Treatment for fungal infection can be topical or systemic. Topical antifungals are generally considered as first-line therapy for uncomplicated, superficial, relatively localized dermatomycoses due to their high efficacy and low potential for systemic adverse effects. Systemic antifungal agents are absorbed and delivered to the body tissues by way of the vascular system. The oral route is usually the safest, the most economical, and the easiest route for systemic antifungal drugs. The choice of an oral form over other forms involves a consideration of both drug and patient variables.
A growing and aging population, increasing incidence of fungal conditions, the development and approval of new products, additional indications and formulations, and increased worldwide market penetration will be driving factors for this market over the next decade. The total market for antifungal drugs is estimated to total $6.1 billion for 2011, increasing 3.2% over 2010. Kalorama expects growth as high as four percent in the coming years with increased demand and product innovation.
There are four segments in this market: allylamines, azoles, polyene macrolides, and other treatments.
Azole drugs, which inhibit the key enzyme that allows fungi to grow, are the largest segment in the antifungal group by revenues of products sold, with leading products such as Vfend, Noxafil, and Diflucan. Although these brand products still hold large shares of the market, generic penetration is high and continues to increase.
Allylamines prevent fungi cell walls from developing, thus blocking them from growing on human skin. The segment is largely driven by the terbinafine products, namely Lamisil and its generic counterparts. The market began to decline with the generic offering of terbinafine after Lamisil lost patent protection.
Lamisil sales declined from $978 million in 2006 to approximately $100 million in 2011. New developments for this segment are in the pipeline and several late-stage projects could offset the declining streak this segment has experienced over the past few years.
Polyene macrolides are powerful topical antifungals. The segment is highly genericized and is the smallest segment in the antifungal market. All products in this segment have generic counterparts, and new development is lacking. A continued decline of the market will be realized during the next five years.
Sales for other antifungals—products that do not fit into one of the three categories above—have shown the highest growth of all segments.