Ticagrelor Market

Market Overview

The global ticagrelor market size was valued at USD 1,672 million in 2022. It is estimated to reach USD 3,692 million by 2031, growing at a CAGR of 9.2% during the forecast period (2023–2031).

Ticagrelor is a member of a group of organic compounds called triazolopyrimidines. It is an antiplatelet drug that decreases platelet aggregation and prevents blood clots. Ticagrelor works by binding to the P2Y12 in a unique manner and inhibits the Adenosine diphosphate (ADP) signaling by locking the receptor and making it inactive. This inactivation hinders platelet aggregation and reduces blood clots, reducing the risk of acute coronary syndrome (ACS). For oral use, it is prepared in tablet form.

In addition, the drug ticagrelor, also known by the trade name Brilinta, is used to treat the acute coronary syndrome, characterized by issues with blood flow in the coronary arteries, and is used to prevent stroke, heart attack, and other occurrences. Breathlessness, headaches, nausea, dizziness, and nosebleeds are all potential side effects of this drug.

Market Dynamics

Global Ticagrelor Market Drivers

Rising Cardiovascular Disorders

Cardiovascular disorders are heart conditions that include diseased vessels, structural problems, and blood clots. Ticagrelor drugs used in the treatment of cardiovascular disorders interfere with blood coagulation by inhibiting platelet aggregation. In acute coronary syndrome, the combination of ticagrelor and aspirin is reported to have reduced the prevalence of vascular deaths and myocardial infarctions more than the combination of clopidogrel and aspirin. In addition, the increasing cardiovascular rate is eventually driving the growth of the market. For instance, according to the American Heart Association, in 2014, around 31% of the deaths in the US were due to cardiovascular disorders.

Similarly, according to the American Heart Association, around USD 555 billion was spent on cardiovascular illnesses across the Americas. Additionally, according to the European Heart Network, in 2015, 85 million people were living with cardiovascular disorders in Europe. The high occurrence rate of cardiovascular diseases (CVD) globally relates to the high prevalence of well-known risk factors such as hypertension, smoking, dyslipidemia (high cholesterol), diabetes, obesity, and unhealthy lifestyle. Further, the US tops the chart as the most obese country in North America, with 36.2% of its total population having a body mass index of over 30.0. Thus, the increasing occurrences of obesity are likely to indirectly fuel the cardiovascular patient pool, thus spurring the demand for the market.

Increasing Geriatric Population

The increasing aging population is likely to affect market growth positively. The aged population is more prone to chronic diseases such as arthritis, kidney diseases, cardiovascular diseases, and others, likely to boost the market growth. According to the World Population Prospects by the United Nations, approximately 962 million older population aged 60 and above were present globally as of 2017, representing about 13% of the global population. More than 20% of the US population will be 65 years or over by 2030. Similarly, according to the United Nations, around 857,040 older population is expected to reside in Asia by 2050.

Additionally, according to WHO, it is expected that the world's population aged 60 years and above will nearly double from 12 to 22% by 2050. This alarming rise in the older population has a direct effect on the market, as the aging population is more prone to injuries and other health conditions such as gastrointestinal problems, orthopedic diseases, and other diseases that are caused due to low immunity, which in turn, increases their hospital visits and drives the global market.

Global Ticagrelor Market Restraint

High Bleeding Complications

Ticagrelor is used to lower the chance of having another heart attack or dying from a heart attack or stroke but is reported to have caused bleeding that can be serious and sometimes leads to death. Severe bleeding, such as internal bleeding, requires blood transfusions or surgery. Furthermore, ticagrelor is likely to lead to bruising and bleeding more quickly, and patients are more likely to have nosebleeds with bleeding taking longer than usual to stop. These high bleeding complications are likely to hamper the growth of the market.

Global Ticagrelor Market Opportunities

Exploring New Applications

Ticagrelor finds its primary application in preventing strokes in patients with a record of an acute coronary syndrome. Introducing ticagrelor in various applications is one of the emerging opportunities for the global market. The application of ticagrelor in preventing multiple other disorders drives the market's growth. For instance, AstraZeneca has various applications of its ticagrelor (Brilinta) in the pipeline. The firm is exploring the application of ticagrelor in the attack of acute ischemic stroke or transient ischemic and the prevention of vaso-occlusive crises in pediatric patients with sickle cell disease. These new applications of ticagrelor open up new markets for the global market.

Regional Analysis

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

Americas Dominates the Global Market

Americas is the most significant shareholder in the global market and is anticipated to grow at a CAGR of 9.31% during the forecast period. This high growth is due to its sustainable development in GDP per capita income and the rising geriatric population prone to degenerative diseases and chronic illnesses, which have caused an increased verge on diagnosis and therapeutics. According to the US Census Bureau, around 49.2 million individuals were 65 or older in 2016. This huge aging population led to over 15.2 % of the total population, likely driving the market. Thus, the increasing patient pool and per capita income of citizens will propel the market growth of ticagrelor as their role is indispensable in cardiovascular disorders. According to the American Heart Association, cardiovascular diseases caused one in every three fatalities in the US in 2014.

Similarly, cardiovascular disorders claimed over 801,000 lives in 2014 in the US. Furthermore, according to the American Heart Association, around USD 555 billion was spent in the Americas to treat a cardiovascular disorder in 2015. Also, the expenditure is expected to reach USD 1.1 Trillion by 2035. This rise in cardiovascular diseases is driving the growth of the market in the American region.

Europe is expected to grow at a CAGR of 9.25% over the forecast period. This is due to major driving factors such as the rising patient population of strokes and cardiovascular disorders, increasing research on antiplatelets, availability of advanced treatment facilities, increasing healthcare expenditure, and introduction of advanced and integrated treatment options into the market, along with the presence of good healthcare infrastructure. For instance, according to the 2017 statistics presented by the European Society of Cardiology, there were more than 6 million reported new cases of cardiovascular diseases in the European Union and over 11 million in Europe as a whole. Additionally, Europe spent around 210 Euros in 2015 on treating cardiovascular disorders. This rising healthcare expenditure due to cardiovascular disorders is expected to positively impact the market's growth.

Asia-Pacific is expected to grow significantly over the forecast period due to the increasing per capita income, government initiatives to enhance healthcare quality, and rising cardiovascular diseases being the primary concern in this region. China, India, and Australia have a lucrative market for ticagrelor. Moreover, according to the report published by the United Nations in 2015, the number of older people aged 60 years or above worldwide is predicted to grow by 56% between 2015 and 2030. In addition, 66% of the older population would also reside in the Asia-Pacific region. The increasing geriatric population will lead to an increase in metabolic disorders which will, in turn, increase the patient population. Thus, the market is expected to see a positive growth trend during the forecast period.

The rest of the world's countries might show stagnant growth. The rest of the world accounted for the most negligible market share due to the high price of ticagrelor drugs, lack of awareness regarding health, and lack of skilled professionals. However, countries such as Kuwait, the UAE, and Saudi Arabia are likely to show steady growth due to increasing obesity issues, government initiatives to improve patient care, and favorable reimbursement policies.

Segmental Analysis

The global ticagrelor market is segmented by dosage, route of administration, application, and end-user.

Based on dosage, the global market is divided into 60 mg and 90 mg.

The 90 mg segment is responsible for the highest market share and is expected to grow at a CAGR of 9.47% over the forecast period. The largest share of this segment can be attributed to factors such as its high platelet reactivity and high levels of efficacy. AstraZeneca's ticagrelor (brilinta) 90 mg is accepted in more than 100 nations and is recommended by 12 of the world's most important acute coronary syndrome (ACS) therapy recommendations. Ticagrelor 90mg is also the initial treatment recommended for ACS and myocardial infarction (MI) for the first year.

For patients who have already experienced myocardial infarction, 60 mg is strongly recommended to prevent ischemic episodes. To prevent CV mortality, heart attack, and stroke over the long term in patients who have already experienced a heart attack, ticagrelor (brilinta) 60mg has been approved in more than 60 countries.

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

The oral route segment is the highest contributor to the market share and is anticipated to grow at a CAGR of 9.63% during the forecast period. For individuals who have trouble ingesting pills orally or in situations where water is not accessible, the tablet can be dissolved in water and given orally or through a nasogastric tube (e.g., for urgent treatment). As ticagrelor is reported to be highly soluble in the human intestinal fluid, it is recommended in the nasogastric tube for patients who are bedridden and unable to swallow orally. Patients having a history of myocardial infarction are prescribed ticagrelor at a recommended dose of 60 mg twice daily for two years.

Ticagrelor drug through a nasogastric tube (size CH8 or greater), is recommended for patients with dysphagia (approximately 5 to 10% of patients with ACS are intubated and in need of nasogastric tube for feeding and administration of drugs).

Based on application, the global market is segmented into acute coronary syndromes and heart surgeries.

The acute coronary syndromes segment owns the highest market share and is estimated to grow at a CAGR of 9.31% during the forecast period. The term "acute coronary syndromes" refers to various conditions in which the blood supply to the heart muscle is rapidly cut off. Antiplatelet therapy is considered the first-line medical treatment for patients with acute coronary syndrome (ACS). Ticagrelor is an oral antiplatelet drug that binds to the P2Y12 adenosine diphosphate receptor to reduce platelet activation and aggregation. In acute coronary syndrome, the combination of ticagrelor and aspirin is reported to have reduced the prevalence of vascular deaths and myocardial infarctions compared to the combination of clopidogrel and aspirin. The inhibitory impact of ticagrelor on platelet aggregation is more quickly reversed because of its reversible binding. BRILINTA is also used to lessen the risk of dying from a heart attack or another cardiovascular event.

Problems include heart failure, plaque formation that wholly or partially limits blood flow in a coronary artery, damaged heart valves, dilated or diseased major blood arteries (such as the aorta), and irregular cardiac rhythms are frequently treated with heart surgery. Heart surgeries are further segmented into stent placement, coronary artery bypass graft, and angioplasty. Angioplasty contributes to the largest share in the heart surgery segment.

Based on end-user, the global market is segmented into hospitals and clinics, ambulatory centers, and others.

The hospitals and clinics segment dominates the market share and is expected to grow at a CAGR of 9.68% for the forecast period. Hospitals and clinics dominate the global market due to the increasing need to diagnose and treat acute coronary syndromes and heart surgeries. In addition, due to the sophisticated infrastructure and cutting-edge equipment hospitals provide, the hospital segment is anticipated to increase significantly over the forecast period.

Recent Developments

• In September 2022, PhaseBio Pharmaceuticals Inc was notified that its partner SFJ Pharmaceuticals Group opted to transfer bentracimab rights to SFJ due to PhaseBio's inability to repair its Going Concern Condition. Bentracimab, formerly known as PB2452, reverses the effects of AstraZeneca Plc's (NASDAQ: AZN) Brilinta (ticagrelor).
• In January 2023, CytoSorbents Corporation announced that it had received regulatory approval from Health Canada, allowing the inclusion of Canadian sites into the pivotal Safe and Timely Antithrombotic Removal–Ticagrelor (STAR-T) randomized, controlled trial. STAR-T will help improve the drug ticagrelor's clinical outcomes during surgeries.