Total sales for cardiovascular disease drugs will grow steadily over the next six years, from almost $47 billion in 2018 to over $70 billion in 2024, according to estimates published by GlobalData’s Pharma Intelligence Center.

The top five major drivers of this growth are made up of: two anticoagulants (Bristol-Myers Squibb’s Eliquis [apixaban]‎ and Johnson & Johnson/Bayer’s Xarelto [rivaroxaban]), a heart failure drug (Novartis’s Entresto [sacubitril/valsartan]), and two drugs for pulmonary arterial hypertension (Johnson & Johnson’s Uptravi [selexipag] and Opsumit [macitentan]).

Cardiovascular disease drugs: blockbusters

These five drugs will represent almost 50% of the total cardiovascular market in 2024, with Eliquis and Xarelto alone representing 36%. Cholesterol-lowering drugs were not part of this analysis as they were considered to be part of the metabolic disorders therapeutic area.

According to the analyst consensus forecast on GlobalData’s Pharma Intelligence Center, only two pipeline agents in the cardiovascular space are expected to reach blockbuster status (with sales over $1 billion) by 2024: Mesoblast’s Revascor, a stem cell therapy for heart failure, and MyoKardia’s SAR440181, an oral therapy for dilated cardiomyopathy and systolic heart failure.

Revascor is a mesenchymal precursor stem cell therapy that is delivered to damaged areas of the heart. It is currently the most advanced regenerative therapy in development for heart failure. Revascor is in Phase III trials, which are expected to complete within one year.

Cardiovascular disease drugs: trials

SAR440181 is a myosin activator, a new small molecule entity that is administered orally and is currently in Phase II trials. The drug was developed based on MyoKardia’s precision medicine platform, which the company utilises to develop therapies for rare cardiovascular diseases. In September 2014, Sanofi licensed the product from MyoKardia. However, in December 2018, this agreement was terminated and all the rights were returned to MyoKardia. This move was said to be unrelated to any problems with the clinical data.

Although the cardiovascular market is very mature and heavily genericised, and therefore difficult to penetrate, this space is replete with unmet needs as most of the cardiovascular conditions are incurable. There still remains a huge opportunity for drug developers to tap into this potentially lucrative market with innovative and ideally disease-modifying therapies.

Major drivers of cardiovascular market growth

Source: GlobalData