Compound antihypertensive drugs rush into the 10 billion market: Top 5 varieties account for nearly 90%

According to the data of 2015 China's guidelines for rational use of drugs in the treatment of hypertension, the number of Chinese adults with hypertension has reached 298 million At present, the awareness rate of patients is 46.5%, the treatment rate is 41.1%, and the control rate is 13.8% In the 2017 edition of the catalogue of drugs for national basic medical insurance, work injury insurance and maternity insurance, 21 new cardiovascular drugs were added Of the 16 new western drugs for hypertension treatment, 14 were compound preparations, accounting for 87.50% of the new drugs for hypertension treatment The compound preparation of ACE inhibitor and ACE II antagonist has become the highlight In recent years, with the improvement of hypertension education and medication level in China, most elderly people's hypertension management has improved, objectively promoting the stable growth of hypertension treatment market in China, but the development trend of hypertension youth still makes the prevalence of hypertension significantly increased According to the database data of Nanfang Institute of pharmaceutical economics, in 2015, the sales of hypertension drugs in the six major markets of China's urban public hospitals, county-level public hospitals, urban communities, township hospitals, physical pharmacies and online stores were 38.2 billion yuan, an increase of 10.72% over the previous year In the market of hypertension treatment, calcium antagonists (CCB), angiotension receptor antagonists (ARB) and compound antihypertensive drugs have formed a great potential Compound antihypertensive drugs have been a fast growing category in the market The guideline of hypertension prevention and treatment emphasizes that sequential treatment is adopted for hypertension control, and combined treatment is included in the basic medication of blood pressure control Especially for the elderly who have suffered from hypertension for many years, a single drug has been unable to make the blood pressure reach the standard, so the combination of two or more drugs has become the first choice The research shows that fixed dose of FDC can bring great benefits to hypertension treatment, and the standard rate of FDC is significantly higher than that of free combination, which can achieve 24-hour stable hypotension and have better compliance According to the data of the first three quarters of 2016 from the midnet HDM system, there are 20 drugs in the fixed compound preparation of antihypertensive used clinically, with the main varieties showing an increasing trend It is predicted that the fixed dose of compound antihypertensive drugs in public hospitals in key cities in 2016 will be 843 million yuan, an increase of 11.99% over the previous year From 2011 to 2016, the five-year average growth rate reached 29.28% The domestic market of compound antihypertensives has reached 6 billion yuan, and it is predicted that it will break the 10 billion yuan mark in the past two years Compound fixed dose antihypertensive drug perspective compound fixed dose ARB At present, in the clinical use of compound antihypertensive agents, the first one is seven compound fixed dose sartans (ARB) preparations, which are valsartan amlodipine, irbesartan hydrochlorothiazide, losartan hydrochlorothiazide, valsartan hydrochlorothiazide, telmisartan hydrochlorothiazide, olmesartan hydrochlorothiazide and candesartan hydrochlorothiazide It is predicted that the fixed dose of compound ARB preparation in public hospitals in key cities in 2016 will be RMB 704 million, an increase of 10.42% over the previous year From 2011 to 2016, the annual average growth rate reached 24.86%, which is the leading variety in the compound antihypertensive market The second category of compound fixed dose ACEI is 7 compound fixed dose ACEI drugs, which are perindopril indapamide, enalapril folate, enalapril hydrochlorothiazide, benazepril amlodipine, lisinopril hydrochlorothiazide, benazepril hydrochlorothiazide and captopril hydrochlorothiazide In 2016, the fixed dose of compound ACEI preparation in public hospitals in key cities in China was 74.67 million yuan, an increase of 34.88% over the previous year The annual average growth rate from 2011 to 2016 reached 113.49% The drugs with rapid growth in the amount of drug use are doprilindapamide of Servier (Tianjin) and enalapril folic acid of Shenzhen oza, which have driven the rapid growth of this kind of drugs The third kind of other kinds of compound antihypertensive agents is other kinds of compound antihypertensive agents, mainly including amlodipine and atorvastatin calcium, reserpine and triamterene, amiloride and hydrochlorothiazide, nitrendrol, reserpine and dihydralazine In 2016, the amount of other kinds of compound antihypertensives used in public hospitals in key cities in China was 64.54 million yuan, an increase of 8.84% over the previous year Pfizer's amlodipine and atorvastatin calcium (trade name as many as one) are the leading varieties The other two fast-growing drugs are amiloride and hydrochlorothiazide tablets, potassium retention diuretic and antihypertensive drugs, and nitrendipine and atenolol compound preparations of Jiangsu jibel Pharmaceutical Co., Ltd The mechanism of hypertension of top 10 compound antihypertensive drug has not been fully understood at present Many methods are needed to prevent hypertension, reduce heart load and influence on coronary artery, which is the basis of combined medication Internationally, the fixed dose formula has played a good role because of its small dose, high efficacy and small side effects In China's market, the top five drugs of the top 10 varieties of compound antihypertensive drugs are valsartan amlodipine tablets, irbesartan hydrochlorothiazide tablets and capsules, losartan hydrochlorothiazide tablets, valsartan hydrochlorothiazide tablets and capsules, and amlodipine atorvastatin tablets, which account for 88% of the total market share of the compound antihypertensive drugs The last five drugs of top 10 compound antihypertensive drugs were perindopril indapamide tablets, enalapril folate tablets, telmisartan hydrochlorothiazide tablets and capsules, amlodipine tablets and olmesartan hydrochlorothiazide tablets These drugs are high growth varieties in recent two years, with an increase rate of more than 30% in 2016 compared with the previous year Valsartan amlodipine and valsartan amlodipine tablets are the first drugs in the market of compound antihypertensive drugs The drug was developed and marketed by Novartis, Switzerland It is a fixed group of angiotension receptor antagonist (ARB), valsartan (Diovan) and calcium channel antagonist (CCB), amlodipine (Norvasc) On June 20, 2007, it was approved by FDA to be listed under the trade name of exforge, thus driving the market of valsartan series drugs In 2016, the market size of Novartis' valsartan series drugs reached 4.168 billion US dollars, and that of China's valsartan series drugs exceeded 3 billion yuan In 2009, valsartan amlodipine tablets entered the domestic public hospital market, with the trade name of beibote, which is the exclusive product in China In 2016, the amount of drugs used by public hospitals in key cities in China was 280 million yuan, an increase of 16.74% over the previous year Irbesartan hydrochlorothiazide irbesartan hydrochlorothiazide is developed by Sanofi company, with the trade name of COAPROVEL At present, ambonor has been listed in China, and its trade name is ambonor In 2015, ambonor accounted for 3.83% of the domestic cardiovascular system drugs In 2016, the amount of drug use of irbesartan hydrochlorothiazide in public hospitals in key cities in China was 170 million yuan, an increase of 6.01% over the previous year At present, CFDA has approved the listing of 8 domestic companies' products In the public hospital market, ambonor, Zhengda Tianqing, Inner Mongolia Yuanhe, Huahai, wangao and others account for 61.92%, 21.76%, 9.14%, 3.54%, 3.13% and 0.51% respectively In 2016, the amount of losartan hydrochlorothiazide used in public hospitals in key cities in China was 140 million yuan, an increase of 7.38% over the previous year The original research drug is hybrida of MSD, the United States CFDA has approved the production and listing of the product by six domestic enterprises, namely Beijing Wansheng pharmaceutical, Suzhou Dongrui pharmaceutical, Beijing Shuangji pharmaceutical, Shandong Xinyi pharmaceutical, Tianjin ZHONGXIN PHARMACEUTICAL new pharmaceutical and Henan Meihua pharmaceutical The original research drug hybrida accounts for more than 70% of the total Losartan hydrochlorothiazide is a new FDA approved drug for the treatment of left ventricular hypertrophy, which is used in patients with hypertension Losartan 50mg + hydrochlorothiazide 12.5mg is widely used in clinical practice in China After the new product of losartan 100mg + hydrochlorothiazide 12.5mg is put on the market, new choices for differential drugs are added Valsartan hydrochlorothiazide the original drug of valsartan hydrochlorothiazide is a compound of Novartis CFDA has approved the production and listing of 9 domestic enterprises In 2016, the amount of valsartan hydrochlorothiazide used in public hospitals in key cities in China was 86.5 million yuan, an increase of 3.12% over the previous year From the perspective of market competition pattern, the proportion of compound agent is 84.16%; among the domestic drugs, Jiangsu Vango company accounts for 11.48%, China Resources SECCO accounts for 2.79% and others account for 1.57% Amlodipine atorvastatin amlodipine atorvastatin calcium tablet is the exclusive product of Pfizer in China, with the trade name of up to one In 2016, as much as 60 million yuan was used in one public hospital in key cities in China, an increase of 18.95% over the previous year, making it the only compound antihypertensive and cholesterol lowering drug Atorvastatin has been a leader in blood lipid regulation market for many years In 2015, the sales volume of atorvastatin calcium tablets in Pfizer China was 7.782 billion yuan, and that of amlodipine tablets was 4.371 billion yuan The data shows that this is a potential market There are as many as one imitators in China, led by Beijing Jialin Pharmaceutical Co., Ltd., with 25 enterprises competing for success With the continuous improvement of the production process of amlodipine atorvastatin, some of the declared manufacturers have reached the same structure and route of administration as the original research drug, and there is no difference between the bioavailability and dissolution of the original research drug Domestic drugs will break the pattern that the original drugs are under the control of the whole country and bring good news to the patients with hypertension and hyperlipidemia Enalapril folic acid and enalapril folic acid tablets rank eighth in the top 10 of compound antihypertensive drugs, and maintain a high growth rate with its unique mechanism of action Enalapril folate tablet is a new drug developed by Shenzhen AoSA Pharmaceutical Co., Ltd It is used to treat essential hypertension with elevated plasma homocysteine level In 2010, CFDA approved the listing of enalapril folate tablets of Shenzhen OSA, with the trade name of Yiye Enalapril maleate reduces blood pressure in patients with hypertension Folic acid can reduce plasma homocysteine level In 2016, the amount of enalapril folate tablets used in public hospitals in key cities in China was 25.3 million yuan, an increase of 35.76% over the previous year, and the sales volume is expected to grow steadily in the next few years.