The respiratory syncytial virus (RSV) market is expected to grow from $418.6m in 2018 to $5.39bn by 2028 across the seven major markets (7MM*) at a compound annual growth rate (CAGR) of 29.1%, according to GlobalData, a leading data and analytics company.

GlobalData’s latest report: ‘Respiratory Syncytial Virus: Opportunity Analysis and Forecasts to 2028’ reveals that the main driver of growth will be the launch of new products to prevent medically-significant RSV infections, including vaccines for adult and pediatric patients, as well as single-dose prophylactic monoclonal antibodies (mAbs).

Paul Jeng, PhD, Senior Pharma Analyst at GlobalData, comments: “AstraZeneca/AbbVie’s Synagis is currently the only licensed product in the 7MM for prevention of RSV infections in young children, but its high price and restrictive label have narrowed its clinical applications to only the highest-risk infants. In addition, the requirement for five monthly injections of Synagis is a substantial barrier to full patient compliance. Sales of Synagis are expected to drop substantially after the launch of the experimental mAb MEDI8897 in 2023, which is projected to reach $1.63bn in annual revenue by 2028.”

GlobalData’s report also identifies a high level of unmet need for RSV infections in adults 60 years of age or older, which remains an untapped market associated with over 150,000 hospitalizations in the US in 2018. There are currently five vaccines in Phase II clinical development in elderly adults, including Pfizer’s subunit vaccine PF-06928316 and Johnson & Johnson’s Ad26.RSV.preF, which both target the RSV prefusion F protein.

Jeng continues: “On the therapeutics side, a licensed antiviral for RSV remains out of reach for developers following a string of late-stage clinical failures that key opinion leaders have attributed to potential flaws in trial design. GlobalData expects this to change in the next ten years with the launch of five pipeline products, including Johnson & Johnson’s fusion inhibitor JNJ-53718678.”

Notably, the annual cost of therapy for antivirals is expected to be significantly lower than that of prophylactics, accounting for just 1% of total RSV sales in 2028.

Jeng concludes: “It is likely that several first-in-class products for the management of RSV will coexist simultaneously by 2028, including both vaccines and antivirals for treatment of severe or breakthrough RSV infections. However, the global impact of new products in reducing overall RSV burden will depend on the cost-effectiveness of these drugs, as well as how vaccines are eventually integrated into national immunization policies throughout the 7MM.”

*7MM = US, France, Germany, Italy, Spain, UK and Japan