Cholesterol, a waxy, fat-like substance, is essential for the preparation of hormones, vitamin D, and substances that help in the digestion of food. High-density lipoproteins (HDL) and low-density lipoproteins (LDL) carry cholesterol throughout the body. LDL cholesterol, also known as bad cholesterol, leads to a buildup of cholesterol in arteries causing atherosclerosis. HDL cholesterol, also known as good cholesterol, is responsible for the removal of cholesterol from the body through the liver. Maintaining a proper balance among them is important for a healthy heart. Total cholesterol in the blood below 200 mg/dL is a desirable category. Increase in the level of LDL cholesterol causes deposition of cholesterol on walls of artery in the form of plaques. When these plaques start breaking, blood clots appear around the plaques leading to narrowing of blood vessels and reduced oxygen carrying capacity.
Changing lifestyles, lack of exercise, and increase in the intake of saturated and trans fat, smoking, and alcohol consumption are major factors contributing to the increased prevalence of high cholesterol levels in patients. Genetics can be another reason for high cholesterol levels in blood as high LDL levels are found in people who have familial hypercholesterolemia, an inherited condition. Abnormal levels of cholesterol also occur due to presence of one or more conditions such as diabetes, liver or kidney disease, underactive thyroid gland, polycystic ovary syndrome, pregnancy, and other conditions that increase the level of female hormones and drugs that increase LDL cholesterol and decrease HDL cholesterol (progestins, anabolic steroids, and corticosteroids). Moreover, increasing intake of white bread & pastas instead of whole wheat and rising consumption of cheese, whole milk, and red meat are driving the growth of the Cholesterol Lowering Drugs Market.
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The global cholesterol lowering drugs market can be segmented as drug class and region. Based on drug class, the market is segmented as statins, bile acid sequestrants, nicotinic acid, fibrates, ezetimibe, and PCSK9 inhibitors. Statins, bile acid sequestrants, and ezetimibe lower the LDL cholesterol while nicotinic acid lowers LDL cholesterol as well as triglycerides. Statins (HMG-CoA reductase inhibitors) are the first line drug therapy to lower LDL cholesterol and also help in the prevention of coronary heart disease, heart attack, and stroke. Few examples of statin drugs include lovastatin, pravastatin, simvastatin, fluvastatin, atorvastatin, and rosuvastatin. Among these, atorvastatin (Lipitor) and rosuvastatin (Crestor) are leading the market. In addition, the added anti-inflammatory property of statins has increased the demand for statin drug class.
However, development of statin resistance in some patients and rhabdomyelosis, a severe side effect caused by statins, are restraining the market growth. The availability of generic drugs of leading brands is likely to restraint the market growth during the forecast period. Drug class of bile acid sequestrants include cholestyramine, colestipol, and colesevelam. These drugs are not effective when used alone.
Hence, they are recommended to be used along with statins. Ezetimibe is an adjuvant therapy to be used with statins to manage hyperlipidemia. PCSK9 is a protein that blocks the LDL cholesterol binding sites in the liver thus lowering LDL cholesterol removal from body. PCSK9 inhibitor is an emerging class of cholesterol lowering agent. Monoclonal antibodies such as Repatha (evolocumab) by Amegen and Praluent (alirocumab) by Regeneron Pharmaceuticals, Inc. are few examples which come under this class. The approval of Repatha and Praluent has influenced the immediate cost of drugs under PCSK9 inhibitors.
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Geographically, the cholesterol lowering drugs market is distributed over North America, Latin America, Europe, Asia Pacific, and Middle East & Africa. Europe is the largest market for cholesterol lowering drugs owing to high prevalence of hyperlipidemia. According to the WHO, 133 million people suffer from bad cholesterol in EU’s five countries: Germany, France, Italy, Spain, and the U.K. North America is also a large market for cholesterol lowering drugs. According to the Centers for Disease Control and Prevention, about 610,000 people die of heart disease in the U.S. every year. Drivers boosting the market growth in this region are unhealthy lifestyles and genes. The prevalence of hyperlipidemia is increasing in some countries of Asia and South American. Thus, these regions are emerging markets for cholesterol lowering drugs.
Key players operating in the cholesterol lowering drugs market are AstraZeneca, Merck, Pfizer, AbbVie, Novartis, Sanofi, Kowa, Daiichi Sankyo, and Amgen.