CNS Therapeutics Market

Market Overview

The global CNS therapeutics market size was valued at USD 120.60 billion in 2022. It is estimated to reach USD 214.36 billion by 2031, growing at a CAGR of 6.6% during the forecast period (2023–2031). Factors such as increasing prevalence of CNS disorders and presence of strong pipeline drugs, significantly drives the demand for CNS therapeutics market by 2031.

The brain and spinal cord form the central nervous system (CNS), a crucial part of the nervous system. The central nervous system is the body's processing hub. The brain controls most body processes, including awareness, motion, thought, speech, and the five senses of taste, sight, touch, hearing, and smell. Spinal cord tissue is surrounded by brain tissue. It transmits and receives communications between the brain and the rest of the body via the network of peripheral nerves.

The medulla is also connected to the spinal cord by nerves. Neurons are the fundamental component of the central nervous system. The neurons are arranged in networks that convey electrical or chemical signals to and from the brain. Anesthesia, anticonvulsants, CNS stimulants, muscle relaxants, narcotic analgesics, sedatives, etc., comprise the majority of CNS therapeutics. In the treatment of Parkinson's disease, melancholy, Alzheimer's disease, epilepsy, traumatic brain injury, spinal cord injury, CNS cancer, etc., they are widely utilized.

Market Dynamics

Global CNS Therapeutics Market Drivers

Increasing Prevalence of CNS Disorders

In recent years, there has been a notable and sustained rise in the incidence of central nervous system (CNS) illnesses. Mental illness can be attributed to several key causes, including heightened stress levels resulting from the demands of daily life, disturbances in achieving a harmonious work-life equilibrium, and a predominantly sedentary lifestyle. As per the National Institute of Mental Health, around 51.5 million people had mental illness in the U.S. in 2019. Hence, the rise in CNS disorders has paved the way for key pharmaceutical players to undertake extensive market development in this sector.

Additionally, the rising prevalence of neurodegenerative illnesses, such as Parkinson's disease, Alzheimer's disease, ALS, and HD, is expected to boost CNS therapeutics market growth. For instance, according to WHO, epilepsy accounts for around 13 million disability-adjusted life years and is accountable for more than 0.5% of the global disease burden. In addition, developing therapeutics for neurological diseases has been difficult, mainly due to the blood-brain barrier. For instance, for the last 17 years, no new drug has been approved for Alzheimer's disease by the U.S. FDA. Moreover, the rising prevalence of neurological diseases presents significant unmet needs. Therefore, there is an increased need for novel therapeutics for use in neurological disease treatment.

Presence of Strong Pipeline Drugs

The pharmaceutical companies are focusing on R&D of potential candidates for the treatment of neurodegenerative disorders, such as Alzheimer's, Parkinson's, and MS. As of February 2020, there were 121 drug candidates for Alzheimer's disease, out of which 29 are currently being studied under phase 3 clinical trials, 65 agents are under phase 2 clinical trials, and 27 are evaluated under phase 1 clinical trials. Likewise, 12 drug candidates target cognitive enhancements, and 9.9% of the pipeline drugs are intended to treat neuropsychiatric and behavioral symptoms.

Additionally, the introduction of late-stage pipeline products is soon projected to fuel the market. For instance, in January 2021, Biogen announced the U.S. FDA's 3-month review extension for BLA of aducanumab to treat Alzheimer's disease. Aducanumab (BIIB037) is a human monoclonal antibody currently being developed through a collaborative effort between Biogen Inc. and Eisai Co., Ltd. The reported action date for the revised Prescription Drug User Fee Act (PDUFA) is June 7, 2021.

Global CNS Therapeutics Market Restraints

High Treatment Cost

Chronic CNS disorders require treatment for a long duration, along with critical care. Treatments for such diseases require high costs or expenditure. The treatment cost for CNS disorders varies depending on the region. According to the American Academy of Neurology, the average cost of treating neurologic disorders was over USD 800 billion as of March 2017.

The cost of dementia and stroke is estimated to be around USD 550-600 billion by 2030. According to NCBI, in 2013, the average treatment cost for neurological diseases in the UK was estimated at USD 13,322 for anxiety disorders, USD 21,930 for mood disorders, and USD 25,266 for dementia. Treatment cost for neurological disorders is expected to be high in developing economies. Thus, high treatment costs are restraining the growth of the overall market.

Global CNS Therapeutics Market Opportunities

Introduction of Novel Drug Delivery Systems in CNS

Several R&D initiatives have launched innovative drug-delivery systems in the CNS therapies market over the last decade. These innovative drug delivery systems have an advantage over conventional methods due to fewer side effects. For instance, In August 2020, Johnson & Johnson Services, Inc. received the sNDA approval for SPRAVATO (esketamine) CIII nasal spray for treating patients with Major Depressive Disorder (MDD). In this difficult-to-treat patient population, SPRAVATO was the first and only approved antidepressant drug shown to improve depressive symptoms with the first dose.

Moreover, the availability of different dosage forms can enable product differentiation for pharmaceutical companies, resulting in greater profits. NeuroDerm is developing ND0612 to treat patients with moderate-to-severe Parkinson's disease for whom oral medications are no longer effective. Deep Brain Stimulation (DBS) and levodopa/carbidopa intestinal gel are two current treatment modalities that require surgery. ND0612 is a safer, more efficient, and more convenient option for continuous subcutaneous delivery of levodopa/carbidopa. Therefore, the dynamics of demand and the development of novel drug delivery systems directly impact each other, driving the market.

Regional Analysis

Based on region, the global CNS therapeutics market share is bifurcated into North America, Europe, Asia-Pacific, Latin America, and the Middle East and Africa. 

North America Dominates the Global Market

North America is the most significant global CNS therapeutics market shareholder and is estimated to exhibit a CAGR of 6.7% during the forecast period. The presence of highly developed healthcare infrastructure, better reimbursement policies, and high awareness regarding available novel treatment options are anticipated to drive the regional market. The local presence of leading regional players, such as AbbVie Inc.; Biogen; Lilly; Johnson & Johnson Services, Inc.; and Pfizer Inc., is expected to boost growth over the forecast period. The rise in initiatives key players undertake to develop novel therapies for different applications in central nervous system disorders is also expected to propel regional market share. In addition, the growing incidence of mental and neurodegenerative illnesses, such as multiple sclerosis, Alzheimer's disease, Parkinson's disease, and epilepsy, is fueling CNS therapeutics market demand in the region. For instance, about 2.5 million people have been diagnosed with multiple sclerosis worldwide, of which around 20% live in the North American region.

Furthermore, the presence of government and nonprofit organizations in North American countries is expected to increase the treatment rate in this region in the coming years. These organizations are pivotal in creating awareness among people about early diagnosis and treatment to improve their quality of life.

Europe is predicted to exhibit a CAGR of 6.4% over the forecast period. Neurological diseases, including CNS ones, account for a large and increasing health burden in Europe. Stroke, migraine, and other neurological diseases are among the most common types in Europe after cardiovascular diseases and cancers. The region's aging population is one of the factors driving the prevalence of neurodegenerative diseases. The prevalence of Alzheimer's disease, multiple sclerosis, and Parkinson's disease is comparatively higher in the European region.

Moreover, the incidence of mental health disorders is increasing in the region. These disorders, mainly anxiety, depression, and drug-related issues affect 1 in 6 Europeans annually and cost more than 4% of the GDP across 28 EU countries. The surging prevalence of neurodegenerative diseases, like dementia (most commonly due to Alzheimer's), mental disorders, and rising healthcare expenditure in the region is aiding lucrative market growth.

Asia-Pacific region is expected to boost fastest over the forecast period. The high prevalence of neurodegenerative diseases, increasing awareness regarding mental health, and improving healthcare infrastructure in the region are anticipated to boost regional market growth. Developed nations in the Asia Pacific region, such as Japan, South Korea, and Australia, have better healthcare policies and established public health policies focused on mental health. Moreover, developing countries in the region are reforming healthcare policies to improve patients' lives with neurological disorders. In addition, the patent expiry of neurological drugs and increasing penetration of generic forms of these drugs are expected to increase the treatment rate in the region's low- and middle-income countries. For instance, in 2018, Natco Pharma launched the generic version of Aubagio for treating relapsing and remitting forms of multiple sclerosis in India.

In Latin America, neurodegenerative diseases like Alzheimer's disease and dementia result in significant disease burdens to both patients and caregivers. Moreover, it is expected that the number of individuals living with dementia in the region will increase fourfold by 2050. Frontotemporal dementia is the most common type of dementia, mainly associated with three genes: MAPT, GRN, and C9orf72. Moreover, the region faces increased disability due to depression, with depressive disorders being the largest cause of disability, mainly among those aged between 15 and 49. A 2018 study published in the Pan American Journal of Public Health suggests a 14.2% prevalence of mental health disorders in this region. Considering the abovementioned factors, the Latin American market will exhibit prominent growth during the forecast period.

The Middle East and Africa have reported high mental disorder rates over the past few years. For instance, Epidemiology studies in the North African and Middle Eastern regions have demonstrated depression rates ranging from 13 % to 18%, respectively, with women experiencing almost double the rates of depression compared to men. Moreover, recent studies (The Arab Youth Survey 2019) consisting of Arab youth across 15 countries in the Middle East and North Africa found that one-third of the interviewees had a mental disorder such as depression or anxiety.

In addition, the region has a low prevalence of dementia, such as Alzheimer's, due to a relatively young population. However, the number is expected to grow as the population ages. Sub-Saharan African countries consistently have depression rates between 10% and 20%, yet there are not enough mental health professionals to serve the individuals who need help. On the other hand, the prevalence of dementia in Sub-Saharan Africa is reported to be at 7.2% in people aged 60 and above.

Segmental Analysis

The global CNS therapeutics market is segmented by disease.

Based on disease, the global market for CNS therapeutics is bifurcated into neurovascular diseases, CNS trauma, mental health, neurodegenerative diseases, and infectious diseases. 

The neurodegenerative diseases segment dominates the global CNS therapeutics market share and is projected to exhibit a CAGR of 9.1% over the forecast period. Common degenerative CNS disorders include Alzheimer's disease, Parkinson's disease, multiple sclerosis, and Huntington's disease. Most of the drugs used for Alzheimer's disease and Parkinson's disease are for providing symptomatic relief. Several R&D initiatives about this segment are being undertaken, owing to which several pipeline drugs are being introduced. These include Aducanumab, Lecanemab, Solanezumab, Gantenerumab, novel delivery forms of LD/CD, etc. The rising prevalence of these diseases, coupled with the approval of Disease-modifying Therapies (DMTs) for Alzheimer's disease and multiple sclerosis, are expected to be major factors driving the growth of the neurodegenerative disorders segment.

The mental health segment of the central nervous system therapeutics market is further segmented into anxiety disorders, mood disorders, substance abuse disorders, personality disorders, and Attention Deficit Hyperactivity Disorder (ADHD). Personality disorders often co-occur with mental disorders and are sometimes seen as symptoms. As per the American Psychiatric Association, common types of personality disorders are schizoid personality disorder, paranoid personality disorder, borderline personality disorder, etc. Treatment options for these disorders include psychodynamic therapy, cognitive behavioral therapy, group therapy, and dialectical behavior therapy. The main causes of personality disorders include genetics, childhood trauma, verbal abuse, and peers. Until recently, there have been no specific medicines for treating personality disorders.

The CNS has limited self-repairing abilities, which boosts the demand for effective treatment options in emergency departments. Currently used drugs in traumatic brain injury include diuretics, coma-inducing, and antiseizure drugs. According to the CDC, around 1.5 million Americans annually sustain traumatic brain injury, of which around 230,000 require hospitalization. This leads to around 50,000 deaths each year. The burden of the disease is one of the major factors driving the growth of the CNS trauma segment. In addition, ongoing clinical trials suggest that the effectiveness of drugs with potent application in traumatic brain injury depends upon characteristics such as the ability to cross the blood-brain barrier, improve short-term motor function, and protect against excitotoxic injuries. A large number of R&D activities are expected to fuel this segment's future growth.

CNS infections can be caused by bacterial, viral, fungal, or other pathogens. Major CNS bacterial infections include mycobacterial infections, bacterial meningitis, subdural empyema, bacterial brain abscess, nocardiasis, Whipple disease, and actinomycosis. The treatment of these diseases has several limitations, including complexities associated with CNS, as well as the blood-brain barrier. Commonly prescribed treatments include antibiotics such as amoxicillin, cefotaxime, cotrimoxazole, and chloramphenicol. As CNS is more susceptible to bacterial infections, risks involved in these conditions are much higher than other types of infections. These infections require great attention and are most likely to recur in the future. High demand for effective treatment options is expected to boost R&D activities, fueling market growth.

Recent Developments

• January 2023- Capsida Biotherapeutics and Eli Lilly and Company's wholly-owned subsidiary Prevail Therapeutics announced a collaboration to develop non-invasive gene therapies for central nervous system (CNS) disorders.
• March 2023- Confo Therapeutics, a leader in the discovery of drugs targeting G-protein coupled receptors (GPCRs), announced that it entered into a collaboration with Daiichi Sankyo (TSE: 4568) for the discovery and development of small molecule agonists against an unidentified target associated with CNS diseases.