US genericization of clopidogrel will initially contract ACS market, before uptake of novel oral agents lifts sector to $2.7 billion

The 12-month post-hospital acute coronary syndrome market will initially contract from just under $2 billion in 2011 to around $1.6 billion in 2013, mainly as a result of the US genericization of clopidogrel (Bristol-Myers Squibb/Sanofi’s Plavix/Iscover, generics) in 2012, according to Decision Resources.

The health care advisory firm forecasts that the post-hospital acute coronary syndrome market will then expand to almost $2.7 billion in 2021, owing largely to uptake of oral agents with novel modes of action, such as AstraZeneca’s Brilinta/Brilique (ticagrelor) and the CETP inhibitors, Merck & Co’s anacetrapib and Eli Lilly’s evacetrapib.

“We expect anacetrapib to be the first CETP inhibitor to launch for acute coronary syndrome in 2018, followed by evacetrapib in 2019,” said Decision Resources analyst Conor Walsh, adding: “We anticipate that these agents will demonstrate significant reductions in cardiovascular events in their Phase III trials, mainly driven by their highly effective LDL-C-lowering abilities. As a result, sales of this drug class are forecast to be $578 million in 2021 in the 12-month post-hospital setting, equivalent to about one-fifth of total sales in this market.”