Bowel-ing them over

The seven major inflammatory bowel disease markets will grow by more than 60 percent to $5.6 billion in 2019 according to Datamonitor

Jeffrey Bouley
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Driven largely by new product launches, the seven major inflammatory bowel disease markets will grow by more than 60 percent to $5.6 billion in 2019, according to a new report from independent market analyst Datamonitor.

Specifically, Datamonitor cites the launch of seven pipeline drugs for Crohn's disease, for ulcerative colitis, or for both indications; some of these drugs feature entirely new mechanism of action compared to earlier treatments.
"New drug launches, combined with the impending impact from the seminal SONIC study and an increased use of biologics in ulcerative colitis, will drive sales growth over the next 10 years in the seven major markets," says James Wentworth, a senior healthcare analyst at Datamonitor. "Whilst we forecast strong growth, equivalent to a combined annual growth rate (CAGR) of 4.7 percent, it is worth noting that this is a slowdown compared to previous years. Inflammatory bowel disease sales grew steeply in the seven major markets between 2006 and 2009, at a CAGR of 24 percent. This was due to a combination of uptake of drugs, such as Abbott's Humira (adalimumab), price increases and the earlier treatment of patients with expensive biologics, particularly in those who have fistulizing disease and bad prognostic features of disease."

Speaking of Humira—which is also used to treat rheumatoid arthritis and other conditions—the drug is expected to propel Abbott to the front of the pack sales-wise, as research company EvaluatePharma predicts that Humira will outsell Roche Holding AG's Avastin cancer medicine by 2016 to become the world's most lucrative drug.

As for SONIC, which has been evaluating Centocor Ortho Biotech Inc.'s Remicade (infliximab) in the treatment of moderately to severely active Crohn's disease, the study published findings in mid-April in The New England Journal of Medicine showing that a significantly greater proportion of patients receiving Remicade achieved steroid-free remission and mucosal healing compared with patients receiving azathioprine.

"As the first trial to compare an anti-TNF therapy with an immunomodulator in patients who have failed 5-ASA and/or steroids, the SONIC trial has the potential to change how we currently treat patients with moderate to severe Crohn's disease," says Dr. Jean-Frédéric Colombel, professor of hepatogastroenterology at the Centre Hospitalier Universitaire de Lille in France and principal investigator for SONIC. "The results provide new insights into the benefits of starting REMICADE alone or in combination with azathioprine—earlier in the treatment of moderate to severe Crohn's disease."

The data also indicated that the safety profile of Remicade in combination or as monotherapy was similar to that of azathioprine monotherapy in the study.

Despite predicting market growth with regard to inflammatory bowel disease therapies, Datamonitor does warn that drug costs will influence the future of the market.
"Crohn's disease is a lifelong disease and the increasing use of biologics coupled with rising costs of therapies will put significant pressure on market payers. Long-term cost reductions may become necessary," James notes.

Jeffrey Bouley

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