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

Table of Contents

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

Organisation Listed

• Alcon Inc
• ALK-Abello
• Allergan
• Allergy Therapeutics Plc
• Astellas Pharma
• AstraZeneca
• Barr
• Bausch & Lomb
• Biogen Idec
• Boehringer Ingelheim
• Cambridge Antibody Technologies
• Coley Pharmaceutical Group
• Connetics
• Curalogic
• Cytos
• Daiichi Sankyo
• Dainippon Sumitomo
• Elbion
• Evolutec
• GSK
• H. Lundbeck
• Inflazyme
• Kyowa Hakko Kogyo
• MedPointe Pharmaceuticals.
• Merck and Co.
• Mylan, Impax and Dr Reddy's
• Novartis
• Pfizer
• Prasco Labs
• Rigel Pharmaceuticals
• Sanofi-Aventis
• Santen Pharmaceutical
• Schering-Plough
• Shionogi
• Tanabe Seiyaku
• Teva
• UCB