Epilepsy – Landscape & Forecast – Disease Landscape & Forecast
Epilepsy, which afflicts approximately 4.7 million people in the major markets according to Clarivate epidemiology, is a heterogeneous condition requiring individualized treatment based largely on a patient’s seizure syndrome and seizure type. The market is heavily genericized, and most of the anti-epileptic drugs (AEDs) can be used as monotherapies or in combination. However, recent entrants like cenobamate, fenfluramine, and ganaxolone are carving share in the market, despite being high-priced branded products, by targeting underserved and orphan epilepsy populations. This report provides a detailed account of dynamics in this complex market, including the continued dominance of second-generation AEDs while emerging therapies nevertheless gain traction by addressing unmet needs in this diverse patient population.
Questions answered
- What is the current size of epilepsy market by country, and how do we forecast the market will evolve in the coming years?
- What key factors will shape the future market, and what drivers and barriers will influence the use of key AEDs? Will the dominance of second-generation therapies continue, and which third-generation therapies will be successful over our forecast period?
- How will high-priced third-generation AEDs fare in this highly genericized market?
- How have UCB’s Nayzilam and Neurelis’s Valtoco been integrated into the treatment algorithm?
- What are the unmet needs in the current epilepsy treatment paradigm? How will emerging therapies address these unmet needs?
Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, Japan.
Primary research: Approximately 20 country-specific interviews with thought-leading neurologists, supported by survey data collected for this content and other Clarivate research.
Epidemiology: Diagnosed prevalence of epilepsy by country, segmented by generalized and partial-onset seizures; drug-treated cases.
Emerging therapies: Phase II: 12 drugs; Phase III / preregistration: 6 drugs.
Market forecast features: Patient-based market forecast extending through 2032, segmented by brands and generics / biosimilars.
Product description
Disease Landscape & Forecast provides comprehensive market intelligence with world-class epidemiology, keen insight into current treatment paradigms, in-depth pipeline assessments, and drug forecasts supported by detailed primary and secondary research.
Solution enhancement
Disease Landscape & Forecast will be updated throughout the year to provide timely insights and analyses as material indication-specific news and events unfold.
Disease Landscape & Forecast features a Drug Pipeline chapter with real-time, global pipeline intelligence content directly from Cortellis. This chapter is updated daily and features interactive figures that can be easily downloaded for detailed analysis or presentations.
Table of contents
- Epilepsy - Landscape & Forecast - Disease Landscape & Forecast
- Key Findings
- Epilepsy - Key Findings - August 2023
- Key Updates
- September 2023
- August 2023
- March 2023
- Q4 2022
- December 2022
- Market Outlook
- Key findings
- Market share of drug classes for epilepsy: 2022
- Market share of drug classes for epilepsy: 2032
- Epilepsy SWOT analysis
- Market drivers and constraints
- What factors are driving the market for epilepsy?
- What factors are constraining the market for epilepsy?
- Major-market sales by class in epilepsy: 2022-2032
- Major-market patient share by class in epilepsy: 2022-2032
- Total sales by region in epilepsy: 2022-2032
- Major-market sales of recently launched and emerging therapies for epilepsy: 2022-2032
- Drug-class-specific trends
- Major-market sales of first-generation AEDs in epilepsy: 2022-2032
- Major-market patient share of key first-generation AEDs in epilepsy: 2022-2032
- Major-market sales of second-generation AEDs in epilepsy: 2022-2032
- U.S. patient share of key second-generation AEDs in epilepsy: 2022-2032
- European patient share of key second-generation AEDs in epilepsy: 2022-2032
- Japanese patient share of key second-generation AEDs in epilepsy: 2022-2032
- Major-market sales of third-generation AEDs in epilepsy: 2022-2032
- U.S. patient share of key third-generation AEDs in epilepsy: 2022-2032
- European patient share of key third-generation AEDs in epilepsy: 2022-2032
- Japanese patient share of key third-generation AEDs in epilepsy: 2022-2032
- Major-market sales of rescue therapies in epilepsy: 2022-2032
- U.S. patient share of rescue therapies in epilepsy: 2022-2032
- European patient share of rescue therapies in epilepsy: 2022-2032
- Japanese patient share of rescue therapies in epilepsy: 2022-2032
- Key findings
- Forecast
- Market Forecast Assumptions
- Market Forecast Dashboard
- Etiology and Pathophysiology
- Disease overview
- Classification of seizures and epilepsies
- Widely used classification of key types of seizure by clinical presentation
- Examples of epilepsies and syndromes classified by type of seizure and etiology
- 2017 ILAE classification of types of seizure by clinical presentation
- Etiology
- Genes implicated in the etiology of key epilepsies and epilepsy syndromes
- Symptomatic factors implicated in the etiology of epilepsy
- Pathophysiology
- Neuronal signaling from the presynaptic to the postsynaptic neuron
- Key pathways and drug targets
- Key pathways and drug targets in epilepsy
- Disease overview
- Epidemiology
- Key findings
- Epidemiology populations
- Disease definition, methods, and sources used
- Diagnosed prevalent cases of epilepsy: 2022-2032 (thousands)
- Diagnosis of epilepsy
- Disease definition, methods, and sources used
- Diagnosed prevalent cases by type of epileptic seizure: 2022-2032 (thousands)
- Drug-treated diagnosed prevalent cases of epilepsy: 2022-2032 (thousands)
- Key findings
- Current Treatment
- Key findings
- Treatment goals
- Key endpoints used in clinical trials for epilepsy
- Key current therapies
- Overview
- Primary mechanism of action of key current drugs used for epilepsy
- Current treatments used for epilepsy
- U.S. and European approvals of key current therapies by type of seizure
- Market events impacting the use of key current therapies in epilepsy
- Advantages and disadvantages of first-generation AEDs
- Expert insight: use of first-generation AEDs in the treatment of epilepsy
- Expert insight: lamotrigine
- Expert insight: levetiracetam
- Advantages and disadvantages of second-generation AEDs
- Expert insight: use of second-generation AEDs in the treatment of epilepsy
- Advantages and disadvantages of brivaracetam
- Ongoing clinical development of brivaracetam
- Key results from select clinical trials investigating brivaracetam for the treatment of epilepsy
- Expert insight: brivaracetam
- Advantages and disadvantages of cannabidiol
- Ongoing clinical development of cannabidiol
- Key results from select clinical trials investigating cannabidiol for the treatment of epilepsy
- Expert insight: cannabidiol
- Advantages and disadvantages of cenobamate
- Ongoing clinical development of cenobamate
- Key results from select clinical trials investigating cenobamate for the treatment of epilepsy
- Expert insight: cenobamate
- Advantages and disadvantages of eslicarbazepine acetate
- Key results from select clinical trials investigating eslicarbazepine acetate for the treatment of epilepsy
- Expert insight: eslicarbazepine acetate
- Advantages and disadvantages of fenfluramine
- Ongoing clinical development of fenfluramine
- Key results from select clinical trials investigating fenfluramine for the treatment of epilepsy
- Expert insight: fenfluramine
- Advantages and disadvantages of ganaxolone
- Ongoing clinical development of ganaxolone
- Expert insight: ganaxolone
- Advantages and disadvantages of lacosamide
- Ongoing clinical development of lacosamide
- Expert insight: lacosamide
- Advantages and disadvantages of perampanel
- Ongoing clinical development of perampanel
- Key results from select clinical trials investigating perampanel for the treatment of epilepsy
- Expert insight: perampanel
- Advantages and disadvantages of pregabalin
- Expert insight: pregabalin
- Advantages and disadvantages of rufinamide
- Expert insight: rufinamide
- Advantages and disadvantages of stiripentol
- Expert insight: stiripentol
- Advantages and disadvantages of outpatient rescue therapies
- Expert insight: outpatient rescue therapies
- Medical practice
- Overview
- Factors influencing drug selection in epilepsy
- Treatment decision tree for epilepsy: United States
- Treatment decision tree for epilepsy: Europe
- Treatment decision tree for epilepsy: Japan
- Key findings
- Unmet Need Overview
- Current and future attainment of unmet needs in epilepsy
- Top unmet needs in epilepsy: current and future attainment
- Drug Pipeline
- Pipeline
- Regulatory Milestones
- Indication Comparison
- Emerging Therapies
- Key findings
- Key emerging therapies
- Key therapies in development for epilepsy
- Estimated launch dates of key emerging therapies for the treatment of epilepsy
- ET-105 (lamotrigine oral suspension) profile
- Analysis of the clinical development program for ET-105 (lamotrigine oral suspension)
- Expectations for launch and sales opportunity of ET-105 (lamotrigine oral suspension) in epilepsy
- XEN1101 profile
- Analysis of the clinical development program for XEN1101
- Expert insight: XEN1101
- Expectations for launch and sales opportunity of XEN1101 in epilepsy
- Carisbamate profile
- Analysis of the clinical development program for carisbamate
- Expectations for launch and sales opportunity of carisbamate in epilepsy
- Soticlestat profile
- Analysis of the clinical development program for soticlestat
- Expectations for launch and sales opportunity of soticlestat in epilepsy
- Lorcaserin profile
- Analysis of the clinical development program for lorcaserin
- Expectations for launch and sales opportunity of lorcaserin in epilepsy
- STK-001 profile
- Analysis of the clinical development program for STK-001
- Expectations for launch and sales opportunity of STK-001 in epilepsy
- Libervant profile
- Analysis of the clinical development program for Libervant
- Expert insight: Libervant
- Expectations for launch and sales opportunity of Libervant in epilepsy
- Staccato alprazolam profile
- Analysis of the clinical development program for Staccato alprazolam
- Expectations for launch and sales opportunity of Staccato alprazolam in epilepsy
- Early-phase pipeline analysis
- Select compounds in Phase 2 development for epilepsy
- Key findings
- Access & Reimbursement Overview
- Region-specific reimbursement practices
- Key market access considerations in epilepsy: United States
- General reimbursement environment: United States
- Key market access considerations in epilepsy: EU5
- General reimbursement environment: EU5
- Key market access considerations in epilepsy: Japan
- General reimbursement environment: Japan
- Region-specific reimbursement practices
- Appendix
- Abbreviations
- Epilepsy bibliography
- Key Findings
Ankita Sharma, M.B.A., Manager, Healthcare Research & Data Analytics, CNS/Ophthalmology Disorders. Ankita’s focus is the epilepsy market. Prior to joining the company, she was a knowledge management manager at ZS Associates. She received her M.B.A. in hospital and healthcare administration from Symbiosis International University in India.
Andrea S. Witt, Ph.D., is Director of the Central Nervous System and Ophthalmology Disorders Portfolio at Clarivate, where she oversees a team of Business Insights Analysts and Senior Directors responsible for market research encompassing Neurology, Psychiatry, Pain, and Ophthalmology.
Her interests beyond specific CNS indications included the market potential for neuroprotectants and the impact of biomarkers on CNS markets. Dr. Witt’s research, analysis, and commentaries have appeared in Barron’s, Pharmaceutical Executive, PharmaVoice, Nature Medicine, and CNBC. Dr. Witt’s previous experience includes 10 years of scientific research conducted on neurodegenerative disorders at Harvard Medical School/Brigham and Women’s Hospital, Duke University, and the University of Texas-Southwestern Medical Center, where she earned her Ph.D. degree.