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(Health-NewsWire.Net, October 16, 2021 )
Market Overview
The global achalasia treatment market size was valued at US$ YY million in 2020 and is estimated to reach US$ YY million by 2028, growing at a CAGR of YY % during the forecast period (2021-2028).
Achalasia is an uncommon disorder that makes it difficult for food and drink to flow from mouth to stomach via the swallowing tube (oesophagus). When the nerves in the oesophagus are injured, achalasia develops.
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Market Dynamics
The increasing prevalence of achalasia and increasing awareness and availability of treatment are estimated drivers for achalasia treatment market.
The increasing prevalence of achalasia is estimated to drive the achalasia treatment market
Achalasia has been classified as a rare disorder, with an annual incidence of 1.6 cases per 100,000 people and a prevalence of 10 instances per 100,000 people. Despite the lack of epidemiologic data on achalasia, its prevalence appears to be increasing. In people with triple-A syndrome or Allgrove syndrome, a rare autosomal recessive genetic condition, achalasia may be associated with adrenal insufficiency and alacrima. Achalasia is characterised by increasing dysphagia of solids and liquids. Patients with achalasia are frequently misdiagnosed with gastroesophageal reflux disease (GERD) and treated with proton pump inhibitor (PPI) therapy because they have heartburn. Misdiagnosis of GERD often leads to a significant delay in diagnosing achalasia until patients have continuous symptoms that eventually lead to the correct diagnosis. Patients of all ages have dysphagia and regurgitation, but younger patients are more likely to experience chest pain and heartburn. Obese patients (BMI 30) may experience more frequent choking or vomiting symptoms.
The specific cause of achalasia remains unknown. It could be caused by a loss of nerve cells in the oesophagus, according to researchers. There are a few theories about why this happens, but viral infection or autoimmune reactions have been suggested. Hence, the increasing prevalence of achalasia and its related symptoms is estimated to drive the market.
Increasing awareness and availability of treatment is estimated to drive the achalasia treatment market
Achalasia is a rare esophageal condition in which the oesophagus does not adequately drain. Certain nerve fibers in the oesophagus are damaged in people with achalasia, making the oesophagus unable to swallow and preventing the lower esophageal sphincter from relaxing properly, allowing food into the stomach. Achalasia is commonly referred to as the GERD's opposite. Patients with achalasia have an extremely tight lower esophageal sphincter, whereas persons with GERD have a weaker lower esophageal sphincter. Both illnesses cause major problems for those who suffer from them. As it is a very uncommon swallowing disorder, people's awareness about it is less than other diseases. To increase awareness among people about it, there is an organization which is set up known as Achalasia Awareness Organization, which is a non-profit organisation dedicated to raising awareness about achalasia. AAO is a grassroots movement designed to raise awareness about Achalasia, a rare, incurable, and progressive esophageal motility disease with only palliative treatment. Achalasia Awareness Month also takes place in September to raise awareness and understanding of the rare, incurable disease. The Achalasia Awareness Organization created Achalasia Awareness Month as a grassroots effort to educate and engage people about the disease.
Achalasia can be treated using a variety of methods. Unfortunately, none of these can stop or repair the underlying nerve cell loss in achalasia patients' oesophagus. The therapies, on the other hand, are usually efficient in alleviating symptoms. Pharmacotherapy (e.g., botulinum toxin injections), pneumatic dilatation, and laparoscopic Heller myotomy have all been used to treat achalasia. Although the latter two are regarded as conventional therapies due to higher success rates and longer-term efficacy than medication, they are associated with a 1 percent perforation risk. The most invasive surgery is Heller myotomy, which requires laparoscopy and surgical dissection of the esophagogastric junction. There have been reports of 86 percent one-year response rates and 0.6 percent severe mucosal tears necessitating intervention. POEM (peroral endoscopic myotomy) is an endoscopic achalasia treatment. It employs upper endoscopy rather than traditional surgery, which necessitates a skin incision. The lower esophageal sphincter is overly tight in people with achalasia. Every achalasia treatment aims to weaken the lower esophageal sphincter. Hence, the availability of various treatments for achalasia treatment is estimated to drive the market.
The misdiagnosis of achalasia is estimated to hamper the achalasia treatment market
The main symptoms of achalasia are dysphagia, weight loss, regurgitation and chest pain. The word "heartburn" is not mentioned as a symptom of achalasia in most descriptions or most modern textbooks. Achalasia treatment aims to alleviate the symptoms of dysphagia and its consequences. There is currently no medication available that targets pathogenetic factors due to a lack of understanding of pathophysiology. The patient's surgical risk and achalasia subtype are used to guide treatment. Pneumatic dilatation, laparoscopic Heller's myotomy (LHM), or POEM are the cornerstones of treatment in patients with low surgical risk. Botulinum toxin (BT) and medication are only used in individuals at high surgical risk or who have a short life expectancy. Achalasia is often misdiagnosed as GERD.
Chest pain or heartburn, as well as regurgitation, are frequent in the early stages of achalasia. Symptom sensitivity and specificity are poor indications of the presence of esophageal motility dysfunction. The main symptom of GERD is heartburn and regurgitation, which is caused by gastric acid reflux. Patients with achalasia, on the other hand, frequently experience heartburn and regurgitation. Achalasia patients reported heartburn in 13.2–68.0 percent of cases. Proton pump inhibitors were recommended to 53% of achalasia patients, histamine H2 blockers to 10%, and both to 6% on the idea that GERD was the cause of heartburn and regurgitation a prior study. In patients with achalasia, dysphagia occurs and is not easily recognized by patients and physicians.
COVID-19 Impact Analysis
COVID-19 has affected the Injectables industry negatively. To stop its spread, government-imposed lockdown. People are fearful they may experience occupational effects and negative health from the COVID-19 pandemic. All the other treatments and drug approvals were delayed due to the demand for COVID-19 treatment. This has affected the global achalasia treatment market as many have stopped manufacturing units.
Segment Analysis
Calcium channel blockers are estimated to dominate the achalasia treatment market
Calcium channel blockers have previously been found to lower esophageal sphincter (LES) pressure and relieve achalasia symptoms. Calcium channel blockers, such as Nifedipine, are increasingly routinely prescribed and administered sublingually 15-30 minutes before meals. These inhibit the contractility of muscle cells by limiting calcium uptake intracellularly. There have been reports of success rates as high as 65-80%. Calcium channel blockers prevent calcium from being taken up by cells, preventing contraction and increasing relaxation. Nifedipine has been demonstrated to lower LES pressures and give symptomatic relief, while its efficacy is variable, with benefits reported in 50% to 90% of patients. Calcium channel blockers may be the first line of treatment for high or moderate-risk achalasia patients before pneumatic dilatation or surgical myotomy. These drugs relax the muscles of the lower esophageal sphincter, allowing food and drink to move more freely into the stomach in persons with achalasia. Nitrates and calcium channel blockers are taken by mouth 10 to 30 minutes before a meal. They come in tablet form that can be taken under the tongue.
The injectable segment is estimated to dominate the achalasia treatment market
The most common and effective pharmacological therapy used in the treatment of achalasia is botulinum toxin (BT) injection, which is commonly used in the elderly, those with numerous comorbidities, those at high risk for surgery, and as salvage therapy. Botulinum toxin (BT) injections into the LES, nitrates, and calcium channel blockers are the most common medical treatments. BT is the most widely utilised and successful pharmaceutical agent. The Food and Drug Administration (FDA) has currently approved type A and type B serotypes for use in humans for various therapeutic reasons. Although there are seven subtypes of BT (A) (A1-A7), all three formulations of BT (A) available for clinical usage in achalasia patients are of the A1 subtype. Abobotulinum (ABO; Dysport/Azzalure), Incobotulinum (INCO; Xeomin/Bocouture), and Onabotulinum (ONA; Botox/Vistabel) are three of the most common. The most extensively used and well-studied BT formulation is BT (A). Although rimaotulinumtoxin B (Neurobloc/Myobloc) is commercially available, it has not been extensively investigated in achalasia patients.
Injections of BT are thought to be helpful in the short term, but they have a high risk of relapse, necessitating reinjection. For example, one meta-analysis looked at nine trials with a total of 315 patients. It showed that the rate of symptomatic improvement was 78.7% after one month, but dropped to 70% after three months, 53.3 percent after six months, and 40.6 percent after a year. In addition, 46.6 percent of patients required at least a second treatment. Symptom relapse is practically universal after two years, while some studies have demonstrated that efficacy is maintained in up to 34% of patients. The efficacy of BT declines with repeated injections, which is assumed to be due to an increase in the number of injections.
Retail pharmacies are expected to dominate the achalasia treatment market
Any pharmacy where pharmaceuticals are compounded, distributed, stored, or sold to the public or where prescriptions are filled or dispensed to the general public is referred to as a retail pharmacy. Any pharmacy where pharmaceuticals are compounded, distributed, stored, or sold to the public or where prescriptions are filled or dispensed to the general public is referred to as a retail pharmacy. The foundation of a retail pharmacy's connection with its customers is trust. Th clients have personal health information to share with businesses, and they expect the best service available. They want to know that their issues are being acknowledged and aware of their wellness options. As a result of these expectations, pharmacists are implementing long-term success methods. Customer loyalty can be earned by investing in new technologies and expanding services. These tactics keep customers informed about their Injectables, give them seamless access to prescriptions and health items, and maintain the quality and security of their medications across all channels. Hence, with increasing patients purchasing drugs, this segment is estimated to dominate the market.
Geographical Analysis
North America region is estimated to dominate the achalasia treatment market
Achalasia affects about 2,000 people in the United States every year. According to studies carried out, 30000 patients were hospitalized over eight years for the treatment of esophageal achalasia in the United States. This region has developed many new minimally invasive surgeries. For example, The GI surgery team at UC Davis excels in using a robotic-assisted, laparoscopic esophageal Heller myotomy to treat achalasia patients. Miniaturized devices and small incisions are used in the treatment, making it minimally invasive and contributing to faster recovery times and better outcomes. UC Davis Medical Center's GI surgery team consists of highly skilled and experienced surgeons, nurses, and technicians. A team of surgeons has extensively trained the da Vinci robotic surgical system.
More recently, UCLA and a few other institutes have begun doing per-oral endoscopic myotomy, or POEM. This procedure tries to replicate the Heller myotomy in a less intrusive manner. Advances in endoscopic procedures, such as submucosal endoscopy and natural orifice transluminal endoscopic surgery, or NOTES, made POEM conceivable. Hence, the use of advanced technology and rising incidence of achalasia in this region is assumed to dominate the market.
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Competitive Landscape
The global achalasia treatment market is highly competitive with increasing drug approvals and discovery of new treatments. For example, Mirabegron is an FDA-approved oral beta-3 agonist that works by relaxing the bladder muscles. In preclinical experiments, beta-3 receptors have also been found in the LES, with stimulation leading to LES relaxation. Myrbetriq (mirabegron) is a beta-3 adrenergic agonist used to treat overactive bladder. Astellas Pharma, a Tokyo-based pharmaceutical business, created it.
The major key players in the global achalasia treatment market are Bausch Health US LLC., Teva pharmaceutical industries ltd., Zydus Pharmaceuticals (USA) Inc, Pfizer Inc., Accordhealthcare, AdvaCare Pharma, Merz Therapeutics and Galderma
Bausch Health US LLC
Overview: Bausch Health Companies Inc. is a global pharmaceutical, medical device, and over-the-counter product developer, manufacturer, and marketer principally in the therapeutic areas of eye health, gastroenterology, and dermatology. As they establish an innovative firm dedicated to enhancing global health, they are keeping their promises—the company manufactures and markets health care products directly or indirectly in approximately 100 countries.
Product Portfolio: The company comprises eye health, aesthetics, dermatology, neurology, and gastroenterology.
Key Development: The acquisition of certain assets of Synergy Pharmaceuticals Inc. by Bausch Health Companies Inc. was completed in 2019. TRULANCE (plecanatide), Synergy's flagship product, is a once-daily tablet approved for adults with chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C), and dolcanatide, the company's investigational compound, is an incremental peptide with established proof-of-concept studies in multiple GI conditions will be added to their product portfolio with this acquisition.
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