardiovascular Risk Factors: Epidemiology, market and pipeline analysis, evaluates current and future growth prospects for pharma companies to 2008 in five major cardiovascular risk factors that can be moderated by pharmacotherapy; hypertension, dyslipidemia, diabetes, obesity and smoking. Cumulatively, the value of these markets was approximately $66bn in 2002 or around one-fifth of the global pharmaceutical market. In the US alone, the direct and indirect costs of cardiovascular disease (CVD) and stroke in 2003 are estimated at almost $352bn. Reducing these costs by appropriately treating cardiovascular risk factors has become a major focus of the pharmaceutical industry and healthcare payors.

This report sets out to define cardiovascular risk factors and how identifying links to them sooner, will lead to a decline in CVD, resulting in massive cost savings for both pharma companies and healthcare payors. Treating risk factors is preventive medicine at its most challenging and this report provides insights into the risk factors that pharma companies need to overcome this battle - it can be won...let this report help you.

Table of Contents

Executive Summary

Defining cardiovascular risk

Hypertension

Dyslipidemia

Diabetes

Obesity

Smoking cessation

Chapter 1 Defining cardiovascular risk

Summary

Introduction

What is a risk factor?

How do risk factors contribute to cardiovascular disease?

Ethics and practicalities of preventive therapy

Impact of an aging population

Chapter 2 Hypertension

Summary

Overview of hypertension

Classification of hypertension

Epidemiology

Drug therapy

Impact of ALLHAT study on anti-hypertensive therapy

Results . generic diuretics should be first-line therapy

Limitations of ALLHAT

Support for greater ACE inhibitor use is strong

ARBs will drive market growth

Market analysis

Norvasc (amlodipine)

Cozaar/Hyzaar (losartan/losartan HCTZ)

Diovan/Co-Diovan (valsartan/valsartan HCTZ)

Avapro/Aprovel (irbesartan/irbesartan HCTZ)

Outlook for the hypertension market

Unmet needs

Pipeline analysis

Benicar (olmesartan)

Inspra (eplerenone)

Vanlev (omapatrilat)

ALT-711

Chapter 3 Dyslipidemia

Summary

Overview of dyslipidemia

Definition of dyslipidemia

Markers for dyslipidemia

Which markers are the best indicators of cardiovascular risk?

Main types of dyslipidemia

Hypercholesterolemia

Familial hypercholesterolemia

Hypertriglyceridemia

Familial hypertriglyceridemia

Mixed dyslipidemia

Epidemiology

Drug therapy

Statins

Fibrates

Bile acid sequestrants/inhibitors

Nicotinic acid derivatives

Fish oil derivatives

Market analysis

Lipitor (atorvastatin)

Zocor (simvastatin)

Crestor (rosuvastatin)

Zetia (ezetimibe)

Outlook for the dyslipidemia market

Unmet needs

Pipeline analysis

Livalo (pitavastatin)

Caduet (atorvastatin + amlodipine)

Chapter 4 Diabetes

Summary

Overview of diabetes

Pathophysiology and etiology

Cardiovascular complications

Mechanism of increased risk

Epidemiology

Diagnosing diabetes

Drug therapy

Sulfonylureas

Biguanides

Thiazolidinediones

Prandial glucose regulators

Alfa glucosidase inhibitors

Insulins

Monotherapy versus combination therapy

Market analysis

Avandia (rosiglitazone)

Novolin (insulin)

Humalog (insulin lispro)

Lantus (insulin glargine)

Outlook for the diabetes market

Unmet needs

Drug delivery

Efficacy

Side effects

Awareness and education

Glucose monitoring

Pipeline analysis

Exubera (inhaled insulin)

AERx insulin Diabetes Management System (inhaled insulin)

Oralin (transoral insulin)

HIM2 (oral insulin)

Chapter 5 Obesity

Summary

Overview of obesity

Definition of obesity

Measuring and diagnosing obesity

Pathophysiology and etiology

Age and gender influence

Genetic influence

Nutritional influence

Epidemiology

Countering the trend . government action

Drug therapy

Market analysis

Xenical (orlistat)

Reductil/Meridia (sibutramine)

Outlook for the obesity market

Improving long-term drug safety

Pipeline analysis

Topamax (topiramate)

Axokine

P57

Chapter 6 Smoking cessation

Summary

Overview of smoking cessation

Pathophysiology

Epidemiology

Drug therapy

Market analysis

Outlook for the smoking cessation market

Unmet needs

Pipeline analysis

Zyban XL (bupropion)

Rimonabant

TA-NIC

NicVAX

Chapter 7 Appendix

References

Index

List of Figures

Figure 1.1: Cardiovascular risk factors

Figure 1.2: Average annual growth rates of the total population and the population in broad age

groups, by major area, 2000-50 (median variant)

Figure 2.3: Prevalence of hypertension in the seven major markets, 2002

Figure 2.4: Timeline: the development of anti-hypertensive drug therapies

Figure 2.5: Global anti-hypertensive market segmented by class, 2002

Figure 2.6: Commercial opportunities in the treatment of hypertension

Figure 3.7: Prevalence of hyperlipidemia in the major markets, 2002-10

Figure 3.8: Timeline: the development of antidyslipidemic drug therapies

Figure 4.9: Unmet needs in the treatment of diabetes

List of Tables

Table 2.1: Classification and management of blood pressure for adults . JNC 7 guidelines

Table 2.2: Prevalence of hypertension in the seven major markets, 2002

Table 2.3: Anti-hypertensive drug classes: summary of key facts

Table 2.4: Anti-hypertensive drug classes: summary of key facts (continued)

Table 2.5: Sales of the top 10 anti-hypertensives, 2001-08

Table 2.6: Selected hypertension pipeline, phase II and above, 2003

Table 3.7: Prevalence of hyperlipidemia in the major markets, 2002-10

Table 3.8: Selected leading and new antidyslipidemic product sales, 2001-08

Table 3.9: The late-stage dyslipidemia pipeline, 2003

Table 4.10: Prevalence of diabetes in the seven major markets, 2002

Table 4.11: Leading and new diabetes product sales, 2001-08

Table 4.12: Non-invasive insulin pipeline, 2003

Table 5.13: Forecast prevalence of overweight or obese people in major markets, 2001-08 (000s)

Table 5.14: Current anti-obesity drugs

Table 5.15: Leading anti-obesity product sales, 2001-08

Table 5.16: The anti-obesity pipeline, phase II and above, 2003

Table 6.17: Estimated smoking prevalence among men and women, 15 years of age and over

Table 6.18: Commonly used smoking cessation products

Table 6.19: Smoking cessation Rx pipeline, 2003