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Examine the Inflammatory Bowel Disease Market-Convenience and Compliance Drive Market Success

October 6, 2008

Reportlinker.com announces that a new market research report related to the Pharmaceutical industry industry is available in its catalogue.

Commercial Insight: Inflammatory Bowel Disease – Convenience and compliance drive market success

http://www.reportlinker.com/p095770/Commercial-Insight-Inflammatory-Bowel-Disease—Convenience-and-compliance-drive-market-success.html

Introduction

Several product launches and indication expansion caused substantial sales growth in the seven major inflammatory bowel disease markets from $1.7 billion in 2004 to $2.7 billion in 2007. Datamonitor forecasts the IBD market will grow with a CAGR (200717) of 4.6% to reach $4 billion in 2017 and success will depend on brands demonstrating patient convenience and improved compliance.

Scope

– In-depth analysis of the current and future inflammatory bowel disease market across the US, 5 EU and Japanese markets, and a rest of world snapshot

– Crohn’s disease and ulcerative colitis specific sales forecasts for key brands to 2017, with total brand figures to benchmark IBD sales against

– Provides detailed brand dynamics discussion, including analysis of the anti-TNFs Remicade, Humira, Cimzia and impact of new products such as Tysabri

– Assess the strategies of the key developers in the IBD market

Highlights

Anti-TNF sales will peak at over $2 billion in 2012 because of earlier use, extension into ulcerative colitis, uptake of Cimzia (certolizumab) and the launch of golimumab (CNTO-148). Despite competitive pressure from novel agents and biosimilars, the TNF inhibitors will generate $1.8 billion in IBD indications in 2017 and retain market dominance.

Cimzia is the third anti-TNF for Crohn’s disease, but with few perceived advantages, it will remain a third-line therapy. Time on the market, method of delivery and patient preference will increasingly determine anti-TNF choice. Humira will attain market and class leadership from Remicade by 2014, achieving IBD sales of $0.8 billion by 2017.

Patient convenience/compliance will drive brand choice in the homogenous 5-ASA class. Lialda reduces pill burden and data indicate superiority to Asacol. With its favorable once-daily dosing, Lialda is set to head the 5-ASA class and smart marketing will minimize Pentasa cannibalization. Lialda will generate total brand sales of over $400 m in 2017

Reasons to Purchase

– Quantify the current size of IBD sales in the seven major markets and understand trends in the rest of the world

– Assess the impact of events, such as biosimilars entry, on sales of over 30 key brand name products

– Understand the IBD patient acquisition process as well as specific market opportunities and threats

 ABOUT DATAMONITOR HEALTHCARE 2 About the Immunology & Inflammation pharmaceutical analysis team 2 CHAPTER 1 EXECUTIVE SUMMARY 3 Strategic scoping and focus 3 Datamonitor insight into the disease market 4 Related reports 6 Upcoming related reports 6 CHAPTER 2 MARKET DEFINITION 8 The inflammatory bowel disease market definition 8 Biologics 8 TNF inhibitors 8 Integrin inhibitor 9 Intestinal anti-inflammatory drugs (5-aminosalicylates) 9 Immunomodulators 10 Corticosteroids 11 ICD-10 codes used to define the inflammatory bowel disease indications 11 Crohn's disease 12 Ulcerative colitis 12 Assumptions and caveats for diagnosis value estimates 13 Diagnosis value based on retail data only 13 CHAPTER 3 PATIENT ACQUISITION PROCESS 15 Introduction 15 Patient care path 15 Points of influence in the patient care path 15 Trigger Point 1: Disease awareness among patients and physicians is  critical to increasing diagnosis rates 17 Trigger Point 2: Tackling patient compliance during maintenance treatment  19 Trigger Point 3: Physician assessment of disease severity influences  treatment choice - using "step-up" or "top-down" strategies 20 Factors that influence patient flow through the healthcare system 21 Increased public awareness leading to early presentation to PCP or a  specialist 22 Symptoms of disease can be mild, therefore, patients do not present for  treatment 22 Patients sometimes forget to take medication if they feel symptoms have  improved 23 Self-management limits patient follow-up 23 CHAPTER 4 MARKET OVERVIEW 24 Seven major markets 24 Current market assessment 24 Impressive historical growth in inflammatory bowel disease sales from 2004  to 2007 24 Inflammatory bowel disease market volume is increasing, but due to the  uptake of biologics, sales growth is outstripping it 27 Anti-TNFs contributed to half of all sales in the inflammatory bowel  disease market in 2007 29 Spain and France show highest growth in the seven major markets in  2006-07 31 Future market assessment 32 Opportunities and threats 41 Opportunities 41 Threats 46 US 49 Current market assessment 49 The US was the largest of the seven major markets in 2007 49 Anti-TNFs held a 55% share of the US inflammatory bowel disease market  in 2007 50 Corticosteroids demonstrated highest CAGR from 2004 to 2007 51 Abbott's Humira experienced strong US uptake from 2006 to 2007 52 Rowasa's US sales continue to decrease in light of generic competition 53 Future market assessment 54 Opportunities and threats 59 Opportunities 59 Threats 59 Japan 61 Current market assessment 61 Japan was the second largest market in terms of sales in 2007 61 Intestinal anti-inflammatory drug class dominates inflammatory bowel  disease market in Japan 62 Nisshin Kyorin's Pentasa is the leading brand for inflammatory bowel  disease in Japan 63 Mitsubishi Tanabe's Remicade experiences low growth from 2006 to 2007  64 Future market assessment 65 Opportunities and threats 69 Opportunities 69 Threats 71 Europe 73 Current market assessment 73 Inflammatory bowel disease sales grew by 28% in the 5EU from 2006 to  2007 73 Anti-TNFs drive growth in the 5EU inflammatory bowel disease market 74 Intestinal anti-inflammatory drug class sales remain ahead of anti-TNFs  in 5EU 75 Remicade demonstrated the best performance in the 5EU from 2006 to  2007 75 Future market assessment 76 Opportunities and threats 81 Opportunities 81 Threats 82 France 84 Current market assessment 84 Inflammatory bowel disease market achieved sales of $137m in 2007 84 Future market assessment 85 Germany 90 Current market assessment 90 Germany is the largest inflammatory bowel disease market in the 5EU 90 Future market assessment 91 Italy 96 Current market assessment 96 Second smallest inflammatory bowel disease market behind Spain in 2007 96 Future market assessment 97 Spain 102 Current market assessment 102 Spain showed highest CAGR of all the major markets from 2004 to 2007 102 Future market assessment 103 UK 108 Current market assessment 108 Although anti-TNF class is growing rapidly, intestinal anti-inflammatory  agents retain largest share of the UK market 108 Future market assessment 109 Rest of World snapshot 114 Current market assessment 114 Rest of World accounts for only 13% of global inflammatory bowel disease  market sales 115 Global inflammatory bowel disease market sales increased with a 14.3% CAGR  from 2004 to 2007 115 Asia-Pacific, particularly China, is the area of highest growth in the Rest  of World 117 Other regions, such as Russia, show promising growth in the inflammatory  bowel disease market 119 Canada is the largest Rest of World market after the rest of Europe. 120 Remicade is the leading brand in the Rest of World 121 Opportunities and threats 122 Opportunities 122 Threats 123 CHAPTER 5 BRAND DYNAMICS 125 Overview of competitive landscape 125 Drivers of brand choice 126 Factors driving brand choice in the anti-TNF class 128 Patient preference, cost and mode of delivery are among drivers of brand  choice for anti-TNFs 128 US formulary status for leading brands 129 Humira is better positioned than Remicade in most US formularies 130 Asacol has desirable Tier-2 coverage in most plans 131 Remicade (infliximab; Centocor/Johnson & Johnson, Schering-Plough and  Mitsubishi Tanabe) 131 Drug profile 132 Product positioning 133 Remicade is positioned in multiple Crohn's disease patient populations 133 Ulcerative colitis approval expands scope for Remicade product positioning  134 Colectomy avoidance indication will have a small positive impact on  Remicade sales 135 Remicade advances up to second-line therapy for Crohn's disease in the  EU 136 SONIC trial directly evaluates Remicade against immunosuppressants 136 Marketing mix 137 Marketing mix for Remicade is varied, but Centocor is promoting the message  of evidence and experience 137 Centocor finds new marketing channel in the form of a documentary 138 Mitsubishi Tanabe's strengthened promotion of Remicade in Japan is a core  marketing strategy 139 Brand forecast to 2017 140 Remicade's sales grow in the near term but then decline amid competition  from new products and biosimilars 140 Japan is the only major market where Remicade will experience overall  growth to 2017 142 Infliximab biosimilars will achieve sales of $160m in 2017 145 Strategic recommendations 146 Humira (adalimumab; Abbott, Eisai) 146 Drug profile 147 Product positioning 148 The GAIN trial positioned Humira to capture infliximab-failure patients,  however, competition now comes from Cimzia and Tysabri 148 Abbott now has 2-year data for Humira, which will allow better positioning  against Remicade 148 Humira is building up clinical data beyond remission 149 Remicade will remain choice ahead of Humira for treating fistulizing  Crohn's disease 150 Marketing mix 150 Abbott has relied on heavy marketing of Humira 150 Abbott signs up Eisai to co-promote Humira in Japan 152 Abbott promoted the "sustainable impact" of Humira at the DDW 2008 152Brand forecast to 2017 153 Humira will experience strong uptake for inflammatory bowel disease in the  seven major markets and will be market leader by 2014 153 Strategic recommendations 157 Cimzia (certolizumab; UCB) 157 Drug profile 159 Product positioning 160 UCB chose a lower price point to position Cimzia in the competitive  anti-TNF market 160 Like Humira, Cimzia will be positioned in the infliximab-failure  population, but as third-line choice 160 Marketing mix 161 UCB must launch a hard-hitting marketing campaign for Cimzia 161 'CIMplicity' includes the home health nurse program for Cimzia  administration 161 Crohn's & Me society will increase disease awareness and promote Cimzia 162 UCB and Otsuka will co-promote Cimzia in Japan 163 Brand forecast to 2017 163 Third-line competition will cap Cimzia sales in inflammatory bowel disease  163 Strategic recommendations 166 Tysabri (natalizumab; Biogen Idec, Elan) 166 Drug profile 168 Product positioning 169 Tysabri positioned towards Crohn's disease patients who fail anti-TNF  therapy 169 Tysabri reduces hospitalization rates 169 Elan and Biogen Idec funded study shows Tysabri most cost-effective therapy  for anti-TNF-failure patients 170 Marketing mix 170 TOUCH program - newly confirmed cases of PML will limit uptake of Tysabri  in Crohn's disease 171 Brand forecast to 2017 172 Safety concerns dampen Tysabri's sales forecast in Crohn's disease 172 Strategic recommendations 174 Asacol (mesalazine, Procter & Gamble) 175 Drug profile 175 Product positioning 176 Procter & Gamble's strong product positioning facilitates Asacol's market  leadership 176 Asacol looking to compete with Pentasa in Japan 177 Marketing mix 177 Asacol is the most heavily promoted intestinal anti-inflammatory brand, but  Lialda is close behind 177 Brand forecast to 2017 178 Competition from Lialda and Salofalk Granustix will diminish Asacol's US  and 5EU sales 178 Strategic recommendations 181 Pentasa (mesalazine; Shire, Ferring, Nisshin Kyorin) 182 Drug profile 182 Product positioning 183 Pentasa has ulcerative colitis indication, but Crohn's disease generates  majority of sales, especially in the US 183 Pentasa and Lialda co-exist in Shire's gastroenterology franchise without  signs of cannibalization 184 Once-daily Pentasa more effective than twice-daily dosing of Pentasa 185 Marketing mix 185 Pentasa's promotional spend falls behind Asacol and Lialda 185 Brand forecast to 2017 186 Strategic recommendations 188 Lialda/Mezavant (MMX mesalazine; Shire, Giuliani, Cosmo) 189 Target product profile 189 Product positioning 190 Shire will roll-out Lialda across the rest of the EU in 2008 190 Shire markets Lialda as a once-daily tablet in the US, but reduced number  of tablets per day does not equate to lower costs 190 Lialda aims to acquire share from market-leader Asacol 191 Marketing mix 192 Shire and Takeda will co-promote Lialda in the US 192 Drug forecast to 2017 193 Once-daily dosing and reduced pill burden will propel Lialda to become  the market-leading 5-ASA brand 193 Strategic recommendations 197 Golimumab (CNTO-148; Centocor/Johnson & Johnson, Schering-Plough,  Mitsubishi Tanabe, Janssen Pharmaceutical) 197 Target product profile 198 Development overview 199 Product positioning 200 Centocor/Johnson & Johnson and Schering-Plough will position golimumab  (CNTO-148) in the ulcerative colitis population 200 Marketing mix 201 Golimumab's (CNTO-148) marketing will be akin to Remicade's 201 Drug forecast to 2017 201 Strategic recommendations 203 Other marketed brands 204 Salofalk Granustix (mesalazine; Dr Falk Pharma, Salix Pharmaceuticals)  204 Salofalk Granustix is a once-daily granule mesalazine formulation and will  compete with Lialda in the US 205 Salix Pharmaceuticals's experienced sales force an advantage to Salofalk  Granustix 206 Entocort (budesonide; Prometheus Laboratories, AstraZeneca) 207 Entocort patent challenges could result in early generic equivalents in the  US 207 Colazal (balsalazide; Salix Pharmaceuticals) 208 Colazal set for significant generic erosion in the US 208 Salix aiming to launch a 1,100mg formulation of Colazal in the US 209 Other promising late-stage pipeline agents 210 CCX-282 (Traficet-EN; ChemoCentryx, GlaxoSmithKline) 211 Ustekinumab (CNT0-1275; Centocor/Johnson & Johnson, Janssen-Cilag) 214 MMX budesonide 217 Orencia (abatacept) 218 CHAPTER 6 KEY DEVELOPERS 220 Strategic overview 220 Trends in corporate strategy 221 Key companies with a biologic have a single marketed drug for inflammatory  bowel disease 221 Collaboration, licensing arrangements and acquisition are the main  strategic trends in the inflammatory bowel disease market 222 Centocor/Johnson & Johnson 223 Corporate strategy 223 Remicade is the only marketed drug in Centocor/Johnson & Johnson's  immunology portfolio 223 Inflammatory bowel disease portfolio assessment 224 Abbott 226 Corporate strategy 226 Humira is at the core of Abbott's business and is the only product in  its immunology franchise 226 Inflammatory bowel disease portfolio assessment 227 Portfolio assessment of other leading companies 228 Schering-Plough 228 Salix 228 Prometheus 228 Shire 229 BIBLIOGRAPHY 231 Journal papers 231 Websites 236 Publications 242 Datamonitor reports 242 APPENDIX A - MARKET ASSUMPTIONS 243 New product launches 243 Patent expiries 244 Brand erosion 244 US brand erosion: Rowasa case study 244 Patent expiry dates summary 244 Data definitions, limitations and assumptions 245 Standard units 245 Japanese market data 245 Derivation of sales forecasts and pricing trends 245 Forecast methodology 246 APPENDIX B 247 Contributing experts 247 Report methodology 247 About Datamonitor 248 About Datamonitor Healthcare 248 About the Immunology & Inflammation analysis team 249 Disclaimer 250 List of Tables  Table 1: Datamonitor's definition of Crohn's disease 12 Table 2: Datamonitor's definition of ulcerative colitis 13 Table 3: Gastroenterologist breakdown by region for IMS Prescribing  Insight data, 2007 14 Table 4: Key factors influencing patient flow through the healthcare system  22 Table 5: Inflammatory bowel disease-specific volume sales (million standard  units) split by drug class in the seven major markets, 2004-07 29 Table 6: Sales forecasts for inflammatory bowel disease in the seven major  markets ($m), 2007-2017 36 Table 7: Estimated number of patients with Crohn's disease and ulcerative  colitis who are undiagnosed in the seven major markets, 2007 45 Table 8: Patent expiry dates and level of biosimilar risk for the biologic  brands for inflammatory bowel disease, 2008-2017 48 Table 9: Summary of opportunities and threats in the inflammatory bowel  disease market across the seven major markets, 2008 49 Table 10: US sales and growth of drug classes and brands in the  inflammatory bowel disease market, 2007 50 Table 11: Sales forecasts for the inflammatory bowel disease market in the  US ($m), 2007-2017 57 Table 12: Summary of opportunities and threats in the inflammatory bowel  disease market in the US, 2007 61 Table 13: Sales and growth of drug classes and brands in the inflammatory  bowel disease market in Japan, 2007 62 Table 14: Sales forecasts for the inflammatory bowel disease market in  Japan ($m), 2007-2017 68 Table 15: Summary of opportunities and threats in the inflammatory bowel  disease market in Japan, 2007 73 Table 16: Sales and growth of drug classes in the 5EU inflammatory bowel  disease market, 2007 73 Table 17: Sales forecasts for the inflammatory bowel disease market in the  5EU ($m), 2007-2017 79 Table 18: Summary of opportunities and threats in the European market, 2008  84 Table 19: Sales forecasts for inflammatory bowel disease market in France  ($m), 2007-2017 88 Table 20: Sales forecasts for inflammatory bowel disease market in Germany  ($m), 2007-2017 94 Table 21: Sales forecasts for the inflammatory bowel disease market in  Italy ($m), 2007-2017 100 Table 22: Sales forecasts for the inflammatory bowel disease market in  Spain ($m), 2007-2017 106 Table 23: Sales forecasts in the inflammatory bowel disease market in  the UK ($m), 2007-2017 112 Table 24: Annual global sales in the inflammatory bowel disease market  split by region ($m), 2004-07 117 Table 25: Comparison of leading branded drug sales for inflammatory  bowel disease in the seven major markets (7MM) and the Rest of World  (ROW) ($m), 2007 122 Table 26: Leading branded drug sales for inflammatory bowel disease in the  seven major markets ($m), 2007-2017 126 Table 27: Predictors of strong preference for subcutaneous and intravenous  anti-TNF formulations 129 Table 28: Formulary status in the US for leading brands in inflammatory  bowel disease, 2008 130 Table 29: Remicade (infliximab) - drug profile, 2008 132 Table 30: Approvals for Remicade in Crohn's disease populations in the  seven major markets, 1998-2007 133 Table 31: Sales forecast for Remicade (infliximab) for inflammatory  bowel disease in the seven major markets ($m), 2007-2017 141 Table 32: Key factors impacting sales of Remicade, 2007-2017 144 Table 33: Humira (adalimumab) - drug profile, 2008 147 Table 34: Humira sales in inflammatory bowel disease by country in the  seven major markets ($m), 2007-2017 154 Table 35: Key factors impacting sales of Humira, 2007-2017 156 Table 36: Cimzia (certolizumab) - drug profile, 2008 159 Table 37: Comparison of the annual cost per patient of anti-TNF agents  in the US, 2008 160 Table 38: Key factors impacting sales of Cimzia, 2007-2017 165 Table 39: Tysabri (natalizumab) - drug profile, 2008 168 Table 40: Key factors impacting sales of Tysabri, 2007-2017 174 Table 41: Asacol (mesalazine) - drug profile, 2008 175 Table 42: Asacol (mesalamine) sales for inflammatory bowel disease in US,  Japan, Italy and the UK ($m), 2007-2017 180 Table 43: Pentasa (mesalazine) - drug profile, 2008 182 Table 44: Pentasa (mesalamine) sales for inflammatory bowel disease in the  seven major markets ($m), 2007-2017 187Table 45: Lialda - target product profile, 2008 189 Table 46: Cost analysis for Lialda, Asacol and Pentasa in the US, 2007 191 Table 47: Lialda (MMX mesalazine) sales for inflammatory bowel disease  in the US and 5EU ($m) , 2007-2017 195 Table 48: Key factors impacting sales of Lialda, 2007-2017 196 Table 49: Golimumab - target product profile, 2008 198 Table 50: Phase III clinical trial summary for golimumab (CNTO148) in  ulcerative colitis, 2008 200 Table 51: Golimumab (CNTO-148) sales in ulcerative colitis in the US and  5EU, split by country ($m), 2007-2017 202 Table 52: Key factors impacting sales of Golimumab (CNTO-148), 2007-2017 203 Table 53: Other promising late-stage pipeline products for inflammatory  bowel disease, 2008 211 Table 54: Clinical trial summary for CCX-282 in Crohn's disease, 2008 212 Table 55: Leading companies in the seven major markets inflammatory bowel  disease market, 2007-2017 220 Table 56: Summary of licensing deals for major inflammatory bowel disease   players, 2008 221 Table 57: Centocor portfolio assessment of inflammatory bowel disease  agents, 2008 225 Table 58: Abbott portfolio assessment of inflammatory bowel disease agents,  2008 227 Table 59: Portfolio analysis of other key players in the inflammatory bowel  disease market, 2008 230 Table 60: Datamonitor's launch dates for inflammatory bowel disease  products in the US, 5EU and Japan, 2007-2017 243 Table 61: Patent expiry dates for the approved inflammatory bowel disease  drugs in the seven major markets, 2008-2017 245 List of Figures  Figure 1: Crohn's disease patient care path 16 Figure 2: Ulcerative colitis patient care path 17 Figure 3: Inflammatory bowel disease-specific sales in the seven major  markets by region ($m), 2004-07 25 Figure 4: Key events impacting the inflammatory bowel disease market,  2004-08 27 Figure 5: Inflammatory bowel disease-specific volume sales (million  standard units) in the seven major markets by region, 2004-07 28 Figure 6: Inflammatory bowel disease-specific sales split by drug class  in the seven major markets ($m), 2004-07 30 Figure 7: Inflammatory bowel disease market share in the seven major  markets by drug class, 2004-07 31 Figure 8: Sales performance of the seven major inflammatory bowel  disease markets by country, 2006-07 32 Figure 9: Sales forecasts for inflammatory bowel disease in the seven  major markets ($m), 2007-2017 33 Figure 10: Sales forecasts for Crohn's disease and ulcerative colitis  in the seven major markets ($m), 2007-2017 35 Figure 11: Total seven major market forecast sales and market share of  inflammatory bowel disease drug classes ($m), 2017 39 Figure 12: Impact of key events on the inflammatory bowel disease market,  2007-2017 40 Figure 13: Step-up vs. top-down 43 Figure 14: Inflammatory bowel disease-specific sales split by class in the  US ($m), 2004-07 51 Figure 15: Performance of the inflammatory bowel disease therapies in the  US ($m), 2006-07 53 Figure 16: Sales forecasts for inflammatory bowel disease in the US ($m),  2007-2017 55 Figure 17: US forecast sales and market share of inflammatory bowel disease  drug classes, 2017 56 Figure 18: Inflammatory bowel disease-specific sales split by class in  Japan ($m), 2004-07 63 Figure 19: Performance of the inflammatory bowel disease therapies in  Japan, 2006-07 64 Figure 20: Sales forecasts for inflammatory bowel disease in Japan ($m),  2007-2017 66 Figure 21: Japan forecast sales and market share of inflammatory bowel  disease drug classes, 2017 67 Figure 22: Actual and projected annual Crohn's disease prevalence in Japan  1986-2018 70 Figure 23: 5EU inflammatory bowel disease-specific sales split by country  ($m), 2004-07 74 Figure 24: Inflammatory bowel disease-specific sales in the 5EU markets  split by drug class ($m), 2004-07 75 Figure 25: Performance of the inflammatory bowel disease therapies in the  5EU, 2006-07 76 Figure 26: Sales forecasts for inflammatory bowel disease market in the  5EU ($m), 2007-2017 77 Figure 27: 5EU forecast sales and market share of inflammatory bowel  disease drug classes, 2017 78 Figure 28: Inflammatory bowel disease-specific sales split by class in  France ($m), 2004-07 85 Figure 29: Sales forecasts for inflammatory bowel disease in France  ($m), 2007-2017 86 Figure 30: France forecast sales and market share of inflammatory bowel  disease drug classes, 2017 87 Figure 31: Inflammatory bowel disease-specific sales split by class in  Germany ($m), 2004-07 91 Figure 32: Sales forecasts for inflammatory bowel disease in Germany  ($m), 2007-2017 92 Figure 33: Germany forecast sales and market share of inflammatory bowel  disease drug classes, 2017 93 Figure 34: Inflammatory bowel disease-specific sales split by class in  Italy ($m), 2004-07 97 Figure 35: Sales forecasts for inflammatory bowel disease in Italy ($m),  2007-2017 98 Figure 36: Italy forecast sales and market share of inflammatory bowel  disease drug classes, 2017 99 Figure 37: Inflammatory bowel disease-specific sales split by class in  Spain ($m), 2004-07 103 Figure 38: Sales forecasts for inflammatory bowel disease in Spain ($m),  2007-2017 104 Figure 39: Spain forecast sales and market share of inflammatory bowel  disease drug classes, 2017 105 Figure 40: Inflammatory bowel disease-specific sales split by class in  the UK ($m), 2004-07 109 Figure 41: Sales forecasts for inflammatory bowel disease in the UK ($m),  2007-2017 110 Figure 42: UK forecast sales and market share of inflammatory bowel disease  drug classes, 2017 111 Figure 43: Rest of World versus seven major market sales in the  inflammatory bowel disease market ($m), 2007 115 Figure 44: Annual global sales in the inflammatory bowel disease market  split by region, 2004-07 116 Figure 45: Annual Asia-Pacific sales in the inflammatory bowel disease  market split by region, 2004-07 118 Figure 46: Inflammatory bowel disease market sales in Russia, South Africa  and Egypt, 2004-07 120 Figure 47: Drivers of brand choice for inflammatory bowel disease, 2007 127 Figure 48: Promotional activity for Remicade by type as a percentage of  total promotional spend in the seven major markets, 2005-07 138 Figure 49: Remicade sales in inflammatory bowel disease by country in the  seven major markets ($m), 2007-2017 142 Figure 50: Remicade sales in Crohn's disease and ulcerative colitis in  Japan ($m), 2007-2017 143 Figure 51: Remicade sales in Crohn's disease and ulcerative colitis in the  seven major markets ($m), 2007-2017 144 Figure 52: Effect of biosimilars on the sales of Remicade (infliximab) for  inflammatory bowel disease in the seven major markets ($m), 2007-2017 145 Figure 53: Promotional activity for Humira by type as a percentage (%) of  total promotional spend in the seven major markets, 2005-07 152 Figure 54: Humira sales in inflammatory bowel disease by country in the  seven major markets ($m), 2007-2017 155 Figure 55: Humira sales in Crohn's disease and ulcerative colitis in the  seven major markets ($m), 2007-2017 156 Figure 56: Cimzia (certolizumab) sales for inflammatory bowel disease in  the US ($m), 2007-2017 165 Figure 57: Tysabri (natalizumab) sales for inflammatory bowel disease in  the US ($m), 2007-2017 173 Figure 58: Promotional activity for Asacol by type as a percentage of  total promotional spend in the US, Italy and UK, 2005-07 178 Figure 59: Asacol (mesalamine) sales for inflammatory bowel disease in  the US, Japan, Italy and the UK ($m), 2007-2017 180 Figure 60: Asacol (mesalamine) sales Crohn's disease and ulcerative  colitis in Japan ($m), 2007-2017 181 Figure 61: Percentage of Pentasa's sales for each indication in the seven  major markets, 2007 184 Figure 62: Sales of Pentasa and Lialda, as reported by Shire ($m),  2006-07 185 Figure 63: Promotional activity for Pentasa by type as a percentage (%)  of total promotional spend in the major markets, 2005-07 186 Figure 64: Pentasa (mesalamine) sales for inflammatory bowel disease in  the seven major markets ($m), 2007-2017 188 Figure 65: Promotional spend for Lialda split by type of promotion for  US and the UK, 2007 193 Figure 66: Lialda (MMX mesalazine) sales for inflammatory bowel disease  in the US and 5EU ($m), 2007-2017 195 Figure 67: Lialda (MMX mesalazine) sales for ulcerative colitis and  Crohn's disease in the US and 5EU ($m), 2007-2017 196 Figure 68: Golimumab (CNTO-148) sales in ulcerative colitis in the US  and 5EU, split by country ($m), 2007-2017 203 Figure 69: Salofalk Granustix sales in inflammatory bowel in the seven  major markets ($m) , 2007-2017 206 Figure 70: Entocort (budesonide) sales in inflammatory bowel disease in  the US ($m), 2007-2017 208 Figure 71: Colazal (balsalazide) sales in inflammatory bowel disease in  the US ($m), 2007-2017 210 Figure 72: CCX-282 sales for inflammatory bowel disease in the seven  major markets ($m) , 2007-2017 214 Figure 73: Ustekinumab (CNTO-1275) sales for Crohn's disease in the US  ($m), 2007-2017 216 Figure 74: MMX budesonide sales for ulcerative colitis in the US and 5EU  ($m), 2007-2017 218 Figure 75: Centocor's inflammatory bowel disease portfolio sales across  the seven major markets ($m), 2007-2017 226 Figure 76: Brand erosion of Rowasa (mesalazine) following first generic  entrant in the US 244 

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Commercial Insight: Inflammatory Bowel Disease – Convenience and compliance drive market success

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