I. Introduction

Herpes zoster is an acute skin infection caused by the varicella-zoster virus (VZV). Among people with the disease, adults are in the majority, with the incidence showing a significant rising trend as the age increases. There will be an incubation period after average people are infected with the virus, during which, the virus will enter the nerve ending, and transfer toward the nerve center from the never ending along nerve fiber of dorsal root of the spinal nerve, thus to lurk in the neuron. Once the body immunity is low, the virus will be active and proliferate, to cause strong inflammatory response to body nerves and skin. In a serious case, the disease can cause facial paralysis, herpes of external auditory canal, ulcerative keratitis, and even death.

II. Layout of Herpes Zoster Drugs

The current market layout of drugs for the disease is relatively perfect. There have been many herpes zoster drugs marketed at present. According to incomplete statistics, there have been over 20 herpes zoster drugs marketed (including therapeutics and vaccines), which can be roughly divided into four categories by mechanism of action and period of action:

A. Antiviral drugs

During early infection of the VZV, antiviral drug treatment is the most effective measure. There are many antiviral drugs against VZV marketed at present, mainly including Aciclovir, GSK’s Valacyclovir Hydrochloride, Novartis’ Famciclovir, Roche’s Ganciclovir, and Clinigen’s Foscarnet Sodium, etc.

It should be noted that the use of antiviral drugs must be in full dose and in time. In general, the effect will be the best when such drugs are used within 72h of occurrence of herpes zoster.

B. Glucocorticoids

Glucocorticoids can be used to reduce the inflammation caused by herpes zoster, with the representative drug including prednisone, etc.

C. Drugs for external use

Like with other skin diseases, drugs for external use can be used for herpes zoster as an adjunct. Patients without skin damage can use Aciclovir Cream, etc.; while patients with skin damage can be first disinfected with povidone-iodine and then applied with aciclovir, etc.

D. Pain killers

Herpes zoster will invade body nerves and cause pain, therefore, pain killers are also much used in the treatment of herpes zoster, with the frequency next only to antiviral drugs. Pain killers can also be divided into many categories: 1. Nonsteroidal anti-inflammatory drugs (NSAIDs), like aspirin, indomethacin, paracetamol, Fenbid, and celecoxib; 2. Central pain killers, like tramadol; 3. Narcotic analgesic agents, like morphine and Dolantin; 4. Tricyclic antidepressants (TCAs), like amitriptyline, nortriptyline, maprotiline, desipramine, venlafaxine, clomipramine, and doxepin; 5. Antiepileptic drugs, like carbamazepine, phenytoin sodium, clonazepam, sodium valerate, gabapentin, pregabalin, and lamotrigine. Wherein, TCAs and antiepileptic drugs are mainly used for the treatment of postherpetic neuralgia.

Many matters shall be noted during the use, such as the "early detection, and early use" of antiviral drugs, and using pain killers from those with weak potency to those with strong potency, without overusing.

III. R&D of Herpes Zoster Drugs

In December 2016, Slayback and Sandoz signed an agreement with Novartis AG for the sale and marketing rights of Slayback Generic Zovirax Ointment (Acyclovir Ointment). Per the agreement Novartis obtained the sales and marketing rights, which increased their position in the market. Other leading companies operating in the market are Valeant Pharmaceuticals International Inc., Teva Pharmaceutical Industries Ltd, Pfizer Inc., Mylan N.V., Abbott Laboratories, GlaxoSmithKline Plc., and Dr. Reddy's Laboratories Ltd., among others.

At present, the vaccination for shingles treatment are creating significant scope of in the global market to keep patients healthier. This is because it is cost-effective since it reduces unnecessary hospital stay. Medications are Valacyclovir (Valtrex), Acyclovir (Zovirax), and Famciclovir (Famvir). The predominance of antibodies coupled with the pressing need to act fast for more effective meds is evaluated to drive global herpes zoster market development. The rise in geriatric population is increasing the predominance of ailments, for instance, tumor and skin diseases. Pervasiveness of herpes zoster is growing over the globe, fueling the overall market demand.

On the flip side, high cost of antibodies is restraining vaccination drive in developing economies, owing to inadequate scope of prevention. The huge pressure on healthcare specialists is due to reduction in postherpetic neuralgia from the herpes zoster vaccine. Zostavax has been effective till a certain degree in reducing postherpetic neuralgia in due to the effect of the vaccination on reducing the risk of being affected by herpes zoster. Uncertainty in government regulations along with lack of guidance from specialists in choosing appropriate anticoagulant, improper reimbursement policy, and low accuracy are among the other factors hampering the global market growth.

According to the report by Future Market Insights (FMI), the global varicella zoster infection treatment market is expected to register a 4.2% CAGR from 2017 to 2027. In 2016, the market was worth US$ 1,257.1 Mn and is expected to reach a valuation of US$ 1,969.1 Mn by the end of 2027.

Reference:

_{Varicella Zoster Infection Treatment Market is Expected to Register a 4.2% CAGR From 2017 to 2027 [Future Market Insights]}

_{Herpes Zoster Infection Treatment Market Global Industry Analysis and Forecast till 2025 [Persistence Market Research]}

_{Herpes Zoster (Shingles) Market - Global Industry Analysis, Size, Share, Growth, Trends and Forecast 2016 – 2024 [transparencymarketresearch.com]}

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