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According to forecasts by global independent market analyst firm Datamonitor, the cardiovascular and metabolic market across the seven major markets—the United States, Japan, France, Germany, Italy, Spain, and the United Kingdom—will peak in 2011 and then begin to decline, with total sales falling from $105 billion in 2009 to $101 billion in 2019. In contrast, the volume of sales will continue to increase, driven by aging populations and higher rates of obesity. 

"The proportion of the market composed of branded therapies is forecast to fall and by 2019, generics and biosimilars will contribute 68 percent of volume sales across the seven major markets, and 28 percent of sales.," predicts Christine Henry, a healthcare analyst at Datamonitor.  
 
Dyslipidemia and hypertension sales, she adds, are set to become nearly entirely genericized. Lipitor is currently the world-leading pharmaceutical brand, but is set to lose U.S. exclusivity in 2011, further opening up the dyslipidemia market to generics.

Furthermore, in thrombosis, a range of new therapies will balance out generic erosion of leading antithrombotics Plavix and Lovenox, Henry says. The cardiovascular and metabolic pipeline will contribute 17 percent of sales by 2019, driven by a strong pipeline in diabetes therapies, where significant clinical unmet needs remain. The antidiabetic pipeline is forecast to generate close to $10.3 billion in 2019.
 
"Antidiabetics will provide the key growth market in cardiovascular and metabolic disease, and by 2019, seven of the top 10 brands will be antidiabetics," Henry says. "At this point, diabetes will contribute 35 percent of all sales in the seven major markets, and antidiabetics will generate 50 percent of cardiovascular and metabolic sales in the key U.S. market, where the other therapy areas are highly eroded by genericization."
 
Novo Nordisk and Eli Lilly are forecast to be the only two growth companies of the top 10 cardiovascular and metabolic companies from 2009, Henry concludes, "Novo Nordisk due to its highly defensible position in insulin therapies and peptides; and Eli Lilly through its own insulin franchise, and a strong development pipeline in the diabetes market. Merck & Co. is forecast to be the leading cardiovascular and metabolic company by 2019, driven by a diverse product portfolio, and the strength of its blockbuster antidiabetic Januvia franchise."

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