The World Allergy Market 2006-2011 - The Rx-OTC Rush

1 Executive Summary
1.1 Aims of the Report
1.2 Summary of Contents

2 Introduction
2.1 Allergies Defined and Explained
2.1.1 IgEs and Mast Cells Mediate Allergic Reactions
2.2 Allergic Rhinitis
2.2.1 Seasonal Allergic Rhinitis (Hay Fever)
2.2.2 Perennial Allergic Rhinitis
2.3 Other Allergies
2.3.1 Food Allergies
2.3.2 Other Common Allergens
2.4 The Epidemiology of Allergic Rhinitis
2.4.1 Risk Factors
2.4.2 Co-morbidities
2.5 The Treatment of Allergic Rhinitis
2.5.1 First Generation Antihistamine Tablets
2.5.2 Second Generation (Non-sedating) Antihistamines
2.5.3 Nasal Corticosteroids
2.5.4 Other Antihistamine Treatments
2.5.5 Nasal Cromoglycate (Cromolyn)
2.5.6 Decongestants
2.5.7 Immunotherapy (Vaccines)
2.6 Antihistamines and Corticosteroids are The Main Form of Treatment
2.7 OTC Treatments are a Large Part of the Market
2.7.1 Claritin – a Landmark Case
2.8 Patent Expiry Will Be High But OTC Growth Will Soften the Blow
2.9 Allergic Rhinitis Vaccines May Soon be Effective and Will Take Significant Market Share

3 The World Market for Allergic Rhinitis
3.1 The World Prescription Market for Rhinitis Treatment Shows Steady Growth
3.1.1 The 2005 Market for Allergic Rhinitis is Worth over $8bn
3.1.2 Zyrtec is the Leading Allergic Rhinitis Drug
3.2 Prescription Drug Market Remains Steady Despite Patent Loss
3.2.1 Patent Loss is Predicted to Continue
3.2.2 Follow-on Antihistamines Hope to Stem Generic Erosion of Revenues
3.3 Antihistamines Remain the Principal Rhinitis Treatment
3.3.1 Over Two Thirds of Prescription Revenues are from Antihistamines
3.3.2 Nasal Corticosteroids Show the Highest Growth
3.4 The Growth of the OTC Market Will Continue
3.4.1 OTC Switching Reduces the Impact of Generic Competition but Does Not Negate it
3.4.2 More OTC Switches on The Way
3.5 Visiongain Predicts Negative Growth for the Total Allergic Rhinitis Market
3.5.1 The Market Will Decline Sharply
3.5.2 Corticosteroids Will Gain Market Share

4 The World Allergic Rhinitis Market by Geographic Region
4.1 The US Dominates the Rx Market
4.1.1 There are Regional Variations on the Class of Drugs Preferred
4.2 Europe Leads the OTC Market for Allergic Rhinitis
4.3 Growth in the Developing Markets Will Remain Low

5 The World Antihistamine Market for Allergic Rhinitis
5.1 Summary of the World Antihistamine Market, 2005
5.1.1 The Top Two Drugs Control over 70% of the Market
5.2 The Entire Prescription Antihistamine Market is Facing Decline
5.3 Zyrtex and Clarinex Face Imminent Patent Loss
5.3.1 Zrytec is Well Positioned for an OTC Switch
5.3.2 Allegra Revenues Will Continue to Suffer from Generic Competition
5.3.3 Clarinex Prepares to Replace Claritin OTC
5.4 Other Brands Will Not Support the Market in the Future
5.4.1 Claritin Sales Will Decline as Clarinex Goes Generic
5.4.2 Xyzal
5.4.3 Allelock Will Thrive in the Japanese Market
5.5 Other Brands are Growing but Revenues are Relatively Small
5.6 Is OTC Switching a Viable Future Strategy for the Ailing Antihistamine Market?

6 The World Steroid Market for Allergic Rhinitis
6.1 Summary of the World Corticosteroid Market, 2005
6.1.1 Flonase Dominates the Market
6.2 World Steroids Market to Hold Steady Until 2011
6.2.1 Flonase Begins to Feel the Effects of Patent Loss
6.2.2 New Indications and Formulations Drive Nasonex Growth
6.2.3 Rhinocort
6.2.4 Nasacort
6.3 Conclusion: The World Market for Nasal Corticosteroids Will Maintain Value Due to Sales of Nasonex

7 The World OTC Market for Allergic Rhinitis
7.1 New Switches and New Formulations Drive OTC Revenue Growth
7.1.1 Claritin OTC-switch Had Little Effect on Existing OTC Brands
7.1.2 The European and US OTC Markets are Different
7.1.3 Flonase Switch in the US Will Drive the Market Early in the Forecast Period
7.2 OTC Switches are Favoured by Insurers and Health Services
7.3 Pharmacist Recommendations are Key in OTC Allergy Products
7.3.1 Decongestants Play a Large Role in OTC Anti-Allergy Treatments
7.4 The OTC Market Will Peak in 2008

8 SWOT Analysis of the Allergic Rhinitis Market
8.1 Summary of Strengths, Weaknesses, Opportunities and Threats
8.2 High Prevalence Drives the Market
8.3 Low Rate of Adverse Effects is a Clear Advantage
8.4 Anti-allergy Drugs are Obvious Targets for OTC Switching
8.5 There are Disadvantages of OTC Dominance
8.6 Generic Companies Will Target Allergic Rhinitis Treatments
8.7 The OTC Decision is Key for the Allergic Rhinitis Market
8.7.1 US Authorisation for OTC
8.7.2 OTC Status in Other Countries
8.7.3 Considerations for the OTC Decision in the Allergic Rhinitis Market
8.7.4 Timing is Everything in the Anti-Allergy Markets
8.8 Unmet Needs: Persistent Sufferers Require Reliable and Convenient Treatments

9 Future Developments
9.1 New Takes on Established Treatments Will Help Stem the Tide After Patent Loss
9.1.1 Schering Plough and Merck Invest in Combination Therapy
9.1.2 GSK Attempts to Emulate Nasonex’s Success
9.1.3 Is efletirizine Zyrtec’s True Successor?
9.2 Immunotherapy Aims to Meet Unmet Needs
9.2.1 Grazax
9.2.2 Pollinex-Quattro
9.2.3 Curalogic – Three ‘vaccines’ at Phase II or above
9.2.4 Cytos’ QbG10 Technology May Offer Allergen Independent Relief
9.3 Development of New Asthma Treatments Will Lead to a New Allergy Drugs
9.3.1 From Proteins to Oligos – A Variety of Modes of Action
9.3.2 MAbs May Prove Technically Difficult and Expensive

10 Other Allergy Drugs
10.1 Allergic Conjunctivitis
10.2 Atopic dermatitis
10.2.1 The Market for Topical Eczema Treatments is Small and Shrinking
10.2.2 Non-steroidal Treatments Lead the Prescription Market

11 Conclusion: A Mature Market in Need of Innovation
11.1 The Allergy Market is Divided Into Sub-markets
11.2 OTC May be the Answer For Some But Not All
11.3 The Use of Vaccines is Set to Increase

List of Figures
Figure 3.1, Total Revenues ($m) for the Top Ten Allergic Rhinitis Treatments, 2004-2005
Figure 3.2, Growth Rates (%) for the Top Ten Allergic Rhinitis Treatments, 2004-2005
Figure 3.3, Allergic Rhinitis Market Share by Brand, 2005
Figure 3.4, Allergic Rhinitis Market Share by Mode of Action, 2005
Figure 3.5, Growth Rates (%) for Allergic Rhinitis Treatments by Mode of Action, 2004-2005
Figure 3.6, Total Schering Plough Revenues for Claritin, 2002-2005

Figure 5.1, Market Share by Drug for Antihistamines, 2005
Figure 5.2, World Revenues for Prescription Antihistamines, 2004-2011
Figure 5.3, Revenue Forecast for Zyrtec, 2005-2011
Figure 5.4, Revenue Forecast for Allegra, 2005-2011
Figure 5.5, Revenue Forecast for Clarinex, 2005-2011
Figure 5.6, Revenue Forecast for Claritin, 2005-2011
Figure 5.7, Revenue Forecast for Xyzal, 2005-2011
Figure 5.8, Revenue Forecast for Allelock, 2005-2011
Figure 5.9, Revenue Forecast for Other Branded Antihistamines, 2005-2011

Figure 6.1, Leading Nasal Corticosteroids by Market Share, 2005
Figure 6.2, World Revenue Forecast for the Leading Corticosteroids, 2005-2011
Figure 6.3, Revenue Forecast for Flonase, 2005-2011
Figure 6.4, Revenue Forecast for Nasonex, 2005-2011
Figure 6.5, Revenue Forecast for Rhinocort, 2005-2011
Figure 6.6, Revenue Forecast for Nasacort, 2005-2011

Figure 7.1, Brands Recommended by Pharmacists, 2005

Figure 8.1, Branded Drugs Facing Generic Compeition, 2005-2011

Figure 10.1, Revenues ($m) for Leading Atopic Dermatitis Treatments, 2005
Figure 10.2, Market Share for Leading Atopic Dermatitis Treatments, 2005

List of Tables
Table 3.1, Total Revenues and Growth Rates of Leading Allergic Rhinitis Treatments, 2004-2005
Table 3.2, US Patent Expiry Dates for Selected Allergic Rhinitis Treatments, 2006
Table 3.3, Antihistamines and Their Follow-Up Products, 2006
Table 3.4, Total Schering Plough Revenues for Claritin, 2002-2005
Table 3.5, World Market Forecast for Allergic Rhinitis Treatments, 2004-2011

Table 4.1, Market Share for Allergic Rhinitis by Country, 2005
Table 4.2, Allergic Rhinitis Markets in Selected Developing Countries, 2005

Table 5.1, Leading Prescription Antihistamines, 2005
Table 5.2, Forecast Revenues for Antihistamines, 2004-2011
Table 5.3, Revenue Forecast for Zyrtec, 2004-2011
Table 5.4, Revenue Forecast for Allegra, 2004-2011
Table 5.5, Revenue Forecast for Clarinex, 2004-2011
Table 5.6, Revenue Forecast for Claritin, 2004-2011
Table 5.7, Revenue Forecast for Xyzal, 2004-2011
Table 5.8, Revenue Forecast for Allelock, 2004-2011

Table 6.1, Leading Prescription Nasal Corticosteroids, 2005
Table 6.2, World Revenue Forecast for the Leading Corticosteroids, 2004-2011
Table 6.3, Combined Q1 and Q2 Revenues For Flonase, 2006
Table 6.4, Revenue Forecast for Flonase, 2004-2011
Table 6.5, Revenue Forecast for Nasonex, 2004-2011
Table 6.6, Revenue Forecast for Rhinocort, 2004-2011
Table 6.7, Revenue Forecast for Nasacort, 2004-2011

Table 7.1, Candidates for Rx-OTC Switching

Table 8.1, Summary of Strengths, Weaknesses, Opportunities and Threats for the Allergic Rhinitis Market

Table 9.1, Combination Therapies and Follow-on Products in the Pipeline, 2006
Table 9.2, Immunotherapy Products in the Pipeline, 2006
Table 9.3, Pipeline Drugs Indicated for Asthma and Allergic Rhinitis, 2006

Table 10.1, Treatments for Allergic Conjunctivitis
Table 10.2, Leading Treatments for Atopic Dermatitis, 2005

Table 11.1, Selected Allergy Vaccines in Development