The Market for Antifungal Drugs

Lynn Gray

Published April 2003

INTRODUCTION

STUDY GOAL AND OBJECTIVES

This report provides an in-depth look at the prescription and over-the-counter (OTC) markets for systemic and topical antifungal drugs. This report focuses on currently available systemic and topical antifungal drugs, as well as novel drugs in development. The dramatic increase in the incidence of fungal infections as well as the problem of drug resistance, and its effect on drug usage are explored. Analysis of products and companies participating in and changing this market is provided, and revenue forecasts are provided through 2007. Forecasts of the current prescription and OTC antifungals market are provided. Forecasts and trends are gleaned from industry sources as well as from considered assessment of emerging products and technologies.

REASONS FOR DOING THE STUDY

The market for antifungal agents is a steadily growing sector driven largely by an expanding population of immunocompromised patients and the rollout of novel products. The loss of patent protection for the top-selling antifungal agent Diflucan (Pfizer) will mix up the market and allow for the likely emergence of newly introduced products, such as Cancidas (Merck) and Vfend (Pfizer), as market leaders. The appearance of acquired immune deficiency syndrome (AIDS) and the increasing number of patients treated with cancer chemotherapy drugs in the past few decades have created an ever-expanding number of immunocompromised individuals who are at risk for opportunistic infections. As a result, opportunistic infections are at the forefront of important and often life-threatening diseases. In addition, an increasing percentage of fungi are developing resistance to available treatments. There exists a need for safer and more effective drugs to treat serious systemic fungal infections, particularly in immunocompromised individuals, and to develop drugs that address drug-resistant organisms. New classes of of antifungal agents are being developed with the first of the products in these new classes introduced in 2001. This report provides an overview of recently introduced and in-development products and their potential impact on the antifungals market. Also discussed are prescription antifungal agents switched from Rx to OTC status and their effect on treatment of diseases and the healthcare system.

CONTRIBUTIONS OF THE STUDY AND FOR WHOM

This report provides an analysis of the prescription market for systemic and topical antifungals, as well as the OTC market for topical antifungal agents. The report information needed to understand the impact of new products on clinical use and the marketplace. This report is an invaluable tool for business planners, acquisitions specialists, licensing strategists, product managers, market research analysts, investor consultants, and anyone interested in the current and emerging antifungals market, its products, its industry participants, and its future.

SCOPE AND FORMAT

This report focuses on marketed and in-development products to treat fungal diseases. The Overview chapter provides a comprehensive summary of the most clinically significant fungal diseases in humans, their incidence, pathology, and treatment, as well as a discussion of those diseases and organisms for which drug resistance is a problem. Also discussed are the categories of available and emerging antifungal agents and their mechanism of action.

The Products chapter provides detailed discussion of leading antifungal agents and agents in development, how they differ from older products and their potential impact on treatment and the market.

The Applications chapter provides an overview of specific fungal diseases, the agents used to treat them and the markets for these applications.

The Industry chapter provides a breakdown of the worldwide market for antifungal drugs, as well as market share information about leading companies in this sector.

The Company Profiles chapter provides a close look at companies currently participating in the antifungals market and those with products in development.

Trends are assessed based on projected sales for new products and must necessarily be estimates, since the timing of introduction and cost of these agents is not certain.

Included in this report are sales for the year 2001 by antifungal drug class and forecasts from 2002 through 2007, including supporting analyses for projections.

METHODOLOGY

The base year for this study is 2002. Market figures are based on revenues at the manufacturers' level and are projected at 2002 dollar value (i.e., inflation is not computed into the projection figures).

Information to prepare this study was derived from information obtained from product managers, marketing strategists, and research executives. In addition, information also was obtained from others at leading pharmaceutical and biotechnology companies that compete in the market for prescription and OTC antifungal drugs or have products in development for this market.

INFORMATION SOURCES

The information and analysis presented in this report are based on an extensive survey of the pharmaceutical industry as well as a detailed examination of published literature and reports obtained from regulatory authorities, medical research institutions, pharmaceutical trade associations, and national and world health organizations. Key information from the business literature was used as to obtain expert opinion on commercial potential and market sizes from industry professionals.

AUTHOR'S CREDENTIALS

Lynn Gray has been a research analyst since 1989 and with BCC since 1996. During that time, she has authored numerous reports in the biomedical field, 18 for BCC alone. BA, University of California, Riverside, 1973.


TABLE OF CONTENTS

INTRODUCTION

XV

STUDY GOAL AND OBJECTIVES

XV

REASONS FOR DOING THE STUDY

XV

CONTRIBUTIONS OF THE STUDY AND FOR WHOM

XVI

SCOPE AND FORMAT

XVI

METHODOLOGY

XVII

INFORMATION SOURCES

XVII

AUTHOR'S CREDENTIALS

XVII

RELATED BCC WORK CREDENTIALS INCLUDING WORK DONE BY OTHER AUTHORS

XVII

BCC ON-LINE SERVICES

XVIII

INTERNET

XVIII

SUMMARY

XX

Summary Table:
U.S. SALES OF ANTIFUNGAL DRUGS, BY CATEGORY, THROUGH 2007 ($ MILLIONS)

XX

Summary Figure:
U.S. MARKET FOR ANTIFUNGAL DRUGS, BY CATEGORY, 2001, 2002, AND 2007 ($ MILLIONS)

XXI

OVERVIEW

1

THE CLINICAL THREAT OF FUNGAL INFECTIONS

1

Table 1 INCIDENCE OF DISEASES CAUSED ANNUALLY BY SELECTED FUNGAL PATHOGENS, U.S.

2

Table 2 INCIDENCE OF CANDIDAL BLOODSTREAM ISOLATED IN THE SICU AND NICU (%)

2

Table 3 CANDIDA SPECIES INFECTION INCIDENCE OVER TIME (%)

3

INFECTION SITES

3

Table 4 INCIDENCE OF FUNGAL INFECTIONS BY SITE, 1987-1988 TO 1993-1994 (%)

3

DOMINANT CLINICALLY SIGNIFICANT SPECIES

4

Endemic Mycoses

4

Opportunistic Mycoses

4

Increase in Incidence of Invasive Mycoses

4

Causes of Nosocomial Fungal Infections

5

Patients Most at Risk for Nosocomial Infections

6

Emerging Nosocomial Opportunistic Fungal Infections

6

DIFFICULTY IN DIAGNOSING AND TREATING FUNGAL INFECTIONS

6

Need for Reliable, Standardized Susceptibility Testing

7

Advances in Diagnostics for Fungal Diseases

8

Serodiagnostics

9

THE THREAT OF RESISTANCE

10

A PHARMACOECONOMIC ANALYSIS OF ANTIFUNGAL THERAPY

10

THE EMPIRIC NATURE OF ANTIFUNGAL THERAPY

11

STRATEGIES TO IMPROVE RESPONSE AND DECREASE MORTALITY

11

PRE-EMPTIVE THERAPY

12

TYPES OF FUNGAL INFECTIONS

13

SYSTEMIC FUNGAL INFECTIONS

13

PROGRESSION OF INFECTION

13

DIAGNOSIS OF SYSTEMIC FUNGAL INFECTIONS

13

THE MOST COMMON SYSTEMIC FUNGAL INFECTIONS IN IMMUNOCOMPROMISED PATIENTS

14

GEOGRAPHIC DISTRIBUTION OF SYSTEMIC FUNGAL INFECTIONS

14

THE MOST CLINICALLY SIGNIFICANT SYSTEMIC FUNGAL INFECTIONS

15

Aspergillosis

15

Categories of Infection

16

Noninvasive Disease

16

Primary Superficial Invasive Aspergillosis

17

Invasive Pulmonary Aspergillosis

17

Disseminated Aspergillosis

17

Diagnosis

17

Treatment

17

Treatment (Continued)

18

Treatment (Continued)

19

The War on Aspergillosis

20

Blastomycosis

20

Categories of Disease

21

Treatment

21

Candidiasis (Systemic)

21

Table 5 DISTRIBUTION OF CANDIDA BLOODSTREAM ISOLATES IN SELECTED GEOGRAPHIC AREAS

22

Categories of Disease

23

Candidemia and Disseminated Candidiasis

24

Endocarditis, Myocarditis and Pericarditis

24

Esophageal Candidiasis

24

Gastrointestinal Candidiasis

24

Hepatic and Hepatosplenic Candidiasis

24

Intertrigo Candidiasis

25

Meningitis (Candidal)

25

Mucocutaneous Candidiasis

25

Neonatal and Congenital Candidiasis

25

Ocular Candidiasis

25

Oropharyngeal Candidiasis

25

Osteoarticular Candidiasis

26

Paronychial Candidiasis

26

Peritonitis (Candidal)

26

Pulmonary Candidiasis

26

Renal Candidiasis

26

Urinary Tract Candidiasis

27

Vulvovaginal Candidiasis

27

Diagnosis

27

Table 6 AVAILABLE LABORATORY TESTS FOR PRESUMPTIVE IDENTIFICATION OF CANDIDA

28

Treatment

28

Table 7 ACTIVITY OF FLUCONAZOLE AND ITRACONAZOLE AGAINST BLOODSTREAM ISOLATES OF CANDIDA SPECIES

29

Resistance Among Candidas Species

29

Table 8 SUSCEPTIBILITY OF NOSOCOMIAL AND COMMUNITY-ACQUIRED CANDIDA BLOODSTREAM ISOLATES (%)

30

Chromomycosis and Phaeohyphomycosis

30

Treatment

31

Coccidioidomycosis

31

Categories of Disease

31

Treatment

32

Cryptococcosis

32

Treatment

33

Histoplasmosis

34

Categories of Disease

35

Acute Primary Histoplasmosis

35

Progressive Disseminated Histoplasmosis

35

Chronic Cavitary Histoplasmosis

35

Diagnosis

36

Treatment

36

Mucormycosis

36

Treatment

37

Mycetoma

37

Treatment

37

Paracoccidioidomycosis

37

Treatment

38

Pneumocystis Carinii Pneumonia

38

Treatment

39

Sporotrichosis

39

Treatment

39

Other Opportunistic Systemic Fungal Infections

40

DERMATOLOGIC FUNGAL INFECTIONS

40

DERMATOPHYTE INFECTIONS

40

Tinea Barbae

41

Treatment

41

Tinea Capitis

41

Treatment

41

Tinea Corporis

42

Treatment

42

Tinea Cruris

42

Treatment

42

Tinea Pedis

43

Treatment

43

Tinea Unguium

43

Treatment

44

YEAST INFECTIONS

44

Candidiasis

44

Treatment

45

Tinea Versicolor

45

Treatment

45

GYNECOLOGIC FUNGAL INFECTIONS

45

CANDIDIASIS

46

Treatment

46

Table 9 DRUGS USED TO TREAT VAGINAL CANDIDIASIS

46

NASO-ORAL FUNGAL INFECTIONS

47

TREATMENT

47

PATIENT POPULATIONS MOST SUSCEPTIBLE TO SYSTEMIC FUNGAL INFECTIONS

47

Table 10 FACTORS PREDISPOSING PATIENTS TO FUNGAL INFECTION

48

Table 11 SURVEILLANCE STRATEGIES FOR IDENTIFICATION OF FUNGAL INFECTIONS IN AT-RISK PATIENTS

48

PATIENTS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME

49

Table 12 SIGNIFICANT MYCOSES IN PATIENTS WITH AIDS

49

CANCER PATIENTS

50

Table 13 RISK CATEGORIES FOR INVASIVE FUNGAL INFECTIONS IN CANCER PATIENTS

50

Bone Marrow and Stem Cell Transplant Patients

51

Bone Marrow and Stem Cell Transplant Patients (Continued)

52

CATEGORIES OF SYSTEMIC ANTIFUNGAL DRUGS

53

ALLYLAMINES AND OTHER NONAZOLE ERGOSTEROL BIOSYNTHESIS INHIBITORS

53

ANTIMETABOLITES

53

AZOLES

53

ECHINOCANDINS (GLUCAN SYNTHESIS INHIBITORS)

54

POLYENES

54

CATEGORIES OF TOPICAL ANTIFUNGAL AGENTS

54

THE USE OF LONG-TERM THERAPY

54

TAKING ANTIFUNGAL DRUGS OVER THE COUNTER-GREATER CONVENIENCE BUT ALSO HIGHER COSTS TO CONSUMERS

55

PRODUCTS

56

ANTIFUNGAL AGENTS ON THE MARKET IN 2002

56

Table 14 PRESCRIPTION BRANDED ANTIFUNGAL DRUGS ON THE MARKET, 2002

56

Table 15 SELECTED PRESCRIPTION ANTIFUNGAL DRUGS: WORLDWIDE SALES, 2001 AND 2002 ($ MILLIONS)

57

Table 16 PATENT EXPIRATION OF LEADING ANTIFUNGAL AGENTS

58

Table 17 WORLDWIDE SALES OF PRESCRIPTION SYSTEMIC ANTIFUNGAL DRUGS, BY CATEGORY: THROUGH 2007 ($ MILLIONS)

58

Figure 1 PERCENTAGE OF THE WORLDWIDE PRESCRIPTION ANTIFUNGAL DRUGS, BY CATEGORY, 2002 AND 2007 (%)

59

SYSTEMIC ANTIFUNGAL AGENTS

59

Table 18 PREFERRED DRUGS FOR THE TREATMENT OF SYSTEMIC FUNGALINFECTIONS

60

Table 19 USE OF DRUGS TO TREAT SYSTEMIC FUNGAL INFECTIONS, BY COUNTRY, 2000 (%)

60

ALLYLAMINES AND OTHER NONAZOLE ERGOSTEROL BIOSYNTHESIS INHIBITORS

61

Amorolfine

61

Butenafine

61

Terbinafine

61

ANTIMETABOLITES

62

Flucytosine

62

AZOLES

62

Fluconazole

63

Itraconazole

64

Ketoconazole

64

Voriconazole

65

ECHINOCANDINS

66

Caspofungin

66

Synergistic Effects

67

Shortages

67

Market Potential

67

POLYENES

68

Amphotericin B

68

Lipid Formulations

68

Pharmacoeconomics of Lipid Formulations Versus Conventional Amphotericin B

69

The Market for AmBisome and Amphotec

70

The Market for Amphotericin B Products

70

Table 20 THE MARKET FOR AMPHOTERICIN B PRODUCTS: WORLDWIDE SALES, THROUGH 2007 ($ MILLIONS)

70

OTHERS

70

Griseofulvin

70

TOPICAL ANTIFUNGAL AGENTS

71

ALLYLAMINES AND OTHER NONAZOLE ERGOSTEROL BIOSYNTHESIS INHIBITORS

71

Butenafine

71

Terbinafine

72

AZOLES

72

OTHER PRODUCTS

73

Ciclopirox

73

Lithium Succinate

73

Haloprogin

73

Tolnaftate

73

THE U.S. MARKET FOR PRESCRIPTION TOPICAL ANTIFUNGAL AGENTS

73

Table 21 THE MARKET FOR PRESCRIPTION TOPICAL ANTIFUNGAL PRODUCTS: U.S. SALES, THROUGH 2007 ($ MILLIONS)

74

GENERIC ANTIFUNGAL DRUGS

74

Table 22 ANTIFUNGAL AGENTS AMONG THE TOP-SELLING PRESCRIPTION GENERIC DRUGS IN THE U.S., 2001

74

Table 23 ESTIMATES OF MARKET SHARE OF PRESCRIPTION GENERIC ANTI-FUNGAL DRUGS, U.S., THROUGH 2007

75

OVER-THE-COUNTER ANTIFUNGAL AGENTS

75

Table 24 THE MARKET FOR OTC TOPICAL ANTIFUNGAL DRUGS: U.S. SALES, THROUGH 2007 ($ MILLIONS)

76

RX-TO-OTC SWITCHES

76

Table 25 RX-TO-OTC SWITCHES OF ANTIFUNGAL DRUGS, BY MANUFACTURER AND YEAR, 1975-2002

77

Rx-to-OTC Switches (Continued)

78

Potential Rx-to-OTC Switches

79

Table 26 ANTIFUNGAL RX-TO-OTC SWITCH CANDIDATES

79

Potential Rx-to-OTC Switches (Continued)

80

The Market for Rx-to-OTC Switches

81

Table 27 MARKET FOR BRAND NAME OTC ANTIFUNGALS CONTAINING RX-TO-OTC SWITCHED INGREDIENTS: U.S., THROUGH 2007 ($ MILLIONS)

81

The Market for Generic OTC Switched Ingredients

82

Table 28 MARKET FOR OTC GENERIC ANTIFUNGALS CONTAINING RX-TO-OTC SWITCHED INGREDIENTS: U.S., THROUGH 2007 ($ MILLIONS)

82

Table 29 THE MARKET FOR RX-TO-OTC ANTIFUNGAL DRUGS: U.S., THROUGH 2007 ($ MILLIONS)

83

Figure 2 THE MARKET FOR RX-TO-OTC ANTIFUNGAL DRUGS: U.S., 2002 AND 2007 (%)

83

Competitor Analysis

83

Table 30 OTC ANTIFUNGALS MANUFACTURER MARKET SHARE BY REVENUES, 2001 (%)

84

Figure 3 OTC ANTIFUNGALS MANUFACTURER MARKET SHARE BY REVENUES, 2001 (%)

84

Table 31 LEADING SUPPLIERS OF RX-TO-OTC SWITCHED ANTIFUNGALS, 2001

85

ANTIFUNGAL AGENTS IN DEVELOPMENT

85

Table 32 ANTIFUNGAL DRUGS IN CLINICAL DEVELOPMENT

85

Table 32 (CONTINUED)

86

SYSTEMIC AGENTS

86

Allylamines

87

Butenafine

87

Azoles

87

Second-Generation Azoles

87

Posaconazole

87

Ravuconazole

87

Azoles Used in Combination with Immunosuppressants

88

Echinocandins

88

Anidulafungin

88

Anidulafungin (Continued)

89

Caspofungin

90

Micafungin

90

Other Systemic Agents

90

MBI 226

91

Oramed

91

P-113

91

PLD-118

92

UK-292-663

93

The Possibility of an Antifungal Vaccine

93

TOPICAL AGENTS

94

EcoNail

94

Extina

94

Mentax

95

THE ROLE OF GENOMICS AND PROTEOMICS IN THE DEVELOPMENT OF NEW ANTIFUNGAL DRUGS

95

OBSTACLES TO THE DEVELOPMENT OF ANTIFUNGAL DRUGS

95

Obstacles to the Development of Antifungal Drugs (Continued)

96

APPLICATIONS

97

DERMATOLOGIC FUNGAL INFECTIONS

97

ONYCHOMYCOSIS

97

Table 33 AVERAGE WHOLESALE PRICE OF ITRACONAZOLE AND TERBINAFINE FOR THE TREATMENT OF ONYCHOMYCOSIS ($)

97

PARONYCHIA

98

TINEA DISEASES

98

Tinea Pedis

98

Table 34 THE MARKET FOR OTC TOPICAL ANTIFUNGAL DRUGS TO TREAT TINEA PEDIS: U.S., THROUGH 2007 ($ MILLIONS)

99

VAGINAL FUNGAL INFECTIONS

99

Table 35 DOSING REGIMENS OF ANTIFUNGAL AGENTS USED TO TREAT VAGINAL CANDIDIASIS

100

Table 36 LEADERS IN THE U.S. OTC VAGINAL ANTIFUNGALS MARKET: SALES AND UNIT VOLUME, 2001 ($ MILLIONS, RETAIL)

101

THE U.S. MARKET FOR OTC VAGINAL ANTIFUNGAL TREATMENTS

101

Table 37 THE U.S. MARKET FOR OTC VAGINAL ANTIFUNGAL DRUGS, THROUGH 2007 ($ MILLIONS)

102

INDUSTRY

103

REGIONAL SALES OF ANTIFUNGAL DRUGS

103

Table 38 PERCENTAGE OF SALES OF ANTIFUNGAL DRUGS BY GEOGRAPHIC REGION, 2001 (%)

103

Figure 4 PERCENTAGE OF SALES BY GEOGRAPHIC REGION, 2001

103

LEADERS IN THE PRESCRIPTION ANTIFUNGAL DRUG MARKET

104

Figure 5 MARKET SHARES OF LEADING COMPANIES IN THE ANTIFUNGAL DRUG MARKET, 2001 AND 2007

104

COMPANY PROFILES

105

BRISTOL-MYERS SQUIBB COMPANY

105

BUSINESS OVERVIEW

105

FINANCIAL INFORMATION

105

PRODUCTS

105

COMPANY STRATEGY

106

CONNETICS CORPORATION

106

BUSINESS OVERVIEW

106

FINANCIAL INFORMATION

106

PRODUCTS

107

COMPANY STRATEGY

107

Company Strategy (Continued)

108

DEMEGEN, INC.

109

BUSINESS OVERVIEW

109

FINANCIAL INFORMATION

109

PRODUCTS

109

Table 39 DEMEGEN'S PRODUCT PIPELINE

110

CORPORATE STRATEGY

110

FUJISAWA PHARMACEUTICAL COMPANY, LTD.

110

BUSINESS OVERVIEW

110

FINANCIAL INFORMATION

111

PRODUCTS

111

Table 40 FUJISAWA'S PRODUCT PIPELINE

112

Table 40 (CONTINUED)

113

GILEAD SCIENCES INC.

113

BUSINESS OVERVIEW

113

FINANCIAL INFORMATION

114

PRODUCTS

114

Table 41 GILEAD'S PRODUCT PIPELINE

115

CORPORATE STRATEGY

115

INTERMUNE, INC.

116

BUSINESS OVERVIEW

116

FINANCIAL INFORMATION

116

PRODUCTS

117

Table 42 INTERMUNE'S PRODUCT PIPELINE

117

JOHNSON & JOHNSON

118

BUSINESS OVERVIEW

118

FINANCIAL INFORMATION

118

PRODUCTS

119

CORPORATE STRATEGY

119

MACROCHEM CORPORATION

119

BUSINESS OVERVIEW

119

FINANCIAL INFORMATION

119

PRODUCTS

120

Table 43 MACROCHEM'S PRODUCT PIPELINE

121

CORPORATE STRATEGY

121

MICROLOGIX BIOTECH INC.

121

BUSINESS OVERVIEW

121

FINANCIAL INFORMATION

121

PRODUCTS

122

Table 44 MICROLOGIX'S PRODUCT PIPELINE

123

COMPANY STRATEGY

123

Company Strategy (Continued)

124

MYLAN LABORATORIES, INC.

125

BUSINESS OVERVIEW

125

FINANCIAL INFORMATION

125

PRODUCTS

126

CORPORATE STRATEGY

126

NOVARTIS

127

BUSINESS OVERVIEW

127

FINANCIAL INFORMATION

127

PRODUCTS

128

CORPORATE STRATEGY

128

PFIZER CORPORATION

128

BUSINESS OVERVIEW

128

FINANCIAL INFORMATION

128

LEADING PRODUCTS

129

CORPORATE STRATEGY

130

SCHERING-PLOUGH CORPORATION

131

BUSINESS OVERVIEW

131

FINANCIAL INFORMATION

131

LEADING PRODUCTS

131

Table 45 SCHERING-PLOUGH'S PRODUCT PIPELINE

132

CORPORATE STRATEGY

133

VERSICOR, INC.

133

BUSINESS OVERVIEW

133

FINANCIAL INFORMATION

133

LEADING PRODUCT CANDIDATES

133

Table 46 VERSICOR'S PRODUCT PIPELINE

134

CORPORATE STRATEGY

134

Corporate Strategy (Continued)

135

 

 

LIST OF TABLES

 

Summary Table:
WORLDWIDE SALES OF ANTIFUNGAL DRUGS, BY CATEGORY, THROUGH 2007 ($ MILLIONS)

XX

Table 1 INCIDENCE OF DISEASES CAUSED ANNUALLY BY SELECTED FUNGAL PATHOGENS, U.S.

2

Table 2 INCIDENCE OF CANDIDAL BLOODSTREAM ISOLATED IN THE SICU AND NICU (%)

2

Table 3 CANDIDA SPECIES INFECTION INCIDENCE OVER TIME (%)

3

Table 4 INCIDENCE OF FUNGAL INFECTIONS BY SITE, 1987-1988 TO 1993-1994 (%)

3

Table 5 DISTRIBUTION OF CANDIDA BLOODSTREAM ISOLATES IN SELECTED GEOGRAPHIC AREAS

22

Table 6 AVAILABLE LABORATORY TESTS FOR PRESUMPTIVE IDENTIFICATION OF CANDIDA

28

Table 7 ACTIVITY OF FLUCONAZOLE AND ITRACONAZOLE AGAINST BLOODSTREAM ISOLATES OF CANDIDA SPECIES

29

Table 8 SUSCEPTIBILITY OF NOSOCOMIAL AND COMMUNITY-ACQUIRED CANDIDA BLOODSTREAM ISOLATES (%)

30

Table 9 DRUGS USED TO TREAT VAGINAL CANDIDIASIS

46

Table 10 FACTORS PREDISPOSING PATIENTS TO FUNGAL INFECTION

48

Table 11 SURVEILLANCE STRATEGIES FOR IDENTIFICATION OF FUNGAL INFECTIONS IN AT-RISK PATIENTS

48

Table 12 SIGNIFICANT MYCOSES IN PATIENTS WITH AIDS

49

Table 13 RISK CATEGORIES FOR INVASIVE FUNGAL INFECTIONS IN CANCER PATIENTS

50

Table 14 PRESCRIPTION BRANDED ANTIFUNGAL DRUGS ON THE MARKET, 2002

56

Table 15 SELECTED PRESCRIPTION ANTIFUNGAL DRUGS: WORLDWIDE SALES, 2001 AND 2002 ($ MILLIONS)

57

Table 16 PATENT EXPIRATION OF LEADING ANTIFUNGAL AGENTS

58

Table 17 WORLDWIDE SALES OF PRESCRIPTION SYSTEMIC ANTIFUNGAL DRUGS, BY CATEGORY: THROUGH 2007 ($ MILLIONS)

58

Table 18 PREFERRED DRUGS FOR THE TREATMENT OF SYSTEMIC FUNGALINFECTIONS

60

Table 19 USE OF DRUGS TO TREAT SYSTEMIC FUNGAL INFECTIONS, BY COUNTRY, 2000 (%)

60

Table 20 THE MARKET FOR AMPHOTERICIN B PRODUCTS: WORLDWIDE SALES, THROUGH 2007 ($ MILLIONS)

70

Table 21 THE MARKET FOR PRESCRIPTION TOPICAL ANTIFUNGAL PRODUCTS: U.S. SALES, THROUGH 2007 ($ MILLIONS)

74

Table 22 ANTIFUNGAL AGENTS AMONG THE TOP-SELLING PRESCRIPTION GENERIC DRUGS IN THE U.S., 2001

74

Table 23 ESTIMATES OF MARKET SHARE OF PRESCRIPTION GENERIC ANTI-FUNGAL DRUGS, U.S., THROUGH 2007

75

Table 24 THE MARKET FOR OTC TOPICAL ANTIFUNGAL DRUGS: U.S. SALES, THROUGH 2007 ($ MILLIONS)

76

Table 25 RX-TO-OTC SWITCHES OF ANTIFUNGAL DRUGS, BY MANUFACTURER AND YEAR, 1975-2002

77

Table 26 ANTIFUNGAL RX-TO-OTC SWITCH CANDIDATES

79

Table 27 MARKET FOR BRAND NAME OTC ANTIFUNGALS CONTAINING RX-TO-OTC SWITCHED INGREDIENTS: U.S., THROUGH 2007 ($ MILLIONS)

81

Table 28 MARKET FOR OTC GENERIC ANTIFUNGALS CONTAINING RX-TO-OTC SWITCHED INGREDIENTS: U.S., THROUGH 2007 ($ MILLIONS)

82

Table 29 THE MARKET FOR RX-TO-OTC ANTIFUNGAL DRUGS: U.S., THROUGH 2007 ($ MILLIONS)

83

Table 30 OTC ANTIFUNGALS MANUFACTURER MARKET SHARE BY REVENUES, 2001 (%)

84

Table 31 LEADING SUPPLIERS OF RX-TO-OTC SWITCHED ANTIFUNGALS, 2001

85

Table 32 ANTIFUNGAL DRUGS IN CLINICAL DEVELOPMENT

85

Table 33 AVERAGE WHOLESALE PRICE OF ITRACONAZOLE AND TERBINAFINE FOR THE TREATMENT OF ONYCHOMYCOSIS ($)

97

Table 34 THE MARKET FOR OTC TOPICAL ANTIFUNGAL DRUGS TO TREAT TINEA PEDIS: U.S., THROUGH 2007 ($ MILLIONS)

99

Table 35 DOSING REGIMENS OF ANTIFUNGAL AGENTS USED TO TREAT VAGINAL CANDIDIASIS

100

Table 36 LEADERS IN THE U.S. OTC VAGINAL ANTIFUNGALS MARKET: SALES AND UNIT VOLUME, 2001 ($ MILLIONS, RETAIL)

101

Table 37 THE U.S. MARKET FOR OTC VAGINAL ANTIFUNGAL DRUGS, THROUGH 2007 ($ MILLIONS)

102

Table 38 PERCENTAGE OF SALES OF ANTIFUNGAL DRUGS BY GEOGRAPHIC REGION, 2001 (%)

103

Table 39 DEMEGEN'S PRODUCT PIPELINE

110

Table 40 FUJISAWA'S PRODUCT PIPELINE

112

Table 41 GILEAD'S PRODUCT PIPELINE

115

Table 42 INTERMUNE'S PRODUCT PIPELINE

117

Table 43 MACROCHEM'S PRODUCT PIPELINE

121

Table 44 MICROLOGIX'S PRODUCT PIPELINE

123

Table 45 SCHERING-PLOUGH'S PRODUCT PIPELINE

132

Table 46 VERSICOR'S PRODUCT PIPELINE

134

 

 

LIST OF FIGURES

 

Summary Figure:
U.S. MARKET FOR ANTIFUNGAL DRUGS, BY CATEGORY, 2001, 2002, AND 2007 ($ MILLIONS)

XXI

Figure 1 PERCENTAGE OF THE WORLDWIDE PRESCRIPTION ANTIFUNGAL DRUGS, BY CATEGORY, 2002 AND 2007 (%)

59

Figure 2 THE MARKET FOR RX-TO-OTC ANTIFUNGAL DRUGS: U.S., 2002 AND 2007 (%)

83

Figure 3 OTC ANTIFUNGALS MANUFACTURER MARKET SHARE BY REVENUES, 2001 (%)

84

Figure 4 PERCENTAGE OF SALES BY GEOGRAPHIC REGION, 2001

103

Figure 5 MARKET SHARES OF LEADING COMPANIES IN THE ANTIFUNGAL DRUG MARKET, 2001 AND 2007

104