For the Treatment of Fibromyalgia, Eli Lilly/Boehringer Ingelheim’s Cymbalta Was the Patient- and Market-Share Leading Agent in the United States in 2011, after Surpassing Pfizer’s Lyrica in 2010
Decision Resources
Decision Resources, one of the world’s leading research and advisory firms for pharmaceutical and healthcare issues, finds that, for the treatment of fibromyalgia, Eli Lilly/Boehringer Ingelheim’s Cymbalta was the patient- and market-share leader in the United States in 2011, after surpassing Pfizer’s Lyrica in 2010. Cymbalta garnered a 32 percent share of U.S. fibromyalgia patients in 2011, while Lyrica held a patient share of approximately 26 percent. According to interviewed experts, the prescribing of Cymbalta is being driven by the agent’s balance of efficacy and tolerability to patients and it has also benefited from regulatory approval for two common comorbidities of fibromyalgia—anxiety and depression.
The findings from the Pharmacor topic entitled also reveal that the United States accounted for nearly 80 percent of major-market sales of fibromyalgia therapies in 2011 and will account for two-thirds of major-market fibromyalgia sales in 2021. The majority of sales continue to be driven by the leading fibromyalgia-approved therapies, Lyrica and Cymbalta (also available as Xeristar in Europe), and—to a lesser extent—by milnacipran (Forest Laboratories’ Savella, Pierre Fabre’s Ixel). However, expansion of the market in Europe will be constrained by a dearth of approved therapies, resulting in persistent use of low-cost generic agents. Additionally, although diagnosis and drug-treatment rates are improving in Europe, they will remain lower than in the United States through 2021. Historically, diagnosis and drug treatment rates have been lowest in Japan, but we forecast rapid growth of the market in this region due primarily to the June 2012 approval of Lyrica in that country for the treatment of pain associated with fibromyalgia, and new guidelines for the treatment of the disorder.
In the United States, France, Germany, Italy, Spain, the United Kingdom and Japan, the fibromyalgia therapy market will increase from $1.8 billion in 2011 to more than $2 billion in 2018, before declining again to $1.8 billion in 2021. Notably, as awareness and acceptance of fibromyalgia among physicians and the general population continue to increase, the diagnosed and drug-treated population will grow from 3.7 million in 2011 to 5.3 million in 2021.
The findings also reveal that, because its symptoms vary widely from patient to patient and can include pain, depression, fatigue and sleep dysfunction, fibromyalgia remains a very difficult condition to treat.
“Polypharmacy is common in the management of fibromyalgia. Patients are heterogeneous in their response to treatment and no single therapy is likely to provide significant relief of all symptoms,” said Decision Resources Analyst John Crowley, Ph.D. “As a result, the demand for novel treatments is high and significant opportunity exists for a drug that can demonstrate efficacy on one or more symptoms while offering an acceptable safety profile.”
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