Anti-ulcer market fluctuates from impurity risk aftermath

H2 receptor antagonist prescription in November dropped by 6%, nizatidine prescription plunges

Famotidine and lafutidine still going strong

PPI drug prescriptions volume continues to grow, esomeprazole surged by 27% in two months

Apparently, the anti-ulcer treatment market is still shaken with the impurity contamination risk.

 

The market volume of nizatidine drugs, with a recent discovery of impurity exceeding an acceptable level, subsided within a month.

 

A several cases of impurity found in products brought down the H2 receptor antagonist prescription volume, but rather pushed up the proton-pump inhibitors (PPI) prescription volume.

 

Among PPI class drugs, esomeprazole has been the strongest in the market.

 

On Dec.

 

18, pharmaceutical industry research firm UBIST reported the outpatient prescription volume of H2 receptor antagonist last month marked 9.3 billion won with a 5.6-percent decrease from the month before.

 

Immediately after the sales ban on ranitidine, the prescription volume of the medicine has plunged to 40 percent level and the descending trend line continued to last month.

 

Monthly trend of outpatient prescription volume of H2 receptor antagonist-containing drugs (unit: KRW 1 million) Source: UBIST

Monthly trend of outpatient prescription volume of H2 receptor antagonist-containing drugs, except ranitidine drugs (unit: KRW 1 million) Source: UBIST

Ruling out ranitidine, the H2 receptor antagonist market showed inconsistent prescription volume.

 

The H2 receptor antagonist prescription volume, except ranitidine, skyrocketed from 6.4 billion won in September to 9.8 billion won in October by 53.5 percent.

 

As most of ranitidine prescriptions were switched to other H2 receptor antagonist substance, the general market volume also expanded.

 

But the H2 receptor antagonist prescription volume went down only in a month.

 

Specifically, the nizatidine drugs took a noticeable fall.

 

Monthly trend of outpatient prescription volume of major H2 receptor antagonist substance (unit: KRW 1 million) Source: UBIST

In last month, nizatidine drug prescription volume fell by 30.5 percent from the previous month and generated 2.3 billion won.

 

When ranitidine drugs were banned, nizatidine drugs’ perception soared by 42.5 percent from September to October.

 

But merely in a month, the volume went back down to the September volume.

 

The fall was affected by the discovery of impurity in some of the items.

 

On Nov.

 

22, Ministry of Food and Drug Safety (MFDS) found unacceptable level of cancer-causing N-nitrosodimethylamine (NDMA) in nizatidine-containing drugs, and banned sales on 13 items.

 

Unlike ranitidine, only some of nizatidine drugs were banned.

 

Doctors could choose other nizatidine-containing items other than the banned ones, but they started prescribing other options due to unsettling risk of the substance.

 

Benefitting from the sales ban on ranitidine and nizatidine drugs, famotidine and lafutidine drug prescription volumes reached their highest peak.

 

Famotidine prescription volume doubled in October from the previous month, and was increased by 10.6 percent from October to November as well.

 

Whereas lafutidine prescription volume reached 2.6 billion won, increased by 13.3 percent from the previous month and reached its peak.

 

Cimetidine’s prescription volume was at 1.1 billion won last month and took a slight fall.

 

Insufficient supply of active ingredient depleted stock and was excluded the drugs from the impurity risk benefit.

 

Drugs in PPI class maintained a positive trend line last month as well.

 

Last month, PPI-class treatments had outpatient prescription volume of 42.2 billion won with an increase of 1.0 percent from the previous year and recorded the highest volume of the year.

 

In September, the volume reached 37.3 billion won and had a 17.7-percent surge in a month.

 

Monthly trend of outpatient prescription volume of PPI-containing drugs (unit: KRW 1 million) Source: UBIST

Meanwhile, esomeprazole-containing drugs had the steepest growth.

 

Last year, the drug’s outpatient prescription volume grew by 5.0 percent in a month and reached 17.7 billion won.

 

After making an increase of 21.3 percent from September to October, the drug’s prescription volume was expanded even more.

 

Esomeprazole prescription volume last month soared by 27.4 percent from September.

 

As of November, esomeprazole dominated 40.0 percent of the PPI medicine market.

 

It could be interpreted that the doctors have switched from ranitidine and nizatidine to esomeprazole as they prefer the medicine the most within the PPI class.

 

Rabeprazole’s prescription volume in last month went up by 1.2 percent from the month before, but lansoprazole, pantoprazole, ilaprazole and omeprazole’s prescription volume in November were dropped by a little than in October.

 

But in general, the said PPI-class medicines had more than a ten-percent surge from September, benefitting from the impurity contamination risk.

 

Monthly trend of outpatient prescription volume of major PPI substances (unit: KRW 1 million) Source: UBIST