Introduction
The ageing of the population will result in an increased incidence of coronary artery disease, heart failure and stroke. In addition to these epidemiological forces, the antithrombotics market will be sustained by the forthcoming launch of innovative novel agents whose sales revenue is expected to dampen the commercial impact of generic incursion in blockbuster proceeds.

Scope
Country specific event-driven sales forecasts for the period 2006-15 for the US, Japan, France, Germany, Italy, Spain and the UK
Discussion of recent trials and market-shaping future key events
Profiles of the country and market specific issues which will impact future sales in the market including generic erosion and class switching
Case studies evaluating the commercial impact of two developmental agents with blockbuster potential
Highlights
Demographic trends lead to an increase in the patient population requiring antithrombotic therapy. However, the rising age of the population across all developed regions is increasing the fiscal burden on healthcare payors which are likely to respond by limiting the reimbursement potential of therapies and put pricing pressure on all agents.

The highest selling brands in the antidiabetics market are Lovenox (enoxaparin) and Plavix (clopidogrel), but these agents are subject to forthcoming genericization and will thus not contribute to the growth of the antithrombotics market in the medium-to-long term. Pipeline agents are expected to become significant drivers in the market.

The antithrombotics market is characterized by pockets of high unmet need and a broad spectrum of similarly efficacious therapeutic strategies. There is regional bias in the choice and popularity of therapeutic strategies driven by cultural reasons as well as infrastructural confines.

Reasons to Purchase
Quantify future size and scope of the antithrombotics market and potential for new products
Analyze options to expand commercial potential through pursuit of new indications
Formulate successful launch strategies in a highly competitive mature market

TABLE OF CONTENTS
CHAPTER 1 EXECUTIVE SUMMARY 3
Objective of the analysis 3
Datamonitor insight into the antithrombotics market 4
CHAPTER 2 MARKET DEFINITION AND OVERVIEW 12
Market definition for this report 12
Current market situation 13
Antithrombotics market: overview 13
Anticoagulants market 15
Heparins 17
Low molecular weight heparin (LMWH) 19
Parenteral non-heparinoid anticoagulants 30
Oral anticoagulants 43
Antiplatelets market 45
ADP receptor antagonists 47
cAMP enhancing platelet aggregation inhibitors 50
GP 2b/3a inhibitors 54
Other antiplatelets 61
Thrombolytics market 65
National markets 74
Anticoagulants 76
Antiplatelets 79
Thrombolytics 81
Key clinical trials 83
Key clinical trials in the anticoagulant category 83
Lovenox (enoxaparin) 83
Angiomax (bivalirudin) 89
Arixtra (fondaparinux) 96
Key clinical trials in the antiplatelet category 99
Plavix (clopidogrel) 99
Key clinical trials in the thrombolytics category 113
TNK (tenecteplase) 113
Actilyse (tPA, alteplase) 117
CHAPTER 3 COUNTRY MARKET ASSESSMENTS 120
Current and future opportunities and threats in the antithrombotics market 120
Global opportunities and threats 121
Opportunity: increasing patient pool due to changes in demography and lifestyle 121
Threat: cost-conscious pricing and reimbursement environment 128
US 132
US opportunities 132
US threats 134
Japan 138
Japan opportunities 138
Japan threats 141
EU5: opportunities and threats 145
EU5 Opportunities 145
EU5 Threats 146
France: opportunities and threats 149
France opportunities 149
France threats 151
Germany: opportunities and threats 154
Germany opportunities 154
Germany threats 154
Italy: opportunities and threats 161
Italy opportunities 161
Italy threats 162
Spain: opportunities and threats 165
Spain opportunities 165
Spain threats 167
UK: opportunities and threats 169
UK opportunities 169
UK threats 171
Summary of environmental issues affecting the antithrombotic market size 174
CHAPTER 4 FORECAST ANALYSIS 177
Key assumptions and events 177
New products 177
Future outlook on key marketed products 177
Lovenox (enoxaparin) 177
Angiomax (bivalirudin) 181
Arixtra (fondaparinux) 183
Plavix (clopidogrel) 185
GP 2b/3a inhibitors and thrombolytics 190
Generic incursion: patent expiries and marketing exclusivity 194
Limitations of data 195
Forecasts 195
CHAPTER 5 CASE STUDIES: KEY PIPELINE AGENTS 196
Case study A – What commercial potential does the oral anticoagulant market segment harbor? 196
The market opportunity 196
Warfarin’s monitoring requirement and dosing complexity generates an opening in the market for novel oral anticoagulants 196
Oral antiplatelets are unlikely to threaten commercial potential of emerging oral anticoagulants 199
The key competitors in development 201
The commercial potential of oral anticoagulants 205
Patient potential of oral anticoagulants 205
Sales forecast of the two most advanced oral anticoagulants 206
Conclusions 212
Case study B – Will prasugrel capture the antiplatelet market? 214
The market opportunity 214
The unmet need profile of the antiplatelet market indicates opportunities for novel antiplatelets. 214
Commercial potential of prasugrel 221
Drug overview: prasugrel (CS-747) 221
Sales forecast of prasugrel 235
APPENDIX A 238
Bibliography 238
Report methodology 245
Standard units 245
Japanese market data 246
APPENDIX B – MARKET FORECAST DATA 247
US forecasts 247
Japan forecasts 251
France forecasts 255
Germany forecasts 259
Italy forecasts 263
Spain forecasts 267
UK forecasts 271
M5EU forecasts 275
Global forecasts 281
About Datamonitor 288
About Datamonitor Healthcare 288
About the Cardiovascular Disease analysis team 289
Disclaimer 290