Community-Acquired Bacterial Pneumonia

Decision Resources, Inc, December 2011, Pages: 126

The community-acquired bacterial pneumonia (CABP) market is highly crowded and genericized; nevertheless, it has important unmet needs for new therapies that are active against key drug-resistant pathogens and that can demonstrate efficacy in the moderate to severe CABP population. Although the majority of CABP patients are treated in the outpatient setting, the inpatient setting represents more than half of the CABP market and will be the area of highest commercial growth over the 2010-2020 period. Key drivers of the CABP inpatient segment include the uptake of marketed and emerging antibiotic brands and the anticipated increase in disease severity among hospitalized patients.

Executive Summary

What are the key parameters of the CABP market?
What factors are driving the market for CABP therapies?
What factors are constraining the market for CABP therapies?
What are the drug development activities of note in CABP?
What do the experts say?
What key challenges and opportunities remain?

1 Etiology and Pathophysiology
Overview
Etiology
Typical Pathogens
Streptococcus Pneumoniae
Haemophilus Influenzae
Gram-Negative Bacilli
Atypical Pathogens
Mycoplasma Pneumoniae
Chlamydia Pneumoniae
Legionella Pneumophila
Emerging Pathogens
Methicillin-Resistant Staphylococcus Aureus
Pathophysiology
The Immune Response
Risk Factors
Clinical Presentation of Disease
Antimicrobial Resistance

2 Epidemiology and Patient Populations
Overview
Disease Definition
Methods
Inpatient Setting
Outpatient Setting
Subpopulations
Diagnosed and Drug-Treated Populations
Percentage Diagnosed
Percentage Drug-Treated

3 Current Therapies and Medical Practice
Treatment Providers
Goals of Treatment
Currently Marketed Products
Treatment Guidelines and Factors Influencing Drug Selection
Treatment Algorithm
Country-Specific Prescribing Practices
Country-Specific Reimbursement Issues

4 Unmet Needs
Overview
Agents Active Against Drug-Resistant Pathogens
Therapies with a Higher Barrier to Development of Resistance
Launch of Agents from Novel Drug Classes
Rapid Pathogen Identification Methods

5 Emerging Therapies
Overview
Future Positioning of Key Competitors
Drug Development and Regulatory Hurdles
Oxazolidinones
Overview
Mechanism of Action
Radezolid
Macrolides and Related Agents
Overview
Mechanism of Action
Solithromycin
Quinolones
Overview
Mechanism of Action
Nemonoxacin
Delafloxacin
JNJ-Q2
Zabofloxacin
Streptogramins
Overview
Mechanism of Action
NXL-103

6 Market Outlook
Overview
Trends in the Inpatient and Outpatient Settings
Drug-Class-Specific Trends
Quinolones
Penicillins
Cephalosporins
Macrolides and Ketolides
Oxazolidinones
Carbapenems and Penems
Glycylcyclines and Tetracyclines
Other Agents

Appendix A Bibliography—Community Acquired Bacterial Pneumonia

Appendix B Market Forecast Methodology
Bottom-Up Market Forecasting Overview
Patient Populations
Drug-Specific Assumptions
General Sources of Data
Pricing, Dosing, Days of Therapy, and Compliance Assumptions
General Statements About Pricing
Dosing, Days of Therapy, and Compliance
Generic Erosion
Beta-Lactam/Beta-Lactamase Inhibitors
Carbapenems
Quinolones
Tetracyclines and Tetracycline Derivatives
Oxazolidinones
Emerging Therapy Prices
Currently Marketed Products Launching in New Markets
Cephalosporins
Quinolones
Oxazolidinones

Appendix C Experts Interviewed—Community Acquired Bacterial Pneumonia

Tables and Figures

Table 1-1 Characteristics of Select Pathogens in Community-Acquired Bacterial Pneumonia

Table 1-2 Conditions That Increase Susceptibility to Community-Acquired Bacterial Pneumonia

Table 1-3 Mechanisms of Resistance Against Select Antibacterial Classes

Table 2-1 Number of Diagnosed and Drug-Treated Events of Inpatient Community-Acquired Bacterial Pneumonia in the Major Pharmaceutical Markets, 2010-2020 (thousands)

Table 2-2 Number of Diagnosed and Drug-Treated Events of Outpatient Community-Acquired Bacterial Pneumonia in the Major Pharmaceutical Markets, 2010-2020 (thousands)

Table 2-3 Number of Diagnosed Events of Community-Acquired Bacterial Pneumonia in the Major Pharmaceutical Markets by Treatment Setting, 2010-2020 (thousands)

Table 2-4 Key Sources for Epidemiologic Estimates?Community-Acquired Bacterial Pneumonia

Table 3-1 Community-Acquired Bacterial Pneumonia Treatment Providers and Referral Patterns by Market

Table 3-2 Severity Assessment Systems for Community-Acquired Bacterial Pneumonia

Table 3-3 End Points Used in Clinical Trials for Community-Acquired Bacterial Pneumonia

Table 3-4 Current Therapies Used for Community-Acquired Bacterial Pneumonia

Table 3-5 Current Classes Used for Community-Acquired Bacterial Pneumonia—Mechanism of Action

Table 3-6 Clinical Efficacy of Select Therapies for Community-Acquired Bacterial Pneumonia

Table 3-7 Eradication Rates of Key Community-Acquired Bacterial Pneumonia Pathogens by Select Antibiotics

Table 3-8 Comparison of Current Therapies for Community-Acquired Bacterial Pneumonia

Table 3-9 Expert Insight: Leading Therapies in Community-Acquired Bacterial Pneumonia

Table 3-10 Community-Acquired Bacterial Pneumonia Treatment Guidelines by Market

Table 3-11 Factors Influencing Drug Selection in Community-Acquired Bacterial Pneumonia

Table 3-12 Prescribing Practices by Market

Table 3-13 Reimbursement Environment by Market

Table 5-1 Emerging Therapies in Development for Community-Acquired Bacterial Pneumonia

Table 5-2 Estimated Launch Dates for Key Emerging Therapies for the Treatment of Community- Acquired Bacterial Pneumonia

Table 5-3 Efficacy Results of a Phase II Clinical Trial Comparing Oral Nemonoxacin to Levofloxacin in the Treatment of Community-Acquired Bacterial Pneumonia

Table 6-1 Sales of Drugs to Treat Community-Acquired Bacterial Pneumonia (all populations) in the Major Pharmaceutical Markets, 2010-2020

Table 6-2 Timeline of Key Market Events for Community-Acquired Bacterial Pneumonia

Table B-1 Sources for Drug Prices

Figure 1-1 Diagram of the Respiratory Tract and Select Defenses

Figure 3-1 Treatment Algorithm for Community-Acquired Bacterial Pneumonia

Figure 4-1 Unmet Needs: Attainment and Remaining Opportunity in Community-Acquired Bacterial Pneumonia

Figure 6-1 Community-Acquired Bacterial Pneumonia, 2010-2020: Market Share

Figure 6-2 Sales of Therapies to Treat Community-Acquired Bacterial Pneumonia in the Major Pharmaceutical Markets, by Patient Status, 2010-2020

Figure 6-3 Timeline of Near-Term Events in Community-Acquired Bacterial Pneumonia

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