Keywords: Fibromyalgia, USA, Europe, Japan, Forecasts, Boehringer Ingenheim, Eli Lilly, Cymbalta, Pfizer, Lyrica, Decision Resources

Lilly/Boehringer Ingelheim's Cymbalta now fibromyalgia market leader in USA

Article | 22 July 2012

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US drug major Eli Lilly (NYSE: LLY) and German independent Boehringer Ingelheim’s Cymbalta (duloxetine) was the patient- and market-share leader in the USA in 2011 for the treatment of fibromyalgia, (duloxetine), after surpassing Pfizer’s (NYSE: PFE) Lyrica (pregabalin) in 2010, according to the latest findings of advisory firm Decision Resources.

Cymbalta garnered a 32% share of U.S. fibromyalgia patients in 2011, while Lyrica held a patient share of about 26%. According to interviewed experts, the prescribing of Cymbalta is being driven by the agent’s balance of efficacy and tolerability to patients and it has also benefited from regulatory approval for two common co-morbidities of fibromyalgia - anxiety and depression.

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USA makes up 80% of major market sales for fibromyalgia therapies

The findings from the Pharmacor topic titled Fibromyalgia also reveal that the United States, accounted for nearly 80% of major-market sales of fibromyalgia therapies in 2011 and will account for two-thirds of major-market fibromyalgia sales in 2021. The majority of sales continue to be driven by the leading fibromyalgia-approved therapies, Lyrica and Cymbalta (also available as Xeristar in Europe), and - to a lesser extent - by milnacipran (Forest Laboratories’ Savella, Pierre Fabre’s Ixel).

However, expansion of the market in Europe will be constrained by a dearth of approved therapies, resulting in persistent use of low-cost generic agents. Additionally, although diagnosis and drug-treatment rates are improving in Europe, they will remain lower than in the USA through 2021. Historically, diagnosis and drug treatment rates have been lowest in Japan, but Decision Resources forecasts rapid growth of the market in this region due primarily to the June 2012 approval of Lyrica in that country for the treatment of pain associated with fibromyalgia, and new guidelines for the treatment of the disorder.

Major market sales around $1.8 billion in 2011

In the USA, France, Germany, Italy, Spain, the UK and Japan, the fibromyalgia therapy market will increase from $1.8 billion in 2011 to more than $2 billion in 2018, before declining again to $1.8 billion in 2021. Notably, as awareness and acceptance of fibromyalgia among physicians and the general population continue to increase, the diagnosed and drug-treated population will grow from 3.7 million in 2011 to 5.3 million in 2021.

The findings also reveal that, because its symptoms vary widely from patient to patient and can include pain, depression, fatigue and sleep dysfunction, fibromyalgia remains a very difficult condition to treat.

“Polypharmacy is common in the management of fibromyalgia. Patients are heterogeneous in their response to treatment and no single therapy is likely to provide significant relief of all symptoms,” said Decision Resources analyst John Crowley, adding: “As a result, the demand for novel treatments is high and significant opportunity exists for a drug that can demonstrate efficacy on one or more symptoms while offering an acceptable safety profile."