Parkinson's Disease - Review of Key Commercial Opportunities in the Symptomatic Treatment Market
Scope
Report Highlights
Reasons to Purchase
Table of Contents
- ABOUT DATAMONITOR HEALTHCARE - page 2
- About the CNS pharmaceutical analysis team - page 2
- CHAPTER 1 EXECUTIVE SUMMARY - page 3
- Objective of the analysis - page 3
- Datamonitor insight into the Parkinson's disease market - page 3
- CHAPTER 2 MARKET OVERVIEW - page 10
- Market definition for this report - page 10
- Epidemiology - page 10
- The key age group for PD will double by 2050 - page 12
- Recent studies indicate PD is potentially more common in men than women - page 14
- Co-morbid conditions are prevalent in PD - page 14
- Depression- accurate diagnosis is a challenge - page 14
- Risk for developing dementia is greater in PD than in the general population - page 15
- Psychosis occurs throughout all stages of PD - page 16
- Sleep disorders are most common in advanced PD - page 16
- Market segmentation; two key clinical scales are used to categorize stages of PD - page 17
- The Hoehn and Yahr staging is widely used in clinical trials - page 17
- Unified Parkinson's Disease Rating Scale (UPDRS) offers a more comprehensive measure of PD progression - page 19
- Advances being made in diagnostic tools for PD - page 19
- Greater use of neuro-imaging has led to improvement in early PD diagnosis - page 19
- Increase in primary care physicians diagnosing PD in the UK - page 21
- Genetic testing is set to become more widespread - page 21
- Treatment of PD is highly individualized and varies by disease stage - page 22
- Potential neuroprotective and levodopa-sparing effects put MAOIs in the first line for early patients - page 24
- Dopamine agonists positioned as levodopa-sparing monotherapies - page 26
- Levodopa remains the gold-standard treatment of PD - page 29
- COMT inhibitors aim to decrease OFF time and increase ON time in "wearing-off" patients - page 32
- Current market situation - page 34
- Japan and EU drive growth of global market - page 34
- Dopamine agonists drive market growth - page 35
- Mirapex leads the PD market - page 36
- CHAPTER 3 CASE STUDY ANALYSIS - page 39
- Opportunities in early treatment require increasing awareness of PD - page 39
- Case study: Azilect-promoting the "neuroprotective" ability to capture more patients sooner - page 41
- Azilect is not metabolized to amphetamine derivatives - page 41
- Three trials demonstrate efficacy and good tolerability over a six month period - page 42
- Scenario analysis of ADAGIO trial outcome - page 44
- KOLs believe neurologists will prescribe Azilect as a levodopa-sparing strategy - page 45
- Sales of Azilect hang on results of ADAGIO study - page 47
- Marketing strategies: using the internet to promote simplicity, safety and efficacy - page 48
- Azilect strategic analysis - page 50
- Key conclusions drawn from Azilect case study - page 53
- Case study: Azilect-promoting the "neuroprotective" ability to capture more patients sooner - page 41
- Improved drug formulations and delivery technologies - page 54
- Patch (transdermal) formulations - page 54
- Case study-Neupro (rotigotine CDS) - page 55
- Clinical trial data demonstrate improvement in motor function and ADLs - page 56
- Neupro used for non-compliant patients - page 56
- Neupro strategic analysis - page 57
- Key conclusions drawn from Neupro case study - page 60
- Managing levodopa complications - page 61
- Growing trend towards continuous dopamine stimulation - page 61
- Case study: Stalevo and the role of levodopa combinations - page 62
- Clinical trials demonstrate that Stalevo increases ON time, reduces OFF time and improves motor function - page 63
- Stalevo strategic analysis - page 63
- Key conclusions drawn from Stalevo case study - page 67
- Advanced-stage patient treatment opportunities - page 68
- Rescue therapy-a small market niche - page 68
- Case study: Apokyn- targeting a niche cohort of patients - page 68
- Apokyn is effective in providing rapid relief from OFF periods in advanced PD and is well tolerated - page 69
- Sales of Apokyn - page 70
- Apokyn strategic analysis - page 70
- Key conclusions drawn from Apokyn case study - page 76
- Co-morbidities - page 76
- Depression- an under-diagnosed co-morbid condition of PD - page 77
- Tricyclic antidepressants: side effects outweigh therapeutic benefits - page 78
- Dementia- a prevalent yet poorly-treated co-morbid condition - page 83
- Exelon is the first medication available for PD dementia - page 84
- Exelon provides moderate improvements in dementia associated with PD - page 84
- Exelon strategic analysis - page 85
- Psychosis- treatment is characterized by off-label prescribing - page 87
- Off-label use of clozapine is effective in reducing psychotic symptoms in PD - page 88
- Acadia's ACP-103 in development for PD psychosis - page 88
- Sleep disorders- subtypes of sleep disorders represent niche opportunities - page 89
- Seroquel (quetiapine, AstraZeneca) a potential safe and effective treatment for insomnia in PD patients - page 89
- Lunesta (eszopiclone, Sepracor) under investigation for the treatment of insomnia in PD patients - page 90
- Provigil (modafinil, Cephalon) recommended for treating hypersomnolence in PD - page 90
- Key conclusions drawn from examination of co-morbidities - page 91
- Depression- an under-diagnosed co-morbid condition of PD - page 77
- Opportunities in early treatment require increasing awareness of PD - page 39
- APPENDIX - page 93
- Contributing experts - page 93
- Bibliography - page 94
- References - page 94
- Websites - page 100
- Report methodology - page 101
- Market sizing caveats - page 101
- Sales calculations - page 102
- About Datamonitor - page 104
- About Datamonitor Healthcare - page 104
- About the CNS analysis team - page 105
- Disclaimer - page 106
- List of Tables
- Table 1: Prevalence and incidence of Parkinson's disease (PD) according to key epidemiology studies - page 11
- Table 2: Prevalence of PD across the seven major markets, 2006 - page 12
- Table 3: Analysis of key brands in the PD market, 2006 - page 37
- Table 4: Percentage of total value accounted for by Parkinson's disease diagnosis, for marketed brands and generics, 2005 - page 102
- List of Figures
- Figure 1: Projection of the population over 65 across the seven major markets, 2005-50 - page 13
- Figure 2: Prevalence of depression in PD by Hoehn and Yahr scale - page 15
- Figure 3: The five stages of PD according to the Hoehn and Yahr scale - page 18
- Figure 4: Treatment algorithm for PD - page 23
- Figure 5: Advantages and disadvantages of selegiline for initial treatment of PD - page 26
- Figure 6: Advantages and disadvantages of dopamine agonists for the treatment of PD - page 29
- Figure 7: Advantages and disadvantages of levodopa for the treatment of PD - page 32
- Figure 8: Advantages and disadvantages of COMT inhibitors for the treatment of PD - page 33
- Figure 9: Dynamics of the PD market by region 2004-05 - page 34
- Figure 10: The PD market by region, 2002-05 - page 35
- Figure 11: Dynamics of PD drug classes, 2004-05 - page 36
- Figure 12: Breakdown of the PD dollar market by leading brand, 2006 - page 38
- Figure 13: Teva Neuroscience and Eisai's PD information website - page 40
- Figure 14: Lundbeck's website for Azilect, 2006 - page 49
- Figure 15: SWOT analysis for Azilect, 2006 - page 52
- Figure 16: SWOT analysis for Neupro, 2006 - page 58
- Figure 17: SWOT analysis for Stalevo, 2006 - page 64
- Figure 18: SWOT analysis for Apokyn (apomorphine), 2006 - page 71
- Figure 19: Advantages and disadvantages of the use of TCAs in the treatment of depression in PD - page 78
- Figure 20: Advantages and disadvantages of the use of SSRIs in the treatment of depression in PD - page 79
- Figure 21: SWOT analysis for Exelon, 2006 - page 86
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