1. Alimentary/Metabolic
The alimentary/metabolic market is the third largest therapeutic category by sales and generated nearly US$51.3bn (+4% YoY) in 2005. This market spans the sale of a broad range of drugs including; anti-ulcerants (around 34%), drugs for the treatment of gastro-oesophageal reflux disease, anti-diabetics (around 23% of the market) and anti-obesity drugs (around 2%). Sales grew slowly throughout the world with over 50% derived in the US, 25% in Europe and 16% in Japan.

ANTI-ULCERANT MARKET
The anti-ulcerant class totalled US$17.3 billion in 2005 (+1% YoY) and represented 3.4% of global pharmaceutical sales (estimated to be US$600 billion in 2005). The largest segment of the anti-ulcerant market were the proton pump inhibitors (PPIs), which accounted for around 75% of global anti-ulcerant sales, or US$13 billion in 2005.

However, the sale of PPIs has stagnated due to the patent expiry of AstraZeneca's omeprazole and its subsequent availability over-the-counter. This has been partially offset by the sale of Nexium, AstraZeneca's second-generation PPI, which became the third best selling drug in 2005 and generated global sales of US$4.6 billion, equivalent to 1% of of the global pharmaceutical market.

DIABETES MARKET
We estimate the market for anti-diabetic drugs in 2005 was worth around US$11.8 billion (around 23% of alimentary/metabolic sales), an increase of 12% year on year. Oral anti-diabetic agents accounted for over 60% of sales (US$7 billion) versus injectable insulin (US$4.6 billion). However, the revenue growth of oral anti-diabetic agents continues to slow (+5% YoY) due to the patent expiry of leading brands such as Glucophage, Glucophage XR and Glucovance and a slow down in prescription demand. Revenue growth forecasts have been driven by the sales of two of the largest drug classes, namely glitazones (monotherapy/combinations) and insulin, which continue to deliver high growth of 15% and 20% respectively.

OBESITY MARKET
The market for weight-loss drugs in the US, Europe, and Japan totalled around US$800 million in 2005. However, this market still offers huge opportunity for the development of novel, well-tolerated agents. The global anti-obesity market is forecast to reach sales of over US$2 billion by 2010.

2. Anti-Infectives
The anti-infectives market is the fifth largest therapeutic category. We estimate that anti-infectives grossed sales of US$28.5 billion in 2005, with a further US$16 billion being derived from hospital-based use and OTC. The majority of prescription-based sales were derived from the US (around 50%) compared to 22% in Europe and Japan. However, growth in Europe at over 5% exceeded that of the US and Japan compared with around 3%.

ANTIBIOTIC SALES
We estimate the antibiotic market is currently worth nearly US$31 billion, equivalent to around 5% of total global pharmaceutical sales. The market for anti-MRSA antibiotics is expected to reach US$2 billion by 2006, driven by the sales of Pfizer's Zyvox which is available as IV or oral formulation and generated sales of US$618 million in 2005. In contrast, the market for non-MRSA hospital antibiotics is currently valued at around $6 billion.

ANTIVIRAL SALES
We forecast that nearly US$9.8 billion was spent globally on the treatment of antiviral medicines in 2005. The largest segment of this market is derived from the treatment of HIV, with reported sales of around US$7 billion. The US market accounts for around 60%, equating to over US$5 billion, whilst in Europe, France has the largest market value with revenues of around US$600 million. HIV-reverse transcription inhibitors were amongst the top 20 leading therapeutic drug classes (based on 2005 US sales) generating global sales of US$5 billion with products such GSK's Combivir.

The second largest segment of the antiviral market is derived from the treatment of hepatitis B/C which reported sales of around US$3 billion in 2005, generated from combination therapies (pegylated interferon and ribavarin) for the treatment of HCV. This market is dominated by two players: Roche which commands over 60% of the US and global pegylated interferon market through the sale of Pegasys/Copegus (US$1.9 billion in 2005) and Schering-Plough through the sale of PegIntron/ Rebetrol (US$1.1 billion in 2005).

ANTIFUNGAL SALES
We forecast that antifungal medicines generated nearly US$4.0 billion of sales per annum in 2005.

3. Cancer
In 2005, we estimate the global anticancer market was worth over US$42 billion (+12.6% YoY) accounting for 7% of global pharmaceutical sales (US$600 billion). Global sales included the sale of cytotoxics, innovative therapies, anti-hormonals plus supportive care (such as anti-emetics). This final segment accounted for nearly half of global sales.

By 2010, the global cancer market is expected to generate sales in excess of US$60 billion due to growth in the sales of existing innovative products and the launch of nearly 60 new products which will account for around 30% of total drug launches. These will offset the decline in sales of cytotoxics and anti-hormonals, which face generic sales erosion, and the uptake of newer products in preference to these older agents.

Cancer is the second most common cause of mortality in the developed world and accounts for around 12.5% of all deaths worldwide. By 2020, it is predicted that the number of new cases of cancer diagnosed will rise to 16 million per annum from 11 million in 2002, with cancer-related deaths reaching 10 million each year versus 6.7 million in 2002. Excluding non-melanoma skin cancers, lung cancer is the most common cancer worldwide with breast cancer being the second most prevalent.

There are several new products that, over the next five years, will change the dynamics within the cancer market. These include, among others:

The launch of new biologics for colorectal cancer (Panitumumab - Amgen/Abgenix) and advanced melanoma (Ticilimumab -Pfizer/Abgenix).

The treatment of highly prevalent cancers such as breast, NSCLC and colorectal with a new first-line therapy for breast cancer, lapatinib (GSK), a third-generation oral platinum based therapy, Telcyta (Telik) and an interesting angiogenic kinase inhibitor, vatalanib for the treatment of advanced colorectal cancer from Novartis and Schering AG.

A new generation of prostate cancer drugs for hormone refractory patients such as Acapodene (GTx), satraplatin (Spectrum Pharmaceutical/ GPC Biotech) and ixabepilone (BMS).

4. Cardiovascular
Cardiovascular (CV) disease remains the number one killer in the US and Europe. In 2005, global sales of CV drugs were estimated to be worth around US$72.7 billion and accounted for around 12% of the world's total drug expenditure (US$600 billion). The majority of sales are derived from the US (around 52%) which has seen considerable growth (10.5% YoY) due to the uptake of new and more expensive medicines and more aggressive treatment of chronic conditions earlier during the course of the disease. Together Europe and Japan account for around 44% of sales with single digit growth.

By 2010, sales of CV drugs are expected to rise to around US$100 billion as the market continues to grow. The main drivers are an increase in diabetic and obese populations and the continued investment of pharmaceutical companies in the development of new classes of CV drugs to treat and prevent chronic CV conditions, as well as addressing areas of high unmet clinical need. The development of new imaging agents to improve CV diagnosis and treatment and improvement in surgical techniques associated with the treatment of CV diseases is critical to market expansion.

CV disease is the leading cause of death in the world, killing 17 million people each year. Many different aetiologies exist and key prevalence indicators include:

Stroke is the third leading cause of death in the major pharmaceutical markets. It is estimated that there were over 1.75 million stroke cases in the US (0.7 million) and Europe (1.05 million) each year. However only between 2%-8% of patients receive treatment on time.

Unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI) are the leading cause of death in the Western world. Both are conditions of acute coronary syndrome (ACS), are recognised to be among the most frequent and important clinical manifestations of CAD.

Atrial fibrillation affects 2.5 million people in the US alone and is estimated to account for between 15 and 20% of all strokes and causes more than 37,000 deaths a year. Prevalence is expected to reach 5.6 million in the US by 2050. In the UK, AF affects 5% of the over 65 population and 10% of over 75s.

5. Central Nervous System
The Central Nervous System (CNS) market is the second largest therapeutic category and is one of the fastest growing. We forecast the global CNS market generated sales of US$68.7 billion in 2005 (+6.1% from 2004). The majority of sales were derived from the US (c. 66%) although sales growth was stronger ex-US.

Within this market the largest segments by sales are: antidepressants (23% market share), antipsychotics (22.6%) and anti-epileptics (16.8%). Some of the fastest growing segments are: sleep disorders (+14.8% (YoY), attention deficit hyperactivity disorder (+10.8% YoY), Alzheimer's disease (+10.7% YoY) and antipsychotics (+10.2% YoY).

CNS disorders represent more than 15% of the global cost of disease. For example, costs of over $100 billion per annum makes Alzheimer's the third most expensive disease in the USA. In addition, they are the leading cause of disability; at any one time 1.5 billion people suffer with a brain or spinal disorder.

CNS diseases and disorders represent the largest and fastest growing area of unmet medical need. Over 1.5 billion people worldwide, including over 100 million people in the US, suffer from CNS diseases or disorders. Key prevalence indicators:

Alzheimer's disease: Almost 5 million individuals in the US alone currently suffer from AD and the US Alzheimer's Association estimates that by 2025, over 22 million people worldwide will be afflicted with AD.

Dementia: Approximately 18 million people suffer with dementia worldwide and this figure is expected to increase to 34 million by 2025.

Muiltiple sclerosis: It is estimated that approximately 3 million live with MS worldwide; over 350,000 Americans (approximately 1 in 1000 aged over 30 years) live with multiple sclerosis.

Whilst we anticipate antidepressants will to continue to command the largest percentage of the CNS market, revenue growth will slow as many of the leading brands face generic competition. Newer products such as DVS 233 (Wyeth) and saredutant (sanofi-aventis) will enter the market from 2006 and enable new pharma players to penetrate this multi billion dollar arena.

6. Musculoskeletal
The musculoskeletal market is the sixth largest therapeutic category by sales and generated over US$228 billion (+0.8% YoY) in 2005. Sales grew strongly in the US and Europe which accounted for 54% and 23% of sales however, sales have slowed significantly, largely due to the withdrawal of a number of COX-2 inhibitors during 2004 and early 2005.

Two of the largest segments of the musculoskeletal market are rheumatoid arthritis (anti-rheumatics) and osteoporosis (bone calcium regulators). The remaining sales are derived from the treatment of a mixture of aetiologies such as anti-inflammatory conditions and muscle relaxants.

ANTI-RHEUMATOID DRUG SALES
We estimate the rheumatoid arthritis (RA) market was worth around US$5.9 billion in 2005 and is expected to reach nearly US$7 billion by 2008 and over US$9 billion by 2013.

Rheumatoid arthritis was estimated to affect more than 21 million people worldwide in 2004. According to the American College of Rheumatology, approximately two million US citizens suffer from RA where around 75% are women with a peak age group of between 20 and 45 years old.

Rheumatoid arthritis is a progressive, systemic autoimmune disease characterised by inflammation of the membrane lining in joints. This inflammation causes a loss of joint shape and function, resulting in pain, stiffness and swelling, ultimately leading to irreversible joint destruction and disability. In more severe cases of RA the eyes, lungs or blood vessels may be involved. RA may also shorten life expectancy by affecting major organ systems and after 10 years, less than 50% of patients can function normally.

OSTEOPOROSIS
We forecast the osteoporosis market was worth nearly US$6 billion in 2005, with around 80% of sales being derived in the US. It has been forecast to be worth between US$8-10 billion by 2010 and nearly US$14 billion by 2014.

Osteoporosis was estimated to affect approximately 100 million people worldwide in 2005. Approximately eight million US women are estimated to have osteoporosis and 22 million are at risk of the disease.

7. Respiratory
The Respiratory market is the fourth largest therapeutic category by sales and generated nearly US$32.4 billion (+8% YoY) in 2005. Sales grew steadily in the US, which accounted for around 54% of global respiratory sales, driven by growth in Advair, GlaxoSmithKline's leading combination therapy for the treatment of asthma/COPD and Merck's Singulair for the treatment of asthma and allergic rhinitis. Sales in Europe are now growing steadily; around 5% following the uptake of new treatments such as Symbicort (AstraZeneca) and Alvesco (Altana/sanofi-aventis) which have yet to be approved in the US markets.

Over 50% of respiratory drug sales were spent on asthma and chronic obstructive pulmonary disease (COPD), the remainder is spent on other respiratory diseases such as allergic rhinitis, coughs and colds, cystic fibrosis and pneumonia. We estimate that the asthma market was worth US$13.5 billion in 2005 and dominated by the sale of inhaled corticosteroids. We forecast that the current market for COPD drug therapy is worth nearly
US$4.4 billion per annum and it is predicted to increase to nearly US$7 billion by 2010.

ASTHMA
Asthma affects over 100 million people worldwide. Approximately 5%-10% of adults and 10%-15% of children suffer from asthma globally and it continues to grow at around 5%-6% per annum. Over 18 million Americans have asthma, but only around 60% of US sufferers are treated. US asthma prevalence rates have risen by almost 50% in the ten years ending 1994 and are expected to increase by 20%-50% every ten years.

COPD
COPD is the fastest-growing cause of death amongst the world's most advanced economies and is responsible for over 2.7 million deaths worldwide. It is estimated that there are up to 20 million sufferers in Japan (the highest cigarette consumption per capita of the world) and 7-10 million and 8-12 million in the US and Europe, respectively. Unfortunately, only around 40% of US COPD sufferers are adequately treated and, by 2025, the World Health Organisation estimates it will be the third leading cause of death in the world.

8. Vaccines
We estimate that vaccines generated sales of over US$10.6 billion in 2005, with over 50% derived from traditional, domestic paediatric vaccines and the development of novel vaccines that can command price premiums.

The market is beginning to turn around after a period of slow growth and it is forecast to be worth nearly US$20 billion by 2010. Growth will be driven principally by the adolescent and adult vaccine segment of the market as well as the development of therapeutic vaccines.

The market has attracted the attention of eleven pharma players, with six of these accounting for around 90% of vaccine sales by value.

ROTAVIRUS
It is estimated that all children over five years old are infected with rotavirus, however the severity of infection may vary between individuals. Acute gastroenteritis is responsible for around 2 million hospitalisations worldwide and 223,000 hospitalisations in industrialised countries annually. Rotavirus is the leading cause of death in children younger than five years of age and accounts for 20% to 25% of all deaths in this age group.

ZOSTER VIRUS
It is estimated that over 90% of adults in the US acquired chicken pox virus as children and between 15-20% experience reactivation during their lifetime. An estimated 800,000 US citizens are diagnosed with herpes zoster virus which may result in severe post herpetic neuralgia in 50%+ of cases.

CERVICAL CANCER VACCINES
Cervical cancer is a major global health problem, with nearly 500,000 new cases occurring each year worldwide. It is the second most common cancer and the third leading cause of cancer deaths in women worldwide.

LUNG CANCER VACCINES
Lung cancer affects more than 1.2 million patients a year, with around 500,000 in the US, Europe and Japan. Non-small cell lung cancer is one of the leading causes of death, resulting in the worst survival rates for all cancers and killing more patients than breast, colon and prostate cancer together. This 400-page report evaluates, compares and contrasts the prospects for the compounds that will revolutionise the pharmaceutical industry over the next 5 years and beyond. The report covers 8 key therapy areas (alimentary/metabolic, anti-infectives, cancer, cardiovascular, CNS, musculoskeletal, respiratory, vaccines) and includes unique sales forecasts by major product.

The search for blockbusters has never been greater - and what's in the pipelines has never generated more interest. That is why this study is so important!

MAJOR THERAPY AREAS ANALYSED

Alimentary/Metabolic
Anti-Infectives
Cancer
Cardiovascular
CNS
Musculoskeletal
Respiratory
Vaccines ... This 400-page report evaluates, compares and contrasts the prospects for the compounds that will revolutionise the pharmaceutical industry over the next 5 years and beyond:

Unique sales forecasts by major product to 2010 and beyond
100 key products assessed
Eight key therapy areas covered
Likelihood to launch assessment
Unique competitor evaluation scores
Critical and detailed appraisal of the research and development background
Detailed background and market context

THE PHARMA MARKET IN CONTEXT
Too few novel products and an aggressive generic sector are taking their toll ... There are many prophets of doom all too ready to write off the research based pharma industry in the future.

And there is plenty on which to base such anxiety. The research-based industry must achieve a fair price in the face of greater cost control, while the burden of red tape and regulation is setting the bar high for successful product introduction. All the time the generics sector eats away at ageing and established portfolios.

It is a fair assessment to say that the industry, in the 1990s, rested too much on its laurels and successful product portfolios. For many years, too few truly novel medicines were brought to market, laying the foundations for the industry's current ills.

But that was then!
There is now considerable reason to view the future more positively; to coolly evaluate the research pipeline and to put that pipeline into its future market environment.

Pharmaceutical winners & losers
Essential analysis of 110 products that could change the face of the market Following the analysis of eight key therapeutic categories, we have identified 100 winning drugs that we forecast to be launched by 2011. Products come from over 50 companies ranging from large pharma and specialty pharma to biopharmaceuticals and biotechnology companies.

Will they make it?
Our estimates assume products will gain approval for the indications we have forecast in the timeframe we have analysed. Regulatory demands and pressures on cost and development budgets increasingly mean safe and effective medicines are not brought to market. That is why we provide a unique assessment of their likelihood to launch.

This report is essential reading for industry planners and investors
Anyone wanting an insightful analysis of the companies and products which will shape the global pharmaceutical industry over the next 5 years need look no further than this report.

Unique competitor/product evaluation
A key feature of this report is the unique assessment made of products and companies that evaluates not only their pharmacological profile and clinical benefits, but also assesses their chances of reaching the market. Each product is assessed to see if:

It has new/novel late phase clinical data (Phase II to III);
It has been highlighted in company reports or R&D presentations as key drivers for the company;
It has a novel mechanism of action that make them stand out amongst their competitors - not a 'me too' drug;
Its approval could drastically change the course of treatment of a disease, i.e. a reformulation improving compliance, improved efficacy improving clinical outcome, stop or reverse the course of a disease etc.
It has a relatively high chance of entering the marketplace by 2010.

A scoring system is applied to both the company and the product as follows:

Competitor Ratio Score

25-29=1 point
30-34=2 points
35-40=3 points
41-45=4 points
46-50=5 points Sales Score (US$)

150-499 million=1 point
500-749 million=2 points
750-999 million=3 points
1,000-1,499 million=4 points
>1,500 million=5 points

Each therapy chapter covers: Current Market Size
Addressable Patient Population
Current Treatments
Sales Drivers
Sales Breakers Future Treatments - Early Stage
Market Dynamics - Winners and Losers
Key launches to 2011
Competitor Ratio Analysis - Products
Competitor Ratio Analysis - Companies