The global anticoagulation market size was valued at USD 21,813.4 million in 2022. It is expected to reach USD 43,243.1 million by 2031, growing at a CAGR of 18.4% during the forecast period (2023–2031).
Anticoagulant medications (blood thinners) are chemical agents that prevent or diminish blood coagulation and lengthen the time required for blood to clot. Many medical diseases, including atrial fibrillation, deep vein thrombosis, myocardial infarction, c, stroke, and others, are associated with an increased risk of blood clots. The increasing prevalence of venous thromboembolism (VTE) and cardiovascular disorders, growing adoption of novel oral anticoagulants (NOACs), and raising awareness of NOACs in developing regions are expected to contribute to significant growth in the global anticoagulants market over the forecast period. In addition, an increase in the number of obese and older people, more significant unmet needs, and a surge in demand for innovative therapies all contribute to the expansion of the market. However, the price of NOACs and the absence of antidotes for NOACs hinder the market's growth.
Cardiovascular health awareness and the rise in new therapeutic launches are two major factors influencing global market growth. Blood thinners are a vital part of that treatment regimen. Cardiovascular treatment through therapeutics includes a multifaceted approach that may result in the use of several different types of medications. Several significant market leaders have launched anticoagulants, addressing the urgent treatment requirements for blood clot prevention. For instance, Bristol-Myers Squibb Company and Pfizer Inc. introduced the anticoagulant Eliquis (apixaban). The product has solid sales and has been shown to reduce risks better than other medications in the global context.
The high prevalence of cardiovascular diseases (CVD) worldwide and the rising demand for more potent blood thinners are additional significant driving forces. Since they were first made available to the general public, anticoagulants have undergone significant R&D advancements. Since then, several novel therapeutics have been introduced to the market and have achieved great success, including novel oral anticoagulants (NOACS). Eliquis and Xarelto, two of the most popular anticoagulants, now dominate the global market. Generic anticoagulant launches and their increased availability could hurt the market. However, cardiovascular diseases (CVD) are nearly incurable due to their nature, and the treatment outlook for patients is getting worse due to the disease's rising prevalence. This is expected to be one of the other major driving forces in the global market because of numerous unmet treatment needs.
The Institute of Safe Medication Practices (ISMP) has categorized oral anticoagulants as high-alert medications because they can potentially cause harm when used clinically. There have been numerous reports on the risk of bleeding when anticoagulants are used alongside other similar medications (antiplatelet drugs), when the medicine is duplicated, when dosing errors occur, when treatment is unintentionally stopped, and when monitoring issues arise. Moreover, the Joint Commission has included the prudent use of an oral anticoagulant in the National Patient Safety Goals (NQF). One of the market restraints is the inclusion of anticoagulants in the high-risk category of drugs and the strict regulatory standards.
Products that can aid patients in extensive applications have been developed due to the growing development in treatment options. The rising number of patients who require anticoagulants is the cause of the increasing product launches in the global anticoagulation market. The demand for distributors in remote regions is anticipated to increase as new products are introduced. The target population is expanding due to the rising rates of cardiovascular disease and deep vein thrombosis patients. The number of manufacturers on the market is growing due to the research and development efforts to release a generic version of medications following the end of the patent-protection regime.
The global anticoagulation market is segmented by drug class, disease indication, route of administration, and distribution channel.
Based on drug class, the global market is bifurcated into direct anticoagulants (DOACS), heparin and low molecular weight (LMWH), warfarin, and other vitamin k antagonists.
The DOACs segment is the highest contributor to the market and is expected to grow at a CAGR of 10.56% during the forecast period. Rivaroxaban, Apixaban, Dabigatran, Edoxaban, and Betrixaban are recent oral anticoagulants. These brand-new medications have a wide range of potential advantages. They promise to lower the risk of stroke and systemic embolism and prevent deep vein thrombosis and pulmonary embolism (PE). NOACs, which include the drugs Dabigatran, Rivaroxaban, Apixaban, and Edoxaban, is approved in the U.S., according to an article published in the Journal of Nursing Critical Care in 2017. Additionally, this market's expansion is fueled by the rising incidence of strokes globally.
For over 60 years, the only oral anticoagulants used were warfarin and acenocoumarol. In the N-terminal regions of the vitamin K-dependent proteins, vitamin K is a cofactor in the post-translational carboxylation of glutamate residues to -carboxyl glutamates. Treatment with VKA is recommended for several medical conditions, including acute myocardial infarction, vasculopathy, atrial fibrillation (AF), DVT, PE, prevention of recurrence, atrial fibrillation and stroke, tissue heart valves, and mechanical prosthetic cardiac valves.
The global market is bifurcated based on disease indication into a heart attack, stroke, deep vein thrombosis/pulmonary embolism (pe), and mechanical heart valves (MHV).
The heart attack segment is the highest contributor to the market and is expected to grow at a CAGR of 9.15% during the forecast period. Heart failure (HF) and heart attacks with impaired left ventricular function are significant causes of morbidity and mortality in the United States and worldwide. A factor in this burden is stroke. The greatest risks for stroke are seen when other risk factors, such as atrial fibrillation, are present, even though it appears that HF may carry some risk. In this population, the cornerstone of risk reduction tactics is therapeutic anticoagulation.
Medications in the anticoagulation class are used to treat and prevent strokes. Anticoagulants have been used in the emergency care of patients with acute ischemic stroke for a long time. An increase in the use of these anticoagulants for stroke treatment is driving this segment's market growth.
Based on the route of administration, the global market is bifurcated into oral and injectable.
The oral segment is the highest contributor to the market and is expected to grow at a CAGR of 8.72% during the forecast period. Direct oral anticoagulants (DOACs) are administered by the oral route, representing a significant advancement in the anticoagulation field. Additionally, DOACs are more widely available in anticoagulation and have demonstrated efficacy across various indications. As a result, this factor significantly supports the market growth of this industry, which in turn helps the market growth for anticoagulants.
The preferred methods of administration for injectable anticoagulants are subcutaneous (SC) injection or intravenous (IV) infusion of unfractionated heparin (UFH). IV administration (with a bolus dose) is preferred when rapid anticoagulation is required because it quickly reaches therapeutic plasma concentrations. Depending on the dose administered, the bioavailability of UFH when administered SC ranges from 30 to 70%. Vitamin K can be administered intravenously (IV) or orally; the SC route is not advised.
Based on the distribution channel, the global market is bifurcated into hospital, retail, and online pharmacies.
The retail pharmacies segment is the highest contributor to the market and is expected to grow at a CAGR of 6.96% during the forecast period. As the cost of drugs provided by retail pharmacies is comparably lower than that of pharmacies associated with hospitals, this segment's market is anticipated to grow. During the assessment period, the demand for retail pharmacies is expected to increase due to the rise in the number of pharmacies selling anticoagulant medications.
Hospital pharmacies are a unique subset of pharmacies that work hand in hand with medical facilities to provide care. Examples include hospitals, drug-dependency facilities, outpatient clinics, drug information centers, and residential care facilities. The market expansion of this sector is being driven by an increasing number of hospital pharmacies engaged in the sale of anticoagulant medications.
The global anticoagulation market is segmented by region into North America, Europe, Asia-Pacific, and the Rest of the World.
North America is the most significant revenue contributor and is expected to grow at a CAGR of 8.3% during the forecast period. Canada and the US make up the two halves of North America. Several factors, including the global adoption of novel oral anticoagulants (NOACs) and the rising prevalence of venous thromboembolism (VTE) and cardiovascular disorders, contribute to North America's largest market share of 33.99%. Novel oral anticoagulants (NOACs), although there are some concerns and difficulties with their introduction in developing nations, have emerged as promising substitutes for vitamin K antagonists (VKAs), according to a published article in PubMed in 2016. Additionally, significant market players in this area engaged in product innovation expansion, expansion, strategic collaborations, and the region's highly developed healthcare infrastructure are fostering the market growth.
Europe is expected to grow at a CAGR of 7.36% during the forecast period. With an increase in the prevalence of cardiovascular diseases and rising R&D spending in the pharmaceutical industry, Europe has also developed into a significant market. The area has considerable growth potential to contribute to expanding anticoagulation globally in the upcoming years. However, the market expansion of the European anticoagulants market is being constrained by strict regulations put in place by various governments. Additionally, oral anticoagulant side effects and complications limit the growth of the European anticoagulation market.
The Asia-Pacific region offers lucrative opportunities for players operating in the anticoagulants market due to its growing patient population suffering from chronic and acute diseases, rising prevalence of cardiovascular disease and VTE, developing economies, improving diagnosis rates, and increasing demand for ideal therapeutics. Additionally, the market growth has been supported by ongoing economic development, which has led to improved healthcare awareness and the development of healthcare infrastructure. However, rising anticoagulant drug treatment costs are anticipated to restrain the market's expansion in the Asia-Pacific region.
In the Middle East and Africa, the market is expanding significantly in these regions due to the rising prevalence of cardiovascular diseases and the rising number of research organizations and subsidiaries working on anticoagulant R&D. The Middle East and North Africa (MENA) region has a high burden of morbidity and mortality due to early (55 years for men; 65 years for women) myocardial infarction (MI) and acute coronary syndrome, according to a Pubmed article from 2020. (ACS). The rising prevalence of this disease in the area will increase the need for effective anticoagulant therapy, which in turn is fueling the expansion of the anticoagulation market.
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