The eosinophilic oesophagitis (EoE) market in the US is forecast to grow from $202 million in 2020 to $1.19 billion in 2030, representing a robust compound annual growth rate of 19.4%, according to GlobalData. This growth will be fueled by the shift from off-label treatments such as proton pump inhibitors and compounded topical corticosteroids, towards more patient-friendly, US Food and Drug Association-approved therapies such as Sanofi/Regeneron’s Dupixent (dupilumab), Takeda’s Eohilia (budesonide oral suspension and Ellodi Pharmaceuticals’ late-stage pipeline agent, APT-1011, an orally disintegrating tablet (ODT).
Dupixent, first approved for EoE in adults and adolescents in 2022 then expanded in 2024 to treat children as young as one, has quickly established itself as a first-line biologic due to its strong efficacy, favourable safety profile and biweekly subcutaneous administration. Takeda’s Eohilia, approved in 2024 as the first oral, targeted steroid for EoE, is expected to capture significant market share thanks to its ease of use compared to swallowed inhaler steroids. The anticipated launch of APT-1011, an ODT formulation of fluticasone propionate, will add further choice for patients, particularly in paediatrics where dosage form is a major factor in adherence.
By 2030, Dupixent and Eohilia are expected to account for 75% of the US EoE market, with APT-1011 contributing 12.5%. The late-stage pipeline remains active, with more than 100 interventional trials initiated as of 2025, including novel biologics such as Amgen and AstraZeneca’s co-developed Tezspire (tezepelumab), which targets upstream thymic stromal lymphopoietin (TSLP) signalling and next-generation corticosteroid formulations.
Key opinion leaders interviewed by GlobalData noted a shift in clinical trial design toward multidomain endpoints that integrate histologic, endoscopic and patient-reported outcomes, moving beyond the traditional histologic remission threshold of 15 eosinophils or fewer per high-power field. This evolution reflects payer demand for more comprehensive measures of clinical benefit, particularly sustained improvement in swallowing function and quality of life.
Despite the strong growth outlook, the market faces challenges. Payer step therapy and restrictive coverage criteria may limit broad adoption of biologics, while high list prices, such as Eohilia’s reported launch price at approximately $5,250, could hinder uptake without robust cost-effectiveness data. Reliance on invasive endoscopy for diagnosis and monitoring also remains a significant burden, particularly in paediatric populations, though emerging tools such as the oesophageal string test and cytosponge could reduce procedure frequency.
With multiple novel therapies expected to launch and the treatment paradigm shifting toward earlier, targeted intervention, GlobalData anticipates that the US EoE market will undergo rapid expansion over the forecast period, offering substantial opportunities for both biologic and small-molecule developers targeting this historically underserved condition.
