GlobalData has released its new PharmaPoint Drug Evaluation report, “Cangrelor (Acute Coronary Syndrome) – Forecast and Market Analysis to 2023”. The current ACS market – primarily comprised of antithrombotics, antihypertensives, and statins – is flush with well-established standard-of-care therapies, many of which are generic. Therefore, the pipeline therapies that show the most promise exploit novel mechanisms of action and target orphan biochemical pathways. The ACS market will be driven by an aging population with a preponderance of lifestyle-based diseases, such as obesity, and the growing prevalence of metabolic disorders such as diabetes. The expansion of biologics into the ACS mainstream during the ten year forecast period is expected to significantly and fundamentally alter the ACS market, both medically and financially.

The Medicines Company’s co-promotion of Brilinta began in the US in 2012. AstraZeneca’s role in marketing cangrelor, if and when it is approved, is unclear. According to the 2003 acquisition and the 2012 agreement, The Medicines Company will not have marketing rights to cangrelor in Japan. GlobalData assumes, for this forecast, that AstraZeneca will retain marketing privileges for cangrelor in Japan, where GlobalData expects cangrelor will launch in 2018.

Scope

• Overview of ACS, including epidemiology, etiology, symptoms, diagnosis, pathology and treatment guidelines as well as an overview on the competitive landscape.
• Detailed information on Aricept including product description, safety and efficacy profiles as well as a SWOT analysis.
• Sales forecast for Aricept for the top seven countries from 2013 to 2023.
• Sales information covered for the US, France, Germany, Italy, Spain, the UK and Japan.

Reasons To Buy

• Understand and capitalize by identifying products that are most likely to ensure a robust return
• Stay ahead of the competition by understanding the changing competitive landscape for ACS
• Effectively plan your M&A and partnership strategies by identifying drugs with the most promising sales potential
• Make more informed business decisions from insightful and in-depth analysis of Aricept performance
• Obtain sales forecast for Aricept from 2013-2023 in top seven countries (the US, France, Germany, Italy, Spain, the UK and Japan)

Table of Contents

1 Table of Contents 1
1.1 List of Tables 4
1.2 List of Figures 6

2 Executive Summary 6
2.1 Sales for Cangrelor in the Global Acute Coronary Syndrome Market 6
2.2 What Do the Physicians Think? 7

3 Introduction 11
3.1 Catalyst 11
3.2 Related Reports 12
3.3 Upcoming Related Reports 14

4 Disease Overview 14
4.1 Etiology and Pathophysiology 16
4.1.1 Etiology 16
4.1.2 Pathophysiology 20
4.1.3 Prognosis 21
4.1.4 Quality of Life 21
4.2 Symptoms 22

5 Disease Management 23
5.1 Treatment Overview 23

6 Competitive Assessment 30
6.1 Overview 30
6.2 Strategic Competitor Assessment 31

7 Unmet Need and Opportunity 35
7.1 Overview 35
7.2 Therapies that Directly Treat Thrombogenic Atherosclerotic Plaques 36
7.2.1 Unmet Need 36
7.2.2 Gap Analysis 37
7.2.3 Opportunity 38
7.3 Therapies that Treat Fibrotic Myocardium and Associated Comorbidities 38
7.3.1 Unmet Need 38
7.3.2 Gap Analysis 39
7.3.3 Opportunity 39
7.4 LDL-C-Lowering Drugs for Statin-Intolerant, Refractory, or Non-Compliant Patients 40
7.4.1 Unmet Need 40
7.4.2 Gap Analysis 42
7.4.3 Opportunity 43
7.5 Antidotes for New Oral Anticoagulants (NOACs) 44
7.5.1 Unmet Need 44
7.5.2 Gap Analysis 45
7.5.3 Opportunity 45
7.6 Blood-Thinning Agents with Significantly Reduced Bleeding Risks 46
7.6.1 Unmet Need 46
7.6.2 Gap Analysis 47
7.6.3 Opportunity 47

8 Pipeline Assessment 48
8.1 Overview 48
8.2 Clinical Trials by Phase and Trial Status 50
8.3 Promising Drugs in Clinical Development 52

9 Cangrelor 56
9.1 Overview 56
9.2 Efficacy 59
9.3 Safety 60
9.4 Dosing and Formulation 61
9.5 Potential Clinical Positioning 61
9.6 Potential Commercial Positioning 61
9.7 Pricing and Reimbursement 61
9.8 SWOT Analysis 63
9.9 Forecast 63

10 Appendix 64
10.1 Bibliography 64
10.2 Abbreviations 71
10.3 Methodology 75
10.4 Forecasting Methodology 75
10.4.1 Methodology for Forecasting Selected Portions of the Diagnosed Prevalent ACS Population 75
10.4.2 Diagnosed Acute Coronary Syndrome Patients 76
10.4.3 Percent Drug-Treated Patients 77
10.4.4 General Pricing Assumptions 77
10.4.5 Generic Erosion 79
10.4.6 Pricing of Pipeline Agents 79
10.5 Physicians and Specialists Included in this Study 80
10.6 About the Authors 83
10.6.1 Author 83
10.6.2 Reviewer 83
10.6.3 Global Head of Healthcare 84
10.7 About GlobalData 84
10.8 Contact Us 84
10.9 Disclaimer 85

List of Tables

Table 1: Cangrelor: Key Metrics in the 7MM for Acute Coronary Syndrome in 2023 5
Table 2: Antiplatelet Agents that Inhibit Platelet Activation 16
Table 3: Anticoagulants that Inhibit the Coagulatory Cascade 17
Table 4: Symptoms of Acute Coronary Syndrome 22
Table 5: Treatment Guidelines for Acute Coronary Syndromes (UA, NSTEMI, and STEMI) 27
Table 6: Most Prescribed Drugs for ACS by Class in the Global Markets, 2014 29
Table 7: Leading Treatments for Acute Coronary Syndrome, 2014 35
Table 8: Unmet Need and Opportunity in Acute Coronary Syndrome 37
Table 9: Acute Coronary Syndrome – Clinical Trials by Phase and Status, 2014 52
Table 10: Acute Coronary Syndrome – Late-Stage Pipeline, 2014 55
Table 11: Comparison of Therapeutic Classes in Development for ACS, 2014 56
Table 12: Product Profile – Cangrelor 59
Table 13: Cangrelor SWOT Analysis, 2014 64
Table 14: Global Sales Forecasts ($m) for Cangrelor, 2013–2023 65
Table 15: Price Sources and Calculations, by Country 79
Table 16: Physicians Surveyed, By Country 83

List of Figures

Figure 1: Sales for Cangrelor by Region, 2023 7
Figure 2: The ACS Timeline and the Scope of GlobalData’s ACS Report and Forecast 15
Figure 3: Progression of Coronary Artery Disease, Atherosclerotic Plaque Rupture, Thrombosis, and Acute Coronary Syndrome 16
Figure 4: Platelet and Coagulatory Factors Implicated in Thrombosis 18
Figure 5: Electrocardiography in the Diagnosis of ACS 19
Figure 6: Acute Coronary Syndrome Therapeutics – Clinical Trials by Phase in the 7MM, 2014 51
Figure 7: Competitive Assessment of Late-Stage Pipeline Agents for ACS, 2013–2023 55