Decision Resources Group has found the market for Alzheimer's disease (AD) therapies will more than triple, reaching nearly $12 billion by 2023, largely due to the forecasted launch of the first disease-modifying therapies (DMTs), a landmark event in AD treatment.

In 2023, these novel premium-priced agents—which include the anti-beta-amyloid monoclonal antibodies solanezumab (Eli Lilly) and gantenerumab (Roche), as well as the BACE inhibitor MK-8931 (Roche/Chugai/MorphoSys)—will earn sales of $7 billion in the U.S., France, Germany, Italy, Spain, U.K. and Japan.

Other key findings from the Pharmacor report Alzheimer's Disease:

• A new symptomatic alternative: Lundbeck/Otsuka's novel 5HT-6 receptor   antagonist, Lu-AE58054, will launch as an adjunctive symptomatic treatment for AD and achieve blockbuster sales within the forecast period, capturing nearly 10% of major-market sales in 2023.
• Population growth: The surging prevalence of AD as the population ages will drive growth across the major markets. We also expect diagnosis and drug-treatment rates to rise modestly in the pre-AD 1-2 years (those patients who will go on to develop AD within the next one to two years) and mild AD patient segments as DMTs and new diagnostic technologies gradually gain traction.
• Current agents stay relevant: Today's clinical mainstays deliver modest symptomatic efficacy and do not affect disease progression but will remain the foundation of treatment throughout the forecast period—aided, in part by growing generic availability. It forecast acetylcholinesterase inhibitors (AChEIs) will continue to capture over 70% total patient share (across all AD subpopulations) in 2023, while NMDA receptor antagonist products, including Forest's Namenda/Namenda XR, will continue to capture approximately 35% patient share.

"The projected launch of Eli Lilly's solanezumab, potentially the first ever DMT approved for the treatment of AD, will be a transformative event affecting the AD market as early as 2018,” said Decision Resources Group analyst Alana Simorellis, Ph.D. “We expect future DMTs will most likely see the greatest uptake in the pre-AD and mild AD populations. Moreover, experts interviewed note that new symptomatic options also are sorely needed."

"While AD drug development is understandably focused on disease modification, there exists an important area of additional unmet need for safer, more-effective symptomatic therapies that can control the behavior disturbances associated with later-stage AD,” said Simorellis. “Development in this arena is underway, with clinical trials assessing promising agents like Lundbeck/Otsuka's brexpiprazole for AD-associated agitation."

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