Axial Spondyloarthritis: Forecast in Asia-Pacific Markets to 2028

Axial Spondyloarthritis: Forecast in Asia-Pacific Markets to 2028



Axial spondyloarthritis (axSpA) is a disease group encompassing both ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA). These conditions are chronic, autoinflammatory disorders of the sacroiliac joints and spine, an area also known as the axial skeleton. The disease is typically diagnosed in young adulthood to middle age (16-45 years) and has a seven- to nine-year delay of diagnosis. The axSpA market has historically been reliant on anti-tumor necrosis factor (TNF) therapies that have been available for over a decade, and the pipeline for drugs in late-stage development was lacking, but recent developments have led to research on novel treatment mechanisms. This will be vital in treating the underdiagnosed nr-axSpA population.

In 2016, Novartis gained approval for Cosentyx (secukinumab), the first-in-class interleukin (IL)-17 inhibitor that was the first new biologic treatment approved for AS that was not an anti-TNF. Moreover, biosimilars of currently marketed anti-TNF biologics such as etanercept, infliximab and adalimumab are also available in Asia-Pacific markets. This is likely to result in a highly competitive market for patients who have failed multiple non-steroidal anti-inflammatory drugs (NSAIDs). Competition will intensify with the arrival of new anti-IL-17 treatments and a new class of therapies in development, Janus kinase (JAK) inhibitors, which will offer a more convenient form of administration. With existing unmet need for all patients, particularly nr-axSpA patients, being diagnosed in a timely manner and having treatment options that are not solely subcutaneously or intravenously administered, axSpA represents an increasingly important rheumatology sector for drug developers.

This estimates that sales of drugs in the axSpA market were approximately $368.6M in 2018 in the 5GM in Asia-Pacific region. China was the largest market, with approximately $106.5M in drug sales, which represented 28.9% of the total axSpA market. South Korea and Australia contributed $83.5M and $73M in sales respectively, while Japan and India contributed sales of $53.9M and $51.7M respectively in 2018.

APAC sales in the axSpA market are expected to grow $551.6M at a Compound Annual Growth Rate (CAGR) of 4.1% from 20182028. This forecasts India to grow to $101.4M (18.4% of APAC sales), China to grow to $212.6M (38.5% of APAC sales), Australia to grow to $91M (16.5% of APAC sales), South Korea to grow to $94.6M (17.2% of APAC sales), and Japan to slightly reduce to $52M (9.4% of APAC sales) over the next 10 years.

Key Highlights

- The greatest driver of growth in the Asia-Pacific axSpA market will be the launches of four pipeline therapies during the forecast period. The entry of these anticipated therapies, including Eli Lillys Taltz and Pfizers tofacitinib, will be subject to moderate uptake among the AS and nr-axSpA populations.
- The main barrier to growth in the axSpA market will be the patent expiry of key marketed products, and subsequent launch of biosimilars of Humira (adalimumab) and the genericization of tofacitinib in the latter half of the forecast across the 5GM.
- The most important unmet needs in axSpA are the need for speedier diagnosis and convincing patients to start biologic therapy. The former is being addressed by the increasingly routine use of MRI instead of X-ray to diagnose patients, and the greater understanding and awareness of nr-axSpA. The latter is impacted by poor patient education about their disease and a fear of subcutaneous/intravenous injection.
- Factors driving a low biologic therapy treatment rate include some negative or fearful attitudes towards subcutaneously/intravenously administered therapeutics, nr-axSpA patients not perceiving themselves as severe enough to warrant biologic treatment, and a high ACOT for biologic therapies currently on the market and therapies in late-stage development.

Key Questions Answered

- Over the forecast period, the axSpA market will see the entry of pipeline agents such as the interleukin 17 inhibitors and the JAK inhibitors, the sales of which will offset the loss of sales caused by the entry of biosimilars. How do products compete against each other? Which of these drugs will have the highest peak sales, and why?
- Key Opinion Leaders (KOLs) interviewed by This have indicated that there are several unmet needs within the axSpA indication. What are the main unmet needs in this market? How can the pharmaceutical industry address these needs? To what degree will the therapies under development fulfill these unmet needs?
- The axSpA market is likely to become a turbulent space throughout the forecast period and beyond. Which companies are set to be major players in axSpA during the forecast period?

Scope

- Overview of axSpA including epidemiology, etiology, pathophysiology, symptoms, diagnosis, and treatment guidelines.
- Annualized axSpA therapeutics market revenue, annual cost of therapy and treatment usage pattern data from 2018 and forecast for ten years to 2028.
- Key topics covered include strategic competitor assessment, market characterization, unmet needs, clinical trial mapping and implications for the axSpA therapeutics market.
- Pipeline analysis: comprehensive data split across different phases, emerging novel trends under development, and detailed analysis of late-stage pipeline drugs.
- Analysis of the current and future market competition in the Asia-Pacific axSpA therapeutics market. Insightful review of the key industry drivers, restraints and challenges. Each trend is independently researched to provide qualitative analysis of its implications.

Reasons to buy

The report will enable you to -
- Develop and design your in-licensing and out-licensing strategies through a review of pipeline products and technologies, and by identifying the companies with the most robust pipeline.
- Develop business strategies by understanding the trends shaping and driving the Asia-Pacific axSpA therapeutics market.
- Drive revenues by understanding the key trends, innovative products and technologies, market segments, and companies likely to impact the Asia-Pacific axSpA therapeutics market in future.
- Formulate effective sales and marketing strategies by understanding the competitive landscape and by analyzing the performance of various competitors.
- Identify emerging players with potentially strong product portfolios and create effective counter-strategies to gain a competitive advantage.
- Track drug sales in the Asia-Pacific axSpA therapeutics market from 2018-2028.
- Organize your sales and marketing efforts by identifying the market categories and segments that present maximum opportunities for consolidations, investments and strategic partnerships.

1


2 Axial Spondyloarthritis: Executive Summary
2.1 Axial Spondyloarthritis Market to Experience Mild Growth from 2018-2028
2.2 Late-Stage Pipeline Product Launches Will Result in New Players Establishing Themselves
2.3 Persistent Unmet Needs Will Be Addressed Over the Forecast Period
2.4 Interleukin Inhibitors and Janus Kinase Inhibitors Dominate the Axial Spondyloarthritis Pipeline
2.5 What Do Physicians Think?
3 Introduction
3.1 Catalyst
3.2 Related Reports
3.3 Upcoming Related Reports
4 Disease Overview
4.1 Etiology and Pathophysiology
4.1.1 Etiology
4.1.2 Pathophysiology
4.2 Classification or Staging Systems
5 Epidemiology
5.1 Disease Background
5.2 Risk Factors and Comorbidities
5.3 Global and Historical Trends
5.4 Forecast Methodology
5.4.1 Sources
5.4.2 Forecast Assumptions and Methods, Diagnosed Prevalent Cases of AS - Base Scenario
5.4.3 Forecast Assumptions and Methods, Diagnosed Prevalent Cases of Nr-axSpA - Base Scenario
5.4.4 Forecast Assumptions and Methods, Diagnosed Prevalent Cases of AS - Alternative Scenario
5.4.5 Forecast Assumptions and Methods, Diagnosed Prevalent Cases of Nr-axSpA - Alternative Scenario
5.4.6 Forecast Assumptions and Methods, HLA-B27 Seropositivity Among Diagnosed AS Patients
5.5 Epidemiological Forecast for AS and Nr-axSpA (2018-2028) - Base Scenario
5.5.1 Diagnosed Prevalent Cases of AS
5.5.2 Diagnosed Prevalent Cases of Nr-axSpA
5.6 Epidemiological Forecast for AS and Nr-axSpA (2018-2028) - Alternative Scenario
5.6.1 Diagnosed Prevalent Cases of AS
5.6.2 Age-Specific Diagnosed Prevalent Cases of AS
5.6.3 Sex-Specific Diagnosed Prevalent Cases of AS
5.6.4 Diagnosed Prevalent Cases of AS by HLA-B27 Seropositivity
5.6.5 Diagnosed Prevalent Cases of Nr-axSpA
5.6.6 Age-Specific Diagnosed Prevalent Cases of Nr-axSpA
5.6.7 Sex-Specific Diagnosed Prevalent Cases of Nr-axSpA
5.7 Discussion
5.7.1 Epidemiological Forecast Insight
5.7.2 Limitations of the Analysis
5.7.3 Strengths of the Analysis
6 Disease Management in APAC
6.1 Diagnosis and Treatment Overview
6.2 India
6.3 China
6.4 Australia
6.5 South Korea
6.6 Japan
7 Competitive Assessment
8 Unmet Needs and Opportunity Assessment in APAC
10 Current and Future Players in APAC
11 APAC Markets
12 Appendix

List Of Tables

Table 1: Axial Spondyloarthritis: Key Metrics in the 5GM
Table 2: Risk Factors and Comorbidities for AS
Table 3: Treatment Guidelines for AxSpA
Table 4: Country Profile - India
Table 5: Country Profile - China
Table 6: Country Profile - Australia
Table 7: Country Profile - South Korea
Table 8: Country Profile - Japan
Table 9: Leading Treatments for Axial Spondyloarthritis, 2020
Table 10: Average Percent Discount on Biosimilars Compared to Biologic Reference Products Across the 5GM, 2019
Table 11: AbbVies AxSpA Portfolio Assessment, 2020
Table 12: Pfizers AxSpA Portfolio Assessment, 2020
Table 13: J&Js AxSpA Portfolio Assessment, 2020
Table 14: UCBs AxSpA Portfolio Assessment, 2020
Table 15: Novartis AxSpA Portfolio Assessment, 2020
Table 16: Eli Lillys AxSpA Portfolio Assessment, 2020
Table 17: Kyowa Hakko Kirins AxSpA Portfolio Assessment, 2020
Table 18: Axial Spondyloarthritis Market - APAC Drivers and Barriers, 2018-2028
Table 19: Key Events Impacting Sales for Axial Spondyloarthritis in India, 2018-2028
Table 20: Axial Spondyloarthritis Market - Drivers and Barriers in India, 2018-2028
Table 21: Key Events Impacting Sales for Axial Spondyloarthritis in China, 2018-2028
Table 22: Axial Spondyloarthritis Market - Drivers and Barriers in China, 2018-2028
Table 23: Key Events Impacting Sales for AxSpA in Australia, 2018-2028
Table 24: AxSpA Market - Drivers and Barriers in Australia, 2018-2028
Table 25: Key Events Impacting Sales for Axial Spondyloarthritis in South Korea, 2018-2028
Table 26: AxSpA Market - Drivers and Barriers in South Korea, 2018-2028
Table 27: Key Events Impacting Sales for Axial Spondyloarthritis in Japan, 2018-2028
Table 28: AxSpA Market - Drivers and Barriers in Japan, 2018-2028
Table 29: Key Historical and Projected Launch Dates for Axial Spondyloarthritis
Table 30: Key Historical and Projected Patent Expiry Dates for Axial Spondyloarthritis
Table 31: High-Prescribing Physicians (non-KOLs) Surveyed, By Country

List Of Figures

Figure 1: Global Sales Forecast by Country for Axial Spondyloarthritis in 2018 and 2028
Figure 2: Analysis of the Company Portfolio Gap in Axial Spondyloarthritis During the Forecast Period
Figure 3: Competitive Assessment of the Late-Stage Pipeline Agents That GlobalData Expects to Be Licensed for the Treatment of Axial Spondyloarthritis During the Forecast Period
Figure 4: Pathogenic Mechanisms of Axial Spondyloarthritis
Figure 5: 5GM, Diagnosed Prevalence (%) of AxSpA, Both Sexes, Ages 18 Years, 2008-2028 - Base Scenario
Figure 6: 5GM, Sources Used, Diagnosed Prevalent Cases of AS - Base Scenario
Figure 7: 5GM, Sources Used, Diagnosed Prevalent Cases of Nr-axSpA - Base Scenario
Figure 8: 5GM, Sources Used, Diagnosed Prevalent Cases of AS - Alternative Scenario
Figure 9: 5GM, Sources Used, Diagnosed Prevalent Cases of Nr-axSpA - Alternative Scenario
Figure 10: 5GM, Sources Used, HLA-B27 Seropositivity Data Among the Diagnosed Prevalent Cases of AS - Alternative Scenario
Figure 11: 5GM, Diagnosed Prevalent Cases of AS, Ages 18 Years, Both Sexes, N, 2018 - Base Scenario
Figure 12: 5GM, Diagnosed Prevalent Cases of Nr-axSpA, Ages 18 Years, Both Sexes, N, 2018 - Base Scenario
Figure 13: 5GM, Diagnosed Prevalent Cases of AS, Ages 18 Years, Both Sexes, N, 2018 - Alternative Scenario
Figure 14: 5GM, Age-Specific Diagnosed Prevalent Cases of AS, Both Sexes, N, 2018 - Alternative Scenario
Figure 15: 5GM, Sex-Specific Diagnosed Prevalent Cases of AS, Ages 18 Years, N, 2018 - Alternative Scenario
Figure 16: 5GM, Diagnosed Prevalent Cases of AS by HLA-B27 Seropositivity, Ages 18 Years, Both Sexes, N, 2018 - Alternative Scenario
Figure 17: 5GM, Diagnosed Prevalent Cases of Nr-axSpA, Ages 18 Years, Both Sexes, N, 2018 - Alternative Scenario
Figure 18: 5GM, Age-Specific Diagnosed Prevalent Cases of Nr-axSpA, Both Sexes, N, 2018 - Alternative Scenario
Figure 19: 5GM, Sex-Specific Diagnosed Prevalent Cases of Nr-axSpA, Ages 18 Years, N, 2018 - Alternative Scenario
Figure 20: Flowchart of the Diagnosis and Management of Axial Spondyloarthritis
Figure 21: Unmet Needs and Opportunities in AxSpA
Figure 22: Overview of the Development Pipeline for AxSpA
Figure 23: Key Phase II/III Trials for the Promising Pipeline Agents that GlobalData Expects to Be Licensed for AxSpA in the Five Growth Markets in Asia-Pacific During the Forecast Period
Figure 24: Competitive Assessment of the Late-Stage Pipeline Agents that GlobalData Expects to Be Licensed for the Treatment of AxSpA in the Five Growth Markets in Asia-Pacific During the Forecast Period
Figure 25: Analysis of the Company Portfolio Gap in AxSpA in the 5GM, During the Forecast Period
Figure 26: APAC (5GM) Sales Forecast by Country for Axial Spondyloarthritis in 2018 and 2028
Figure 27: Sales Forecast by Class for Axial Spondyloarthritis in India in 2018 and 2028
Figure 28: Sales Forecast by Class for Axial Spondyloarthritis in China in 2018 and 2028
Figure 29: Sales Forecast by Class for Axial Spondyloarthritis in Australia in 2018 and 2028
Figure 30: Sales Forecast by Class for Axial Spondyloarthritis in South Korea in 2018 and 2028
Figure 31: Sales Forecast by Class for Axial Spondyloarthritis in Japan in 2018 and 2028

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