Heart Failure – Landscape & Forecast – Disease Landscape & Forecast
Heart failure (HF) is classified as acute or chronic, and both settings are the focus of this report. Although much progress has been made in the pharmacological management of HF, it mainly relates to chronic HF (CHF), particularly HF with reduced ejection fraction (HFrEF); significant unmet need remains in the treatment of HF with preserved ejection fraction (HFpEF). Additionally, the treatment of acute HF (AHF) is dominated by old, generic products. This report provides insights into the current and future CHF and AHF therapy markets, the performance of current market leader, Entresto, and the expected dynamics of the HFrEF and HFpEF therapy markets following the entries of several new therapies (Boehringer Ingelheim / Eli Lilly’s Jardiance, AstraZeneca’s Farxiga, Bayer / Merck Sharp & Dohme’s vericiguat, Cytokinetics’ omecamtiv mecarbil, and Bayer’s finerenone). This report also assesses how the AHF therapy market will evolve given the lack of new drug launches in this patient population.
QUESTIONS ANSWERED
- How large are the treatable AHF, HFrEF, and HFpEF populations, and how will diagnosis rates change over time?
- What is the state of treatment for heart failure? What are the most important drugs and why? What clinical needs remain unfulfilled?
- How will the use of Entresto evolve over the forecast period?
- How will the treatment of HFpEF change following the launches of the first evidence-based drugs for this population?
- For which emerging therapies do thought leaders express the most enthusiasm, and what level of market penetration can they expect?
GEOGRAPHIES
United States, EU5, Japan.
PRIMARY RESEARCH
20 country-specific interviews with thought-leading cardiologists; supported by survey data collected for this and other Clarivate research.
EPIDEMIOLOGY
Diagnosed events of AHF by country and diagnosed prevalence of CHF by country, segmented by ejection fraction.
FORECAST
10-year, annualized, drug-level sales and patient shares of key HF therapies through 2029, segmented by brands / generics and ejection fraction (HFrEF and HFpEF).
EMERGING THERAPIES
Phase III/PR: 5 drugs; Phase II: 10 drugs.
PRODUCT DESCRIPTION
Disease Landscape & Forecast provides comprehensive market intelligence with world-class epidemiology, keen insight into current treatment paradigms, in-depth pipeline assessments, and drug forecasts supported by detailed primary and secondary research.
SOLUTION ENHANCEMENT
Disease Landscape & Forecast features continual updates to provide timely insights and analyses as meaningful indication-specific news and events unfold. Additionally, Disease Landscape & Forecast introduces a new Drug Pipeline chapter with real-time, global pipeline intelligence content directly from Cortellis. This chapter is updated daily and features interactive figures that can be easily downloaded for detailed analysis or presentations.
Table of contents
- Heart Failure - Landscape & Forecast - Disease Landscape & Forecast
- Key findings
- Heart Failure Key findings: December 2022
- Key updates
- Q4 2022
- December 2022
- Q3 2022
- September 2022
- August 2022
- July 2022
- Q2 2022
- May 2022
- May 2022
- Q1 2022
- March 2022
- February 2022
- January 2022
- Q4 2022
- Market outlook
- Key findings
- Market share of drug classes for acute heart failure: 2021
- Market share of drug classes for acute heart failure: 2031
- Market share of drug classes for chronic heart failure: 2021
- Market share of drug classes for chronic heart failure: 2031
- Heart failure SWOT analysis
- Market drivers and constraints
- What factors are driving the market for heart failure?
- What factors are constraining the market for heart failure?
- Patient share of AHF drug classes in the major pharmaceutical markets: 2021-2031
- Patient share of HFrEF drug classes in the major pharmaceutical markets: 2021-2031
- Patient share of HFpEF drug classes in the major pharmaceutical markets: 2021-2031
- Drug-class-specific trends
- Major-market patient share of RAAS-blocking agents in CHF: 2021-2031
- Patient share of sacubitril/valsartan in HFrEF by country/region: 2021-2031
- Sales of branded sacubitril / valsartan by country/region: 2021-2031
- Total major-market patient share of SGLT-2 inhibitors in HFrEF: 2021-2031
- Total major-market patient share of SGLT-2 inhibitors in HFpEF: 2021-2031
- United States sales of SGLT-2 inhibitors in CHF: 2021-2031
- Europe sales of SGLT-2 inhibitors in CHF: 2021 -2031
- Japan sales of SGLT-2 inhibitors in CHF: 2021 - 2031
- Patient Share of vericiguat in HFrEF by Market: 2021-2031
- Sales of vericiguat by country/region: 2021-2031
- Patient share of omecamtiv mecarbil, by market: 2021-2031
- Sales of omecamtiv mecarbil by country/region: 2021-2031
- Key findings
- Forecast
- Market Forecast Assumptions - AHF (2021 -2031) - November 2022
- Market Forecast Assumptions - CHF (2021-2031) - November 2022
- Market Forecast Dashboard - AHF (2021-2031) - November 2022
- Market Forecast Dashboard - CHF (2021-2031) - November 2022
- Etiology and pathophysiology
- Disease overview
- Etiology
- Most common causes of heart failure
- Pathophysiology
- Pathological ventricular remodeling in HFpEF and HFrEF
- Compensatory mechanisms in the heart
- Development of heart failure
- Staging of heart failure
- ACC/AHA prognostic classification system and the NYHA system
- Key pathways and drug targets
- Drug targets in heart failure
- Disease overview
- Epidemiology
- Key findings
- Epidemiology populations
- Diagnosed events of acute heart failure in the major mature pharmaceutical markets: 2021-2031
- Disease definition and methods and sources used
- Diagnosed prevalent cases of chronic heart failure in the major mature pharmaceutical markets: 2021-2031
- Disease definition and methods and sources used
- Number of diagnosed prevalent cases of chronic heart failure in the major pharmaceutical markets by NYHA functional class: 2021-2031
- Disease definition and methods and sources used
- Number of diagnosed prevalent cases of chronic heart failure in the major pharmaceutical markets classified by ejection fraction: 2021-2031
- Sources used for drug-treated prevalent cases of CHF and events of AHF
- Drug-treated prevalent cases of chronic heart failure
- Drug-treated events of acute heart failure
- Key findings
- Current treatment
- Key findings
- Treatment goals
- Key endpoints used in clinical trials for acute heart failure
- Key endpoints used in clinical trials for chronic heart failure
- Key current therapies
- Overview
- Mechanism of action of key current drug classes used for acute and chronic heart failure
- Current treatments used for acute heart failure
- Current treatments used for chronic heart failure
- Advantages and disadvantages of loop diuretics
- Expert insight: loop diuretics
- Advantages and disadvantages of nitrate vasodilators
- Expert insight: nitrate vasodilators
- Advantages and disadvantages of inotropic sympathomimetics
- Expert insight: inotropic sympathomimetics
- Advantages and disadvantages of phosphodiesterase 3 inhibitors
- Expert insight: phosphodiesterase 3 inhibitors
- Advantages and disadvantages of natriuretic peptide receptor agonists
- Expert insight: natriuretic peptide receptor agonists
- Advantages and disadvantages of calcium sensitizers
- Expert insight: calcium sensitizers
- Advantages and disadvantages of ACE inhibitors
- Expert insight: ACE inhibitors
- Advantages and disadvantages of AIIRAs / ARBs
- Expert insight: angiotensin II receptor blockers
- Advantages and disadvantages of sacubitril / valsartan
- Expert insight: sacubitril / valsartan
- Advantages and disadvantages of beta blockers
- Expert insight: beta blockers
- Advantages and disadvantages of mineralocorticoid receptor antagonists
- Expert insight: mineralocorticoid receptor antagonists
- Advantages and disadvantages of digitalis glycosides
- Expert insight: digitalis glycosides
- Advantages and disadvantages of ivabradine
- Expert insight: ivabradine
- Advantages and disadvantages of vasodilator combination therapies
- Expert insight: vasodilator combination therapies
- Advantages and disadvantages of vasopressin receptor antagonists
- Expert insight: vasopressin receptor antagonists
- Advantages and disadvantages of empagliflozin
- Expert insight: empagliflozin
- Expert insight: dapagliflozin
- Advantages and disadvantages of dapagliflozin
- Medical practice
- Overview
- Factors influencing drug selection in heart failure
- Treatment decision tree for acute heart failure: United States
- Treatment decision tree for chronic heart failure: United States
- Treatment decision tree for acute heart failure: Europe
- Treatment decision tree for chronic heart failure: Europe
- Treatment decision tree for acute heart failure: Japan
- Treatment decision tree for chronic heart failure: Japan
- Key findings
- Unmet need overview
- Current and future attainment of unmet needs in heart failure
- Top unmet needs in heart failure: current and future attainment
- Expert insight: unmet need in heart failure
- Drug pipeline
- Pipeline
- Regulatory Milestones
- Indication Comparison
- Emerging therapies
- Key findings
- Key emerging therapies
- Notable developments among key emerging therapies for heart failure
- Key therapies in development for heart failure
- Estimated launch dates of key emerging therapies for the treatment of heart failure
- Istaroxime profile
- Analysis of clinical development program for istaroxime
- Expectations for launch and sales opportunity of istaroxime in heart failure
- Tirzepatide profile
- Analysis of the clinical development program for tirzepatide
- Expert insight: tirzepatide
- Expectations for launch and sales opportunity of tirzepatide in heart failure
- Vericiguat profile
- Analysis of clinical development program for vericiguat
- Expert insight: vericiguat
- Expectations for launch and sales opportunity of vericiguat in heart failure
- Sotagliflozin profile
- Analysis of the clinical development program for sotagliflozin
- Expert insight: sotagliflozin
- Expectations for launch and sales opportunity of sotagliflozin in heart failure
- Omecamtiv mecarbil profile
- Analysis of clinical development program for omecamtiv mecarbil
- Expert insight: omecamtiv mecarbil
- Expectations for launch and sales opportunity of omecamtiv mecarbil in heart failure
- Finerenone profile
- Analysis of the clinical development program for finerenone
- Expert insight: finerenone
- Expectations for launch and sales opportunity of finerenone in heart failure
- Analysis of clinical development program for stem cell therapies
- Expert insight: stem cell therapies
- Expectations for launch and sales opportunity of stem cell therapies in heart failure
- Early-phase pipeline analysis
- Select compounds in early-phase development for heart failure
- Key discontinuations and failures in heart failure
- Key findings
- Access & reimbursement overview
- Region-specific reimbursement practices
- Key market access considerations in heart failure: United States
- General reimbursement environment: United States
- Key market access considerations in heart failure: EU5
- General reimbursement environment: EU5
- Key market access considerations in heart failure: Japan
- General reimbursement environment: Japan
- Region-specific reimbursement practices
- Appendix
- Heart failure bibliography
- Abbreviations
- Key findings
Dwaipayan Chatterjee, M.Pharm., Senior Healthcare Research & Data Analyst, Cardiovascular, Metabolic, Renal, and Hematologic (CMRH) Disorders analyst. Mr. Chatterjee authors reports on metabolic and cardiovascular indications. Previously, he was an equity analyst for the U.S. healthcare sector with Market Realist, where he worked on competitive intelligence and analysis of financial data. He was also a market research analyst for Mordor Intelligence, where he gained experience in market sizing, forecasting, and analyzing market dynamics. He holds a master’s degree with a specialization in pharmaceutical chemistry from the Birla Institute of Technology & Science in Pilani, India.
Sunali D. Goonesekera, S.M., Senior Manager, Epidemiology. Prior to joining Clarivate, Ms. Goonesekera conducted epidemiological research on racial/ethnic disparities in metabolic diseases at the New England Research Institute and lead-authored two manuscripts. She has contributed to multiple publications in peer-reviewed journals in epidemiology and the biological sciences. She holds a master’s degree in epidemiology from the Harvard School of Public Health and a B.A. in biology (Honors) from Dartmouth College.