The Global Multiple Sclerosis Market 2009-2024

1 Executive Summary
1.1 Multiple Sclerosis Market Review
1.2 Aims, Scope and Format of the Report

2 Introduction to Multiple Sclerosis
2.1 The Biology of MS
2.2 The Disease
2.2.1 Symptoms of MS
2.2.2 Diagnosis of MS
2.3 Measuring MS
2.3.1 The Kurtzke Expanded Disability Status Scale (EDSS)
2.4 The Different Types of MS
2.4.1 Relapsing-Remitting MS
2.4.2 Secondary Progressive MS
2.4.3 Progressive Relapsing MS
2.4.4 Primary Progressive MS
2.4.5 Other Atypical Presentations
2.5 Causational Factors of MS
2.5.1 Genetic Factors
2.5.2 Infection
2.5.3 Environmental Factors and Less Supported Theories
2.6 World Demographics and Economic Costs of MS
2.7 Treatment Options
2.7.1 Alternative Treatments
2.7.2 Medical Approaches
2.8 Pharmacotherapy
2.8.1 Treatment of Acute Symptomatic Attack
2.8.2 Disease-Modifying Treatments

3 The Market for MS Drugs 2009-2024
3.1 MS Market Analysis
3.2 The Leading MS Drugs – Overall Sales Comparisons
3.3 Biogen's Avonex was Top-Selling MS Drug – How will it Fare?
3.3.1 Avonex Sales from 2009 to 2024
3.3.2 Patent Expiry in Major Markets Will Impact on Revenues
3.3.3 How Will Increased Competition Affect Sales from 2010 Onwards?
3.4 Will Copaxone’s Revenues Increase Despite Competitive Threats?
3.4.1 Copaxone and Direct Competition
3.4.2 Will Product Development Increase Market Potential?
3.4.3 Competition Resulting from Newer Therapies and Patent Expiry – What Effects on Sales?
3.5 Will Rebif's Efficacy and Drug Delivery Lead to Market Dominance?
3.5.1 Will Novel Delivery Mechanism Drive Sales in the Retail Sector?
3.5.2 Rebif’s Sales During Forecast Period
3.6 Betaferon Faces Patent Expiry During the Forecast Period
3.6.1 Will Betaferon Be Competitive Enough in the Market?
3.7 Will Re-Launched Tysabri Generate Blockbuster Sales?
3.7.1 Two New PML Cases May Erode Sales
3.7.2 Tysabri (natalizumab) for Oncology
3.8 Prospects for the Oral MS Drug Market
3.9 MS Market Summary 2009-2024

4 The Market for MS Drugs in the Seven Major Markets, 2009-2024
4.1 MS Drugs in the Seven Major Markets: Analysis
4.2 MS Market in the US
4.2.1 Leading MS Products in the US Market
4.2.2 Market Drivers
4.2.3 Market Restraints
4.3 MS Market in Germany
4.3.1 Leading MS Products in the German Market
4.3.2 Market Drivers
4.3.3 Market Restraints
4.4 MS Market in France
4.4.1 Leading MS Products in the French Market
4.4.2 Market Drivers
4.4.3 Market Restraints
4.5 MS Market in Italy
4.5.1 Leading MS Products in the Italian Market
4.5.2 Market Drivers
4.5.3 Market Restraints
4.6 MS Market in Canada
4.6.1 Leading MS Products in the Canadian Market
4.6.2 Market Drivers
4.6.3 Market Restraints
4.7 MS Market in Spain
4.7.1 Leading MS Products in the Spanish Market
4.7.2 Market Drivers
4.7.3 Market Restraints
4.8 MS Market in the UK
4.8.1 Leading MS Products in the UK Market
4.8.2 Market Drivers
4.8.3 Market Restraints

5 An Analysis of Factors that Influence the Global MS Market
5.1 SWOT Analysis of the MS Market 2009-2024
5.2 Market Drivers
5.3 Market Restraints
5.4 The MS Market Has Opportunities for Continuing Growth
5.5 Entry of Oral MS Drugs Will Provide More-Accessible Treatment Options
5.6 Advances in Technology Likely to Bring Benefits to the Market
5.7 Comparative Studies - a Two-Edged Sword
5.8 Important Patient Sub-Populations: Potential for Companies to Increase Market Leverage Through Product Differentiation
5.9 Concerns Over the High Price of Treatments - Who Yields the Power?
5.10 A Discussion of Generic Drugs in This Market - How Great is Their Threat?
5.11 How Much Scope is There to Improve Safety and Tolerability in MS Drugs?

6 Leading Companies in MS Therapy Development
6.1 Key Companies Delivering MS Therapies Highlighted
6.1.1 Biogen Idec and Elan Pharmaceuticals
6.1.2 Merck Serono
6.1.3 Bayer-Schering
6.1.4 Sanofi-Aventis and Teva

7 Pipeline Drugs for MS
7.1 MS Pipeline Drugs
7.2 The Potential Treatment Options in MS
7.2.1 Reducing Inflammatory Response
7.2.2 Managing Autoimmune Response
7.2.3 Manipulating the Permeability of the Blood-Brain Barrier
7.2.4 Inhibiting Demyelination
7.2.5 Protection Axons from Damage
7.2.6 Encouraging Remyelination
7.3 Drugs that Regulate Immune Response by Destroying Lymphocytes
7.3.1 Fingolimod (FTY720)
7.3.2 Mylinax (Oral Formulation)
7.3.3 Alemtuzumab
7.3.4 Rituximab
7.4 Drugs that Manage Immune Activity
7.4.1 Teriflunomide
7.4.2 Laquinimod
7.4.3 Daclizumab
7.4.4 MBP 8298
7.4.5 Integrin Inhibitors
7.5 Drugs that Reduce Inflammation
7.5.1 BG-12
7.5.2 MLN 1202
7.5.3 Ibudilast
7.6 MS Vaccines
7.6.1 Tovaxin
7.6.2 BHT-3009
7.7 Drugs to Improve Nerve Function
7.7.1 Fampridine-SR
7.7.2 Lamotrigine
7.8 Pfizer's Lipitor (atorvastin) and Other Statins
7.9 GW Sativex Investigational Cannabis-Based Treatment for MS
7.10 An “Oral Drug Revolution” in MS Treatment – a Possibility?
7.11 MS Pipeline Shows Short- and Long-Term Potential
7.12 The Future of MS Treatments
7.12.1 Stem Cell Therapy
7.12.2 Thyroid Hormone has Treatment Potential

8 Experts’ Views
8.1 Interview with Dr. Rosie Jones from Bristol General Hospital, MS Research Unit, UK
8.1.1 Introduction
8.1.2 Understanding MS
8.1.3 On Disease-Modifying Treatments
8.1.4 On Oral Drugs
8.1.5 On the Problems of Long-Term Treatments
8.1.6 On Natalizumab (Tysabri) and Progressive Multifocal             Leukoencephalopathy (PML)
8.1.7 On Alternative Treatments
8.1.8 On Medical Marijuana Use
8.1.9 The Future of MS Treatments
8.2 Interview with Dr Johan Luthman (Merck Serono)
8.2.1 On Understanding the Disease and its Treatment
8.2.2 On Unmet Needs for MS Therapy
8.2.3 On Current Treatment Options
8.2.4 On Medical Marijuana Use
8.2.5 On Oral Drugs
8.2.6 On Future Treatment Possibilities
8.3 Second Interview with Dr Johan Luthman (Merck Serono), Specifically Concerning Stem Cell Potential in MS
8.3.1 On Stem Cell Media Coverage
8.3.2 On the Therapeutic and Curative Potential of Stem Cells for Neurological Disorders
8.3.3 On the Treatment of Neurological Disorders
8.3.4 On Stem Cell Treatment of MS - Viability, Curative Power, Treatment Strategy and Results
8.3.5 On the Timeframe for Marketable Stem Cell Treatment Options
8.4 Concluding Thoughts
8.4.1 Concerning Symptom Management
8.4.2 Concerning Current Treatments and Patient Sub-Groups
8.4.3 Concerning Oral Drugs
8.4.4 Concerning Stem Cell Treatment

9 Conclusions
9.1 The MS Market Will Achieve Continued Growth
9.2 Great Scope for an Oral MS Drug to Enter the Market
9.3 Major Players in the MS Market
9.4 Market Drivers
9.5 Market Restraints
9.6 MS Market - Overview

List of Tables
Table 2.1 The Kurtzke Expanded Disability Scale
Table 3.1 The Total Market for MS Drugs: Revenue ($m) Forecast, 2009-2024
Table 3.2 Revenues ($m), 7-Year CAGR (%) and Market Share (%) for the Leading MS Drugs, 2007 & 2014
Table 3.3 Top 5 MS Products Rank Comparison, 2007 and 2024
Table 4.1 MS Drugs: Revenue ($m) Forecast in the Seven Major Markets, 2009-2024
Table 4.2 The Leading MS Drugs in the US Market, 2007
Table 4.3 The Leading MS Drugs in the German Market, 2007
Table 4.4 The Leading MS Drugs in the French Market, 2007
Table 4.5 The Leading MS Drugs in the Italian Market, 2007
Table 4.6 The Leading MS Drugs in the Canadian Market, 2007
Table 4.7 The Leading MS Drugs in the Spanish Market, 2007
Table 4.8 The Leading MS Drugs in the UK Market, 2007
Table 5.1 A SWOT Chart for the MS Market, 2009-2024
Table 6.1 Top 5 Companies in the MS Market, 2007
Table 7.1 MS Pipeline Drugs: Phase II and Beyond, 2008

List of Figures
Figure 3.1 The Total MS Market: Revenue ($m) Forecast, 2009-2024
Figure 3.2 The Leading MS Drugs: Market Revenue ($m) Forecast, 2009-2024
Figure 3.3 Leading MS Drugs: Revenue ($m) by Sector, 2007
Figure 3.4 Leading MS Drugs: Market Share (%), 2007
Figure 3.5 Leading MS Drugs: Market Share (%), 2014
Figure 3.6 Avonex Revenue ($m) Forecast 2009-2024
Figure 3.7 Copaxone Revenue ($m) Forecast 2009-2024
Figure 3.8 Rebif Revenue ($m) Forecast 2009-2024
Figure 3.9 Betaferon Revenue ($m) Forecast 2009-2024
Figure 3.10 Tysabri Revenue ($m) Forecast 2009-2024
Figure 4.1 The US MS Market Revenue ($m) Forecast, 2009-2024
Figure 4.2 The German MS Market Revenue ($m) Forecast, 2009-2024
Figure 4.3 The French MS Market Revenue ($m) Forecast, 2009-2024
Figure 4.4 The Italian MS Market Revenue ($m) Forecast, 2009-2024
Figure 4.5 The Canadian MS Market Revenue ($m) Forecast, 2009-2024
Figure 4.6 The Spanish MS Market Revenue ($m) Forecast, 2009-2024
Figure 4.7 The UK MS Market Revenue ($m) Forecast, 2009-2024
Figure 9.1 Total Revenues ($m) for MS Drugs, 2009-2024