Stakeholder Opinions: Ophthalmology - Leading brands under threat - Market Research Reports On Aarks

Introductionmajor markets 39
Ophthalmology encompasses some lucrativePrevalence of glaucoma in India and China is similar
markets, but the future of leading brands into that of the seven major markets 43
glaucoma and AMD is under threat, and whileCurrent treatment options in glaucoma 46
established markets like glaucoma andOverview of treatments in glaucoma 46
conjunctivitis have many therapeutic options,Beta-blockers 50
diabetic retinopathy remains largely untapped. KeyProstaglandin analogs 50
opinion leaders agree there is unmet need inAlpha-agonists 50
terms of drug delivery methods and doseCarbonic anhydrase inhibitors 51
frequency across ophthalmology diseases.Miotics 51
ScopeHyperosmotic agents 51
*Snapshot of ophthalmology diseases based onGlaucoma treatment guidelines 51
the worldwide leading causes of blindnessDiagnosing glaucoma 51
*Review of current treatment options, andSales analysis of brands in glaucoma 54
epidemiology in eye diseases in each of the sevenGlobal glaucoma market reached over $5 billion
major markets and selected rest of the worldsales in 2008 54
regionsCombigan experienced rapid growth in the
*Analysis of ophthalmology ATC drug classes withglaucoma market between 2004 and 2008 56
assessment of key brand and country dynamicsMajor brands in glaucoma therapy 58
*Assessment of unmet needs based on keyXalatan (latanoprost, Pfizer) 58
opinion leader interviews and a review of pipelineCosopt (dorzolamide and timolol,
therapies in leading ophthalmic diseasesMerck-Schering-Plough) 60
HighlightsTravatan (travoprost, Alcon) 61
The future of leading brands LucentisUnmet needs and future treatments in glaucoma
(ranibizumab) and Xalatan (latanoprost) is at risk.65
Lucentis dominates AMD with 91% market shareUnmet needs in glaucoma 65
but the use of currently off-label AvastinNeuroprotection is a significant unmet need in
(bevacizumab, Roche) is a threat. Xalatan, the goldglaucoma 65
standard in glaucoma achieved $1.5 billion in 2008Simplified treatment regimens are likely to lead to
but the drug faces generic erosion after patentgreater patient compliance 66
expiry in 2011Preservative-free formulations 67
Diabetic retinopathy and AMD markets show highTherapies with better side-effect profiles 68
growth potential. Both diseases are highlyPipeline analysis of glaucoma treatments 68
prevalent, with 11.5 million cases of diabeticChapter 3. Age-related macular degeneration 70
retinopathy, and 7.5 million in AMD, in the sevenKey findings 70
major markets in 2010. There are few drugDefinition and classification of age-related macular
treatments for AMD, while no approved drugs fordegeneration (AMD) 71
diabetic retinopathy mean this market is untapped.Dry (nonexudative) age-related macular
Key opinion leaders report high unmet need fordegeneration 71
reduced dosing regimens of existing therapies andWet (exudative/neovascular) age-related macular
an improvement in drug delivery methods.degeneration 71
However, any new formulations of existing drugsEpidemiology of age-related macular degeneration
will have to compete with cheap generics and(AMD) 72
need to show significant additional benefits.Over 7.5 million sufferers of age-related macular
Reasons to Purchasedegeneration in the seven major markets in 2010
*Validate the market potential of particular72estimates over 2.7 million cases of age-related
ophthalmology indications based on prevalencemacular degeneration in the US in 2010 76
numbers in each of the seven major marketsJapanese males have higher prevalence of
*Understand the commercial potential ofage-related macular degeneration 77estimates
ophthalmic diseases with Datamonitor'sover 4.3 million cases of age-related macular
assessment of market and brand dynamicsdegeneration across the five major EU markets in
*Assess the key unmet needs and possible new2010 78
approaches in the treatment of eye diseases asAge-related macular degeneration prevalence is
noted by opinion leadershigh in India 80
Table of Contents :Age-related macular degeneration prevalence
"Overview 1varies in racial groups 83
Catalyst 1Current treatment options in age-related macular
Summary 1degeneration (AMD) 83
About healthcare 2Overview of treatments in age-related macular
About the Immunology & Inflammationdegeneration (AMD) 83
pharmaceutical analysis team 2Anti-vascular endothelial growth factor (VEGF)
Executive Summary 3therapy 84
Scope of the analysis 3insight into theOff-label use of Avastin in age-related macular
ophthalmology market 3degeneration 85
Table of Contents 5Laser photocoagulation and photodynamic therapy
Chapter 1. Overview of the ophthalmology86
market 6Other surgical treatments for AMD 87
Key findings of the ophthalmology market 6Vitamins and lifestyle change are the main
Introduction to ophthalmology and the human eyetreatment options in dry AMD 87
7Age-related macular degeneration (AMD)
Ophthalmology market attractivenesstreatment guidelines 88
11ophthalmology market definition 11Diagnosis of AMD 88
Therapeutic sales for ophthalmology disordersTreatment guidelines on the management of AMD
exceeded $12 billion in 2008 1288
High growth potential observed in diabeticSales analysis of brands in age-related macular
retinopathy and age-related macular degenerationdegeneration (AMD) 89
markets 13Lucentis drives rapid growth in AMD market
Age-related macular degeneration shows a highbetween 2004 and 2008 89
growth rate, and seemingly unsaturated marketMajor brands in AMD therapy 91
15Lucentis (ranibizumab, Roche/Novartis/Alcon) 91
Middle Eastern, North African (MENA) and Brazil,Macugen (pegaptanib, Eyetech/Pfizer) 93
Russia, India and China (BRIC) ophthalmologyVisudyne (verteporfin, QLT /Novartis) 94
markets are growing rapidly 16Avastin (bevacizumab, Roche) 95
Brand and company dynamics in ophthalmology 19Unmet needs and future treatments in
Current leading brands Lucentis and Xalatan areage-related macular degeneration (AMD) 97
both under threat 19Unmet needs in AMD 97
Lucentis versus Avastin in the treatment ofTreatment frequency 97
age-related macular degeneration (AMD) 19Combination of different therapies 98
Xalatan sales set to decline with looming patentImprovement in method of drug delivery 99
expiry in 2011 21No standard treatment exists for dry age-related
Established eye care companies within themacular degeneration patients 99
ophthalmology market 22Pipeline analysis of age-related macular
Future of the ophthalmology market 24degeneration treatments 99
Reducing the dosing frequency and improvingChapter 4. Diabetic retinopathy 103
current drug delivery methods are key unmetKey findings 103
needs 24Definition and classification of diabetic retinopathy
High pipeline potential in diabetic retinopathy and104
age-related macular degeneration (AMD) 25Diabetic macular edema can occur from any
Chapter 2. Glaucoma 29stage of diabetic retinopathy 104
Key findings 29Epidemiology of diabetic retinopathy 105estimates
Definition and classification of glaucoma 3011.5 million diabetic retinopathy patients across the
Primary open-angle glaucoma (POAG) 30seven major markets in 2010 105
Angle-closure glaucoma (ACG) 30Diabetic retinopathy prevalence in the rest of the
Primary angle-closure glaucoma 30world 107
Secondary angle-closure glaucoma 31Current treatment options in diabetic retinopathy
Normal tension and secondary glaucoma 31108
Risk factors associated with glaucoma 31Overview of treatments in diabetic retinopathy
Epidemiology of glaucoma 32108
Total glaucoma patient potential is up to 7.0 millionDiabetic retinopathy treatment guidelines 111
in the seven major markets in 2010 32estimatesSales analysis in diabetic retinopathy 111
5.4 million primary open-angle glaucoma sufferersUnmet needs and future treatments in diabetic
across the seven major markets in 2010 34retinopathy 112
Assumptions and limitations in estimating theUnmet needs in diabetic retinopathy 112
primary open-angle glaucoma population in theEfficacious drugs that maintain vision or prevent
seven major markets 35disease progression 112
Primary open-angle glaucoma is more prevalent inEarlier diagnosis of diabetic retinopathy 113
older US females 35Improved methods of administering treatments
Prevalence of primary open-angle glaucoma in114
different racial groups 37Improved drug therapies to extend the period
Epidemiology of primary angle-closure glaucoma inbetween laser treatments 114
the seven major markets 38Pipeline analysis of diabetic retinopathy treatments
Epidemiology of other types of glaucoma in the114
seven major markets 39Chapter 5.
Epidemiology studies of glaucoma in the seven