Executive Summary
Chart E1 Demographics of MS across Seven Major Markets
Chart E2 Avonex Revenues ($m) across seven major markets, 2006
Chart E3 Copaxone Revenues ($m) across six major markets, 2006
Chart E4 Rebif Revenues ($m) across six major markets, 2006
Chart E5 Betaseron/Betaferon Revenues ($m) across seven major markets, 2006
Chart E6 Novantrone Revenues ($m) across seven major markets, 2006
Chart E7 Tysabri Revenues ($m) in US and Germany, 2006
Table E1 MS Revenue Forecast for Seven Major Markets, 2007-2012
Chart E8 MS Revenue Forecast for Seven Major Markets, 2007-2012
Table E2 MS Revenue Forecast for Other Markets 2007-2012
Chart E9 MS Revenue Forecast for Other Markets 2007-2012
Chapter 1. Introduction to Multiple Sclerosis (MS)
1.1 Introduction
Chapter 2. Defining Multiple Sclerosis
2.1.1 Benign MS
2.1.2 Relapse-remitting MS
2.1.3 Primary progressive MS
2.1.4 Secondary progressive
2.1.5 Progressive relapsing MS
2.2 Symptoms and Differential Diagnosis
2.2.1 Primary symptoms
2.2.2 Secondary symptoms
2.2.3 Tertiary symptoms
2.2.4 Diagnosis of MS
2.3 The Risk factors of MS
2.3.1 Immunologic Factors
2.3.2 Environmental Effects may influence MS Incidence
2.3.3 The Viral Induction of MS is possible
2.3.4 The Genetic Basis of MS Exists
2.3.5 Hormones Predispose Women to MS
2.4 The Demographics of MS
Chart 2.1 Demographics of MS across Seven Major Markets
Chapter 3. Pharmaceutical Products for MS Treatment
3.1 Current Pharmaceutical Drug Therapies
Table 3.1. The Major Drug Treatments of MS
3.2 Relapsing-Remitting MS
3.2.1 Avonex (Interferon beta 1a) to Reduce Severity of MS
3.2.2 Rebif (Interferon beta 1a)
3.2.3 Betaseron (Interferon beta 1b)
3.2.4 Copaxone (Glatiramer acetate)
3.4 Antineoplastic Drugs (Relapse-Remitting & Secondary progressive)
3.4.1 Cancer Drug, Novantrone (Mixonatrone) Benefits MS Sufferers
3.4.2 Taxanes
3.4.2.1 Taxol (paclitaxel)
3.4.3 Immunosuppressants - Secondary Progressive and Worsening Relapse-Remitting MS
3.4.3.1 Imuran (Azathioprine)
3.4.3.2 Sandimmune (Cyclosporine)
3.5 Corticosteroids
Chapter 4. Leading Companies behind MS Therapy
4.1 Key Companies delivering MS Therapy
4.1.1 Biogen Idec and Elan Pharmeceuticals
4.1.2 Merck Serono
4.1.3 Bayer-Schering Pharmaceuticals' Betaseron
4.1.4 Teva and Sanofi Aventis
Chapter 5. Oral MS Pharmaceuticals Research and Development (R&D)
5.1 Oral Market Industry
Table 5.1. Factors influencing oral delivery of pharmaceutical products
5.1.1 Oral drugs development for MS
5.1.2 Leading companies in Oral delivery of MS therapeutics
5.1.2.1 Biogen Idec and UCB
5.1.2.2 Teva's Laquinomod
5.1.2.3 Serono's Mylinax oral formulation given fast tract
5.1.2.4 Novartis's Fingolimod (FTY720)
5.1.2.5 Sanofi-Aventis's Teriflunomide set to file
5.1.2.6 GW Sativex Investigational Cannabis-Based Treatment for MS
5.1.2.7 Pfizer's Lipitor (atorvastin) May See Extension through MS
5.2. Progressive forms of MS studies underway
5.2.1 Biogen Idec and Genentech to deliver MS therapeutics through Monoclonal Antibodies (Mabs)
5.2.2 Bayhill Therapeutics Vacine (BHT-3009)
5.2.3 BHT-3009 Non-broad-based immunosuppressant mechanism
5.2.4 BioMS (MBP 8298) synthetic fragment Phase II study shows delayed progression of MS for 5 years
Table 5.2. MS phase III pipeline
Table 5.3. MS phase II pipeline
Table 5.4. MS phase I pipeline
Chapter 6. Children with MS
6.1 Paediatric MS
6.1.1 Disease course of Paediatric MS
6.1.2 Progression of Paediatric MS
6.1.3 Challenges in diagnosis of paediatric MS
6.1.4 Treatment options for Paediatric MS
Table 6.1 Paediatric MS Dosage of Disease Modifying Drugs
Chapter 7. Multiple Sclerosis Disease Modifying Drugs Market Analysis in the Seven Major Markets
7.1 US Market Analysis
Chart 7.1 US Market Growth Rate 2002-2003
Chart 7.2 US Health Budget Allocation in comparison to other Regions
Chart 7.3. Population With and Without Health Insurance Coverage in the US
Chart 7.4. Split of Health Insurance Providers in the US
7.1.2 US Expenditure on Pharmaceutical products
Chart 7.5. US Pharmaceutical Market Revenue 2005-2006
7.1.3 Overview of Approved MS Therapeutics in US Market
Chart 7.6. US one year cost to treat MS patients with the disease modifying drugs
7.1.4 US Major MS Therapeutics
7.1.5.1 Biogen Idec's Avonex
7.1.5.2 Biogen Idec Future targets for Avonex
7.1.5.3 Teva and Aventis (Sanofi-Aventis) Copaxane
7.1.5.4 Merck Serono's Rebif
7.1.5.5 Bayer Schering Betaseron
7.1.5.6 Biogen Idec and Elan's Tysabri
7.1.5.7 Antineoplastic Drugs (Relapse-Remitting & Secondary progressive)
7.1.5.8 Cancer Drug, Novantrone (Mixonatrone) Benefits MS Sufferers
7.1.5.9 US MS Market Revenue Forecast 2007-2012
Table 7.1. US MS Disease Modifying Drugs Revenues ($bn), Forecast 2007-2012, 2017 & 2022
Chart 7.7. US MS Disease Modifying Drugs Revenues ($bn) Forecast 2007-2012, 2017 & 2022
Chart 7.8.1 US Avonex Combined Revenues ($m), 2003-2006
Chart 7.8.2 US Avonex Split Revenues ($m), 2003-2006
Chart 7.8.3 US Copaxone Combined Revenues ($m), 2003-2006
Chart 7.8.4 US Copaxone split Revenues ($m), 2003-2006
Chart 7.8.5 US Rebif Combined Revenues ($m), 2003-2006
Chart 7.8.6 US Rebif split Revenues ($m), 2003-2006
Chart 7.8.7 US Befaseron Combined Revenues ($m), 2003-2006
Chart 7.8.8 US Befaseron split Revenues ($m) 2003-2006
Chart 7.8.9 Tysabri split Revenues ($m), 2006
Chart 7.8.10 US Novantrone combined Revenues ($m) 2003-2006
Chart 7.8.11 US Novantrone split Revenues ($m) 2003-2006
7.2. US MS Market Drivers and Restraints
7.2.1 Market Drivers
7.2.2 Market Restraints
7.2 Japan Pharmaceutical Market Outlook
Chart 7.12 Japan Pharmaceutical Revenues ($bn), 2004-2006
7.3 Japan's Healthcare System
7.3.1 Medical Expenditure in Japan
Chart 7.13 Japan Medical Expenditure 1990s (JPY Trillions)
7.3.2 Japan Healthcare Strategic Reform
7.3.3 Strategic long-term care insurance care reforms
7.3.4 Japan Pharmaceutical Market Analysis
7.3.5 Overview of Approved MS Therapeutics in Japanese Market
7.3.6.1 MS Product in the Japanese Market
Chart 7.14 Revenues of Three Major MS Drugs in Japan, 2006
7.3.6.2 Biogen Idec's Avonex Japanese Market Analysis
Chart 7.15 Avonex Split Revenues ($m) in Japan,2006
7.3.6.3 Bayer Schering's Betaseron Japanese Market Analysis
Chart 7.1.6 Betaferon Combined Revenues ($m) in Japan 2003- 2006
Chart 7.17 Betaferon Split Revenues ($m) in Japan 2003-2006
7.3.6.4 Merck Serono's Novantrone Japanese Market Analysis
Chart 7.18 Novantrone Combined Revenues ($m) in Japan 2003-2006
Chart 7.19 Novantrone split Revenues ($m) in Japan 2003-2006
7.3.6.5 Japan MS Market Revenue Forecast 2007-2012,2017 & 2022
Table 7.2 Japan MS Major Drugs Revenue ($m) Forecast 2007-2012, 2017 & 2022
Chart 7.20 Japan MS Major Drugs Revenue ($m) Forecast 2007-2012
7.4 Market Drivers and Restraints
7.4.1 Market Drivers
7.4.2 Market Restraints
7.5 France Pharmaceutical Market Outlook
Chart 7.21 France’s Pharmaceutical Market Revenues ($bn) 2002-2006
7.5.1 Healthcare System
7.5.2 France’s Health and Medical Expenditure
7.5.3 Major MS Product in the French Market
Chart 7.22 Major MS disease modifying drugs in France
7.5.4.1 Biogen Idec's Avonex Market Analysis in France
Chart 7.23 Biogen Idec combined Revenue ($m), 2003-2006
Chart 7.24 Biogen Idec Avonex Split Revenue ($m), 2003-2006
7.5.4.2 Merck Serono's Rebif Market Analysis in France
Chart 7.25 Rebif combined Revenue ($m), 2003-2006
Chart 7.26 Rebif Split Revenue ($m), 2003-2006
7.5.4.3 Bayer Schering's Betaferon Market Analysis in France
Chart 7.27 Betaferon combined Revenues ($m), 2003-2006
Chart 7.28 Betaferon Split Revenues ($m), 2003-2006
7.5.4.4 Teva and Sanofi-Aventis' Copaxone Market Analysis in France
Chart 7.29 Copaxone combined Revenue ($m) 2003-2006
Chart 7.30 Copaxone split Revenue ($m) 2003-2006
7.5.4.5 Merck Serono's Novantrone Market Analysis in France
Chart 7.31 Serono’s declining Novantrone Revenue ($m), 2003-2006
7.6 Tysabri to reach the French Market
7.7 France’s MS Market Revenue ($m) Forecast 2007-2012, 2017 & 2022
Chart 7.32 France Disease Modifying Drugs Revenue ($m) Forecast 2007-2012, 2017 & 2022
Table 7.3 France Disease Modifying Drugs Revenues ($m), Forecast 2007-2012, 2017 & 2022
7.8 France’s MS Market Drivers and Restraints
7.8.1 Market Drivers
7.8.2 Market Restraints
7.9 Germany Pharmaceutical Outlook
Chart 7.33 Germany’s Pharmaceutical Revenues ($bn), 2002-2007
7.9.1 Germany Healthcare System
7.9.2 Pharmaceutical Sector Reforms
7.9.3 Major MS Product in the German Market
Chart 7.34 Major MS disease modifying drugs in Germany
7.9.3.1 Merck Serono's Rebif leading disease modifying drug in Germany 2006
Chart 7.35 Rebif’s Combined Revenues ($m), 2003-2006
Chart 7.36 Rebif’s Split Revenues ($m), 2003-2006
7.9.3.2 Bayer Schering Betaferon German Market Analysis
Chart 7.37 Betaferon Combined Revenues ($m), 2003-2006
Chart 7.38 Betaferon Split Revenues ($m),.2003-2006
7.9.3.3 Biogen Idec's Avonex Market Analysis in Germany
Chart 7.39 Avonex Combined Revenues ($m), 2003-2006
Chart 7.40 Avonex Revenues ($m), 2003-2006
7.9.3.4 Teva and Sanofi-Aventis Copaxone Market Analysis in Germany
Chart 7.41 Copaxone Combined Revenues ($m), 2003-2006
Chart 7.42 Copaxone Split Revenues ($m), 2003-2006
7.9.3.5 Serono's Novantrone Market Analysis in Germany
Chart 7.43 Novantrone Combined Revenues ($m), 2003-2006
7.9.3.6 Biogen Idec and Elan's Tysabri Market Analysis in Germany
Chart 7.41 Tysabri Split Revenues ($m), 2006
7.10 Germany MS Market Revenue ($m) Forecast 2007-2012, 2017 & 2022
Table 7.4 Germany Disease Modifying Drugs Revenue ($m) Forecast 2007-2012, 2017 & 2022
Chart 7.45 Germany Disease Modifying Drugs Revenue ($m) Forecast 2007-2012, 2017 & 2022
7.11 Germany MS Market Drivers and Restraints
7.11.1 Market Drivers
7.11.2 Market Restraints
7.12 UK Pharmaceutical Outlook
Chart 7.46 UK Global Pharmaceutical Revenues ($bn), 2002-2006
7.12.1 UK Healthcare system
7.12.2 UK NHS and Department of Health
7.12.3 NHS and Private Healthcare
7.12.4 UK Healthcare Insurance Policies
7.12.5 Current NHS Prescription Volumes
7.12.6 Dominance of Generic Market
7.12.7 Major MS Product in the UK market
Chart 7.47 UK Major MS Disease Modifying Drugs
7.12.7.1 Teva and Sanofi-Aventis's Copaxone leading Disease modifying drug in the UK in 2006
Chart 7.48 Copaxone Combined Revenues ($m), 2003-2006
Chart 7.49 Copaxone Split Revenues ($m), 2003-2006
7.12.7.2 Merck Serono's Rebif UK market analysis
Chart 7.50 Rebif Combined Revenues ($m), 2003-2006
Chart 7.51 Rebif Split Revenues ($m), 2003-2006
7.12.7.3 Biogen Idec Avonex UK market Growth
Chart 7.52 Avonex Combined Revenues ($m), 2003-2006
Chart 7.53 Avonex Split Revenues ($m), 2003-2006
7.12.7.4 Bayer Schering Betaferon UK market Growth
Chart 7.54 Betaferon Combined Revenues ($m), 2003-2006
7.12.7.5 Serono's Novantrone UK Market
Chart 7.56 Novantrone Combined Revenues ($m), 2003-2006
7.13. NICE approves Biogen Idec and Elan's Tysabri in the UK
7.14. UK Sector to grow and dominate MS Market in Europe
7.15. UK MS Market Revenues ($m) Forecast 2007-2012, 2017 & 2022
Table 7.5 UK Disease Modifying Drugs Revenue ($m) Forecast 2007-2012, 2017 & 2022
Chart 7.57 UK Disease Modifying Drugs Revenue ($m) Forecast 2007-2012, 2017 & 2022
7.16 UK MS Market Drivers and Restraints
7.16.1 Market Drivers
7.16.2 Market Restraints
7.17 Italy Pharmaceutical Outlook
Chart 7.58 Italy’s Pharmaceutical Revenues ($bn), 2004-2006
7.17.1 Italy's Healthcare System and Reforms
7.17.2 The Major MS Product in the Italian market
Chart 7.59 Italy’s Major MS Disease Modifying Drugs
7.17.2.1 Merck Serono's Rebif leading beta interferon for MS in Italy
Chart 7.60 Rebif Combined Revenues ($m),2003-2006
Chart 7.61 Rebif Split Revenues ($m),2003-2006 Avonex Italy Market Analysis
7.17.2.2 Biogen Idec‘s Avonex Italy Market Analysis
Chart 7.62 Avonex Combined Revenues ($m),2003-2006
Chart 7.63 Avonex Split Revenues ($m),2003-2006
7.17.2.3 Bayer Schering Betaseron Italy Market Analysis
Chart 7.64 Betaferon Total Revenues ($m),2003-2006
7.17.2.4 Teva and Sanofi-Aventis’ Copaxone Italy Market Analysis
Chart 7.65 Copaxone Combined Revenues ($m), 2003-2006
Chart 7.66 Copaxone Split Revenues ($m), 2003-2006
7.17.2.5 Serono's Novantrone Italy Market Analysis
Chart 7.67 Novantrone Total Revenues ($m), 2003-2006
7.18 Italy MS Market Revenue ($m) Forecast 2007-2012, 2017 & 2022
Table 7.6 Italy Disease Modifying Drugs Revenue ($m) Forecast 2007-2012, 2017 & 2022
Chart 7.68 Italy Disease Modifying Drugs Revenue ($m) Forecast 2007-2012, 2017 & 2022
7.19 Italy MS Market Drivers and Restraints
7.19.1 Market Drivers
7.19.2 Market Restraints
7.20 Spain's Pharmaceutical Outlook
Chart 7.69 Spain Pharmaceutical Revenues ($bn), 2002-2006
7.20.1 The Major MS Product in the Spanish market
Chart 7.70 Major MS Disease Modifying Drugs in Spain
7.20.1.1 Merck Serono's Rebif leading MS product in Spain
Chart 7.71 Rebif Total Revenues ($m), 2003-2006
7.19.2.2 Biogen Idec’s Avonex Spainish Market Analysis
Chart 7.72 Avonex Total Revenues ($m), 2003-2006
7.20.1.3 Bayer Schering Betaferon Spain Market Analysis
Chart 7.73 Betaferon Total Revenues ($m), 2003-2006
7.20.1.4 Teva and Sanofi-Aventis Copaxone Spain Market Analysis
Chart 7.74 Copaxone Total Revenues ($m), 2003-2006
7.20.1.5 Serono's Novantone Spain Market analysis
Chart 7.75 Novantrone Total Revenues ($m), 2003-2006
7.21 Spain MS Market Revenues ($m) Forecast, 2007-2012, 2017 & 2022
Table 7.7 Spain Disease Modifying Drugs Revenue ($m) Forecast 2007-2012, 2017 & 2022
Chart 7.76 Spain Disease Modifying Drugs Revenue ($m) Forecast 2007-2012, 2017 & 2022
7.22 Spain MS Market Drivers and Restraints
7.22.1 Market Drivers
7.22.2 Market Restraints
Chapter 8. Conclusion
Table 8.1 Leading Companies with Oral MS Products late stage phase III studies to reach market by 2010