The multiple sclerosis (MS) therapeutics market is becoming increasingly crowded, but the overall fulfillment of unmet needs is medium. There are no curative therapies for MS, and most existing disease modifying therapies (DMTs) are only partially effective in preventing relapses, with limited impact on the accrual of disability. This means that most patients still experience exacerbations of the disease and face the prospect of life-long treatment with MS medications, says GlobalData, a leading data and analytics company.

According to GlobalData’s report, ‘Multiple Sclerosis: Global Drug Forecast and Market Analysis to 2028’, the MS market will grow from $21.4bn in 2020 across the seven major markets (*7MM) to $32.9bn in 2028 at a compound annual growth rate (CAGR) of 5.2%. This growth will be driven by the launches of efficacious pipeline products with convenient oral formulations or less frequent dosing; the continued uptake of oral DMTs, which typically have a higher annual cost of therapy (ACOT) and improved compliance rates; and an increase in the number of DMT options that target progressive MS subtypes.

Alessio Brunello, Managing Pharma Analyst at GlobalData, comments: “The current MS market is becoming increasingly competitive, with a large number of drugs that offer good safety profiles but only moderate efficacy. Despite the increasingly competitive nature of the MS market, lucrative opportunities remain for products that target unmet needs. Drugs with better efficacy in terms of relapse rates and good safety profiles will continue to be viewed favorably by physicians, however, the current late-stage pipeline contains multiple highly efficacious products with proven mechanisms of action (MOAs).”

Opportunities still remain for the development of safer and better-tolerated therapies for MS. There is limited experience and long-term safety data for most of the current pipeline drugs; thus, the likelihood of complications stemming from these agents has not been fully elucidated. The same is true for key pipeline candidates for escalation therapy, where an improvement in long-term safety over the current treatments remains to be observed.

Brunello continues: “Targeting progressive MS will be an ongoing opportunity, as competition for market share in that segment will be considerably less fierce than in RRMS. According to key opinion leaders (KOLs) interviewed by GlobalData, physicians agree that DMTs with additional neuroprotective properties have the potential to fill this significant unmet need and delay the neurodegenerative process.”

Opportunity also remains for the development of adjunct therapies. The use of DMTs in combination could improve patient outcomes. At present, this is largely prevented by the high cost of treatments making reimbursement very unlikely, so future products intending to target this approach would need to be priced at a considerable discount.

Brunello concludes: “The development of biomarkers for diagnosis, therapy selection, and prognosis represents a potentially lucrative opportunity that will increase as more DMTs enter the market. The availability of predictive tests would aid in early diagnosis of the disease and expand the window of opportunity for patients to receive efficacious therapy.

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