Acute coronary syndrome (ACS)─an umbrella term that encompasses acute ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and unstable angina─is a leading cause of morbidity and mortality in the developed world. We focus on two specific settings in the treatment of ACS: the acute hospital setting and the 12-month posthospital setting in the seven major pharmaceutical markets we cover (United States, France, Germany, Italy, Spain, United Kingdom, and Japan). In the acute setting, where injectable anticoagulants, thrombolytics, and glycoprotein (gp) IIb/IIIa inhibitors dominate, the market is set to suffer a decline in sales due to the generic erosion of key brands and a lack of novel drugs launching. The 12-month posthospital ACS market, which is dominated by oral antiplatelet agents, is currently seen by drug developers as a potentially more-lucrative source of sales compared with the acute setting. Indeed, this market is set to see the launch of ten add-on or replacement therapies during the forecast period.
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