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MIDAS Sales by Disease Insights Series #7
Immunology: The state of the market today
Aaron Wright, Analyst, EMEA Thought Leadership
Dec 20, 2021

The immunology market is an area of great interest in the pharmaceutical industry. High-value medicines and large potential patient populations make it an attractive therapy area. Indeed, the world’s best-selling drug for the past decade, Humira, is an immunology product. In this first article, we will look at the current state of the immunology market. In subsequent articles we will look towards the future, including what diseases are getting the attention of the pharma industry and potential trends to take note of.

Firstly, we should understand where immunology sits as a market compared to other therapy areas. As shown in figure 1a, whilst oncology remains the largest market by overall value, immunology shows the highest short and long-term growth rates, of 16.5% and 17.1% respectively. In addition, figure 1b highlights how immunology sales comprise a quarter of the overall growth in the market in the past five years.

The US has been the primary driver of this growth, accounting for over three quarters of the immunology sales increase since 2016. It is also, as figure 2b shows, the most valuable region for immunology with over $85bn in sales in the past year at list prices.

However, as figure 2a illustrates this growth has been slowing, having nearly halved from its 2016 growth rate. This is in comparison to the Pharmerging market, where growth has increased dramatically. Whilst its overall market share remains small, the continued rapid growth in China, both in terms of innovation and regulatory strength, means that this may change in the future.

In terms of sales by molecule, Adalimumab retains the largest share with over $30bn sales globally in the past year. Whilst this molecule may make up the bulk of sales currently, US LOE in 2023 will increase biosimilar erosion for the molecule. In general, the bulk of immunology sales is comprised of a handful of molecules; the top five selling molecules in 2021 make up around 60 per cent of the total market, as figure 3 highlights. The multi-indicationality of many immunology products is something we will investigate further in a future article.

Immunology is also a highly specialised field, and this is reflected in the breakdown of molecules we see. Figure 4 shows how the overwhelming majority of immunology sales are classified as specialty medicines. A similar trend is seen between biologics and small molecules, with nearly ninety per cent of sales in the past year coming from biologics. Again, this is perhaps not surprising due to the enormous success of specialty biologics in immunology, such as Adalimumab and Ustekinumab.

The splits in volume, however, are completely different, as shown in figure 5. The share of biologics versus small molecules is opposite as to what we see in the sales value, with ninety per cent of volume sales coming from small molecules. Here we can see the distinction between low volume, high-value specialty molecules, and high volume and low-value traditional molecules such as methotrexate.

In the next article we will take a more granular look at the immunology market and investigate sales for specific indications.

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