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Commercial Insight: Osteoporosis ' Market players maximize
revenue growth before the next challenging phase
Published on July 2010

                                                                                                                               Report Summary

Introduction


Globally, the osteoporosis market displayed a 3.5% compound annual growth rate (CAGR) between 2005'09, reaching $9.4 billion in
2009. However, the launch of generic alendronate in the majority of markets resulted in a temporary decline in sales during 2009. The
market will stabilize during the next 5 years due to generic incursion and then resume growth from 2015 as new drugs are launched.


Scope


Analysis of global osteoporosis prescriptions from 2005'09, split by geographical region (including emerging markets), drug class, and
brand.Discussion of key commercial opportunities and threats in the US, Japan, and five major European markets. In depth profiles of
13 key osteoporosis brands and pipeline agents with SWOT analyses and country-specific sales forecasts to 2019. Detailed analysis
of key developer trends, strategies and portfolios including a case study of Novartis's Aclasta (zoledronic acid).


Highlights


The rest of world, outside of the seven major markets, achieved osteoporosis-specific sales of $2.4 billion in 2009 with an impressive
CAGR of 8.7% from 2005. Brazil, Russia, India and China were the fastest growing nations, driving a combined 2005'09 CAGR of
17%.


The osteoporosis market offers multiple opportunities for current and future market players. In addition to increasing awareness,
diagnosis and treatment, there is the need to develop new drugs that promote bone building. However, the increase in cost pressure
resulting from generic penetration poses a major barrier to entry.


Leading market players continue to pursue their direct-to-consumer advertising campaigns, sponsoring events to raise awareness of
the disorder and of respective treatments. Innovative strategies to increase brand loyalty and confidence, such as risk-sharing
schemes, have also been implemented by Novartis and Sanofi-Aventis.


Reasons to Purchase


Understand historical (2005'09) and future (2010'19) osteoporosis drug market dynamics and competitive environment.Gain insight
into the main opportunities and threats specific to the osteoporosis market.Evaluate the sales forecasts of marketed, generic, and key
pipeline drugs to 2019 in the US, Japan, France, Germany, Italy, Spain, and the UK.




                                                                                                                                Table of Content

OVERVIEW 1
Catalyst 1


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Summary 1
EXECUTIVE SUMMARY 2
Strategic scoping and focus 2
Datamonitor insight into the osteoporosis market 2
Related reports 4
Upcoming related reports 4
Table of Contents 5
MARKET DEFINITION 6
Market definition for this report 6
MARKET OVERVIEW 8
Seven major markets 9
Current and future market overview 9
Despite a recent setback the osteoporosis market will resume growth 9
Regional dynamics: the US is set to remain the largest major market but Japan and the EU are also growing 11
Anatomical Therapeutic Chemical (ATC) class dynamics 14
Brand splits 17
Opportunities and threats 22
Opportunity one: anabolic drugs still needed 23
Opportunity two: the male osteoporosis market remains underdeveloped 25
Opportunity three: aging population increases osteoporosis population 27
Opportunity four: raising awareness remains critical to expand the patient population 29
Opportunity five: as patent expiries near there will be reduced marketing competition 33
Threat one: the osteoporosis market is becoming highly genericized, increasing cost competitiveness 33
US 36
Current and future market assessment 36
Despite new drug launches US market growth will slow down 36
Bisphosphonates will remain the largest osteoporosis drug class in the US 37
Brand dynamics 38
Opportunities and threats 42
Opportunity one: the US healthcare reform increases the treatable patient population 42
Opportunity two: the US health reform aims to close the donut hole 43
Opportunity three: risk-sharing schemes increase brand loyalty 44
Threat one: speed to market in the US is greatly reduced as FDA increases scrutiny 44
Threat two: FDA tightens marketing controls in the US 45
Japan 45
Current and future market assessment 45
Japanese market set to grow after new drug launches 45
Opportunities and threats 51
Opportunity one: launch of new drugs 51
Opportunity two: training of physicians 52
Opportunity three: partnerships with Japanese Pharma companies is beneficial 52
Threat 1: Cost cutting policies 53
Five major EU markets 53
Current and future market assessment 53
Italy and Spain are the fastest growing osteoporosis markets in the five major EU region 53
Anabolic drugs and new drug classes drive market growth 56
Opportunities and threats 62
Opportunity one: osteoporosis remains a priority in the European Union 62
Threat one: in Germany, reimbursement of treatment and diagnostic scans remains limited 64
Threat two: German government increases the pressure to manage the cost of healthcare with NICE equivalent 65


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Threat three: NICE continues to restrict drug access in the UK in favor of alendronate 66
France 67
Current and future market assessment 67
Germany 73
Current and future market assessment 73
Italy 78
Current and future market assessment 78
Spain 83
Current and future market assessment 83
UK 88
Current and future market assessment 88
Rest of the world snapshot 93
Current market assessment 93
The global osteoporosis market shrank in 2009 93
The rest of the world accounted for 26% of the global osteoporosis market in 2009 93
The rest of the world outstrips the seven major markets in terms of volume 95
BRIC and Canada were the only markets to display growth between 2008 and 2009 97
Bisphosphonates and calcium dominate the rest of the world osteoporosis market but anabolic drugs are the fastest growing 99
BRAND DYNAMICS 103
Overview of competitive landscape 103
Patient acquisition process 104
Introduction 104
Patient care path 104
Points of influence in the patient care path 106
Trigger point one: osteoporosis prevention 106
Trigger point two: disease severity influences osteoporosis treatment 106
Trigger point three: compliance issues and fractures 107
Drivers of drug choice 107
US formulary tier status for leading brands 109
EU osteoporosis reimbursement policies 110
Trends in marketing strategies 111
Marketing strategy for leading brands 111
Sponsorship/disease awareness campaigns 111
Direct-to-consumer advertising 112
Bisphosphonates: Fosamax/Fosamax Plus D (alendronate; Merck & Co) 114
Drug profile 114
Alendronate generics still available in Europe despite 2006 European Patent Office ruling 115
Product positioning 115
Fosamax is positioned as the market gold standard 115
SWOT analysis 116
Brand forecast to 2019 117
Fosamax Plus D fails to maintain market share upon alendronate generic penetration in the US 118
Bisphosphonates: Actonel/Actonel with Calcium (risedronic acid; Sanofi-Aventis/Warner Chilcott) 119
Drug profile 119
Product positioning 121
Actonel is commonly positioned as a first-line alternative to Fosamax 121
SWOT analysis 121
Brand forecast to 2019 122
Bisphosphonates: Bonviva/Boniva (ibandronic acid; Roche/GlaxoSmithKline) 125
Drug profile 125


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Product positioning 126
Bonviva caters for two different types of patients 126
Bonviva sales remain lower than other bisphosphonates due to lack of non-vertebral fracture protection data 127
SWOT analysis 127
Brand forecast to 2019 128
Bisphosphonates: Aclasta (zoledronic acid; Novartis) 131
Drug profile 131
Product positioning 132
First yearly osteoporosis therapy tackles compliance issues 132
SWOT analysis 132
Brand forecast to 2019 132
Bisphosphonates: Bonoteo/Recalbon (minodronic acid; Astellas/Ono Pharmaceutical) 134
Drug profile 134
Product positioning 135
SWOT analysis 136
Brand forecast to 2019 136
Selective estrogen receptor modulators: Evista (raloxifene; Eli Lilly) 137
Drug profile 137
Product positioning 138
Evista is positioned as a treatment for mild osteoporosis and osteopenia 138
SWOT analysis 139
Brand forecast to 2019 140
Selective estrogen receptor modulators: Conbriza/Viviant (bazedoxifene; Pfizer) 142
Drug overview 142
Product positioning 143
Should Conbriza launch it will be the second SERM to reach the osteoporosis market 143
Conbriza is likely to be positioned as a follow-on therapy to Aprela 143
SWOT analysis 144
Brand forecast to 2019 144
Selective estrogen receptor modulators: Fablyn (lasofoxifene; Pfizer/Ligand) 146
Drug overview 146
Product positioning 147
Physicians are unlikely to prescribe Fablyn over Evista 147
SWOT analysis 147
Brand forecast to 2019 148
Parathyroid hormones: Forteo (teriparatide; Eli Lilly) 150
Drug profile 150
Product positioning 151
Forteo remains positioned to treat severe osteoporosis patients due to it high cost 151
SWOT analysis 152
Brand forecast to 2019 152
Parathyroid hormones: Preotact (full-length parathyroid hormone PTH 1-84; NPS/Nycomed) 154
Drug profile 154
Product positioning 154
SWOT analysis 155
Brand forecast to 2019 155
Dual acting bone agents: Protelos (strontium ranelate; Servier) 157
Drug profile 157
Product positioning 157
Protelos uniquely combines anabolic and antiresorptive action 157


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SWOT analysis 158
Brand forecast to 2019 159
Calcitonins: Miacalcic (calcitonin-salmon; Novartis) 160
Drug profile 160
Product positioning 161
SWOT analysis 161
Brand forecast to 2019 161
Calcitonins: Fortical (calcitonin-salmon; Unigene) 163
Drug profile 163
Product positioning 164
SWOT analysis 164
Brand forecast to 2019 164
Pipeline drugs: Prolia (denosumab; Amgen/GlaxoSmithKline) 166
Drug profile 166
Development overview 167
Product positioning 169
SWOT analysis 169
Drug forecast to 2019 170
Pipeline drugs: Eldecalcitol (ED-71; Chugai/Taisho) 171
Product positioning 174
SWOT analysis 174
Drug forecast to 2019 174
KEY DEVELOPERS 176
Strategic overview 176
Trends in corporate strategy 176
Intermittent dosing 176
Differentiation remains key to success 176
Innovative lifecycle management strategies 176
Recent strategic partnerships/deals 177
Offsetting of lack of research with deals 177
Merck & Co 179
Corporate strategy 179
Osteoporosis portfolio assessment 179
Eli Lilly 180
Corporate strategy 180
Osteoporosis portfolio assessment 180
Portfolio assessment of other leading companies 181
Novartis: continued interest in the market is reflected in the pipeline activity 181
GlaxoSmithKline: deal with Amgen allows GlaxoSmithKline to keep market share 182
Pfizer: Wyeth acquisition allows Pfizer to finally enter this market 183
CASE STUDIES 184
Aclasta: the market leader that never was 184
Once yearly addresses compliance, but mode of administration limits use 185
Access to Aclasta remains problematic in many major markets 186
Overall the cost for Aclasta does not exceed other bisphosphonate therapies 186
Reimbursement policies can affect the frequency with which the drug is used 188
Patient and physician education 188
BIBLIOGRAPHY 190
Journal papers 190
Websites 192


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Datamonitor reports 196
Conferences attended 196
APPENDIX A 197
MARKET ASSUMPTIONS 197
New product launches and expiries 197
Data definitions, limitations and assumptions 200
Standard units 200
Country group definitions 200
Rest of European Union 200
Middle East and North Africa (MENA) 200
Rest of World 200
Derivation of sales forecasts and pricing trends 200
Indication-specific sales calculations 201
Caveats to using Prescribing insight 201
Forecast methodology 201
APPENDIX B 202
Contributing experts 202
Conferences attended 202
Report methodology 202
About Datamonitor 202
About Datamonitor Healthcare 203
About the Genitourinary analysis team 203
Disclaimer 205
List of Tables
Table 1: Summary of therapeutic classes in osteoporosis by Anatomical Therapeutic Chemical (ATC) code, 2009 6
Table 2: Summary of the ICD-10 codes used to derive osteoporosis-specific sales from each brand 7
Table 3: Regional osteoporosis market value sales ($m) in the seven major markets, 2005-2019 13
Table 4: Anatomical Therapeutic Chemical (ATC) class sales dynamics ($m) in osteoporosis across the seven major markets,
2005-2019 17
Table 5: Osteoporosis brand sales ($m) dynamics across the seven major markets, 2009-2019 18
Table 6: Key events impacting the osteoporosis market, by region, 2010-2019 22
Table 7: Osteoporosis global market opportunities and threats, 2010-2019 22
Table 8: Summary of key osteoporosis drug patent expiries in the seven major markets, 2010-2020 34
Table 9: Prices of key osteoporosis drugs in the US and the five major EU markets, 2009 35
Table 10: Osteoporosis sales ($m) dynamics in the US by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 38
Table 11: Osteoporosis brand sales ($m) dynamics in the US, 2009-2019 39
Table 12: Osteoporosis market opportunities and threats in the US, 2010-2019 42
Table 13: Uninsured osteoporosis population in the US aged 50-64 years, 2010 43
Table 14: Medicare payments, 2009 43
Table 15: Price per year ($) of key osteoporosis brands in the US, 2009 44
Table 16: Osteoporosis sales ($m) dynamics in Japan by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 47
Table 17: Osteoporosis brand sales ($m) dynamics in Japan, 2009-2019 48
Table 18: Osteoporosis market opportunities and threats in Japan, 2010-2019 51
Table 19: Osteoporosis sales ($m) dynamics in the five major EU markets, 2005-2019 55
Table 20: Osteoporosis sales ($m) dynamics in the five major EU markets by Anatomical Therapeutic Chemical (ATC) class,
2005-2019 58
Table 21: Osteoporosis brand sales ($m) dynamics in the five major EU markets, 2009-2019 59
Table 22: Osteoporosis market opportunities and threats in the five major EU markets, 2010-2019 62
Table 23: Implementation of EU recommendations in the five major EU markets, 2008 64
Table 24: Osteoporosis sales ($m) dynamics in France by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 68


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Table 25: Osteoporosis sales forecasts in France ($m), 2009-2019 70
Table 26: Osteoporosis sales ($m) dynamics in Germany by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 73
Table 27: Osteoporosis sales forecasts in Germany ($m), 2009-2019 75
Table 28: Osteoporosis sales ($m) dynamics in Italy by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 78
Table 29: Osteoporosis sales forecasts in Italy ($m), 2009-2019 80
Table 30: Osteoporosis sales ($m) dynamics in Spain by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 83
Table 31: Osteoporosis sales forecasts in Spain ($m), 2009-2019 85
Table 32: Osteoporosis sales ($m) dynamics in the UK by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 88
Table 33: Osteoporosis sales forecasts in the UK ($m), 2009-2019 90
Table 34: Global sales ($m) dynamics of the osteoporosis market, 2005-09 95
Table 35: Regional split of the global osteoporosis market sales, 2005-09 99
Table 36: Rest of the world osteoporosis sales by Anatomical Therapeutic Chemical (ATC) class, 2005-09 102
Table 37: Leading branded drug sales for osteoporosis in the seven major markets ($m), 2009-2019 103
Table 38: Key products in late-stage R&D pipeline for osteoporosis, 2010 104
Table 39: Results from the Timeless Woman Study, 2008 109
Table 40: Representative formulary tier status in the US for leading brands in osteoporosis, 2010 109
Table 41: EU osteoporosis treatment reimbursement policies, 2008 110
Table 42: Marketing strategies employed by the companies behind the top three pain market brands, 2010 111
Table 43: Fosamax (alendronate; Merck & Co.): key facts, 2010 115
Table 44: Impacting factors on the revenues of the Fosamax brand franchise (alendronate; Merck & Co), 2010-2019 118
Table 45: Actonel (risedronic acid; Sanofi-Aventis/Warner Chilcott): key facts, 2010 120
Table 46: Impacting factors on the revenues of the Actonel brand franchise, 2010-2019 124
Table 47: Bonviva (ibandronic acid; Roche/GlaxoSmithKline): key facts, 2010 125
Table 48: Impacting factors on the revenues of the Bonviva brand franchise, 2010-2019 130
Table 49: Aclasta (zoledronic acid; Novartis): key facts, 2010 131
Table 50: Impacting factors on the revenues of Aclasta, 2010-2019 133
Table 51: Bonoteo (minodronic acid; Astellas/Ono Pharmaceutical): key facts, 2010 134
Table 52: Evista: key facts, 2010 138
Table 53: Impacting factors on the revenues of Evista, 2010-2019 141
Table 54: Conbriza (bazedoxifene; Pfizer): key facts, 2010 142
Table 55: Impacting factors on the revenues of Conbriza, 2010-2019 145
Table 56: Fablyn (lasofoxifene; Pfizer/Ligand): key facts, 2010 146
Table 57: Impacting factors on the revenues of Fablyn (lasofoxifene; Pfizer/Ligand), 2010-2019 149
Table 58: Forteo (teriparatide; Eli Lilly): key facts, 2010 150
Table 59: Impacting factors on the revenues of Forteo (teriparatide; Eli Lilly), 2010-2019 153
Table 60: Preotact (full-length parathyroid hormone PTH 1-84; NPS/Nycomed): key facts, 2010 154
Table 61: Impacting factors on the revenues of Preotact, 2010-2019 156
Table 62: Protelos (strontium ranelate; Servier): key facts, 2010 157
Table 63: Impacting factors on the revenues of Protelos, 2010-2019 160
Table 64: Miacalcic (calcitonin-salmon; Novartis): key facts, 2010 160
Table 65: Impacting factors on the revenues of Miacalcic (calcitonin-salmon; Novartis), 2010-2019 162
Table 66: Fortical (calcitonin-salmon; Unigene): key facts, 2009 163
Table 67: Impacting factors on the revenues of Fortical (calcitonin-salmon; Unigene, 2009-2018 165
Table 68: Prolia (denosumab; Amgen/GlaxoSmithKline): key facts, 2010 166
Table 69: Summary of key Prolia (denosumab; Amgen/GlaxoSmithKline) studies, 2010 168
Table 70: Impacting factors on the revenues of Prolia (denosumab; Amgen/GlaxoSmithKline) in osteoporosis, 2010-2019 171
Table 71: Eldecalcitol (ED-71; Chugai/Taisho): key facts, 2010 171
Table 72: Summary of key clinical trials for eldecalcitol (ED-71; Chugai/Taisho), 2010 173
Table 73: Key strategic deals and events in the osteoporosis market, 2008-2010 178
Table 74: Merck & Co osteoporosis portfolio assessment, 2010 180


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Table 75: Eli Lilly osteoporosis portfolio assessment, 2010 181
Table 76: Novartis's osteoporosis portfolio assessment, 2010 182
Table 77: GlaxoSmithKline's osteoporosis portfolio assessment, 2010 183
Table 78: Pfizer's osteoporosis portfolio assessment, 2010 183
Table 79: Key drivers and resistors to the use of Aclasta, 2010 185
Table 80: Prices per year ($) of key osteoporosis drugs in the US and the five major EU drugs, 2009 187
Table 81: Patent expiry dates for key marketed brands in osteoporosis in the US and Japan, 2010 197
Table 82: Patent expiry dates for key marketed brands in osteoporosis in the five major European market regions, 2010 198
Table 83: Estimated launch dates for key late-stage pipeline products and marketed brands in the seven major market regions,
2009-2018 199
List of Figures
Figure 1: Osteoporosis market sales ($m) across the seven major markets, 2005-2019 9
Figure 2: Osteoporosis market sales (IMS Standard Units) across the seven major markets, 2005-2019 11
Figure 3: Regional osteoporosis market value sales ($m) in the seven major markets, 2005-09 12
Figure 4: Regional osteoporosis market value sales ($m) in the seven major markets, 2009-2019 13
Figure 5: Anatomical Therapeutic Chemical (ATC) class sales dynamics ($m) in osteoporosis across the seven major markets,
2005-09 15
Figure 6: Anatomical Therapeutic Chemical (ATC) class sales dynamics ($m) in osteoporosis across the seven major markets,
2009-2019 16
Figure 7: Osteoporosis antiresorptive and anabolic drugs sales ($) dynamics in the seven major markets, 2005-2019 24
Figure 8: Antiresorptive and anabolic pipelines for osteoporosis, 2005 and 2010 25
Figure 9: Lifetime risk of hip fracture at 50 years in men versus women by country, 2002 27
Figure 10: Change in the population over 50 years of age across the seven major markets, 2010-2020 28
Figure 11: Increase of male and female osteoporosis over the age of 50 years' patient potential by severity in the seven major
markets, 2010-2020 29
Figure 12: Women perception of health priorities in the five major EU markets, 2000 30
Figure 13: Comparison of screening for different diseases in the five major EU markets, 2000 32
Figure 14: Osteoporosis sales across the seven major markets, 2005-2019 34
Figure 15: Osteoporosis sales ($m) dynamics in the US, 2005-2019 37
Figure 16: Osteoporosis sales ($m) dynamics in Japan, 2005-2019 46
Figure 17: Japan osteoporosis market ($m), 2009-2019 52
Figure 18: Osteoporosis sales ($m) dynamics in the five major EU markets, 2005-09 54
Figure 19: Osteoporosis sales ($m) dynamics in the five major EU markets, 2009-2019 55
Figure 20: Osteoporosis sales ($m) dynamics in the five major EU markets by Anatomical Therapeutic Chemical (ATC) class,
2005-2019 57
Figure 21: The burden of osteoporosis (DALYs) compared to cancers, 2006 63
Figure 22: Osteoporosis sales ($m) dynamics in France, 2005-2019 69
Figure 23: Osteoporosis sales ($m) dynamics in Germany, 2005-2019 74
Figure 24: Osteoporosis sales ($m) dynamics in Italy by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 79
Figure 25: Osteoporosis sales ($m) dynamics in Spain by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 84
Figure 26: Osteoporosis sales ($m) dynamics in the UK by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 89
Figure 27: Global osteoporosis market sales ($m), 2005-09 93
Figure 28: Global osteoporosis market sales ($m) dynamics, 2005-09 94
Figure 29: Global osteoporosis market volume (IMS standard units sold) and value ($) sales, by region, 2009 96
Figure 30: Rest of the world osteoporosis market sales value ($m), 2005-09 97
Figure 31: Rest of the world osteoporosis market regional dynamics, 2005-09 98
Figure 32: Rest of the world osteoporosis sales by Anatomical Therapeutic Chemical (ATC) class, 2005-09 100
Figure 33: Rest of the world osteoporosis sales dynamics by Anatomical Therapeutic Chemical (ATC) class, 2005-09 101
Figure 34: Osteoporosis patient care path in the seven major markets, 2010 105
Figure 35: Key drivers of drug choice in osteoporosis across the seven major markets 108


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Figure 36: Assessment of formulary status in osteoporosis in the US, 2010 110
Figure 37: Amgen's 'Know My Bones' osteoporosis patient information website , 2010 112
Figure 38: GlaxoSmithKline's and Roche's celebrity spokesperson strategy for marketing Bonviva in the US 113
Figure 39: Actonel (risedronate; Sanofi-Aventis/Warner Chilcott) web page, 2010 114
Figure 40: Fosamax brand franchise (alendronate; Merck & Co): SWOT analysis, 2010 116
Figure 41: Fosamax brand franchise (alendronate; Merck & Co) osteoporosis sales ($m) forecast across the seven major markets,
2005-2019 117
Figure 42: Fosamax brand franchise (alendronate; Merck & Co) sales ($m) performance for osteoporosis in the seven major markets,
2005-2019 119
Figure 43: Actonel brand franchise (risedronic acid; Sanofi-Aventis/Warner Chilcott): SWOT analysis, 2010 122
Figure 44: Actonel brand franchise (risedronic acid; Sanofi-Aventis/Warner Chilcott) osteoporosis sales ($m) forecast across the
seven major markets, 2005-2019 123
Figure 45: Actonel brand franchise (risedronic acid; Sanofi-Aventis/Warner Chilcott) sales performance for osteoporosis in the seven
major markets, 2005-2019 124
Figure 46: Bonviva brand franchise (ibandronate; Roche/GlaxoSmithKline): SWOT analysis, 2010 128
Figure 47: Bonviva brand franchise (ibandronate; Roche/GlaxoSmithKline) osteoporosis sales ($m) forecast across the seven major
markets, 2005-2019 129
Figure 48: Bonviva brand franchise (ibandronate; Roche/GlaxoSmithKline) sales performance for osteoporosis in the seven major
markets, 2005-2019 130
Figure 49: Aclasta: SWOT analysis, 2010 132
Figure 50: Aclasta (zoledronic acid; Novartis) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 133
Figure 51: Bonoteo (minodronic acid; Astellas/Ono Pharmaceutical): SWOT analysis, 2010 136
Figure 52: Bonoteo/Recalbon (minodronic acid; Astellas/Ono Pharmaceutical) osteoporosis sales ($m) forecast across the seven
major markets, 2005-2019 137
Figure 53: Evista: SWOT analysis, 2010 140
Figure 54: Evista (raloxifene; Eli Lilly) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 141
Figure 55: Conbriza: SWOT analysis, 2010 144
Figure 56: Conbriza (bazedoxifene; Pfizer) osteoporosis sales ($m) forecast across the seven major markets, 2011-19 145
Figure 57: Fablyn (lasofoxifene; Pfizer/Ligand): SWOT analysis, 2010 148
Figure 58: Fablyn (lasofoxifene; Pfizer) osteoporosis sales ($m) forecast across the seven major markets, 2011-19 149
Figure 59: Forteo (teriparatide, Eli Lilly): SWOT analysis, 2010 152
Figure 60: Forteo (teriparatide; Eli Lilly) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 153
Figure 61: Preotact (full-length parathyroid hormone PTH 1-84; NPS/Nycomed): SWOT analysis, 2010 155
Figure 62: Preotact (PTH 1-84; Nycomed) osteoporosis sales ($m) forecast across the seven major markets, 2007-2019 156
Figure 63: Protelos (strontium ranelate, Servier): SWOT analysis, 2010 158
Figure 64: Protelos (strontium renalate; Servier) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 159
Figure 65: Miacalcic (calcitonin-salmon; Novartis): SWOT analysis, 2010 161
Figure 66: Miacalcic (calcitonin salmon; Novartis) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 162
Figure 67: Fortical: SWOT analysis, 2009 164
Figure 68: Fortical (calcitonin salmon; Unigene) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 165
Figure 69: Prolia (denosumab; Amgen): SWOT analysis, 2010 169
Figure 70: Prolia (denosumab; Amgen/GlaxoSmithKline) osteoporosis sales ($m) forecast across the seven major markets,
2010-2019 170
Figure 71: Eldecalcitol (ED-71, Chugai/Taisho): SWOT analysis, 2010 174
Figure 72: Eldecalcitol (ED-71; Chugai/Taisho) osteoporosis sales ($m) forecast across the seven major markets, 2010-2019 175




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Commercial Insight: Osteoporosis ' Market players maximize revenue growth before the next challenging phase

  • 1. Find Industry reports, Company profiles ReportLinker and Market Statistics >> Get this Report Now by email! Commercial Insight: Osteoporosis ' Market players maximize revenue growth before the next challenging phase Published on July 2010 Report Summary Introduction Globally, the osteoporosis market displayed a 3.5% compound annual growth rate (CAGR) between 2005'09, reaching $9.4 billion in 2009. However, the launch of generic alendronate in the majority of markets resulted in a temporary decline in sales during 2009. The market will stabilize during the next 5 years due to generic incursion and then resume growth from 2015 as new drugs are launched. Scope Analysis of global osteoporosis prescriptions from 2005'09, split by geographical region (including emerging markets), drug class, and brand.Discussion of key commercial opportunities and threats in the US, Japan, and five major European markets. In depth profiles of 13 key osteoporosis brands and pipeline agents with SWOT analyses and country-specific sales forecasts to 2019. Detailed analysis of key developer trends, strategies and portfolios including a case study of Novartis's Aclasta (zoledronic acid). Highlights The rest of world, outside of the seven major markets, achieved osteoporosis-specific sales of $2.4 billion in 2009 with an impressive CAGR of 8.7% from 2005. Brazil, Russia, India and China were the fastest growing nations, driving a combined 2005'09 CAGR of 17%. The osteoporosis market offers multiple opportunities for current and future market players. In addition to increasing awareness, diagnosis and treatment, there is the need to develop new drugs that promote bone building. However, the increase in cost pressure resulting from generic penetration poses a major barrier to entry. Leading market players continue to pursue their direct-to-consumer advertising campaigns, sponsoring events to raise awareness of the disorder and of respective treatments. Innovative strategies to increase brand loyalty and confidence, such as risk-sharing schemes, have also been implemented by Novartis and Sanofi-Aventis. Reasons to Purchase Understand historical (2005'09) and future (2010'19) osteoporosis drug market dynamics and competitive environment.Gain insight into the main opportunities and threats specific to the osteoporosis market.Evaluate the sales forecasts of marketed, generic, and key pipeline drugs to 2019 in the US, Japan, France, Germany, Italy, Spain, and the UK. Table of Content OVERVIEW 1 Catalyst 1 Commercial Insight: Osteoporosis ' Market players maximize revenue growth before the next challenging phase Page 1/11
  • 2. Find Industry reports, Company profiles ReportLinker and Market Statistics Summary 1 EXECUTIVE SUMMARY 2 Strategic scoping and focus 2 Datamonitor insight into the osteoporosis market 2 Related reports 4 Upcoming related reports 4 Table of Contents 5 MARKET DEFINITION 6 Market definition for this report 6 MARKET OVERVIEW 8 Seven major markets 9 Current and future market overview 9 Despite a recent setback the osteoporosis market will resume growth 9 Regional dynamics: the US is set to remain the largest major market but Japan and the EU are also growing 11 Anatomical Therapeutic Chemical (ATC) class dynamics 14 Brand splits 17 Opportunities and threats 22 Opportunity one: anabolic drugs still needed 23 Opportunity two: the male osteoporosis market remains underdeveloped 25 Opportunity three: aging population increases osteoporosis population 27 Opportunity four: raising awareness remains critical to expand the patient population 29 Opportunity five: as patent expiries near there will be reduced marketing competition 33 Threat one: the osteoporosis market is becoming highly genericized, increasing cost competitiveness 33 US 36 Current and future market assessment 36 Despite new drug launches US market growth will slow down 36 Bisphosphonates will remain the largest osteoporosis drug class in the US 37 Brand dynamics 38 Opportunities and threats 42 Opportunity one: the US healthcare reform increases the treatable patient population 42 Opportunity two: the US health reform aims to close the donut hole 43 Opportunity three: risk-sharing schemes increase brand loyalty 44 Threat one: speed to market in the US is greatly reduced as FDA increases scrutiny 44 Threat two: FDA tightens marketing controls in the US 45 Japan 45 Current and future market assessment 45 Japanese market set to grow after new drug launches 45 Opportunities and threats 51 Opportunity one: launch of new drugs 51 Opportunity two: training of physicians 52 Opportunity three: partnerships with Japanese Pharma companies is beneficial 52 Threat 1: Cost cutting policies 53 Five major EU markets 53 Current and future market assessment 53 Italy and Spain are the fastest growing osteoporosis markets in the five major EU region 53 Anabolic drugs and new drug classes drive market growth 56 Opportunities and threats 62 Opportunity one: osteoporosis remains a priority in the European Union 62 Threat one: in Germany, reimbursement of treatment and diagnostic scans remains limited 64 Threat two: German government increases the pressure to manage the cost of healthcare with NICE equivalent 65 Commercial Insight: Osteoporosis ' Market players maximize revenue growth before the next challenging phase Page 2/11
  • 3. Find Industry reports, Company profiles ReportLinker and Market Statistics Threat three: NICE continues to restrict drug access in the UK in favor of alendronate 66 France 67 Current and future market assessment 67 Germany 73 Current and future market assessment 73 Italy 78 Current and future market assessment 78 Spain 83 Current and future market assessment 83 UK 88 Current and future market assessment 88 Rest of the world snapshot 93 Current market assessment 93 The global osteoporosis market shrank in 2009 93 The rest of the world accounted for 26% of the global osteoporosis market in 2009 93 The rest of the world outstrips the seven major markets in terms of volume 95 BRIC and Canada were the only markets to display growth between 2008 and 2009 97 Bisphosphonates and calcium dominate the rest of the world osteoporosis market but anabolic drugs are the fastest growing 99 BRAND DYNAMICS 103 Overview of competitive landscape 103 Patient acquisition process 104 Introduction 104 Patient care path 104 Points of influence in the patient care path 106 Trigger point one: osteoporosis prevention 106 Trigger point two: disease severity influences osteoporosis treatment 106 Trigger point three: compliance issues and fractures 107 Drivers of drug choice 107 US formulary tier status for leading brands 109 EU osteoporosis reimbursement policies 110 Trends in marketing strategies 111 Marketing strategy for leading brands 111 Sponsorship/disease awareness campaigns 111 Direct-to-consumer advertising 112 Bisphosphonates: Fosamax/Fosamax Plus D (alendronate; Merck & Co) 114 Drug profile 114 Alendronate generics still available in Europe despite 2006 European Patent Office ruling 115 Product positioning 115 Fosamax is positioned as the market gold standard 115 SWOT analysis 116 Brand forecast to 2019 117 Fosamax Plus D fails to maintain market share upon alendronate generic penetration in the US 118 Bisphosphonates: Actonel/Actonel with Calcium (risedronic acid; Sanofi-Aventis/Warner Chilcott) 119 Drug profile 119 Product positioning 121 Actonel is commonly positioned as a first-line alternative to Fosamax 121 SWOT analysis 121 Brand forecast to 2019 122 Bisphosphonates: Bonviva/Boniva (ibandronic acid; Roche/GlaxoSmithKline) 125 Drug profile 125 Commercial Insight: Osteoporosis ' Market players maximize revenue growth before the next challenging phase Page 3/11
  • 4. Find Industry reports, Company profiles ReportLinker and Market Statistics Product positioning 126 Bonviva caters for two different types of patients 126 Bonviva sales remain lower than other bisphosphonates due to lack of non-vertebral fracture protection data 127 SWOT analysis 127 Brand forecast to 2019 128 Bisphosphonates: Aclasta (zoledronic acid; Novartis) 131 Drug profile 131 Product positioning 132 First yearly osteoporosis therapy tackles compliance issues 132 SWOT analysis 132 Brand forecast to 2019 132 Bisphosphonates: Bonoteo/Recalbon (minodronic acid; Astellas/Ono Pharmaceutical) 134 Drug profile 134 Product positioning 135 SWOT analysis 136 Brand forecast to 2019 136 Selective estrogen receptor modulators: Evista (raloxifene; Eli Lilly) 137 Drug profile 137 Product positioning 138 Evista is positioned as a treatment for mild osteoporosis and osteopenia 138 SWOT analysis 139 Brand forecast to 2019 140 Selective estrogen receptor modulators: Conbriza/Viviant (bazedoxifene; Pfizer) 142 Drug overview 142 Product positioning 143 Should Conbriza launch it will be the second SERM to reach the osteoporosis market 143 Conbriza is likely to be positioned as a follow-on therapy to Aprela 143 SWOT analysis 144 Brand forecast to 2019 144 Selective estrogen receptor modulators: Fablyn (lasofoxifene; Pfizer/Ligand) 146 Drug overview 146 Product positioning 147 Physicians are unlikely to prescribe Fablyn over Evista 147 SWOT analysis 147 Brand forecast to 2019 148 Parathyroid hormones: Forteo (teriparatide; Eli Lilly) 150 Drug profile 150 Product positioning 151 Forteo remains positioned to treat severe osteoporosis patients due to it high cost 151 SWOT analysis 152 Brand forecast to 2019 152 Parathyroid hormones: Preotact (full-length parathyroid hormone PTH 1-84; NPS/Nycomed) 154 Drug profile 154 Product positioning 154 SWOT analysis 155 Brand forecast to 2019 155 Dual acting bone agents: Protelos (strontium ranelate; Servier) 157 Drug profile 157 Product positioning 157 Protelos uniquely combines anabolic and antiresorptive action 157 Commercial Insight: Osteoporosis ' Market players maximize revenue growth before the next challenging phase Page 4/11
  • 5. Find Industry reports, Company profiles ReportLinker and Market Statistics SWOT analysis 158 Brand forecast to 2019 159 Calcitonins: Miacalcic (calcitonin-salmon; Novartis) 160 Drug profile 160 Product positioning 161 SWOT analysis 161 Brand forecast to 2019 161 Calcitonins: Fortical (calcitonin-salmon; Unigene) 163 Drug profile 163 Product positioning 164 SWOT analysis 164 Brand forecast to 2019 164 Pipeline drugs: Prolia (denosumab; Amgen/GlaxoSmithKline) 166 Drug profile 166 Development overview 167 Product positioning 169 SWOT analysis 169 Drug forecast to 2019 170 Pipeline drugs: Eldecalcitol (ED-71; Chugai/Taisho) 171 Product positioning 174 SWOT analysis 174 Drug forecast to 2019 174 KEY DEVELOPERS 176 Strategic overview 176 Trends in corporate strategy 176 Intermittent dosing 176 Differentiation remains key to success 176 Innovative lifecycle management strategies 176 Recent strategic partnerships/deals 177 Offsetting of lack of research with deals 177 Merck & Co 179 Corporate strategy 179 Osteoporosis portfolio assessment 179 Eli Lilly 180 Corporate strategy 180 Osteoporosis portfolio assessment 180 Portfolio assessment of other leading companies 181 Novartis: continued interest in the market is reflected in the pipeline activity 181 GlaxoSmithKline: deal with Amgen allows GlaxoSmithKline to keep market share 182 Pfizer: Wyeth acquisition allows Pfizer to finally enter this market 183 CASE STUDIES 184 Aclasta: the market leader that never was 184 Once yearly addresses compliance, but mode of administration limits use 185 Access to Aclasta remains problematic in many major markets 186 Overall the cost for Aclasta does not exceed other bisphosphonate therapies 186 Reimbursement policies can affect the frequency with which the drug is used 188 Patient and physician education 188 BIBLIOGRAPHY 190 Journal papers 190 Websites 192 Commercial Insight: Osteoporosis ' Market players maximize revenue growth before the next challenging phase Page 5/11
  • 6. Find Industry reports, Company profiles ReportLinker and Market Statistics Datamonitor reports 196 Conferences attended 196 APPENDIX A 197 MARKET ASSUMPTIONS 197 New product launches and expiries 197 Data definitions, limitations and assumptions 200 Standard units 200 Country group definitions 200 Rest of European Union 200 Middle East and North Africa (MENA) 200 Rest of World 200 Derivation of sales forecasts and pricing trends 200 Indication-specific sales calculations 201 Caveats to using Prescribing insight 201 Forecast methodology 201 APPENDIX B 202 Contributing experts 202 Conferences attended 202 Report methodology 202 About Datamonitor 202 About Datamonitor Healthcare 203 About the Genitourinary analysis team 203 Disclaimer 205 List of Tables Table 1: Summary of therapeutic classes in osteoporosis by Anatomical Therapeutic Chemical (ATC) code, 2009 6 Table 2: Summary of the ICD-10 codes used to derive osteoporosis-specific sales from each brand 7 Table 3: Regional osteoporosis market value sales ($m) in the seven major markets, 2005-2019 13 Table 4: Anatomical Therapeutic Chemical (ATC) class sales dynamics ($m) in osteoporosis across the seven major markets, 2005-2019 17 Table 5: Osteoporosis brand sales ($m) dynamics across the seven major markets, 2009-2019 18 Table 6: Key events impacting the osteoporosis market, by region, 2010-2019 22 Table 7: Osteoporosis global market opportunities and threats, 2010-2019 22 Table 8: Summary of key osteoporosis drug patent expiries in the seven major markets, 2010-2020 34 Table 9: Prices of key osteoporosis drugs in the US and the five major EU markets, 2009 35 Table 10: Osteoporosis sales ($m) dynamics in the US by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 38 Table 11: Osteoporosis brand sales ($m) dynamics in the US, 2009-2019 39 Table 12: Osteoporosis market opportunities and threats in the US, 2010-2019 42 Table 13: Uninsured osteoporosis population in the US aged 50-64 years, 2010 43 Table 14: Medicare payments, 2009 43 Table 15: Price per year ($) of key osteoporosis brands in the US, 2009 44 Table 16: Osteoporosis sales ($m) dynamics in Japan by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 47 Table 17: Osteoporosis brand sales ($m) dynamics in Japan, 2009-2019 48 Table 18: Osteoporosis market opportunities and threats in Japan, 2010-2019 51 Table 19: Osteoporosis sales ($m) dynamics in the five major EU markets, 2005-2019 55 Table 20: Osteoporosis sales ($m) dynamics in the five major EU markets by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 58 Table 21: Osteoporosis brand sales ($m) dynamics in the five major EU markets, 2009-2019 59 Table 22: Osteoporosis market opportunities and threats in the five major EU markets, 2010-2019 62 Table 23: Implementation of EU recommendations in the five major EU markets, 2008 64 Table 24: Osteoporosis sales ($m) dynamics in France by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 68 Commercial Insight: Osteoporosis ' Market players maximize revenue growth before the next challenging phase Page 6/11
  • 7. Find Industry reports, Company profiles ReportLinker and Market Statistics Table 25: Osteoporosis sales forecasts in France ($m), 2009-2019 70 Table 26: Osteoporosis sales ($m) dynamics in Germany by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 73 Table 27: Osteoporosis sales forecasts in Germany ($m), 2009-2019 75 Table 28: Osteoporosis sales ($m) dynamics in Italy by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 78 Table 29: Osteoporosis sales forecasts in Italy ($m), 2009-2019 80 Table 30: Osteoporosis sales ($m) dynamics in Spain by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 83 Table 31: Osteoporosis sales forecasts in Spain ($m), 2009-2019 85 Table 32: Osteoporosis sales ($m) dynamics in the UK by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 88 Table 33: Osteoporosis sales forecasts in the UK ($m), 2009-2019 90 Table 34: Global sales ($m) dynamics of the osteoporosis market, 2005-09 95 Table 35: Regional split of the global osteoporosis market sales, 2005-09 99 Table 36: Rest of the world osteoporosis sales by Anatomical Therapeutic Chemical (ATC) class, 2005-09 102 Table 37: Leading branded drug sales for osteoporosis in the seven major markets ($m), 2009-2019 103 Table 38: Key products in late-stage R&D pipeline for osteoporosis, 2010 104 Table 39: Results from the Timeless Woman Study, 2008 109 Table 40: Representative formulary tier status in the US for leading brands in osteoporosis, 2010 109 Table 41: EU osteoporosis treatment reimbursement policies, 2008 110 Table 42: Marketing strategies employed by the companies behind the top three pain market brands, 2010 111 Table 43: Fosamax (alendronate; Merck & Co.): key facts, 2010 115 Table 44: Impacting factors on the revenues of the Fosamax brand franchise (alendronate; Merck & Co), 2010-2019 118 Table 45: Actonel (risedronic acid; Sanofi-Aventis/Warner Chilcott): key facts, 2010 120 Table 46: Impacting factors on the revenues of the Actonel brand franchise, 2010-2019 124 Table 47: Bonviva (ibandronic acid; Roche/GlaxoSmithKline): key facts, 2010 125 Table 48: Impacting factors on the revenues of the Bonviva brand franchise, 2010-2019 130 Table 49: Aclasta (zoledronic acid; Novartis): key facts, 2010 131 Table 50: Impacting factors on the revenues of Aclasta, 2010-2019 133 Table 51: Bonoteo (minodronic acid; Astellas/Ono Pharmaceutical): key facts, 2010 134 Table 52: Evista: key facts, 2010 138 Table 53: Impacting factors on the revenues of Evista, 2010-2019 141 Table 54: Conbriza (bazedoxifene; Pfizer): key facts, 2010 142 Table 55: Impacting factors on the revenues of Conbriza, 2010-2019 145 Table 56: Fablyn (lasofoxifene; Pfizer/Ligand): key facts, 2010 146 Table 57: Impacting factors on the revenues of Fablyn (lasofoxifene; Pfizer/Ligand), 2010-2019 149 Table 58: Forteo (teriparatide; Eli Lilly): key facts, 2010 150 Table 59: Impacting factors on the revenues of Forteo (teriparatide; Eli Lilly), 2010-2019 153 Table 60: Preotact (full-length parathyroid hormone PTH 1-84; NPS/Nycomed): key facts, 2010 154 Table 61: Impacting factors on the revenues of Preotact, 2010-2019 156 Table 62: Protelos (strontium ranelate; Servier): key facts, 2010 157 Table 63: Impacting factors on the revenues of Protelos, 2010-2019 160 Table 64: Miacalcic (calcitonin-salmon; Novartis): key facts, 2010 160 Table 65: Impacting factors on the revenues of Miacalcic (calcitonin-salmon; Novartis), 2010-2019 162 Table 66: Fortical (calcitonin-salmon; Unigene): key facts, 2009 163 Table 67: Impacting factors on the revenues of Fortical (calcitonin-salmon; Unigene, 2009-2018 165 Table 68: Prolia (denosumab; Amgen/GlaxoSmithKline): key facts, 2010 166 Table 69: Summary of key Prolia (denosumab; Amgen/GlaxoSmithKline) studies, 2010 168 Table 70: Impacting factors on the revenues of Prolia (denosumab; Amgen/GlaxoSmithKline) in osteoporosis, 2010-2019 171 Table 71: Eldecalcitol (ED-71; Chugai/Taisho): key facts, 2010 171 Table 72: Summary of key clinical trials for eldecalcitol (ED-71; Chugai/Taisho), 2010 173 Table 73: Key strategic deals and events in the osteoporosis market, 2008-2010 178 Table 74: Merck & Co osteoporosis portfolio assessment, 2010 180 Commercial Insight: Osteoporosis ' Market players maximize revenue growth before the next challenging phase Page 7/11
  • 8. Find Industry reports, Company profiles ReportLinker and Market Statistics Table 75: Eli Lilly osteoporosis portfolio assessment, 2010 181 Table 76: Novartis's osteoporosis portfolio assessment, 2010 182 Table 77: GlaxoSmithKline's osteoporosis portfolio assessment, 2010 183 Table 78: Pfizer's osteoporosis portfolio assessment, 2010 183 Table 79: Key drivers and resistors to the use of Aclasta, 2010 185 Table 80: Prices per year ($) of key osteoporosis drugs in the US and the five major EU drugs, 2009 187 Table 81: Patent expiry dates for key marketed brands in osteoporosis in the US and Japan, 2010 197 Table 82: Patent expiry dates for key marketed brands in osteoporosis in the five major European market regions, 2010 198 Table 83: Estimated launch dates for key late-stage pipeline products and marketed brands in the seven major market regions, 2009-2018 199 List of Figures Figure 1: Osteoporosis market sales ($m) across the seven major markets, 2005-2019 9 Figure 2: Osteoporosis market sales (IMS Standard Units) across the seven major markets, 2005-2019 11 Figure 3: Regional osteoporosis market value sales ($m) in the seven major markets, 2005-09 12 Figure 4: Regional osteoporosis market value sales ($m) in the seven major markets, 2009-2019 13 Figure 5: Anatomical Therapeutic Chemical (ATC) class sales dynamics ($m) in osteoporosis across the seven major markets, 2005-09 15 Figure 6: Anatomical Therapeutic Chemical (ATC) class sales dynamics ($m) in osteoporosis across the seven major markets, 2009-2019 16 Figure 7: Osteoporosis antiresorptive and anabolic drugs sales ($) dynamics in the seven major markets, 2005-2019 24 Figure 8: Antiresorptive and anabolic pipelines for osteoporosis, 2005 and 2010 25 Figure 9: Lifetime risk of hip fracture at 50 years in men versus women by country, 2002 27 Figure 10: Change in the population over 50 years of age across the seven major markets, 2010-2020 28 Figure 11: Increase of male and female osteoporosis over the age of 50 years' patient potential by severity in the seven major markets, 2010-2020 29 Figure 12: Women perception of health priorities in the five major EU markets, 2000 30 Figure 13: Comparison of screening for different diseases in the five major EU markets, 2000 32 Figure 14: Osteoporosis sales across the seven major markets, 2005-2019 34 Figure 15: Osteoporosis sales ($m) dynamics in the US, 2005-2019 37 Figure 16: Osteoporosis sales ($m) dynamics in Japan, 2005-2019 46 Figure 17: Japan osteoporosis market ($m), 2009-2019 52 Figure 18: Osteoporosis sales ($m) dynamics in the five major EU markets, 2005-09 54 Figure 19: Osteoporosis sales ($m) dynamics in the five major EU markets, 2009-2019 55 Figure 20: Osteoporosis sales ($m) dynamics in the five major EU markets by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 57 Figure 21: The burden of osteoporosis (DALYs) compared to cancers, 2006 63 Figure 22: Osteoporosis sales ($m) dynamics in France, 2005-2019 69 Figure 23: Osteoporosis sales ($m) dynamics in Germany, 2005-2019 74 Figure 24: Osteoporosis sales ($m) dynamics in Italy by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 79 Figure 25: Osteoporosis sales ($m) dynamics in Spain by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 84 Figure 26: Osteoporosis sales ($m) dynamics in the UK by Anatomical Therapeutic Chemical (ATC) class, 2005-2019 89 Figure 27: Global osteoporosis market sales ($m), 2005-09 93 Figure 28: Global osteoporosis market sales ($m) dynamics, 2005-09 94 Figure 29: Global osteoporosis market volume (IMS standard units sold) and value ($) sales, by region, 2009 96 Figure 30: Rest of the world osteoporosis market sales value ($m), 2005-09 97 Figure 31: Rest of the world osteoporosis market regional dynamics, 2005-09 98 Figure 32: Rest of the world osteoporosis sales by Anatomical Therapeutic Chemical (ATC) class, 2005-09 100 Figure 33: Rest of the world osteoporosis sales dynamics by Anatomical Therapeutic Chemical (ATC) class, 2005-09 101 Figure 34: Osteoporosis patient care path in the seven major markets, 2010 105 Figure 35: Key drivers of drug choice in osteoporosis across the seven major markets 108 Commercial Insight: Osteoporosis ' Market players maximize revenue growth before the next challenging phase Page 8/11
  • 9. Find Industry reports, Company profiles ReportLinker and Market Statistics Figure 36: Assessment of formulary status in osteoporosis in the US, 2010 110 Figure 37: Amgen's 'Know My Bones' osteoporosis patient information website , 2010 112 Figure 38: GlaxoSmithKline's and Roche's celebrity spokesperson strategy for marketing Bonviva in the US 113 Figure 39: Actonel (risedronate; Sanofi-Aventis/Warner Chilcott) web page, 2010 114 Figure 40: Fosamax brand franchise (alendronate; Merck & Co): SWOT analysis, 2010 116 Figure 41: Fosamax brand franchise (alendronate; Merck & Co) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 117 Figure 42: Fosamax brand franchise (alendronate; Merck & Co) sales ($m) performance for osteoporosis in the seven major markets, 2005-2019 119 Figure 43: Actonel brand franchise (risedronic acid; Sanofi-Aventis/Warner Chilcott): SWOT analysis, 2010 122 Figure 44: Actonel brand franchise (risedronic acid; Sanofi-Aventis/Warner Chilcott) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 123 Figure 45: Actonel brand franchise (risedronic acid; Sanofi-Aventis/Warner Chilcott) sales performance for osteoporosis in the seven major markets, 2005-2019 124 Figure 46: Bonviva brand franchise (ibandronate; Roche/GlaxoSmithKline): SWOT analysis, 2010 128 Figure 47: Bonviva brand franchise (ibandronate; Roche/GlaxoSmithKline) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 129 Figure 48: Bonviva brand franchise (ibandronate; Roche/GlaxoSmithKline) sales performance for osteoporosis in the seven major markets, 2005-2019 130 Figure 49: Aclasta: SWOT analysis, 2010 132 Figure 50: Aclasta (zoledronic acid; Novartis) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 133 Figure 51: Bonoteo (minodronic acid; Astellas/Ono Pharmaceutical): SWOT analysis, 2010 136 Figure 52: Bonoteo/Recalbon (minodronic acid; Astellas/Ono Pharmaceutical) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 137 Figure 53: Evista: SWOT analysis, 2010 140 Figure 54: Evista (raloxifene; Eli Lilly) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 141 Figure 55: Conbriza: SWOT analysis, 2010 144 Figure 56: Conbriza (bazedoxifene; Pfizer) osteoporosis sales ($m) forecast across the seven major markets, 2011-19 145 Figure 57: Fablyn (lasofoxifene; Pfizer/Ligand): SWOT analysis, 2010 148 Figure 58: Fablyn (lasofoxifene; Pfizer) osteoporosis sales ($m) forecast across the seven major markets, 2011-19 149 Figure 59: Forteo (teriparatide, Eli Lilly): SWOT analysis, 2010 152 Figure 60: Forteo (teriparatide; Eli Lilly) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 153 Figure 61: Preotact (full-length parathyroid hormone PTH 1-84; NPS/Nycomed): SWOT analysis, 2010 155 Figure 62: Preotact (PTH 1-84; Nycomed) osteoporosis sales ($m) forecast across the seven major markets, 2007-2019 156 Figure 63: Protelos (strontium ranelate, Servier): SWOT analysis, 2010 158 Figure 64: Protelos (strontium renalate; Servier) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 159 Figure 65: Miacalcic (calcitonin-salmon; Novartis): SWOT analysis, 2010 161 Figure 66: Miacalcic (calcitonin salmon; Novartis) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 162 Figure 67: Fortical: SWOT analysis, 2009 164 Figure 68: Fortical (calcitonin salmon; Unigene) osteoporosis sales ($m) forecast across the seven major markets, 2005-2019 165 Figure 69: Prolia (denosumab; Amgen): SWOT analysis, 2010 169 Figure 70: Prolia (denosumab; Amgen/GlaxoSmithKline) osteoporosis sales ($m) forecast across the seven major markets, 2010-2019 170 Figure 71: Eldecalcitol (ED-71, Chugai/Taisho): SWOT analysis, 2010 174 Figure 72: Eldecalcitol (ED-71; Chugai/Taisho) osteoporosis sales ($m) forecast across the seven major markets, 2010-2019 175 Commercial Insight: Osteoporosis ' Market players maximize revenue growth before the next challenging phase Page 9/11
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