The global cardiovascular drug market is primarily driven by increase in prevalence of heart diseases coupled with rising geriatric population and lifestyle related diseases. In order to cater to this increasing population suffering from cardiovascular diseases, drugs for treatment and prevention for these diseases is required. Rising number of diabetic patients is also expected to be another factor for growth of the global cardiovascular drugs market. According American Diabetes Association, in 2015, 30.3 Americans had diabetes, which is 9.4% of the total U.S population.

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Some of the common cardiovascular diseases include hypertensive heart disease, rheumatic heart disease, ischemic heart disease, inflammatory heart disease, and cerebrovascular heart disease. Major problems associated with hypertensive heart disease include angina, hypertrophy, and heart failure. These problems are caused due to high blood pressure in the heart’s arteries and muscles, which causes narrowing of arteries and thickening and enlargement of heart.

Manufacturers in the market are focusing on mergers and acquisition and new product launches, which is positively affecting the market growth. However, stringent drug approval process and side effects of some cardiovascular drugs hamper growth of the global cardiovascular drugs market. Moreover, the patent expiry of various blockbuster drugs is also expected to adversely affect revenue growth of the global cardiovascular drugs market.

According to American Heart Association (AHA), in 2013, cardiovascular diseases accounted for over 17.3 million deaths globally, representing 31% of all global deaths. The global number is expected to rise to 23.6 million by 2030. In 2010, the global burden of cardiovascular diseases was US$ 863 billion, and it is expected to rise to US$1044 billion by 2030. Around 2,200 U.S. citizens die due to cardiovascular diseases, everyday, which is one death in every 40 seconds. Moreover, coronary heart disease accounts for (45.1%) of the total cardiovascular disease, followed by stroke (16.5%), high blood pressure (9.1%), heart failure (8.5%), diseases related to arteries (3.2%), and other cardiovascular diseases in the U.S.

Spinal fusion devices are used to provide stability to spinal structure, which has lost stability due to a fracture, degenerative disorders of the spine, trauma, tumors, and deformity. Spinal cord injuries majorly happen due to various reasons such as a blocked blood supply, infections, injuries, and compression by a fractured bone or a tumor. Spinal fusion devices technology and mechanism of functioning has evolved over the years. Advanced plating systems offer improved stability and structural integrity. Spinal fusion devices have innovative locking mechanisms and screw systems, which can have self-drilling and self-tapping functions, made from modern manufacturing material such as titanium alloy, and single as well as double holes per vertebrae through which the screw fixation is done.

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In 2015, Aesculap Implant Systems, a division of B. BRAUN MELSUNGEN AG, launched Modulift Vertebral Body Replacement System (VBR). It is the latest generation of expandable cage technology. In 2017, Stryker’s Spine division launched Serrato pedicle screw, a unique dual-lead screw intended for use in the non-cervical spine. In 2016, Stryker launched Aero-C Cervical Stability System at the meeting of the American Academy of Orthopedic Surgeons in Orlando. Entry of these novel products in market is expected to support the growth of global spinal fusion devices market in near future.

Furthermore, frequent approvals of innovative products is also expected to drive market growth. For instance in 2018, Orthofix International N.V., received U S Food and Drug Administration 510(k) clearance of FORZA XP Expandable Spacer System. FORZA XP is designed to restore normal disc height in patients suffering from degenerative disc disease. In 2016, Orthofix International N.V. received US Food and Drug Administration 510(k) clearance for FORZA PTC (Peek Titanium Composite) Spacer System, and Wenzel Spine, Inc., received clearance from the U.S. Food and Drug Administration (FDA) to market VariLift-LX, an interbody fusion device for stand-alone use in the lumbar spine.

Factors responsible for spinal deformities include weight, diet, smoking, and other lifestyle factors. Early onset of degenerative spinal changes is attributed to the toxins in cigarette smoke damaging the cartilage of spine. According to World Health Organization (WHO), more than 1.1 billion people smoked tobacco in 2015 worldwide. According to a study published in SpineUniverse in 2017, disc herniation is the most common indication for spinal surgery, and around 75% of all spinal surgeries were performed for herniated disc. Increasing prevalence of spinal deformities due to unhealthy lifestyle and high chances of disc herniation are expected to drive growth of the spinal fusion devices market in near future.

Carcinoid syndrome is caused by secretion of certain harmful chemicals by carcinoid tumors. Carcinoid syndrome may occur due to infection or other related diseases, and medical or surgical treatments such as anesthesia, chemotherapy, embolization, and tumor debulking. The key symptoms of the syndrome include flushing of the skin and diarrhea, rapid heartbeat, and bronchoconstriction. If remained undiagnosed, it could lead to several complications such as weight loss, electrolyte imbalance, dehydrations, menopause, irritable bowel disease, and asthma.

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For instance, in 2009, a study by Journal of Clinical Oncology, showed 4 to 5 out of every 100,000 people are diagnosed with a neuroendocrine tumor and over 100,000 people suffering from neuroendocrine tumor in the U.S., also most individual suffering from carcinoid are asymptomatic until the tumor is fully developed. To overcome the carcinoid crisis, treatment options may considered such as surgery, chemotherapy, targeted radionuclide therapy, radiofrequency ablation, and chemoembolization on the basis of patient-by-patient. Carcinoid syndrome being a rare condition, there are very few if any treatment options available. This in turn, creates a highly lucrative opportunities for market players.

In February 2017, Lexicon Pharmaceutical Inc., announced that the U.S. Food and Drug Administration (FDA) approved Xermelo (Telotristat etiprate) as the first and only orally administered therapy for the treatment of carcinoid syndrome diarrhea in combination with somatostatin analog therapy (SSA) for adults. Xermelo mainly targets the overproduction of serotonin hormone inside mNET cells and reduces the frequency of carcinoid syndrome diarrhea. Furthermore, in 2017, Ipsen Biopharmaceutical, announced the U.S. Food and Drug Administration (FDA) approval for a supplemental indication of Somatuline Depot (lanreotide) Injection 120 mg for the treatment of carcinoid syndrome, to reduce the frequency of short-acting somatostatin analogue rescue therapy.

However, low awareness and certain side effects associated with this therapy are expected to hinder growth of the carcinoid syndrome diarrhea treatment market.

According to the National Organization for Rare Disorders (NORD), 2017, each year, only 27 individuals per million population are estimated to be diagnosed with carcinoid tumors in the U.S., amongst whom, only 10% individuals develop carcinoid syndrome. Moreover, it affects both males and females in equal number. Increasing prevalence of the disease is in turn, increasing demand for carcinoid syndrome diarrhea treatment devices. This in turn is expected to fuel growth of the carcinoid syndrome diarrhea treatment market.

Therapeutic drug monitoring is a multidisciplinary practice of measuring drug amount in bloodstream to maintain its effective concentration. It is used to maximize efficacy of drug, avoid toxicity and adverse drug reactions (ADR), facilitate dose adjustment according patient requirement, and to identify therapeutic failure. It is used especially for drugs characterized by narrow therapeutic window, drugs that are highly protein bound and those in which the metabolite might be toxic. Physicians and hospitals use therapeutic drug monitoring to maximize the clinical benefits of the drug by minimizing the toxic side effects thereby improving the quality of life for the patients.

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North America holds the dominant position in therapeutic drug monitoring (TDM) market, owing to robust health care infrastructure, high awareness for treatment regime and increasing patient awareness regarding adverse drug reaction (ADR). According to 2013 survey by Medical Expenditure Panel published in Scientific American, 1 in 7 American adult consume Anti-Psychotic drug, a class of drugs which requires TDM. Stringent government regulations regarding safe medication practices especially with drugs having narrow therapeutic range would propel growth therapeutic drug monitoring. Moreover, increasing adoption of instruments such as monitors and analytic equipment, reagents, and diagnostics tools for drug monitoring is driving the growth of therapeutic drug monitoring market.

However, difficulty in reimbursement bars the widespread usage of TDM, as often the cost associated with TDM is high. Furthermore, insufficient infrastructure and skilled manpower is restraining the growth of the market in emerging economies.

Personalized medicine is driving the growth of therapeutic drug monitoring market, owing to increasing demand for better treatment outcome with minimum side effects from the medication. For instance, TDM is majorly used for anti-cancer drugs monitoring for which standard guidelines are recommended by many oncology Journal and associations, one of them being the European Journal of Oncology. Moreover, advanced treatment therapies such pharmacogenomics, gene testing, and proteomics is further expected to boost the growth of market. Increasing antimicrobial resistance is one of the key factor driving the growth of TDM market. According to WHO Factsheet 2017, antimicrobial resistance is one of the leading cause of death. For instance, according to WHO factsheet, around 4,80,000 multi-drug resistance TB cases were reported, which is creating an opportunity for physicians to optimize or monitor the drug therapies through TDM.