GlobalData estimates that the total market size for the 7MM in 2013 was $12.3bn, comprised of $5.0bn in branded drug sales (40%) and $7.3bn in generic sales (60%). GlobalData expects that the ACS drug market will grow at a CAGR of 13.4% over the ten year forecast period, resulting in a market value of $43.4bn by 2023, of which 64% will be attributed to branded drug sales ($27.7bn) and 36% to generic drug sales ($15.7bn). 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.

Highlights

Key Questions Answered

• The current panel of standard ACS drugs are products of years or decades of research, development, and clinical research and are, in general, considered to be safe and effective in most cases. However, the rate of recurrent ACS events is unacceptably high. What are the major unmet clinical needs with regard to ACS event reduction and long term disease management?
• Many of the ACS pipeline drugs will serve as add-on treatments to well-established standard-of-care therapies. How are drug companies exploiting novel therapies to drive market growth while simultaneously targeting niche patient populations? Which pipeline drugs will drive market growth?
• The main-stream drugs in ACS have historically been predominantly small-molecule based. How will the entry of biologics into the ACS population at-large alter the dynamics of the market? Further, how will the clinic respond and adapt to biologic drug treatment strategies.
• What unique drug-development strategies are companies using to shape the future and shift the trajectory of ACS treatment?

Key Findings

• The highest-impact driver of the ACS market will be the launch of the PCSK9 inhibitors, human monoclonal antibody biologics that will be used to treat high LDL-C in addition to statins. Therapeutic novelty combined with biologic pricing will make the PCSK9s the largest contributors to ACS market growth, even if their use is reserved for niche or high-risk cases.
• The entry of novel antithrombotic therapies, such as Xarelto, Zontivity, and cangrelor, into the ACS drug treatment space will also drive the expansion of the ACS market. These therapies will provide physicians with new treatment options that exploit unique targets. New therapies may be especially useful for patients at high risk or that have cardiovascular comorbidities that complicate the use of currently established SOC therapies.
• Due to the maturity of the current ACS market, new therapies will exploit novel mechanisms of action and/or target orphan drug targets and are more likely to be utilized as add-on therapies to existing treatments. The pipeline predominantly treats established problems in new ways, leaving space for further innovation in the ACS space.

Scope

• Overview of ACS, including epidemiology, etiology, pathophysiology, symptoms, diagnosis, and treatment guidelines.
• Annualized ACS therapeutics market revenue, annual cost of therapy and treatment usage pattern data from 2013 and forecast for ten years to 2023.
• Key topics covered include strategic competitor assessment, market characterization, unmet needs, clinical trial mapping, and implications for the ACS therapeutics market.
• Pipeline analysis: comprehensive data split across different phases, emerging novel trends under development, and detailed analysis of late-stage pipeline drugs.
• Analysis of the current and future market competition in the global ACS therapeutics market. Insightful review of the key industry drivers, restraints and challenges. Each trend is independently researched to provide qualitative analysis of its implications.

Reasons to buy

• Develop and design your in-licensing and out-licensing strategies through a review of pipeline products and technologies, and by identifying the companies with the most robust pipeline. Additionally a list of acquisition targets included in the pipeline product company list.
• Develop business strategies by understanding the trends shaping and driving the gout therapeutics market.
• Drive revenues by understanding the key trends, innovative products and technologies, market segments, and companies likely to impact the ACS therapeutics market in future.
• Formulate effective sales and marketing strategies by understanding the competitive landscape and by analysing the performance of various competitors.
• Identify emerging players with potentially strong product portfolios and create effective counter-strategies to gain a competitive advantage.
• Track drug sales in the 7MM ACS therapeutics market from 2013-2023.
• Organize your sales and marketing efforts by identifying the market categories and segments that present maximum opportunities for consolidations, investments and strategic partnerships.

Table of Contents

1 Table of Contents 11
1.1 List of Tables 18
1.2 List of Figures 26

2 Introduction 28
2.1 Catalyst 28
2.2 Related Reports 29
2.3 Upcoming Related Reports 29

3 Disease Overview 30
3.1 Etiology and Pathophysiology 31
3.1.1 Etiology 31
3.1.2 Pathophysiology 35
3.1.3 Prognosis 36
3.1.4 Quality of Life 37
3.2 Symptoms 37

4 Epidemiology 39
4.1 Disease Background 39
4.2 Risk Factors and Comorbidities 40
4.2.1 Controlling hypertension can decrease the CHD incidence by 20-25% 41
4.2.2 Every 1% decrease in cholesterol levels is associated with a 2% decrease in the CHD risk 42
4.2.3 Women who have diabetes have a higher risk of developing CHD than men with diabetes 43
4.2.4 Cigarette smoking increases the risk of CHD and also increases the risk of developing other risk factors for CHD 43
4.2.5 Obese and physically inactive persons are more likely to develop CHD through an increased risk of developing the traditional risk factors 44
4.2.6 Non-modifiable risk factors, such as family history, age, and sex, contribute to CHD development 44
4.2.7 Comorbidities 45
4.3 Global Trends - MI 46
4.3.1 MI Incidence and Mortality Trends 46
4.3.2 STEMI and NSTEMI Trends 56
4.3.3 Trends in MI Mortality and Case-Fatality Rates 58
4.3.4 MI Prevalence 60
4.4 Global Trends - UA 61
4.5 Forecast Methodology 63
4.5.1 Forecast Case Flow Map 65
4.5.2 Sources Used 71
4.5.3 Sources Not Used 80
4.5.4 Forecast Assumptions and Methods, Hospitalized MI Incident Cases 81
4.5.5 Forecast Assumptions and Methods, STEMI and NSTEMI Cases that Survived until Hospital Discharge 86
4.5.6 Forecast Assumptions and Methods, STEMI and NSTEMI Cases that Survived for One Year after Discharge 88
4.5.7 Forecast Assumptions and Methods, Diagnosed Prevalent Cases of MI 89
4.5.8 Forecast Assumptions and Methods, Hospitalized Cases of UA 91
4.5.9 Forecast Assumptions and Methods, UA Cases that Survived until Hospital Discharge and for One Year Post-Discharge 93
4.6 Epidemiological Forecast for ACS (2013-2023) - Hospitalized Incident Cases 93
4.6.1 Hospitalized Incident Cases of ACS 93
4.6.2 Age-Specific Hospitalized Incident Cases of ACS 95
4.6.3 Sex-Specific Hospitalized Incident Cases of ACS 97
4.6.4 Hospitalized Incident Cases of ACS by STEMI, NSTEMI, and UA 99
4.6.5 ACS Cases that Survived until Hospital Discharge and for One Year 101
4.6.6 Age-Specific ACS Cases that Survived until Hospital Discharge 104
4.6.7 Age-Standardized Incidence of ACS 105
4.7 Epidemiological Forecast for MI (2013-2023) - Prevalent Cases 106
4.7.1 Diagnosed Prevalent Cases of MI 106
4.7.2 Diagnosed Prevalent Cases of MI Segmented by STEMI and NSTEMI 108
4.7.3 Age-Specific Diagnosed Prevalent Cases of MI 109
4.7.4 Sex-Specific Diagnosed Prevalent Cases of MI 111
4.7.5 Age-Standardized Diagnosed Prevalence of MI 112
4.8 Discussion 113
4.8.1 Epidemiological Forecast Insight 113
4.8.2 Limitations of the Analysis 114
4.8.3 Strengths of the Analysis 115

5 Disease Management 118
5.1 Treatment Overview 118
5.2 US 124
5.2.1 Diagnosis 124
5.2.2 Clinical Practice 125
5.3 France 126
5.3.1 Diagnosis 126
5.3.2 Clinical Practice 126
5.4 Germany 127
5.4.1 Diagnosis 127
5.4.2 Clinical Practice 127
5.5 Italy 128
5.5.1 Diagnosis 128
5.5.2 Clinical Practice 128
5.6 Spain 130
5.6.1 Diagnosis 130
5.6.2 Clinical Practice 130
5.7 UK 131
5.7.1 Diagnosis 131
5.7.2 Clinical Practice 132
5.8 Japan 133
5.8.1 Diagnosis 133
5.8.2 Clinical Practice 133

6 Competitive Assessment 135
6.1 Overview 135
6.2 Strategic Competitor Assessment 136
6.3 Product Profiles 141
6.3.1 Fibrinolytic (Thrombolytic) Drugs - Tissue Plasminogen Activator (tPA) 141
6.3.2 Clopidogrel 146
6.3.3 Brilinta (ticagrelor) 151
6.3.4 Effient (prasugrel) 156
6.3.5 Integrilin (eptifibatide) 161
6.3.6 Warfarin 165
6.3.7 Angiomax (bivalirudin) 170
6.3.8 Arixtra (fondaparinux) and the Heparins 173
6.3.9 Statins - HMG-CoA Reductase Inhibitors 178
6.3.10 Beta-Adrenergic Receptor Antagonists (Beta Blockers) 192
6.3.11 Renin-Angiotensin-Aldosterone System (RAAS) Inhibitors 196

7 Unmet Need and Opportunity 213
7.1 Overview 213
7.2 Therapies that Directly Treat Thrombogenic Atherosclerotic Plaques 214
7.2.1 Unmet Need 214
7.2.2 Gap Analysis 215
7.2.3 Opportunity 215
7.3 Therapies that Treat Fibrotic Myocardium and Associated Comorbidities 216
7.3.1 Unmet Need 216
7.3.2 Gap Analysis 217
7.3.3 Opportunity 217
7.4 LDL-C-Lowering Drugs for Statin-Intolerant, Refractory, or Non-Compliant Patients 218
7.4.1 Unmet Need 218
7.4.2 Gap Analysis 220
7.4.3 Opportunity 222
7.5 Antidotes for New Oral Anticoagulants (NOACs) 222
7.5.1 Unmet Need 222
7.5.2 Gap Analysis 223
7.5.3 Opportunity 223
7.6 Blood-Thinning Agents with Significantly Reduced Bleeding Risks 224
7.6.1 Unmet Need 224
7.6.2 Gap Analysis 225
7.6.3 Opportunity 225

8 Pipeline Assessment 227
8.1 Overview 227
8.2 Clinical Trial Mapping 229
8.2.1 Clinical Trials by Country 229
8.3 Clinical Trials by Phase and Trial Status 230
8.4 Promising Drugs in Clinical Development 232
8.4.1 Xarelto (rivaroxaban) 236
8.4.2 Cangrelor 245
8.4.3 Zontivity (vorapaxar) 252
8.4.4 Alirocumab (RGN727) 259
8.4.5 Evolocumab (AMG 145) 268
8.4.6 Bococizumab (PF-04950615) 277
8.4.7 Anacetrapib 282
8.4.8 Evacetrapib 289
8.4.9 Darapladib 295

9 Current and Future Players 301
9.1 Overview 301
9.2 Trends in Corporate Strategy 307
9.3 Company Profiles 309
9.3.1 Amgen 309
9.3.2 AstraZeneca 311
9.3.3 Bristol-Myers Squibb 314
9.3.4 Daiichi Sankyo 317
9.3.5 Eli Lilly 319
9.3.6 GlaxoSmithKline 321
9.3.7 Janssen Pharmaceuticals (Johnson & Johnson) 324
9.3.8 The Medicines Company 325
9.3.9 Merck & Co. 329
9.3.10 Pfizer 332
9.3.11 Sanofi 335

10 Market Outlook 339
10.1 Global Markets 339
10.1.1 Forecast 339
10.1.2 Drivers and Barriers - Global Issues 349
10.2 United States 355
10.2.1 Forecast 355
10.2.2 Key Events 360
10.2.3 Drivers and Barriers 360
10.3 France 363
10.3.1 Forecast 363
10.3.2 Key Events 368
10.3.3 Drivers and Barriers 368
10.4 Germany 370
10.4.1 Forecast 370
10.4.2 Key Events 376
10.4.3 Drivers and Barriers 376
10.5 Italy 379
10.5.1 Forecast 379
10.5.2 Key Events 385
10.5.3 Drivers and Barriers 386
10.6 Spain 388
10.6.1 Forecast 388
10.6.2 Key Events 394
10.6.3 Drivers and Barriers 394
10.7 United Kingdom 396
10.7.1 Forecast 396
10.7.2 Key Events 402
10.7.3 Drivers and Barriers 402
10.8 Japan 404
10.8.1 Forecast 404
10.8.2 Key Events 409
10.8.3 Drivers and Barriers 409

11 Appendix 412
11.1 Bibliography 412
11.2 Abbreviations 440
11.3 Methodology 448
11.4 Forecasting Methodology 448
11.4.1 Methodology for Forecasting Selected Portions of the Diagnosed Prevalent ACS Population 448
11.4.2 Diagnosed Acute Coronary Syndrome Patients 449
11.4.3 Percent Drug-Treated Patients 450
11.4.4 Drugs Included in Each Therapeutic Class 450
11.4.5 Launch and Patent Expiry Dates 451
11.4.6 General Pricing Assumptions 452
11.4.7 Individual Drug Assumptions 454
11.4.8 Generic Erosion 463
11.4.9 Pricing of Pipeline Agents 463
11.5 Physicians and Specialists Included in this Study 465
11.6 About the Authors 468
11.6.1 Author 468
11.6.2 Epidemiologist 468
11.6.3 Reviewer 469
11.6.4 Global Head of Healthcare 469
11.7 About GlobalData 470
11.8 Disclaimer 470

List of Tables

Table 1: Antiplatelet Agents that Inhibit Platelet Activation 33
Table 2: Anticoagulants that Inhibit the Coagulatory Cascade 33
Table 3: Symptoms of Acute Coronary Syndrome 38
Table 4: Risk Factors and Comorbidities for CHD and ACS 41
Table 5: Germany, MI Incidence and Re-Infarction Rates (Cases per 100,000 Population), 1985-1987 and 2001-2003 50
Table 6: Spain, MI Incidence Rate (Cases per 100,000 Population) and Incidence Trends, 2000 and 2013 52
Table 7: England and Scotland, Temporal Trends in the MI Incidence (Cases per 100,000 Population), 2002-2010 52
Table 8: 7MM, Summary of STEMI and NSTEMI In-Hospital and One-Year Case-Fatality Rates 59
Table 9: Global, Crude Total Population Prevalence Percentages of Angina Pectoris and Mean Age of Study Participants 62
Table 10: 7MM, Sources of MI and UA Incidence Data 67
Table 11: 7MM, Sources of Diagnosed Prevalence Data for MI 69
Table 12: 7MM, Data Sources of STEMI and NSTEMI Proportions Among Hospitalized Cases of MI 70
Table 13: 7MM, Hospitalized Incident Cases of ACS, Ages ?25 Years, Both Sexes, N (Col %), Selected Years, 2013-2023 94
Table 14: 7MM, Age-Specific Hospitalized Incident Cases of ACS, Both Sexes, N (Row %), 2013 96
Table 15: 7MM, Sex-Specific Hospitalized Incident Cases of ACS, Ages ?25 Years, N (Row %), 2013 98
Table 16: 7MM, Hospitalized Incident Cases of ACS Segmented by STEMI, NSTEMI, and UA (N, Row %), Ages ?25 Years, Both Sexes, 2013 100
Table 17: 7MM, ACS Cases That Survived Until Hospital Discharge, Ages ?25 Years, Both Sexes, N, 2013 103
Table 18: 7MM, ACS Cases That Survived for One Year Post-Discharge, Ages?25 Years, Both Sexes, N, 2013 103
Table 19: 7MM, Age-Specific ACS Cases That Survived Until Hospital Discharge and for One Year, Post-Discharge Both Sexes, N, 2013 105
Table 20: 6MM, Diagnosed Prevalent Cases of MI, Ages ?25 Years, Both Sexes, N (Col %), Select Years, 2013-2023 107
Table 21: 6MM, Diagnosed Prevalent Cases of MI Segmented by STEMI and NSTEMI, Ages ?25 Years, Both Sexes, N (Row %), 2013 108
Table 22: 6MM, Age-Specific Diagnosed Prevalent Cases of MI, Both Sexes, N (Row %), 2013 110
Table 23: 6MM, Sex-Specific Diagnosed Prevalent Cases of MI, Ages ?25 Years, N (Row %), 2013 111
Table 24: 7MM, Historical Data Validation 117
Table 25: Treatment Guidelines for Acute Coronary Syndromes (UA, NSTEMI, and STEMI) 121
Table 26: Most Prescribed Drugs for ACS by Class in the Global Markets, 2014 123
Table 27: Leading Treatments for Acute Coronary Syndrome, 2014 140
Table 28: Commonly Used tPAs 143
Table 29: Product Profile - Tissue Plasminogen Activator (tPA) 144
Table 30: Fibrinolytics?SWOT Analysis, 2014 145
Table 31: Global Sales Forecasts ($m) for Fibrinolytics, 2013-2023 146
Table 32: Product Profile - Plavix (clopidogrel) 148
Table 33: Clopidogrel SWOT Analysis, 2014 150
Table 34: Global Sales Forecasts ($m) for Plavix, 2013-2023 151
Table 35: Product Profile - Brilinta (ticagrelor) 153
Table 36: Brilinta (ticagrelor) SWOT Analysis, 2014 154
Table 37: Global Sales Forecasts ($m) for Brilinta, 2013-2023 155
Table 38: Product Profile - Effient (prasugrel) 158
Table 39: Effient (prasugrel) SWOT Analysis, 2014 160
Table 40: Global Sales Forecasts ($m) for Effient, 2013-2023 161
Table 41: Product Profile - Integrilin (eptifibatide) 162
Table 42: Integrilin (eptifibatide) SWOT Analysis, 2014 164
Table 43: Global Sales Forecasts ($m) for Integrilin, 2013-2023 165
Table 44: Product Profile - Warfarin 167
Table 45: Warfarin SWOT Analysis, 2014 169
Table 46: Global Sales Forecasts ($m) for Warfarin, 2013-2023 170
Table 47: Product Profile - Angiomax 171
Table 48: Angiomax (bivalirudin) SWOT Analysis, 2014 172
Table 49: Global Sales Forecasts ($m) for Angiomax, 2013-2023 173
Table 50: Product Profile - Arixtra (fondaparinux) 175
Table 51: Arixtra (fondaparinux sodium) SWOT Analysis, 2014 177
Table 52: Global Sales Forecasts ($m) for Arixtra, 2013-2023 178
Table 53: Product Profile - Lipitor 180
Table 54: Lipitor (atorvastatin) SWOT Analysis, 2014 182
Table 55: Global Sales Forecasts ($m) for Lipitor, 2013-2023 183
Table 56: Product Profile - Crestor (rosuvastatin) 185
Table 57: Crestor (rosuvastatin) SWOT Analysis, 2014 187
Table 58: Global Sales Forecasts ($m) for Crestor, 2013-2023 188
Table 59: Product Profile - Zocor (simvastatin) 189
Table 60: Zocor (simvastatin) SWOT Analysis, 2014 191
Table 61: Global Sales Forecasts ($m) for Zocor, 2013-2023 192
Table 62: Commonly Used Beta Blockers 193
Table 63: Product Profile - Beta Blockers 193
Table 64: Beta Blockers SWOT Analysis, 2014 195
Table 65: Global Sales Forecasts ($m) for Beta Blockers 2013-2023 196
Table 66: Product Profile - Tekturna (aliskiren) 197
Table 67: Tekturna (aliskiren) SWOT Analysis, 2014 199
Table 68: Global Sales Forecasts ($m) for Tekturna, 2013-2023 200
Table 69: Commonly Used ACE Inhibitors 201
Table 70: Product Profile - ACE Inhibitors 201
Table 71: ACE Inhibitor?SWOT Analysis, 2014 203
Table 72: Global Sales Forecasts ($m) for Angiotensin Converting Enzyme (ACE) Inhibitors, 2013-2023 204
Table 73: Commonly Used ARBs 205
Table 74: Product Profile - Angiotensin Receptor Blockers (ARBs) 205
Table 75: ARB SWOT Analysis, 2014 207
Table 76: Global Sales Forecasts ($m) for Angiotensin Receptor Blockers (ARB), 2013-2023 208
Table 77: Product Profile - Mineralocorticoid Receptor Antagonists (MRAs) 209
Table 78: MRA SWOT Analysis, 2014 211
Table 79: Global Sales Forecasts ($m) for Eplerenone, 2013-2023 212
Table 80: Global Sales Forecasts ($m) for Spironolactone, 2013-2023 212
Table 81: Unmet Need and Opportunity in Acute Coronary Syndrome 214
Table 82: Acute Coronary Syndrome - Clinical Trials by Phase and Status, 2014 231
Table 83: Acute Coronary Syndrome - Late-Stage Pipeline, 2014 234
Table 84: Comparison of Therapeutic Classes in Development for ACS, 2014 235
Table 85: Product Profile - Xarelto (rivaroxaban) 239
Table 86: Xarelto (rivaroxaban) SWOT Analysis, 2014 243
Table 87: Global Sales Forecasts ($m) for Xarelto, 2013-2023 245
Table 88: Product Profile - Cangrelor 247
Table 89: Cangrelor SWOT Analysis, 2014 251
Table 90: Global Sales Forecasts ($m) for Cangrelor, 2013-2023 252
Table 91: Product Profile - Zontivity (vorapaxar) 254
Table 92: Vorapaxar SWOT Analysis, 2014 258
Table 93: Global Sales Forecasts ($m) for Zontivity, 2013-2023 259
Table 94: Product Profile - Alirocumab (RGN727) 262
Table 95: Alirocumab SWOT Analysis, 2014 267
Table 96: Global Sales Forecasts ($m) for Alirocumab, 2013-2023 268
Table 97: Product Profile - Evolocumab (AMG 145) 270
Table 98: Phase III Clinical Trials of Evolocumab Reported by Amgen from Q4 2013 - Q1 2014 272
Table 99: Evolocumab SWOT Analysis, 2013 276
Table 100: Global Sales Forecasts ($m) for Evolocumab, 2013-2023 277
Table 101: Product Profile - Bococizumab (PF-04950615) 279
Table 102: Bococizumab (PF-04950615) SWOT Analysis, 2014 281
Table 103: Global Sales Forecasts ($m) for Bococizumab, 2013-2023 282
Table 104: Product Profile - Anacetrapib 284
Table 105: Anacetrapib SWOT Analysis, 2014 288
Table 106: Global Sales Forecasts ($m) for Anacetrapib, 2013-2023 289
Table 107: Product Profile - Evacetrapib 291
Table 108: Evacetrapib SWOT Analysis, 2013 294
Table 109: Global Sales Forecasts ($m) for Evacetrapib, 2013-2023 295
Table 110: Product Profile - Darapladib 297
Table 111: Darapladib SWOT Analysis, 2014 300
Table 112: Key Companies in the Acute Coronary Syndrome Market, 2014 306
Table 113: Amgen's Acute Coronary Syndrome Portfolio Assessment, 2014 311
Table 114: Amgen SWOT Analysis, 2014 311
Table 115: AstraZeneca's Acute Coronary Syndrome Portfolio Assessment, 2014 313
Table 116: AstraZeneca SWOT Analysis, 2014 314
Table 117: Bristol-Myers Squibb's Acute Coronary Syndrome Portfolio Assessment, 2014 316
Table 118: Bristol-Myers Squibb SWOT Analysis, 2014 316
Table 119: Daiichi Sankyo's Acute Coronary Syndrome Portfolio Assessment, 2014 318
Table 120: Daiichi Sankyo SWOT Analysis, 2014 319
Table 121: Eli Lilly's Acute Coronary Syndrome Portfolio Assessment, 2014 321
Table 122: Eli Lilly SWOT Analysis, 2014 321
Table 123: GlaxoSmithKline's Acute Coronary Syndrome Portfolio Assessment, 2014 323
Table 124: GlaxoSmithKline SWOT Analysis, 2014 323
Table 125: Janssen's Acute Coronary Syndrome Portfolio Assessment, 2014 325
Table 126: Janssen SWOT Analysis, 2014 325
Table 127: The Medicines Company's Acute Coronary Syndrome Portfolio Assessment, 2014 328
Table 128: The Medicines Company SWOT Analysis, 2014 329
Table 129: Merck's Acute Coronary Syndrome Portfolio Assessment, 2014 331
Table 130: Merck SWOT Analysis, 2014 332
Table 131: Pfizer's Acute Coronary Syndrome Portfolio Assessment, 2014 334
Table 132: Pfizer SWOT Analysis, 2014 335
Table 133: Sanofi's Acute Coronary Syndrome Portfolio Assessment, 2014 337
Table 134: Sanofi SWOT Analysis, 2014 338
Table 135: Global Sales Forecasts ($bn) for ACS, 2013-2023 342
Table 136: Acute Coronary Syndrome Market - Drivers and Barriers, 2014 349
Table 137: Sales Forecasts ($m) for ACS in US, 2013-2023 357
Table 138: Key Events Impacting Sales for Acute Coronary Syndrome in the US, 2014 360
Table 139: Acute Coronary Syndrome Market - Drivers and Barriers in the US, 2014 360
Table 140: Sales Forecasts ($m) for ACS in France, 2013-2023 365
Table 141: Key Events Impacting Sales for Acute Coronary Syndrome in France, 2014 368
Table 142: Acute Coronary Syndrome Market - Drivers and Barriers in France, 2014 368
Table 143: Sales Forecasts ($m) for ACS in Germany, 2013-2023 373
Table 144: Key Events Impacting Sales for Acute Coronary Syndrome in Germany, 2014 376
Table 145: Acute Coronary Syndrome Market - Drivers and Barriers in Germany, 2014 376
Table 146: Sales Forecasts ($m) for ACS in Italy, 2013-2023 382
Table 147: Key Events Impacting Sales for Acute Coronary Syndrome in Italy, 2014 385
Table 148: Acute Coronary Syndrome Market - Drivers and Barriers in Italy, 2014 386
Table 149: Sales Forecasts ($m) for ACS in Spain, 2013-2023 391
Table 150: Key Events Impacting Sales for Acute Coronary Syndrome in Spain, 2014 394
Table 151: Acute Coronary Syndrome Market - Drivers and Barriers in Spain, 2014 394
Table 152: Sales Forecasts ($m) for ACS in UK, 2013-2023 399
Table 153: Key Events Impacting Sales for Acute Coronary Syndrome in the UK, 2014 402
Table 154: Acute Coronary Syndrome Market - Drivers and Barriers in the UK, 2014 402
Table 155: Sales Forecasts ($m) for ACS in Japan, 2013-2023 406
Table 156: Key Events Impacting Sales for Acute Coronary Syndrome in Japan, 2014 409
Table 157: Acute Coronary Syndrome Market - Drivers and Barriers in Japan, 2014 409
Table 158: Key Launch Dates 451
Table 159: Key Patent Expiries 451
Table 160: Price Sources and Calculations, by Country 453
Table 161: Physicians Surveyed, By Country 467

List of Figures

Figure 1: The ACS Timeline and the Scope of GlobalData's ACS Report and Forecast 31
Figure 2: Progression of Coronary Artery Disease, Atherosclerotic Plaque Rupture, Thrombosis, and Acute Coronary Syndrome 32
Figure 3: Platelet and Coagulatory Factors Implicated in Thrombosis 34
Figure 4: Electrocardiography in the Diagnosis of ACS 35
Figure 5: US, Temporal Trend in the Hospitalized MI Incidence from the Worcester Heart Attack Study, All Ages, 1975-2005 48
Figure 6: UK, Age-Adjusted MI Incidence and Hospitalized Incidence (Cases per 100,000 Population), Men, 2002-2010 53
Figure 7: UK, Age-Adjusted MI Incidence and Hospitalized Incidence (Cases per 100,000 Population), Women, 2002-2010 54
Figure 8: England and Scotland, Age-Adjusted Temporal Trends in MI Mortality, Deaths per 100,000 Population, Men and Women, 2002-2010 55
Figure 9: US, Germany, and UK, Crude Diagnosed MI Prevalence in Men and Women, 1990-2008 60
Figure 10: Global, Crude Total Population Prevalence Percentages of Angina Pectoris (%) 63
Figure 11: MI Forecast Case Flow Map 66
Figure 12: 7MM, Hospitalized Incident Cases of ACS, Ages ?25 Years, Both Sexes, N, Select Years, 2013-2023 95
Figure 13: 7MM, Age-Specific Hospitalized Incident Cases of ACS, Both Sexes, N, 2013 97
Figure 14: 7MM, Sex-Specific Hospitalized Incident Cases of ACS, Ages ?25 Years, N, 2013 99
Figure 15: 7MM, Hospitalized Incident Cases of ACS Segmented by STEMI, NSTEMI, and UA, Ages ?25 Years, Both Sexes, N, 2013 101
Figure 16: 7MM, Survival of Hospitalized Incident Cases of ACS, Ages ?25 Years, Both Sexes, %, 2013 102
Figure 17: 7MM, Age-Specific Survival of Hospitalized Incident Cases of ACS, Both Sexes, %, 2013 104
Figure 18: 7MM, Age-Standardized Incidence of ACS (Cases per 100,000 Population), Ages ?25 Years, 2013 106
Figure 19: 6MM, Diagnosed Prevalent Cases of MI, Ages ?25 Years, Both Sexes, N, 2013-2023 107
Figure 20: 6MM, Diagnosed Prevalent Cases of MI Segmented by STEMI and NSTEMI, Ages ?25 Years, Both Sexes, N, 2013 109
Figure 21: 6MM, Age-Specific Diagnosed Prevalent Cases of MI, Both Sexes, N, 2013 110
Figure 22: 6MM, Sex-Specific Diagnosed Prevalent Cases of MI, Ages ?25 Years, N, 2013 112
Figure 23: 6MM, Age-Standardized Diagnosed Prevalence of MI, Ages ?25 Years, %, 2013 113
Figure 24: Acute Coronary Syndrome Therapeutics - Clinical Trials by Country, 2014 230
Figure 25: Acute Coronary Syndrome Therapeutics - Clinical Trials by Phase in the 7MM, 2014 232
Figure 26: Competitive Assessment of Late-Stage Pipeline Agents for ACS, 2013-2023 236
Figure 27: Company Portfolio Gap Analysis in Acute Coronary Syndrome, 2013-2023 307
Figure 28: Global Sales for Acute Coronary Syndrome by Country, 2013-2023 344
Figure 29: Global* ACS Sales by Drug Class, 2013-2023 345
Figure 30: Global* Sales Forecast for PCSK9 mAbs, 2015-2023 346
Figure 31: Global* Sales Forecast of the New Antithrombotics, Xarelto and Zontivity, 2013-2023 347
Figure 32: Projected Global* Sales of ACS Drugs By Year, 2013-2023 348
Figure 33: Sales for Acute Coronary Syndrome in US by Drug Class, 2013-2023 359
Figure 34: Sales for Acute Coronary Syndrome in France by Drug Class, 2013-2023 367
Figure 35: Sales for Acute Coronary Syndrome in Germany by Drug Class, 2013-2023 375
Figure 36: Sales for Acute Coronary Syndrome in Italy by Drug Class, 2013-2023 384
Figure 37: Sales for Acute Coronary Syndrome in Spain by Drug Class, 2013-2023 393
Figure 38: Sales for Acute Coronary Syndrome in the UK by Drug Class, 2013-2023 401
Figure 39: Sales for Acute Coronary Syndrome in Japan by Drug Class, 2013-2023 408