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Stakeholder Opinions: Parkinson's Disease

Review of Key Commercial Opportunities in the Symptomatic Treatment Market

Publication Date   July 2006
Publisher   Datamonitor
Product Type   Report
Pages   105
ISBN Number   not applicable
Product Code   DAT534
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Price £2,110.00

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Summary


Introduction

Parkinson's disease (PD) is a progressive, degenerative condition of the central nervous system (CNS), caused by the degeneration of dopaminergic neurons in the substantia nigra of the midbrain. The PD market grew by 6.9% to $1.8 billion between 2004 and 2005. In the absence of conclusive evidence for a neuroprotective compound, the focus on the market remains on symptomatic treatment.

Highlights

Manufacturers of neuroprotective products will benefit from driving research and awareness of new diagnostic technologies such as genetic testing to better identify patients in the very early stages of PD or those at risk of the disease.Companies developing improved delivery technologies including continuous transdermal dopamine agonist stimulation and smooth delivery of levodopa will be at a competitive advantage and that novel formulations will become an increasingly important product differentiating strategy.The major unmet need in the treatment in advanced PD is the reduction of OFF periods. Few companies have investigated this area since advanced patient opportunities represent a very small market and Vernalis' Apokyn (apomorphine) is presently the only drug available for this specific use.

Scope

  • Assessment of patient size across the seven major markets (US, Japan, France, Germany, Italy, Spain, UK) including prevalence of co-morbid conditions.h3>
  • Overview of Parkinson's disease market dynamics, discussing market share across the seven major markets, drug classes and brands.h3>
  • Qualitative interviews with key international opinion leaders.h3>
  • Case study analysis of new market entrants which target different disease stages, leading to recommendations to companies entering the market.h3>

Reasons to Purchase

  • Understand key opinion leaders (KOL) views on hot issues in Parkinson's disease diagnosis, treatment, and unmet needs.h3>
  • Identify the opportunities and threats for Azilect (rasagiline), Neupro (rotigotine CDS), and Apokyn (apomorphine) in the market.h3>
  • Identify future challenges to Parkinson's disease drugs and best method of overcoming these.h3>

Content


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