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Business review – markets

Inhalation market – why
deliver drugs to the lungs?

Delivering drugs directly to their site of action in the lungs often results in fewer systemic side-effects and generally requires lower doses.

Respiratory market

The majority of treatments for asthma and COPD are delivered by inhalation, with many sufferers taking more than one type of therapy. Most drugs that are used to treat respiratory disease are designed to work in the lung, with relatively little active drug passing into the bloodstream.

The asthma and COPD markets comprise the third-fastest growing therapeutic targets (with 21 million people suffering from asthma in the USA alone) and are forecast to continue to grow rapidly, achieving sales in 2011 of $21bn and $11bn respectively. This growth is being driven by two main trends: the use of fixed-dose combinations, and more targeted and effective therapies.

Inhaled fixed-dose combination therapy requires the combination (usually) of two drugs at fixed doses with the aim of providing optimal clinical benefits for the patient. An example is Seretide®/Advair® (salmeterol/fluticasone), marketed by GlaxoSmithKline (GSK), which is now the fourth-biggest selling pharmaceutical product worldwide with sales of $7.7bn in 2008. Fixed-dose combination therapy is likely to remain fundamental to the treatment of both asthma and COPD, and sales of such products is seen as a major driver for growth in the respiratory market.

The COPD market is less well developed than that for asthma. It is estimated that up to 50% of Americans and 75% of Europeans with COPD are undiagnosed. Treatments for COPD, such as Spiriva® (tiotropium), have made an important therapeutic contribution and are driving growth forecasts. Spiriva® sales for 2008 were in excess of $3bn.