Despite Dupixent's dominance, Apogee's CEO claims the atopic dermatitis market has so much unmet need that new drugs with even limited differentiation are achieving blockbuster status. This suggests the market is expanding to accommodate new entrants, rather than being a zero-sum game of stealing market share.

A key trend in 2025's drug approvals is that "best-in-class" therapies are distinguished not just by efficacy, but by innovations in formulation and delivery that improve the patient experience. Examples include subcutaneous versions of IV drugs and new delivery methods that expand patient access.

Protagonist believes its oral IL-23 blocker will not just compete with existing injectables but will capture a new market. They target the over 50% of eligible patients who currently take no therapy due to a dislike of injections or the safety profiles of other oral options, thereby expanding the total addressable market.

The introduction of oral GLP-1 medications is proving to be a market expansion strategy, not a cannibalization one. Data shows that the majority of patients starting on oral versions are new to the GLP-1 category entirely, indicating the new form factor overcomes a key barrier to adoption.

The transition to oral GLP-1 therapies is a significant market expander, not just a convenience upgrade. Nearly 80% of patients starting oral medications are new to the drug category, indicating a substantial increase in the addressable patient pool rather than simple conversion of existing users.

Upcoming oral psoriasis drugs from J&J, Alumis, and Takeda offer efficacy close to injectables but with greater convenience. This strategy is not about stealing market share but about massive market expansion, targeting millions of patients using only topicals and potentially growing the market to over $40 billion.

New drug formulations, like those for HIV prevention or cholesterol, create an internal depot that releases medicine over months. This dramatically improves efficacy by solving the massive problem of patient non-adherence to daily pills, representing a major shift in managing chronic conditions.

Beyond converting patients from existing injectable therapies, the company's core growth strategy for its oral IL-23 drug is to capture the 50%+ of eligible patients who currently refuse treatment altogether because they dislike injections. This transforms the strategy from market share capture to market creation.

Despite concerns about cannibalizing its injectable user base, Novo Nordisk found that approximately 80% of patients taking the new Wegovy pill are new to the treatment segment. This demonstrates that introducing a new form factor can be a powerful market expansion strategy.