PharmaPoint: Dyslipidemia-Global Drug Forecast and Market Analysis to 2025

PharmaPoint: Dyslipidemia-Global Drug Forecast and Market Analysis to 2025


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Executive Summary

PharmaPoint: Dyslipidemia-Global Drug Forecast and Market Analysis to 2025

Summary

GlobalData estimates sales of dyslipidemia therapeutics to be approximately $11.2B across the 7MM in 2015, encompassing the US, 5EU, and Japan. The dyslipidemia market will grow at a strong CAGR of 10.1% over the forecast period, reaching sales of $29.2B by 2025. The US is the largest market for dyslipidemia therapies, contributing approximately 61.5% of total sales in the base year. GlobalData expects uptake of the revolutionary class of PCSK9 targeting biologics to be the strongest driver of growth in the dyslipidemia market in the 7MM, reaching peak sales of $9.5B in 2025. Despite the launch of such efficacious lipid-lowering therapies, there is ample opportunity for pipeline drugs targeting the broader mixed dyslipidemia market. As pricing is expected to be the strongest barrier to uptake in the dyslipidemia space, cost-effective therapies will be more successful at penetrating the market.

Highlights

Key Questions Answered

The level of unmet needs in the dyslipidemia market remains high. Will the pipeline drugs fulfil these unmet needs of the market? Key Opinion Leaders (KOLs) interviewed by GlobalData provide insights and highlight opportunities for drug developers.

The 10-year forecast period will mark the launch of several biologics targeting PCSK9. How will the market be impacted? Which of the marketed and pipeline drugs will have the highest peak sales at the highest CAGR, and why?

Pricing has a strong influence over drug uptake. How will reimbursement affect the adoption of combination therapy in the different markets?

Key Findings

The major drivers for growth across the 7MM in the dyslipidemia market during the forecast period will be the launch of the novel PCSK9 targeting therapies.

KOLs interviewed by GlobalData opined that ETC-1002 (bempedoic acid) will be a strong contender, and will displace ezetimibe as the standard of care for statin intolerant patients.

The highest revenue generators in the 7MM market at the end of 2025 will be the PCSK9 targeting therapies and ETC-1002.

In other interviews, KOLs highlighted that the greatest unmet need in the dyslipidemia space is disease awareness, with a large proportion of patients going underdiagnosed, and of those who are diagnosed, drug treatment rates are also low.

Scope

Overview of dyslipidemia, including epidemiology, etiology, pathophysiology, symptoms, diagnosis, and treatment guidelines.

Annualized dyslipidemia therapeutics market revenue, annual cost of therapy and treatment usage pattern data from 2015 and forecast for ten years to 2025.

Key topics covered include strategic competitor assessment, market characterization, unmet needs, clinical trial mapping and implications for the dyslipidemia therapeutics market.

Pipeline analysis: comprehensive data split across different phases, emerging novel trends under development, and detailed analysis of late-stage pipeline drugs.

Analysis of the current and future market competition in the global dyslipidemia therapeutics market. Insightful review of the key industry drivers, restraints and challenges. Each trend is independently researched to provide qualitative analysis of its implications.

Reasons to Buy

The report will enable you to

Develop and design your in-licensing and out-licensing strategies through a review of pipeline products and technologies, and by identifying the companies with the most robust pipeline. Additionally a list of acquisition targets included in the pipeline product company list.

Develop business strategies by understanding the trends shaping and driving the dyslipidemia therapeutics market.

Drive revenues by understanding the key trends, innovative products and technologies, market segments, and companies likely to impact the dyslipidemia therapeutics market in future.

Formulate effective sales and marketing strategies by understanding the competitive landscape and by analysing the performance of various competitors.

Identify emerging players with potentially strong product portfolios and create effective counter-strategies to gain a competitive advantage.

Track drug sales in the 7MM dyslipidemia therapeutics market from 2015-2025.

Organize your sales and marketing efforts by identifying the market categories and segments that present maximum opportunities for consolidations, investments and strategic partnerships.



Read More



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Ken Research
Ankur Gupta, Head Marketing & Communications

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1 Table of Contents

1 Table of Contents 10

1.1 List of Tables 19

1.2 List of Figures 24

2 Introduction 26

2.1 Catalyst 26

2.2 Related Reports 27

3 Disease Overview 28

3.1 Etiology and Pathophysiology 28

3.1.1 Etiology 28

3.1.2 Pathophysiology 30

3.2 Symptoms 34

3.3 Prognosis 34

3.4 Quality of Life 34

4 Epidemiology 35

4.1 Disease Background 35

4.2 Risk Factors and Comorbidities 35

4.3 Global Trends 37

4.4 Forecast Methodology 37

4.4.1 Sources Used Tables 37

4.4.2 Forecast Assumptions and Methods 42

4.4.3 Sources Not Used 58

4.5 Epidemiological Forecast for Dyslipidemia (2015-2025) 59

4.5.1 Dyslipidemia 59

4.5.2 Familial Hypercholesterolemia 63

4.5.3 Increased Low-Density Lipoprotein Cholesterol 64

4.5.4 High Triglycerides 69

4.5.5 Very High Triglycerides 74

4.5.6 Low High-Density Lipoprotein Cholesterol 76

4.6 Discussion 81

4.6.1 Epidemiological Forecast Insight 81

4.6.2 Limitations of the Analysis 83

4.6.3 Strengths of the Analysis 84

5 Disease Management 85

5.1 Diagnosis and Treatment Overview 85

5.1.1 Diagnosis 85

5.1.2 Treatment Guidelines and Leading Prescribed Drugs 87

5.1.3 Clinical Practice 90

5.2 US 92

5.3 5EU 94

5.4 Japan 97

6 Competitive Assessment 99

6.1 Overview 99

6.2 Statins 102

6.2.1 Overview of drug class 102

6.2.2 Crestor (Rosuvastatin) 104

6.3 Zetia (Ezetimibe) 110

6.3.1 Overview 110

6.3.2 Efficacy 113

6.3.3 Safety 114

6.3.4 SWOT Analysis 116

6.3.5 Forecast 116

6.4 Praluent (Alirocumab) 117

6.4.1 Overview 117

6.4.2 Efficacy 120

6.4.3 Safety 122

6.4.4 SWOT Analysis 123

6.4.5 Forecast 124

6.5 Repatha (Evolocumab) 125

6.5.1 Overview 125

6.5.2 Efficacy 127

6.5.3 Safety 130

6.5.4 SWOT Analysis 131

6.5.5 Forecast 132

6.6 Vytorin (Simvastatin/Ezetimibe) 132

6.6.1 Overview 132

6.6.2 Efficacy 134

6.6.3 Safety 135

6.6.4 SWOT Analysis 135

6.6.5 Forecast 136

6.7 Kynamro (Mipomersen) 136

6.7.1 Overview 136

6.7.2 Efficacy 138

6.7.3 Safety 139

6.7.4 SWOT Analysis 141

6.7.5 Forecast 141

6.8 Juxtapid (Lomitapide) 142

6.8.1 Overview 142

6.8.2 Efficacy 144

6.8.3 Safety 146

6.8.4 SWOT Analysis 147

6.8.5 Forecast 147

6.9 Niacin/Nicotinic Acid 148

6.9.1 Overview 148

6.9.2 Efficacy 150

6.9.3 Safety 152

6.9.4 SWOT Analysis 153

6.9.5 Forecast 153

6.10 Fibrates 153

6.10.1 Overview of Drug Class 153

6.10.2 Tricor/Trilipix (Fenofibrate/Fenofibric acid) 155

6.11 Omega-3 Fatty Acids 159

6.11.1 Overview 159

6.11.2 Lovaza (omega-3 acid ethyl esters) 160

6.11.3 Vascepa (Icosapent Ethyl) 163

6.11.4 Epanova (omega-3 carboxylic acids) 168

6.12 Bile Acid Sequestrants 172

6.12.1 Overview 172

6.12.2 Efficacy 174

6.12.3 Safety 174

6.12.4 SWOT Analysis 175

6.12.5 Forecast 175

7 Unmet Needs Assessment and Opportunity Analysis 176

7.1 Overview 176

7.2 Therapies that Target Lipoprotein(a) 178

7.2.1 Unmet Need 178

7.2.2 Gap Analysis 179

7.2.3 Opportunity 180

7.3 Cost-Effective Therapies for Dyslipidemia 180

7.3.1 Unmet Need 180

7.3.2 Gap Analysis 181

7.3.3 Opportunity 181

7.4 Efficacious TG-Lowering Therapies 182

7.4.1 Unmet Need 182

7.4.2 Gap Analysis 183

7.4.3 Opportunity 184

7.5 Improved Diagnosis, Patient Education, and Long-Term Compliance 185

7.5.1 Unmet Need 185

7.5.2 Gap Analysis 187

7.5.3 Opportunity 188

7.6 HoFH Therapies with Reduced Side Effects 189

7.6.1 Unmet Need 189

7.6.2 Gap Analysis 190

7.6.3 Opportunity 191

7.7 Therapies that Prevent or Reverse the Buildup of Atherosclerotic Plaque 191

7.7.1 Unmet Need 191

7.7.2 Gap Analysis 192

7.7.3 Opportunity 193

8 Pipeline Assessment 194

8.1 Overview 194

8.2 Promising Drugs in Clinical Development 195

8.2.1 LY3015014 197

8.2.2 Anacetrapib 202

8.2.3 AMG-899 (TA-8995/DEZ-001) 210

8.2.4 Bempedoic Acid (ETC-1002) 216

8.2.5 Volanesorsen 223

8.2.6 CER-001 228

8.2.7 ALN-PCSsc 233

8.2.8 Gemcabene 238

8.2.9 Pemafibrate (K-877) 243

8.3 Other Drugs in Development 248

9 Current and Future Players 250

9.1 Overview 250

9.2 Trends in Corporate Strategy 253

9.3 Company Profiles 255

9.3.1 AbbVie 255

9.3.2 Aegerion Pharmaceuticals, Inc. 257

9.3.3 Akcea Therapeutics, Inc. and Ionis Pharmaceuticals 258

9.3.4 Amarin 260

9.3.5 Amgen 262

9.3.6 AstraZeneca 263

9.3.7 Cerenis Therapeutics, Inc. 265

9.3.8 Daiichi Sankyo 266

9.3.9 Eli Lilly 267

9.3.10 Esperion Therapeutics, Inc. 269

9.3.11 Genzyme 270

9.3.12 Merck & Co. 272

9.3.13 Regeneron Pharmaceuticals, Inc. 274

9.3.14 Sanofi 275

9.3.15 The Medicines Company 277

10 Market Outlook 280

10.1 Global Markets 280

10.1.1 Forecast 280

10.1.2 Drivers and Barriers-Global Issues 285

10.2 US 290

10.2.1 Forecast 290

10.2.2 Key Events 293

10.2.3 Drivers and Barriers 294

10.3 5EU 296

10.3.1 Forecast 296

10.3.2 Key Events 298

10.3.3 Drivers and Barriers 299

10.4 Japan 302

10.4.1 Forecast 302

10.4.2 Key Events 304

10.4.3 Drivers and Barriers 305

11 Appendix 308

11.1 Bibliography 308

11.2 Abbreviations 332

11.3 Methodology 338

11.4 Forecasting Methodology 338

11.4.1 Diagnosed Dyslipidemia Patients 338

11.4.2 Percent Drug-Treated Patients 339

11.4.3 Drugs Included in Each Therapeutic Class 339

11.4.4 Launch and Patent Expiry Dates 340

11.4.5 General Pricing Assumptions 341

11.4.6 Individual Drug Assumptions 342

11.4.7 Generic Erosion 348

11.4.8 Pricing of Pipeline Agents 348

11.5 Primary Research-KOLs Interviewed for this Report 349

11.6 Primary Research-Prescriber Survey 351

11.7 About the Authors 352

11.7.1 Analyst 352

11.7.2 Therapy Area Director 352

11.7.3 Epidemiologist 353

11.7.4 Director of Epidemiology 353

11.7.5 Global Director of Therapy Analysis and Epidemiology 354

11.8 About GlobalData 355

11.9 Disclaimer 355

1.2 List of Figures

Figure 1: Classification of Dyslipidemia 30

Figure 2: 8MM Total Prevalent Cases of Dyslipidemia, Ages ?20 Years, Both Sexes, N, 2015-2025 61

Figure 3: 8MM Diagnosed Prevalent Cases of Dyslipidemia, Ages ?20 Years, Both Sexes, N, 2015-2025 63

Figure 4: 8MM, Total Prevalent Cases of FH, Both Sexes, Ages ?20 Years, N, 2015 and 2025 64

Figure 5: 8MM, Total Prevalent Cases of Increased LDL-C, Both Sexes, Ages ?20 Years, N, 2015 and 2025 66

Figure 6: 8MM, Sex-Specific Total Prevalent Cases of Increased LDL-C, Both Sexes, Ages ?20 Years, N, 2015 67

Figure 7: 8MM, Age-Specific Total Prevalent Cases of Increased LDL-C, Both Sexes, Ages ?20 Years, 2015 68

Figure 8: 8MM, Age-Standardized Total Prevalence of Increased LDL-C, Both Sexes, Ages ?20 Years, 2015 69

Figure 9: 8MM, Total Prevalent Cases of High TG, Both Sexes, Ages ?20 Years, N, 2015-2025 71

Figure 10: 8MM, Sex-Specific Total Prevalent Cases of High TG, Both Sexes, Ages ?20 Years, N, 2015 72

Figure 11: 8MM, Age-Specific Total Prevalent Cases of High TG, Both Sexes, Ages ?20 Years, 2015 73

Figure 12: 8MM, Age-Standardized Total Prevalence of High TG, Both Sexes, Ages ?20 Years, 2015 74

Figure 13: 8MM, Total Prevalent Cases of Very High TG, Both Sexes, Ages ?20 Years, N, 2015-2025 76

Figure 14: 8MM, Total Prevalent Cases of Low HDL-C, Both Sexes, Ages ?20 Years, N, 2015-2025 78

Figure 15: 8MM, Sex-Specific Total Prevalent Cases of Low HDL-C, Ages ?20 Years, N, 2015 79

Figure 16: 8MM, Age-Specific Total Prevalent Cases of Low HDL-C, Both Sexes, Ages ?20 Years, 2015 80

Figure 17: 8MM, Age-Standardized Total Prevalence of Low HDL-C, Both Sexes, Ages ?20 Years, 2015 81

Figure 18: Statin Mechanism of Action 103

Figure 19: Competitive Assessment of Late-Stage Pipeline Agents in Dyslipidemia, 2015-2025 197

Figure 20: ACL inhibition 217

Figure 21: Company Portfolio Gap Analysis in Dyslipidemia, 2015-2025 253

Figure 22: Global Sales for Dyslipidemia by Region, 2015 and 2025 283

Figure 23: Global Sales for Dyslipidemia by Drug Class, 2015 and 2025 284

Figure 24: Global Sales for PCSK9 targeting therapies, 2015-2025 285

Figure 25: Sales for Dyslipidemia by Drug Class in the US, 2015 and 2025 292

Figure 26: Sales for Dyslipidemia by Drug Class in the 5EU, 2015 and 2025 297

Figure 27: Sales for Dyslipidemia by Drug Class in Japan, 2015 and 2025 303

1.1 List of Tables

Table 1: Dyslipidemia: Fredrickson Classification System 28

Table 2: Risk Factors and Comorbidities for Dyslipidemia 36

Table 3: 8MM, Sources Used to Forecast the Diagnosed Prevalent Cases of Dyslipidemia 38

Table 4: 8MM, Sources Used to Forecast the Total Prevalent Cases of FH 39

Table 5: 8MM, Sources Used to Forecast the Total Prevalent Cases of Increased LDL-C 40

Table 6: 8MM, Sources Used to Forecast the Total Prevalent Cases of High TG 41

Table 7: 8MM, Sources Used to Forecast the Total Prevalent Cases of Low HDL-C 42

Table 8: 8MM, Total Prevalent Cases of Dyslipidemia, Ages ?20 Years, Both Sexes, N, Selected Years 2015-2025 60

Table 9: 8MM, Diagnosed Prevalent Cases of Dyslipidemia, Ages ?20 Years, Both Sexes, N, Selected Years 2015-2025 62

Table 10: 8MM, Total Prevalent Cases of Increased LDL-C, Ages ?20 Years, Both Sexes, N, Selected Years, 2015-2025 65

Table 11: 8MM, Total Prevalent Cases of High TG, Ages ?20 Years, Both Sexes, N, Selected Years, 2015-2025 70

Table 12: 8MM, Total Prevalent Cases of Very High TG, Ages ?20 Years, Both Sexes, N, Selected Years, 2015-2025 75

Table 13: 8MM, Total Prevalent Cases of Low HDL-C, Ages ?20 Years, Both Sexes, N, Selected Years 2015-2025 77

Table 14: AACE Optimal/Near-Optimal, Borderline, and High-Risk Serum Lipid Concentrations 85

Table 15: Factors Considered for Different CVD Risk Calculators 86

Table 16: Treatment Guidelines for Dyslipidemia 88

Table 17: Most Prescribed Drugs for Dyslipidemia by Class in the Global Markets, 2015 90

Table 18: Country Profile-US 93

Table 19: Market Profile-5EU 95

Table 20: Country Profile-Japan 98

Table 21: Intensity level of commonly used statins 103

Table 22: Product Profile-Crestor (Rosuvastatin) 106

Table 23: Efficacy of Rosuvastatin-Lipid and Lipoprotein Parameters 107

Table 24: Crestor SWOT Analysis, 2015 109

Table 25: Product Profile-Zetia 112

Table 26: Efficacy of Zetia-Primary and Secondary Endpoints, IMPROVE-IT study 114

Table 27: Safety of Zetia (Ezetimibe) 115

Table 28: Drug Zetia (Ezetimibe) SWOT Analysis, 2015-2025 116

Table 29: Product Profile-Praluent 120

Table 30: Efficacy of Praluent (alirocumab)-Primary and Secondary Endpoints, ODYSSEY LONG TERM Phase III Study 121

Table 31: Safety of Praluent (alirocumab) 122

Table 32: Praluent (Alirocumab) SWOT Analysis, 2015-2025 123

Table 33: Product Profile-Repatha 127

Table 34: Pivotal Trials of Repatha (Evolocumab) 128

Table 35: Repatha (Evolocumab) SWOT Analysis, 2015-2025 131

Table 36: Product Profile-Vytorin 133

Table 37: Efficacy of Vytorin-Primary and Secondary Endpoints, VYVA study 134

Table 38: Vytorin SWOT Analysis, 2015 135

Table 39: Product Profile-Kynamro 138

Table 40: Efficacy of Kynamro-Lipid and Lipoprotein Parameters, RADICHOL 1 Phase III Study 139

Table 41: Safety of Kynamro (mipomersen) 140

Table 42: Kynamro SWOT Analysis, 2015 141

Table 43: Product Profile-Juxtapid 144

Table 44: Efficacy of Juxtapid-Lipid and Lipoprotein parameters, Phase III Study 145

Table 45: Juxtapid SWOT Analysis, 2015 147

Table 46: Product Profile-Niaspan 150

Table 47: Niacin/Nicotinic Acid SWOT Analysis, 2015 153

Table 48: Summary of the Therapeutic Properties of Fibrates* 154

Table 49: Product Profile-Tricor/Trilipix 156

Table 50: Tricor/Trilipix SWOT Analysis, 2015 158

Table 51: Product Profile-Lovaza 161

Table 52: Efficacy of Lovaza-Pivotal Studies for the Treatment of Very High TGs 162

Table 53: Lovaza SWOT Analysis, 2015 163

Table 54: Product Profile-Vascepa 165

Table 55: Efficacy of Vascepa-ANCHOR Phase III Study 166

Table 56: Vascepa SWOT Analysis, 2015 167

Table 57: Product Profile-Epanova 169

Table 58: Efficacy of Epanova-ESPRIT Phase III Study 170

Table 59: Epanova SWOT Analysis, 2015 171

Table 60: Product Profile-Welchol 173

Table 61: Efficacy of Welchol-GLOWS Study 174

Table 62: Welchol SWOT Analysis, 2015 175

Table 63: Unmet Need and Opportunity in Dyslipidemia, 2015 178

Table 64: Product Profile-LY3015014 198

Table 65: Efficacy of LY3015014 199

Table 66: LY3015014 SWOT Analysis, 2015 201

Table 67: Product Profile-Anacetrapib 205

Table 68: Efficacy of Anacetrapib-Primary and Secondary Endpoints, DEFINE study 206

Table 69: Safety of Anacetrapib-AEs and Safety Variables, DEFINE study 207

Table 70: Anacetrapib SWOT Analysis, 2015 209

Table 71: Product Profile-AMG-899 ( TA-8995/DEZ-001) 211

Table 72: Efficacy of TA-8995-Primary Endpoints, TULIP study 213

Table 73: AMG-899 SWOT Analysis, 2015 215

Table 74: Product Profile-ETC-1002 (Bempedoic Acid) 218

Table 75: Efficacy of ETC-1002-Lipid and lipoprotein parameters 220

Table 76: ETC-1002 SWOT Analysis, 2015 222

Table 77: Product Profile-Volanesorsen 224

Table 78: Efficacy of Volanesorsen-Lipid and Lipoprotein Levels and Glycemic Control 225

Table 79: Volanesorsen SWOT Analysis, 2015 227

Table 80: Product Profile-CER-001 229

Table 81: Efficacy of CER-001 230

Table 82: CER-001 SWOT Analysis, 2015 232

Table 83: Product Profile-ALN-PCSsc 234

Table 84: ALN-PCSsc SWOT Analysis, 2015 237

Table 85: Product Profile-Gemcabene 239

Table 86: Efficacy of Gemcabene 240

Table 87: Gemcabene SWOT Analysis, 2015 242

Table 88: Product Profile-Pemafibrate 244

Table 89: Efficacy of Pemafibrate 245

Table 90: Safety of Pemafibrate 246

Table 91: Pemafibrate SWOT Analysis, 2015 247

Table 92: Drugs in Development for Dyslipidemia, 2015 249

Table 93: Key Companies in the Dyslipidemia Market in the 7MM, 2015 252

Table 94: Abbvie's Dyslipidemia Portfolio Assessment, 2015 257

Table 95: Aegerion Pharmaceuticals' Dyslipidemia Portfolio Assessment, 2015 258

Table 96: Ionis Pharmaceuticals' Dyslipidemia Portfolio Assessment, 2015 260

Table 97: Amarin's Dyslipidemia Portfolio Assessment, 2015 262

Table 98: Amgen's Dyslipidemia Portfolio Assessment, 2015 263

Table 99: AstraZeneca's Dyslipidemia Portfolio Assessment, 2015 264

Table 100: Cerenis Therapeutics' Dyslipidemia Portfolio Assessment, 2015 266

Table 101: Daiichi Sankyo's Dyslipidemia Portfolio Assessment, 2015 267

Table 102: Eli Lilly's Dyslipidemia Portfolio Assessment, 2015 269

Table 103: Esperion Therapeutics' Dyslipidemia Portfolio Assessment, 2015 270

Table 104: Genzyme's Dyslipidemia Portfolio Assessment, 2015 272

Table 105: Merck & Co.'s Dyslipidemia Portfolio Assessment, 2015 273

Table 106: Regeneron Pharmaceuticals' Dyslipidemia Portfolio Assessment, 2015 275

Table 107: Sanofi's Dyslipidemia Portfolio Assessment, 2015 277

Table 108: The Medicines Company's Dyslipidemia Portfolio Assessment, 2015 279

Table 109: Dyslipidemia Market-Global Drivers and Barriers, 2015?2025 285

Table 110: Key Events Impacting Sales for Dyslipidemia in the US, 2015-2025 293

Table 111: Dyslipidemia Market-Drivers and Barriers in the US, 2015?2025 294

Table 112: Key Events Impacting Sales for Dyslipidemia in the 5EU, 2015-2025 298

Table 113: Dyslipidemia Market-Drivers and Barriers in the 5EU, 2015?2025 299

Table 114: National Healthcare Authorities in the 5EU Nations 299

Table 115: National Public Health Initiatives in the 5EU Nations 300

Table 116: Governmental Drug Pricing Authorities in the 5EU Nations 301

Table 117: Key Events Impacting Sales for Dyslipidemia in Japan, 2015-2025 304

Table 118: Dyslipidemia Market-Drivers and Barriers in Japan, 2015?2025 305

Table 119: Key Launch Dates for Dyslipidemia 340

Table 120: Key Patent Expiry Dates for Dyslipidemia 340

Table 121: High-Prescribing Physicians (non-KOLs) Surveyed, By Country 351

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AbbVie , Aegerion Pharmaceuticals, Inc., Akcea Therapeutics, Inc. and Ionis Pharmaceuticals, Amarin , Amgen , AstraZeneca , Cerenis Therapeutics, Inc., Daiichi Sankyo , Eli Lilly , Esperion Therapeutics, Inc., Genzyme , Merck & Co. , Regeneron Pharmaceuticals, Inc., Sanofi , The Medicines Company

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