TOP 20 accounts for over 75%! Take a closer look at the leading products in the hundreds of billions of cardiovascular and cerebrovascular drugs market

September 24 is world heart day The eternal theme of world heart day is "healthy heart, happy life" As we all know, the heart is the only organ that can't rest for a moment Coronary heart disease, arrhythmia, heart failure, rheumatic heart disease, cardiomyopathy and other cardiovascular diseases are serious threats to human health, and hypertension, hyperlipidemia, hyperglycemia are the main causes of stroke, myocardial infarction and peripheral vascular disease About 17.5 million people die of heart disease every year around the world Although there are at least 20 million survivors of heart attack and stroke every year, most of them are at risk of sequelae and disease recurrence caused by stroke Rigid demand drives the growth of cardiovascular drug consumption IMS data shows that the global cardiovascular system drug market reached 89.872 billion US dollars in 2016, accounting for 8.9% of the total world drug use According to the 2016 China cardiovascular disease report, in 2015, cardiovascular disease death accounted for the first cause of death in urban and rural residents The number of people suffering from cardiovascular disease in China has reached 290 million, and about 2.6 million people die of cardiovascular and cerebrovascular disease every year China's heart disease has a high incidence trend High concentration of cardiovascular and cerebrovascular drug market According to the 2017 blue book on the development of China's pharmaceutical market issued by CFDA Southern Institute of pharmaceutical economics, the sales volume of drugs in the six major terminals of China's urban public hospitals, county-level public hospitals, urban community medicine, township hospitals, entity drugstores and online stores in 2016 was 1497.5 billion yuan, an increase of 8.3% year on year Among them, cardiovascular, cerebrovascular, tumor immune and infectious drugs have become the leading categories According to the HDM system data of Nanfang Institute of pharmaceutical economics, in 2016, the market of cardiovascular and cerebrovascular drugs for public hospitals in 16 key cities in China reached 17.812 billion yuan, an increase of 6.19% over the previous year This category includes heart disease drugs, cerebrovascular system drugs and anticoagulant and antithrombotic drugs Although the growth rate of cardiovascular and cerebrovascular market has slowed down in the past two years, the terminal consumption of drugs has continued to rise According to the data, the market scale of cardiovascular systemized drugs, biological products and Chinese patent medicines in China maintained a continuous growth trend, reaching 276.9 billion yuan in 2016, an increase of 8.08% over the previous year Figure 1: in 2007-2016, the market of cardiovascular and cerebrovascular drugs in public hospitals in key cities in China reached 13.531 billion yuan in 2016, accounting for more than 3 / 4 of the total, showing a high degree of product concentration In 2016, the ranking of top 20 varieties of cardiovascular and cerebrovascular diseases also changed from the previous year The varieties and growth trend are shown in Figure 2, figure 3 and Figure 4 The top 10 drugs were clopidogrel, alprostadil, atorvastatin, creatine phosphate, coenzyme, valsartan and its compound, edaravone, low molecular weight heparin, rosuvastatin and butylphthalide Figure 2 the overall market of cardio cerebrovascular top 20 drugs in public hospitals of key cities in China from 2007 to 2016 Figure 3 the market performance of cardio cerebrovascular top 10 drugs in public hospitals of key cities in China from 2007 to 2016 Figure 4 the market performance of cardio cerebrovascular no.11-20 drugs in public hospitals of key cities in China from 2007 to 2016 atorvastatin led the lipid-lowering Market China cardiovascular disease report 2016, compiled and published by the National Center for cardiovascular disease, is the 11th annual report published in China, reflecting the high attention of the Chinese government to the rising trend of cardiovascular disease To prevent and treat hypertension, dyslipidemia, diabetes and obesity syndrome with a positive attitude, and to take active and effective measures to curb the growth of cardiovascular disease has become an important project in the era of great health Human management of hypertension has a history of more than half a century Relatively speaking, effective management of hyperlipidemia is only a national action for more than 10 years Statins have become a milestone in the program of lowering cholesterol and regulating blood lipid At present, there are more than 10 kinds of statins in the market of reducing blood lipid, such as atorvastatin, rosuvastatin, pivastatin, simvastatin, pravastatin, fluvastatin, lovastatin, as well as compound preparation simvastatin + ezemeb, atorvastatin + amlodipine, lovastatin + niacin Atorvastatin is the first drug in the blood lipid lowering market and the top three drug in the cardiovascular market According to CMH data, atorvastatin is increasing rapidly In 2016, the sales volume of atorvastatin in public hospitals in domestic cities was 6.075 billion yuan, the market of atorvastatin in domestic retail pharmacies reached 2.431 billion yuan, and the two major terminals reached 8.506 billion yuan The sales volume of atorvastatin in 6 major markets, including urban public hospitals, county-level public hospitals, urban community medical care, township hospitals, physical pharmacies and online stores, has exceeded 13 billion yuan According to the data of HDM system, in 2016, atorvastatin, rosuvastatin and pivastatin were the top 3 drugs in the market of reducing blood lipid, with an increase of 8.78%, 10.91% and 50.37% year-on-year, respectively The six markets of the three major terminals in China reached 23.827 billion yuan, and it is expected to reach 25 billion yuan in 2017 The market of clopidogrel in heart medicine ranks first Betrixaban, a new cardio cerebral vascular system drug, is another anticoagulant of factor Xa inhibitor approved by Portola in the first half of 2017 It is the fourth drug with the same mechanism after rivaroxaban, apixaban and eduxaban The advantage of betrixaban is that it can be used as an alternative treatment of warfarin sodium, It provides a new choice for anticoagulation therapy of AF In the field of anticoagulant therapy of atrial fibrillation, with rivaroxaban, apixaban, dabigatran ester, tegrerol and prasugrel entering the clinic, the market of antithrombotic and anticoagulant has been further improved However, clopidogrel and low molecular weight heparin, the mainstay of the market in China, still play an inestimable role In the late 1990s, the US FDA approved clopidogrel developed by Bristol Myers Squibb (BMS) for the prevention and treatment of atherosclerotic diseases, myocardial infarction, stroke and peripheral vascular diseases, becoming a landmark in the field of cardiovascular medicine Clopidogrel and aspirin small dose enteric coated tablets are known as the gold standard treatment plan for anti platelet aggregation and prevention of thrombus They are the drugs for prevention of myocardial infarction and stroke in the treatment of hypertension Clopidogrel is sold jointly by Bristol Myers Squibb and Sanofi Aventis under the trade name Plavix Clopidogrel is one of the early varieties developed and listed in China At present, 16 production lines of clopidogrel API have been built in China In 2000, China first approved the registration and production of clopidogrel in Shenzhen xinlitai Pharmaceutical Co., Ltd under the trade name of "Taijia" The commercial name of clopidogrel of Sanofi Aventis in China is "Plavix" Driven by the original research and domestic drugs, clopidogrel has become a rapidly growing variety From 2005 to 2015, the compound annual growth rate was 29.8% After the market developed to the platform period, the growth rate slowed down in the past three years, and the consumption continued to rise According to the data of HDM system, in 2016, the market of clopidogrel for public hospitals in 16 key cities in China was 1.529 billion yuan, an increase of 6.25% over the previous year Among them, Plavix of Sanofi Aventis accounts for 58.84%, Taijia of Shenzhen xinlitai accounts for 35.27%, and Shuaike of Lepu pharmaceutical accounts for 5.89% The growth rate of Plavix and Taijia was 5.24% and 3.66%, while that of Lepu pharmaceutical was 40.30% In 2016, the overall sales volume of clopidogrel tablets in China exceeded 10 billion yuan, ranking first in the domestic heart drug market Figure 5 from 2007 to 2016, 7 antihypertensives in the market of clopidogrel, a public hospital in key cities in China, ranked among the top 20 calcium antagonists, renin-angiotension receptor antagonists and β receptor blockers in the cardiovascular and cerebrovascular drug market, which are the three powerful drug categories in the antihypertensives market in China Its mechanism is not only to control blood pressure, but also to protect the heart, brain, kidney and other important organs of hypertension patients In clinical treatment, it has positive effects on coronary heart disease, heart failure, arrhythmia, protection of renal function, reversal of left ventricular hypertrophy and vascular remodeling According to CMH data, the market scale of antihypertensive drugs in urban public hospitals in 2016 was 36.6 billion yuan, an increase of 13% over the previous year With the improvement of the medical security system, the market pattern shows that top 5 calcium antagonists account for 34%, renin-angiotension receptor antagonists account for 28%, β blockers account for 8%, compound preparations account for 7%, diuretics account for 2%, and others account for 21% Among the top 20 varieties of cardiovascular and cerebrovascular drug market in public hospitals in key cities, 7 drugs, including antihypertensive drugs amlodipine, Levamlodipine, nifedipine, valsartan and its compound, irbesartan and its compound, losartan and its compound, metoprolol, accounted for 21.40% Figure 6 the market performance of antihypertensive drugs in the top 20 of cardio cerebral blood vessels of public hospitals in key cities from 2007 to 2016 HDM system data shows that in 2016, the amount of calcium antagonists amlodipine, nifedipine and L-amlodipine in public hospitals in key cities was 484 million yuan, 378 million yuan and 281 million yuan, respectively, an increase of 0.16%, 4.79% and 4.32% over the previous year The sum of money of valsartan series, irbesartan series and losartan series was 696 million yuan, 397 million yuan and 382 million yuan, respectively, 1.57%, - 0.16% and 5.15% higher than that of the previous year With a batch of new antihypertensive drugs entering the medical insurance class B, it will directly promote the market growth.