Pemphigus Vulgaris Market Size, Share & Trends Analysis Report By Treatment (Corticosteroids, Immunosuppressants, Biological Therapies, Intravenous Immunoglobulin (IVIG) Therapy, Others), By Route of Administration (Intravenous, Subcutaneous, Oral), By End-User (Hospitals and Clinics, Specialty Dermatology Clinics, Research and Academic Laboratories, Others) and By Region(North America, Europe, APAC, Middle East and Africa, LATAM) Forecasts, 2024-2032

Market Overview

The global pemphigus vulgaris market was valued at USD 470.43 million in 2023. It is expected to reach USD 956.18 million in 2032, growing at a CAGR of 8.2% over the forecast period (2024-32). Greater awareness among healthcare professionals and patients about pemphigus vulgaris, its symptoms, and available treatment options has led to earlier diagnosis and treatment initiation. Efforts by patient advocacy groups and healthcare organizations to raise awareness about rare diseases contribute to market growth.

Pemphigus vulgaris (PV) is an autoimmune condition that can be deadly. Uncommon autoimmune disease pemphigus vulgaris causes severe intraepithelial wounds on the skin and mucous membranes. When the body's immune system begins fighting the proteins on the skin, Pemphigus vulgaris (PV) develops. The main lesion or blister of pemphigus vulgaris is a soft, clear-fluid-filled blister that grows on healthy skin or an itchy base.

Before spreading to other mucous membrane-covered parts of the body like the throat, eyes, lungs, and other areas, PV frequently starts as a mouth blister. Pemphigus vulgaris affects somewhere between 0.5 and 3.2 individuals per 100,000, with a death rate of between 5-15%. Pemphigus vulgaris treatment

Market Dynamics

Market Drivers

Increasing Prevalence of Pemphigus Vulgaris Globally

One of the most severe autoimmune skin conditions, pemphigus vulgaris, can be caused by several factors, including bacterial infections, rising pollution levels, and the adverse effects of several drugs. The frequency of pemphigus was high in the US and Europe in 2015, with between 0.7 to 5 cases per 1,000,000 persons per year in the general population, according to the National Organization for Rare Disorders (NORD). Pemphigus foliaceus, a subtype of pemphigus vulgaris, was also listed as having a high frequency in Africa and several rural parts of the world. The International Pemphigus & Pemphigoid Foundation anticipated that in 2017, there would be between 40,000 and 50,000 cases of pemphigus disease worldwide and 2,500 cases in the US. The rise in pemphigus vulgaris prevalence is anticipated to fuel market expansion over the forecast period.

Growing Private and Government Funding for Disease Research

Many government and private organizations are supporting research on various diseases. In 2017, the International Pemphigus & Pemphigoid Foundation (IPPF) announced research funding programs to encourage and enhance funds for research on diseases and increase awareness about the disease among pemphigus and pemphigoid patients. In addition, the International Pemphigus & Pemphigoid Foundation, in 2017, awarded approximately USD 25,000 to USD 50,000 for research and development to research institutes. According to Biopharma Global 2017, the biopharmaceutical sector is growing faster, with around 8% annually and a global revenue of USD 163 billion. This growth will promote the pharmaceutical market to develop drugs for various diseases. Moreover, increasing research and development investments in the biopharmaceutical sector are coming up with new prospects for the market to grow.

Market Restraint

High Cost of Treatment

Pemphigus vulgaris has various treatment methods, which include corticosteroids, with different effective therapies that may include anti-inflammatory, immunosuppressive, and immunomodulatory procedures. Nowadays, dermatologists use advanced therapeutic techniques such as therapeutic plasma exchange (TPE), intravenous immunoglobulins (IVIG), and rituximab. However, due to their high cost, they are not widely used in low and middle-income countries. According to the Indian Journal of Dermatology 2015, the cost of four injections of rituximab might be around 1.2 to 1.5 lakh rupees in India. Thus, the high price of rituximab is estimated to reduce the adoption rates, leading to restricted market growth.

Market Opportunities

Advancements in Treatments

The number of people suffering from pemphigus vulgaris is increasing globally, and the complication and severity related to this condition are also rising. The South African Dental Association (SADA) reported in 2018 that laser therapy might be utilized as an alternative treatment for pemphigus vulgaris since it is a successful treatment with fewer adverse effects. This study on oral pemphigus vulgaris with cutaneous and ocular involvement. The increase in advancements in treatments is likely to enhance the market growth.

Regional Analysis

Americas Dominates the Global Market

Based on region, the global pemphigus vulgaris market is divided into the Americas, Europe, Asia-Pacific, and the Rest of the World (RoW).

Americas is the most significant shareholder in the global pemphigus vulgaris market and is anticipated to grow at a CAGR of 8.3% during the forecast period. The Americas represent the most significant market because of increased pemphigus vulgaris rates, aging populations, and skin problem research funding. The Americas are further bifurcated into North America and South America. North America is the most prominent contributor to the region. Pemphigus vulgaris prevalence in the U.S. was estimated in 2014 by the National Center for Biotechnology Information to be 0.76 to 5 new cases per million years. Additionally, the International Pemphigus & Pemphigoid Foundation predicted that in 2017, there were around 2,500 cases of pemphigus in the United States.

Europe is estimated to grow at a CAGR of 8.2% over the forecast period. The region is expanding dramatically due to intensive R&D for pemphigus vulgaris, rising financing, and expanding use of the technique. The European region is further segmented into Western Europe and Eastern Europe. The Western Europe region accounted for a larger market share owing to the presence of key countries such as Germany, the U.K., France, Italy, and Spain. The National Center for Biotechnology Information estimates that there are 3 to 6.7 instances of pemphigus vulgaris per million people in Italy and Tunisia, respectively, according to data from 2018.

Furthermore, the pemphigus vulgaris market in Europe is expected to exhibit a healthy CAGR owing to increasing research and development in the region. Due to active government assistance, the demand for Pemphigus Vulgaris (P.V.) treatments is predicted to grow in Europe. In addition, the European Commission approved F. Hoffmann-La Roche Ltd, one of the major companies in the pharmaceutical sector, to commercialize MabThera for treating adults with Pemphigus Vulgaris (P.V.), which is anticipated to grow the market in Europe.

Asia-Pacific is anticipated to contribute to the market expansion for pemphigus vulgaris throughout the forecast period because of the rising demand for pemphigus vulgaris treatments and the rapidly growing healthcare sector. China is the leading market in the region. Technology developments in the health sector and increasing funding for life science research in the Asia-Pacific region fuel regional growth. Due to more widespread government awareness campaigns and the availability of generic medications, Asia-Pacific is the most profitable time. According to clinicopathological research on 41 individuals published in 2016 by the National Center for Biotechnology Information, 85.36% of persons in Eastern India had pemphigus diagnoses.

The Rest of the World comprises the Middle East and Africa. The region is expected to observe slow growth due to low per capita income, lack of awareness, and less exposure to healthcare services in this region. Due to a lack of development and technological knowledge, emerging nations in the Middle East and Africa are expected to have a minor proportion of the global pemphigus vulgaris market forecast. The National Center for Biotechnology Information projected that in 2017, there were 50 cases of pemphigus vulgaris in Iran, 16.1 in Israel, and 1.6 in Saudi Arabia per million inhabitants. The occurrence of skin diseases is likely to support the market growth in this region.

Segmental Analysis

The global pemphigus vulgaris market is segmented by treatment, route of administration, and end-user.

Based on treatment, the global market is divided into corticosteroids, immunosuppressants, biological therapies, intravenous immunoglobulin (IVIG) therapy, and others. 

The corticosteroids segment is responsible for the largest market share and is expected to grow at a CAGR of 7.7% over the forecast period. It is the first preference for treating pemphigus vulgaris due to its fewer side effects and better result. Since the introduction of systemic corticosteroids, the death rate associated with pemphigus has fallen from 90% to 10%, according to the National Center for Biotechnology Information (2014). Within a few weeks, disease activity is often under control with corticosteroids. In addition, complete remission requires months of minimal treatment, but complete remission without treatment sometimes necessitates months or even years of therapy. Corticosteroids can be used with immunosuppressive medication, especially if side effects from anticipated long-term usage (>4 months) are expected, such as hypertension, diabetes mellitus, and osteoporosis.

Immunosuppressants and intravenous immunoglobulin (IVIG) therapy are alternative treatment methods for pemphigus vulgaris. Immunosuppressants are used to control the activities of the immune system. Immunosuppressants include drugs such as Azathioprine, Mycophenolate, Cyclophosphamide, and Cyclosporine, which are recommended depending on the treatment stage. Intravenous immunoglobulin (IVIG) therapy is an intravenous treatment via a catheter or syringe.

Based on the route of administration, the global market is divided into the intravenous, subcutaneous, and oral routes of administration. 

The intravenous (IV) route segment is the highest contributor to the market share and is anticipated to grow at a CAGR of 8.0% over the forecast period. The advantage of intravenous immunoglobulin as adjunctive therapy for pemphigus is that it is not immunosuppressive. Intravenous immunoglobulin is obtained by pooling human plasma and characteristically contains more than or equal to 95% IgG antibodies and only trace amounts of IgA or IgM. In addition, corticosteroid injection is the most effective local treatment for oral pemphigus vulgaris. It is a safe and effective alternative treatment modality in patients with pemphigus vulgaris dependent on systemic corticosteroids or who develop significant adverse effects due to their use. However, there are chances of adopting different routes of administration as an intravenous administration of rituximab is expensive, and neutralizing human anti-chimeric antibodies to rituximab can occur.

Subcutaneous translates as beneath the skin. This injection employs a tiny needle and targets the tissue layer between the muscle and the skin. When administered in this method, medication is often absorbed over a more extended time—sometimes up to 24 hours—than when injected into a vein. This kind of injection is employed when alternative delivery routes may be ineffective. For instance, the stomach's acid and enzymes would destroy various drugs if taken orally. The growth of the subcutaneous route segment is increasing as considered a safe and effective alternative to rituximab for treating pemphigus vulgaris (PV), even in refractory cases.

Based on end-user, the global market is segmented into hospitals and clinics, specialty dermatology clinics, research and academic laboratories, and others. 

The hospitals and clinics segment owns the highest market share and is expected to grow at a CAGR of 8.4% over the forecast period. The majority of autoimmune disease treatments are carried out in hospitals as there is the availability of different diagnostic devices. This share is majorly attributed to the increasing number of patients suffering from autoimmune diseases. Since advanced and complete treatments are available in hospitals, patients usually prefer to get treated at hospitals.

The specialty dermatology clinics segment accounted for the second largest market. Delivering specialized dermatology services requires dedicated multidisciplinary and multi-professional teams with significant experience in diagnosing and managing patients with infrequent and multisystem, complex needs who often require specialist laboratory-based testing, imaging, medical, and surgical management.

Recent Developments

• January 2024 - Recent studies have shown the potential benefits of dapsone and sulfasalazine as adjuvant treatments for PV. A systematic review found that these medications, used alongside standard corticosteroids, helped achieve clinical improvement in a significant number of patients. Specifically, 58% of patients on adjuvant dapsone and 86% on sulfasalazine experienced clinical improvement.
• February 2024 - An unconventional treatment approach using bromocriptine mesylate combined with low-dose prednisone showed successful outcomes in a patient who had refused conventional treatments by North Memorial Health, Minnetonka, MN, and others. This case adds to the growing body of anecdotal evidence suggesting alternative therapeutic pathways for PV.