Table of Contents
The Asthma and COPD Market Outlook: Market
analysis of future growth and leading players by sector
Executive summary 10
Epidemiology analysis 10
Global asthma/COPD market analysis 11
First/second-line treatment market analysis 12
Third-line asthma treatments market analysis 13
Leading players in the asthma/COPD market 14
Chapter 1 Epidemiology analysis 16
Summary 16
Introduction 17
Disease description 17
Asthma 17
Chronic Obstructive Pulmonary Disease 18
Disease classification 18
Asthma 18
COPD 20
Current and future prevalence of asthma/COPD 20
Asthma 20
COPD 23
Diagnosis 26
Asthma 26
COPD 28
Current and future treatment patterns 28
4
Chapter 2 Global asthma/COPD market
analysis 34
Summary 34
Introduction 35
History of asthma drugs 35
Current growth drivers 36
SABA/LABA treatments 37
ICS 37
Xanthines 38
Oral corticosteroids 38
Combination therapies 39
Anticholinergics and leukotriene antagonists 39
Future growth drivers 40
Monoclonal antibodies 40
Anti-muscarinics 40
Chapter 3 First and second-line therapies:
Beta-2 agonists, ICS and
combination ICS/LABA drugs 42
Summary 42
Introduction 43
First and second-line treatment categories and sales 43
Company market share 44
Brand market share and sales 46
SABA/LABA treatments 51
Brand analysis 51
Serevent (salmeterol xinfoate) 51
Xopenex (levalbuterol) 53
Ventolin (salbutamol/albuterol) 55
Foradil (formoterol fumarate) 56
ICS treatments 57
Brand analysis 57
Flixotide/Flovent (fluticasone propionate) 58
Pulmicort (budesonide) 59
LABA/ICS combination treatments 61
Brand analysis 61
Seretide/Advair (fluticasone propionate and salmeterol xinfoate) 61
Symbicort (budesonide and formoterol) 63
5
Chapter 4 Third-line therapies and beyond:
leukotriene antagonists,
anticholinergics and other drugs 66
Summary 66
Introduction 67
Third-line treatment categories and sales 67
Company market share 69
Brand market share and sales 70
Leukotriene antagonist treatments 74
Brand analysis 75
Singulair (montelukast) 75
Anticholinergic and SABA/anticholinergic treatments 77
Brand analysis 77
Combivent (ipratropium and salbutamol) 77
Atrovent (ipratropium) 79
Spiriva (tiotropium) 80
Chapter 5 Leading players in the
asthma/COPD market 84
Summary 84
Introduction 85
Merck & Co 86
Therapeutic focus 86
Third-line treatment market share 87
Marketed products 88
R&D pipeline 88
GSK 89
Therapeutic focus 89
First and second-line treatment market shares 90
Marketed products 90
R&D pipeline 91
Ariflo 92
Boehringer Ingelheim 93
Therapeutic focus 93
Anticholinergic market share 93
Marketed products 94
Schering-Plough 95
Therapeutic focus 95
Marketed products 95
R&D pipeline 96
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AstraZeneca 97
Therapeutic focus 97
Marketed products 97
R&D pipeline 98
Novartis 99
Therapeutic focus 99
Marketed products 99
R&D pipeline 100
Xolair (omalizumab) 100
QAB149 101
Sepracor 102
Therapeutic focus 102
Marketed products 102
R&D pipeline 103
Alformoterol 103
Altana 104
Therapeutic focus 104
Marketed products 105
R&D pipeline 105
Alvesco (ciclesonide) 105
Daxas (roflumilast) 106
Index 109
7
List of Figures
Figure 1.1: Estimated relative prevalence of asthma patients by severity, 2003 19
Figure 1.2: Estimated variation in the prevalence of asthma in the US & five major European
markets, 2003 21
Figure 1.3: Estimated prevalence of asthma in the US & 5 major European markets, 2003-201322
Figure 1.4: Estimated variation in the prevalence of COPD in the US & 5 major European
markets, 2003 24
Figure 1.5: Estimated prevalence of COPD in the US & 5 major European markets, 2003-2013 25
Figure 1.6: Estimated proportion of patients presenting with asthma that are correctly diagnosed
by visit 27
Figure 1.7: Typical treatment patterns in the treatment of asthma 29
Figure 1.8: Estimated proportion of patients on leading therapeutic classes of drugs used in the
treatment of asthma by disease severity, 2003 30
Figure 2.9: Development timeline for major asthma/COPD drugs and classes 35
Figure 3.10: Asthma/COPD first/second-line brands by company and type, 2004 46
Figure 3.11: US/European* market share of leading inhaled corticosteroid brands (%), 1999-2003
47
Figure 3.12: US/European* market share of leading inhaled beta-2 agonist brands (%), 1999-2003
48
Figure 3.13: US/European* market share of leading inhaled beta-2 agonist brands (%), 1999-2003
49
Figure 3.14: Serevent SWOT analysis 52
Figure 3.15: Xopenex SWOT analysis 54
Figure 3.16: Ventolin SWOT analysis 55
Figure 3.17: Foradil SWOT analysis 56
Figure 3.18: Flixotide/Flovent SWOT analysis 59
Figure 3.19: Pulmicort SWOT analysis 60
Figure 3.20: Seretide/Advair SWOT analysis 62
Figure 3.21: Symbicort SWOT analysis 64
Figure 4.22: Asthma/COPD third-line brands by company and type, 2004 70
Figure 4.23: US/European* market share of leading leukotriene antagonist brands (%), 1999-2003
71
Figure 4.24: US/European* market share of leading anticholinergic and SABA/anticholinergic
combination products (%), 1999-2003 72
Figure 4.25: Singulair SWOT analysis 76
Figure 4.26: Combivent SWOT analysis 78
Figure 4.27: Atrovent SWOT analysis 79
Figure 4.28: Spiriva SWOT analysis 80
Figure 5.29: Merck’s forecast therapeutic focus, 2003-2010 86
Figure 5.30: GSK’s therapeutic focus, 2003-2010 89
Figure 5.31: Boehringer Ingelheim’s therapeutic focus, 2003 & 2010 93
Figure 5.32: Schering-Plough’s forecast therapeutic focus, 2003-10 95
Figure 5.33: AstraZeneca’s forecast therapeutic focus, 2003-10 97
Figure 5.34: Novartis’ forecast therapeutic focus, 2003-10 99
Figure 5.35: Altana’s forecast therapeutic focus, 2003-10 104
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List of Tables
Table 1.1: Classification of asthma sufferers according to disease severity 19
Table 1.2: Estimated prevalence of asthma in children and adults across the US & 5 European
markets, 2003 21
Table 1.3: Estimated prevalence of asthma in the US & 5 major European markets, 2003-201323
Table 1.4: Estimated prevalence of adult COPD in the US & 5 major European markets, 2003-
2013 26
Table 1.5: Estimates of the number and proportion of patients receiving asthma treatments by
drug class, 2003 31
Table 1.6: US and European* Sales by Drug Class ($m), 2002-2003 32
Table 2.7: US/European* sales category totals ($m), 2002-2003 36
Table 3.8: US/European* Sales of first and second-line asthma/COPD treatments by category
($m), 2002-2003 44
Table 3.9: First/second-line therapy market share by company and territory (%), 2002-2003 45
Table 3.10: Sales of leading 1st/2nd-line treatments by country ($m), 2002-03 50
Table 3.11: Branded SABA/LABA treatments 51
Table 3.12: Branded ICS treatments 57
Table 3.13: Branded LABA/ICS combination treatments 61
Table 4.14: US/European* Sales of third-line asthma/COPD treatments by category ($m), 2002-
2003 68
Table 4.15: Third-line therapy market share by company and territory (%), 2002-2003 69
Table 4.16: Sales of major branded third-line treatments by country, 2002-03 73
Table 4.17: Major branded leukotriene antagonist treatments 75
Table 4.18: Branded ACh and SABA/ACh treatments 77
Table 5.19: US/European* asthma/COPD market share by company (%), 2002-03 85
Table 5.20: US/European* leukotriene antagonist market share by company (%), 2002-03 87
Table 5.21: US/European* sales of Merck & Co’s marketed asthma/COPD portfolio ($m), 2002-
2003 88
Table 5.22: Projected sales of Merck’s asthma/COPD R&D pipeline ($m), 2007 & 2010 88
Table 5.23: US/European* first/second-line treatment market share by company (%), 2002-200390
Table 5.24: US/European* sales of GSK’s marketed asthma/COPD portfolio ($m), 2002-2003 90
Table 5.25: Projected sales of GSK’s asthma/COPD R&D pipeline ($m), 2007 & 2010 91
Table 5.26: US/European* anticholinergic treatment market share by company (%), 2002-2003 94
Table 5.27: US/European* sales of Boehringer Ingelheim’s marketed asthma/COPD portfolio
($m), 2002-2003 94
Table 5.28: US/European* sales of Schering-Plough’s marketed asthma/COPD portfolio ($m),
2002-2003 96
Table 5.29: Projected sales of Schering-Plough’s asthma/COPD R&D pipeline ($m), 2007 & 2010
96
Table 5.30: US/European* sales of AstraZeneca’s marketed asthma/COPD portfolio ($m), 2002-
2003 98
Table 5.31: Projected sales of AstraZeneca’s asthma/COPD R&D pipeline ($m), 2007 & 2010 98
Table 5.32: US/European* sales of Novartis’ marketed asthma/COPD portfolio ($m), 2002-2003
100
Table 5.33: Projected sales of Novartis’ asthma/COPD R&D pipeline ($m), 2007 & 2010 100
Table 5.34: US/European* sales of Sepracor’s marketed asthma/COPD portfolio ($m), 2002-2003
102
Table 5.35: Projected sales of Sepracor’s asthma/COPD R&D pipeline ($m), 2007 & 2010 103
Table 5.36: Projected sales of Altana’s asthma/COPD R&D pipeline ($m), 2007 & 2010 105
