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Pipeline and Commercial Insight: Urinary Incontinence - Lifecycle management strategies retain mid-term market growth

Published by: Datamonitor

Published: Dec. 26, 2007 - 185 Pages


Table of Contents



ABOUT DATAMONITOR HEALTHCARE

About the Women's Health pharmaceutical analysis team

CHAPTER 1 EXECUTIVE SUMMARY

Scope of the analysis

Contributing experts

Datamonitor insight into the urinary incontinence market

Related reports

CHAPTER 2 MARKET OVERVIEW AND POTENTIAL

Market and disease definition

Normal bladder function

Urinary Incontinence

Relationship between overactive bladder and UI

"Wet" overactive bladder is a form of urge UI

Dry overactive bladder can impact on quality of life

Definition of urinary incontinence market

Market potential

Epidemiology of UI

Prevalence of UI

Prevalence high, but treatment rates are likely to be low

Stress urinary incontinence is the most common form of UI

Patient population with UI likely to rise with the ageing of the general population

Etiology of UI

Urge UI symptoms from overactive bladder

Stress urinary incontinence

Mixed urinary incontinence

Unmet need in UI

Efficacy in controlling symptoms

Reduction of side-effect profile

Alternative delivery mechanism

Reduced pill burden

Alternative targets

Stress urinary incontinence

Current treatment classes and mechanisms

Treatment algorithm

Behavioral techniques

Pharmacological treatment

Medical devices

Surgery

Current market value and future market forecasts

Current market dynamics

Anticholinergics dominate current market

The US generated more revenue from UI therapies than the EU and Japan combined

The UI market is set to grow throughout the forecast period

Near-term growth-reformulations

Medium-term growth-life-cycle management strategies, novel products and new markets

Long-term outlook-patent expiries take their toll

CHAPTER 3 BRAND DYNAMICS AND LEADING COMPARATOR THERAPIES

Marketed brands overview

Detrol (LA) (tolterodine)

Drug overview

Forecasts to 2016

SWOT analysis

Clinical trial data

Detrol's clinical trial program and study designs

Efficacy of Detrol

Detrol side effects

Detrol drug-drug interactions

Mechanism of action

Ditropan (oxybutynin/oxybutynin chloride)

Ditropan drug overview

Ditropan extended release

Forecasts to 2016

SWOT analysis

Clinical trial data

Ditropan's clinical program and study designs

Efficacy of Ditropan XL

Ditropan XL side effects

Oxytrol/Kentera (oxybutynin transdermal patch)

Drug overview

Forecasts to 2016

SWOT analysis

Clinical trial data

Oxytrol clinical program and study designs

Efficacy of Oxytrol

Side effects of Oxytrol

Mechanism of action

Sanctura (trospium chloride)

Drug overview

Forecasts to 2016

Clinical trial data

Sanctura clinical program and study designs

Efficacy of Sanctura

Side effects of Sanctura

Mechanism of action

Vesicare (solifenacin succinate)

Drug overview

Forecasts to 2016

SWOT analysis

Clinical trial data

Vesicare's clinical trial program and study designs

Efficacy of Vesicare

Side effects of Vesicare

Mechanism of action

Enablex (Darifenacin)

Drug overview

Forecasts to 2016

SWOT analysis

Clinical trial data

Enablex's clinical trial program and study designs

Efficacy of Enablex

Side effects of Enablex

Yentreve (duloxetine)

Drug overview

Forecasts to 2016

Clinical trial data

Efficacy and side effect profile observed in clinical trial program

Mictonorm/Detrunorm/BUP-4 (propiverine)

Drug overview

Forecasts to 2016

Clinical trial data

Efficacy

Side-effect profile

Drug-drug interactions

Hormone therapy (Estradiol)

Others

CHAPTER 4 FORECAST ANALYSIS

Key events

New product launches

Key drug launch assumptions

Product launches in Japan

Darifenacin (Enablex)

Imidafenacin (ONO-8025) (KRP-197) (Staybla/Uritos)

Reformulations

Detrol LA, Toviaz

Sanctura, Sanctura XR

Oxybutynin

Patent expiries

Sanctura

Detrol LA

Yentreve

Raft of patent expires in 2015

Data definitions, limitations and assumptions

Standard units

Japanese market data

Derivation of sales forecasts and pricing trends

Forecast methodology

CHAPTER 5 GLOBAL OPPORTUNITIES AND THREATS

Key opportunities

Stress urinary incontinence

Room for a non-anticholinergic treatment

Niche topical market

Increased awareness

Elderly population

Key threats

Generic anticholinergics

Behavioral/surgical techniques

Anticholinergic brands dominant

CHAPTER 6 PIPELINE OVERVIEW - R&D DYNAMICS AND APPROACH

Pipeline overview

Classification of pipeline products

Cholinergics

Adrenergic drugs

NK-1 modulators

Other drug classes

Clinical trial design

Clinical trial endpoints in UI

Subjective outcome measures

Quantification of symptoms

Diaries

Pad weighing tests

Quality of life

Choice of endpoints

Specific safety aspects

CHAPTER 7 LATE-STAGE DRUG ANALYSIS & FORECASTS

Late-stage pipeline overview

Cholinergic class pipeline drugs

Pipeline summary

Sanctura XR

Drug overview

Forecasts to 2016

Marketing factors

Patient potential

Satisfaction of unmet needs

Clinical trial data

Toviaz (fesoterodine)

Drug overview

Forecasts to 2016

Marketing factors

Patient potential

Satisfaction of unmet needs

Clinical trial data

Oxybutynin transdermal gel

Drug overview

Antares Pharma's oxybutynin gel

Watson Pharmaceuticals' oxybutynin gel

Forecasts to 2016

Marketing factors

Patient potential

Satisfaction of unmet needs

Oxybutynin TVR

Botox

Drug overview

Forecasts to 2016

Marketing factors

Patient potential

Satisfaction of unmet needs

Clinical trial data

SVT-40776

Adrenergic class pipeline drugs

Pipeline summary

YM-178

Drug overview:

Forecasts to 2016

Clinical trial data

PSD-503

MN-246

NK-1 modulator class pipeline drugs

Pipeline summary

NK-1 antagonist-theoretical clinical profile and forecast

Forecasts to 2016

Patient potential

Satisfaction of unmet needs

Casopitant (Rezonic)

SSR-240600

TA-5538

Other pipeline drugs

Pipeline summary

VD3 analog (Elocalcitol)

Drug overview

Forecasts to 2016

Marketing factors

Patient potential

Unmet needs

Clinical trial data

RCD-1

FP-1097

URG-101

MK-0634

FE-106483

F-2695

Recently suspended/discontinued drugs

Cizolirtine

(+)-(S,S) Reboxetine

REC-0545

Saredutant

KW-7158

KUC-7483

CHAPTER 8 EARLY-STAGE PROJECTS

Key Phase I and earlier compounds in development for UI

Phase I overview

Stem cell therapy for SUI

Vanilloid agents

BIBLIOGRAPHY

Journal papers

Websites

DM reports

APPENDIX

Report methodology

Contributing experts

About Datamonitor

About Datamonitor Healthcare

About the Women's Health and Urology analysis team

Disclaimer

List of Tables

Abstract

Introduction

The UI market is set to continue to grow over the next 6 years, reaching over $2.5 billion in 2012, a 68% increase from 2006. Lifecycle management strategies, novel formulations and follow-on products will drive the majority of this growth, with key brands expected to be Pfizer's Detrol LA (tolterodine) and Toviaz (fesoterodine), GSK's Vesicare (solifenacin), and Novartis' Enablex (darifenacin).

Scope

Analysis of patient potential, unmet needs and clinical trial design in UI. Overview of key marketed brands, late- and early-stage pipeline drugs, and cell therapies. Indication-specific sales volume and value forecasts to 2016 of marketed brands, generics, and key late-stage pipeline drugs. Identification of future market events that are expected to affect UI drug revenues.

Highlights

Pfizer's Detrol LA (tolterodine) will remain the market leading UI brand through to 2012 when it comes off patent. At this point Detrol LA will be followed by the other second generation anticholinergics, GSK's Vesicare (solifenacin), Novartis' Enablex (darifenacin) and Pfizer's chemical reformulation Toviaz (fesoterodine). Following the patent expiry of the key brands, Detrol LA in 2012, and Enablex/Vesicare in 2015, a novel mechanism of action is required for long-term market growth. Examples of the possible mechanisms of action include the NK-1 antagonists and the adrenergic modulators. Datamonitor has identified a great untapped patient base in the US stress urinary incontinence (SUI) market. A drug that could come into this market would benefit from exclusivity, being the only treatment approved for SUI in the US with a potential 28 million patient base.

Reasons to Purchase

Benchmark key late-stage UI pipeline compounds against current market leading brands. Assess region-specific (US, Japan, 5EU) sales forecasts of key late-stage pipeline drugs and marketed brands. Understand unmet needs and opportunities in the UI market based on key opinion leader comments.

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