The Cardiovascular Market Outlook to 2013: Competitive landscape, global market analysis and pipeline analysis

Executive summary 12
Overview and epidemiology of cardiovascular disorders 12
Global market analysis 12
Pipeline analysis 13
Competitive landscape 14

Chapter 1 Scope and methodology 16
Scope 16
Methodology 17

Chapter 2 Overview and epidemiology of
cardiovascular disorders 20
Summary 20
Introduction 20
Predisposing factors 21
Risk factors 24
Hypertension 24
Diagnosis, treatment and management 25
Epidemiology 27
Forecast epidemiology 28
Dyslipidemia 29
Diagnosis, treatment and management 30
Epidemiology 33
Forecast epidemiology 34
Cardiovascular diseases 35
Arteriosclerosis/atherosclerosis 35
Thrombosis 35
Cardiac arrhythmias 35
Myocardial infarction 36
Acute coronary syndrome (ACS) 36
Congestive heart failure (CHF) 36
Coronary artery disease (CAD) 36
Peripheral artery disease (PAD) 36
Pulmonary hypertension 37
Angina pectoris 37
Stroke 37
Epidemiology 38
Forecast epidemiology 39

Chapter 3 Global market analysis 42
Summary 42
Introduction 43
Market analysis by country 44
Licensing Trends 45
Market analysis by drug class 46
Leading brands dynamics 48
Cardiovascular sales forecast to 2013 49
Key events in the cardiovascular market 50
Therapeutic substitution causing decline in sales of leading
hypercholesterolemia drugs 50
Genericization in the leading classes of hypertension drugs 51
Tekturna/Rasilez launch slower than expected 52
Generic Plavix in Germany represents moderate risk 52
Regulatory delay for Prasugrel improve US Plavix outlook 53
Safety concerns on ESAs to impact the multibillion dollar EPO
franchises 54
Anti-hypertensive treatments 54
Introduction 54
Anti-hypertensives drug classes 55
Leading treatment brands by drug class 57
Key brands analysis 59
Norvasc 59
Diovan 59
Cozaar 60
Sales forecast to 2013 62
Anti-dyslipidemics 63
Introduction 63
Anti-dyslipidemics drug classes 64
Leading treatment brands by drug class 65
Key brands analysis 66
Lipitor 66
Vytorin 68
Crestor 69
Sales forecast to 2013 72
Anti-thrombotics treatments 73
Introduction 73
Anti-thrombotics drug classes 74
Leading treatment brands by drug class 75
Key brands analysis 76
Lovenox 76
Plavix 78
Sales forecast to 2013 80
Hematological preparations 81
Introduction 81
Market analysis by drug class 82
Leading treatment brands by drug class 82
Key brands analysis 83
Aranesp 83
Sales forecast to 2013 85
Cardiac therapies 86
Introduction 86
Market analysis by drug class 86
Leading treatment brands by drug class 88
Sales forecast to 2013 89
Other cardiovascular agents 90
Introduction 90
Leading brands by drug class 90
Key brands analysis 91
Tracleer 91
Sales forecast to 2013 93

Chapter 4 Pipeline analysis 96
Summary 96
Introduction 97
Key events in the development of the cardiovascular pipeline 98
Merck’s Cordaptive/Tredaptive facing regulatory delay owing to safety
concerns 98
Persistent interest in drugs which increase HDL cholesterol levels 99
Mipomersen from Genzyme may become a novel option for high cholesterol 99
New treatments drive robust growth of the anticoagulants class 100
Multaq may become the gold-standard as first-line treatment of chronic atrial
fibrillation 100
Bayer Schering/J&J’s Xarelto demonstrates best in class characteristics 101
Cytos Biotechnology reports encouraging results for its hypertension vaccine 101
Novel reperfusion agent from Neurobiological Technologies presents
significant commercial opportunity 102
Cardiovascular pipeline 104
Leading drugs in development 106
Profiles of key pipeline products 107
Recently marketed drugs 107
Letairis 107
Tekturna/Rasilez 108
Drugs in registration 110
Effient 110
Multaq 111
Xarelto 113
TriLipix 114
Pradaxa/Rendix 116
Drugs in Phase III clinical studies 117
Apixaban 117
Cangrelor 119
SCH 530348 120
Ticagrelor 121
Drugs in Phase II clinical studies 123
E5555 123
Pipeline forecast 124

Chapter 5 Competitive Landscape 128
Summary 128
Introduction 129
Sales performance of leading players 129
Detailed analysis of leading cardiovascular players 133
Pfizer 133
Overview 133
Sales focus by drug class 134
Marketed product portfolio 135
R&D pipeline analysis 138
Strategic and growth analysis 139
Sanofi-Aventis 141
Overview 141
Sales focus by drug class 141
Marketed product portfolio 144
R&D pipeline analysis 146
Strategic and growth analysis 148
Merck 150
Overview 150
Sales focus by drug class 150
Marketed product portfolio 152
R&D pipeline analysis 153
Strategic and growth analysis 154
Novartis 155
Overview 155
Sales focus by drug class 155
Marketed product portfolio 158
R&D pipeline analysis 159
Strategic and growth analysis 160
Amgen 162
Overview 162
Sales focus by drug class 162
Marketed product portfolio 163
R&D pipeline analysis 164
Strategic and growth analysis 164
AstraZeneca 165
Overview 165
Sales focus by drug class 165
Marketed product portfolio 168
R&D pipeline analysis 169
Strategic and growth analysis 171
Bristol-Myers Squibb 171
Overview 171
Sales focus by drug class 172
Marketed product portfolio 174
R&D pipeline analysis 175
Strategic and growth analysis 176
Johnson and Johnson 178
Overview 178
Sales focus by drug class 178
Marketed product portfolio 179
R&D pipeline analysis 180
Strategic and growth analysis 180
Daiichi Sankyo 182
Overview 182
Sales focus by drug class 182
Marketed product portfolio 183
R&D pipeline analysis 184
Strategic and growth analysis 185
GlaxoSmithKline 186
Overview 186
Sales focus by drug class 186
Marketed product portfolio 188
R&D pipeline analysis 189
Strategic and growth analysis 190
Chapter 6 Appendix 192
Glossary 193
Index 197

List of Figures
Figure 2.1: Cardiovascular disease etiology 23
Figure 2.2: Cardiovascular risk factors 24
Figure 2.3: Definition and classification of hypertension 25
Figure 2.4: Hypertension - treatment options 26
Figure 2.5: Types of lipoproteins 30
Figure 2.6: Interpretation of blood lipid levels 31
Figure 2.7: LDL levels and therapy patterns 32
Figure 3.8: Global cardiovascular market share by geography ($m), 2007 44
Figure 3.9: Global sales of types of cardiovascular brands ($bn), 2006–07 45
Figure 4.10: Prevailing R&D approaches, 2008 98
Figure 4.11: Cardiovascular pipeline by indication and stage of development, 2008 104
Figure 4.12: Leading recently marketed and late-stage R&D products in the cardiovascular market, 2008 106
Figure 5.13: Sales of key players in the cardiovascular market, ($m), 2007 130
Figure 5.14: Forecast sales of key players in the cardiovascular market, ($m), 2007 131
Figure 5.15: Market share of key players by sales value, 2013 132
Figure 5.16: Pfizer cardiovascular sales by drug class, ($bn), 2007 134
Figure 5.17: Sanofi’s cardiovascular sales by drug class, ($bn), 2007 142
Figure 5.18: Merck cardiovascular sales by drug class, ($bn), 2007 151
Figure 5.19: Novartis’ cardiovascular sales by drug class, ($bn), 2007 157
Figure 5.20: Amgen’s cardiovascular sales by drug class, ($bn), 2007 163
Figure 5.21: AstraZeneca’s cardiovascular sales by drug class, ($bn), 2007 167
Figure 5.22: BMS’s cardiovascular sales by drug class, ($bn), 2007 173
Figure 5.23: J&J’s cardiovascular sales by drug class, ($bn), 2007 178
Figure 5.24: Daiichi Sankyo’s cardiovascular sales by drug class, ($bn), 2007 182
Figure 5.25: GSK’s cardiovascular sales by drug class, ($bn), 2007 187

List of Tables
Table 2.1: Estimated prevalence of cardiovascular disorders across seven major markets (in thousands), 2007 21
Table 2.2: Estimated prevalence of hypertension across the seven major markets (in thousands), 2007 27
Table 2.3: Forecast epidemiology of hypertension across seven major markets (in thousands), 2007–2013 28
Table 2.4: Estimated prevalence of dyslipidemia across the seven major markets (in thousands), 2007 33
Table 2.5: Forecast epidemiology of dyslipidemia across the seven major markets (in thousands), 2007–2013 34
Table 2.6: Estimated prevalence of stroke across the seven major markets (in thousands), 2007 38
Table 2.7: Forecast epidemiology of stroke across the seven major markets (in thousands), 2007–2013 39
Table 3.8: The global cardiovascular market by drug class ($m), 2006–2007 46
Table 3.9: Leading brands in the global cardiovascular market ($m), 2006–2007 48
Table 3.10: Cardiovascular market sales forecast by drug class ($m), 2007–2013 49
Table 3.11: Leading anti-hypertensives treatments in the global cardiovascular market ($m), 2006–2007 57
Table 3.12: Anti-hypertensives sales forecast ($m), 2007–2013 62
Table 3.13: Leading anti-dyslipidemic treatments in the global cardiovascular market ($m), 2006–2007 65
Table 3.14: Anti-dyslipidemics sales forecast ($m), 2007–2013 72
Table 3.15: Leading anti-thrombotics treatments in the global cardiovascular market ($m), 2006-2007 76
Table 3.16: Anti-thrombotics sales forecast ($m), 2007–2013 80
Table 3.17: Leading hematological preparations in the global cardiovascular market ($m), 2006–2007 83
Table 3.18: Hematological preparations sales forecast ($m), 2007–2013 85
Table 3.19: Leading cardiac therapies in the global cardiovascular market ($m), 2006–2007 88
Table 3.20: Cardiac therapies sales forecast ($m), 2007–2013 89
Table 3.21: Other cardiovascular treatments in the global cardiovascular market ($m), 2006–2007 91
Table 3.22: Cardiovascular treatments sales forecast ($m), 2007–2013 93
Table 4.23: An overview of Letairis 107
Table 4.24: An overview of Tekturna/Rasilez 108
Table 4.25: An overview of Effient 110
Table 4.26: An overview of Multaq 111
Table 4.27: An overview of Xarelto 113
Table 4.28: An overview of TriLipix 114
Table 4.29: An overview of Pradaxa 116
Table 4.30: An overview of Apixaban 117
Table 4.31: An overview of Cangrelor 119
Table 4.32: An overview of SCH530348 120
Table 4.33: An overview of Ticagrelor 122
Table 4.34: An overview of E5555 123
Table 4.35: Cardiovascular disorders pipeline forecast, ($m), 2008–13 125
Table 5.36: Leading Players in the global cardiovascular market, ($m), 129
Table 5.37: Pfizer's leading cardiovascular product portfolio, ($m), 2006–07 135
Table 5.38: Pfizer's cardiovascular R&D product pipeline, 2007 139
Table 5.39: Sanofi-Aventis’ leading cardiovascular product portfolio, ($m), 2006–07 144
Table 5.40: Sanofi-Aventis’ cardiovascular R&D product pipeline, 2007 148
Table 5.41: Merck's leading cardiovascular product portfolio, ($m), 2006–07 152
Table 5.42: Merck's cardiovascular R&D product pipeline, 2007 154
Table 5.43: Novartis’ leading cardiovascular product portfolio, ($m), 2006–07 158
Table 5.44: Novartis’ cardiovascular R&D product pipeline, 2007 160
Table 5.45: Amgen’s cardiovascular R&D product pipeline, 2007 163
Table 5.46: AstraZeneca’s leading cardiovascular product portfolio, ($m), 2006–07 168
Table 5.47: AstraZeneca’s cardiovascular R&D product pipeline, 2007 170
Table 5.48: BMS’s leading cardiovascular product portfolio, ($m), 2006–07 174
Table 5.49: BMS’s cardiovascular R&D product pipeline, 2007 176
Table 5.50: J&J’s leading cardiovascular product portfolio, ($m), 2006–07 179
Table 5.51: J&J’s cardiovascular R&D product pipeline, 2007 180
Table 5.52: Daiichi Sankyo’s leading cardiovascular product portfolio, ($m), 183
Table 5.53: Daiichi Sankyo’s cardiovascular R&D product pipeline, 2007 184
Table 5.54: GSK’s leading cardiovascular product portfolio, ($m), 188
Table 5.55: GSK’s cardiovascular R&D product pipeline, 2007 189