The Alzheimer’s disease (AD) market across the eight major markets (8MM*) is forecast to grow from $2.4 billion in 2023 to $17.0 billion by 2033, at a compound annual growth rate (CAGR) of 21.8 per cent, primarily driven by the entry of expensive disease-modifying therapies (DMTs) into the market, an aging global population leading to an increase in prevalent cases, and the launch of novel symptomatic therapies for the treatment of agitation and psychosis associated with AD, according to GlobalData.
GlobalData’s latest report, “Alzheimer’s Disease: Eight-Market Drug Forecast and Market Analysis – Update,” reveals that DMTs, which will likely result in increased treatment rates as more options become available, are expected to dominate the global AD market, contributing 69.2 per cent of the market by 2033, with drugs targeting amyloid beta (Aβ) making up the majority of this.
Philippa Salter, Managing Neurology Analyst at GlobalData states, “As the first DMTs to be approved across multiple markets, GlobalData forecasts that Eisai/Biogen’s Leqembi (lecanemab) and Eli Lilly’s Kisunla (donanemab) will become the top-selling drugs in the AD market and could generate global sales of approximately $2.9 billion and $2.3 billion, respectively, by 2033.”
Although the approval of the first DMTs for the treatment of AD is a significant step forward, a key limiting factor in their uptake has been integrating them into clinical practice so that they can be widely available for patients. Frequent IV administration and access to positron emission tomography (PET) and magnetic resonance imaging (MRI) scans are key economic and operational limiting factors for access to these drugs.
Salter adds, “In addition to logistical factors, these new DMTs are significantly more expensive than the current highly genericised symptomatic treatments used in the management of AD, providing a further access challenge in the form of reimbursement/payer restrictions. Indeed, in Japan, a 15 per cent price reduction for Leqembi was recently approved, while in the UK, neither Leqembi nor Kisunla are available on the NHS. Developers of these early DMTs are now investigating alternative routes of administration.”
There are also several oral late-stage pipeline products with a variety of mechanisms of action (MOAs) that, if approved, should be easier to integrate into clinical practice. Not only is oral dosing convenient, but the oral drugs could also be safer than the monoclonal antibodies (mAbs) with no amyloid-related imaging abnormalities, and they could also command cheaper prices, therefore allowing them to be more widely accessible for patients.
Salter continues, “While the AD market is projected to experience strong growth throughout the forecast period across the 8MM, unmet needs beyond access to treatment will remain. The new DMTs are only considered moderately effective, so significant opportunity remains for more effective DMTs that do not just slow progression but also stop the disease, with prevention being the end goal. Beyond DMTS, drugs that can effectively improve cognition in the late stages of disease, as well as more effective options for secondary symptoms such as agitation and psychosis, also provide opportunities for developers.”
Salter concludes, “Key opinion leaders (KOLs) interviewed by GlobalData do not believe there will ever be one product that can cure AD. Rather, they consistently expressed that the future of AD treatment will entail the combinatory use of preventative, symptomatic, and disease-modifying products. Despite the significant anticipated growth for the AD market, many opportunities remain for developers.”