Coughonomics 101: The Scramble for the Chronic Cough Market

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    The chronic cough market is large and untapped, with an estimated 10% of the global population suffering from chronic cough. Despite the high prevalence, there has been no new antitussive approved by the FDA since 1958.

    At long last, things are changing, with major pharmaceutical companies racing to develop and bring to market a new generation of antitussives. The aggressive investments and recent market activities have driven up stock prices and interest in companies operating in this space, indicating a high growth potential in the coming years.

    From Wheeze to Ease: The Soaring Prospects of the Chronic Cough Market

    Chronic cough affects 10% of the global population, causing significant quality of life challenges. Chronic coughers all share a similar – and similarly frustrating journey: long and expensive successions of medical opinions, lab tests and toxic treatments, neither of them leading to any positive outcome. 

    The drugs on the market are either ineffective (cough syrup) or they are highly toxic, addictive and not suited for ling term use (Codeine).

    Instead, desperate sufferers seek alternative medicine solutions, which are often aggressive, including radical diets or dubious surgeries. None of them work, of course. The poor care and specifically the lack of effective treatment and management options has created a strong demand for antitussive solutions, contributing to the current scramble among major pharmaceutical companies to bring new therapies to market.

    Coughing Up Profits: The Race for Antitussive Breakthrough

    The first new generation antitussive – pioneered by Merck – is expected to be on the market shortly. Meanwhile, GSK has entered the competition by acquiring Bellus Health for $2 billion and is investing heavily to accelerate its pathway to market. The acquisition has triggered a surge of interest in the chronic cough market, with companies like Trevi Therapeutics more than doubling their stock value since GSK’s announcement.

    Market Size and Growth Potential

    With 10% of the global population suffering from chronic cough, the potential market size is enormous. The high willingness to pay for effective treatments, demonstrated by the substantial investments and acquisition prices in the industry, underscores the significant growth potential of the chronic cough market. Chronic cough prevalence increases with age, which means that as the global population is aging, the prevalence of chronic cough will rise as well. As a result, the demand for effective treatments will grow, further driving the chronic cough market’s expansion.

    Beyond burden of disease alone, the economic burden of chronic cough is significant, with sufferers experiencing lost productivity and increased healthcare costs due to repeated doctor visits and over-the-counter treatments. A new generation of antitussives will not only improve the quality of life for patients but also reduce the economic strain on healthcare systems.

    Additionally, chronic cough is often a symptom of underlying conditions such as asthma, gastroesophageal reflux disease (GERD), or chronic obstructive pulmonary disease (COPD). Although treatments for these conditions exist, they often fail to address the persistent cough, highlighting the unmet clinical need for effective antitussive therapies. With companies such as Hyfe developing innovative, cheap and scaleable methods to screen and segment coughers based on their cough patterns, sufferers are expected to receive better and more accurate care.

    Hacking Around The Challenges and Opportunities

    Meanwhile, there are several challenges that need to be addressed:

    1. Lack of objective data – Until very recently, it was basically impossible to measure cough in the real world. Because of this there are no baselines for chronic cough. How much cough is normal? What does an elevated cough mean and when does cough become severe? With companies like Hyfe pioneering real-world cough detection, this is now a solved problem. 
    2. Regulatory hurdles: The approval process can be stringent. This is also related with the fact that historically it has been fiendishly difficult to collect real-world evidence for coughs, which meant that it was very, very hard to demonstrate clear effectiveness. This is why there have been no new antitussive for more than 70 years – because our scientific standards have evolved and, without an objective way to measure cough in clinical settings, it has been very hard to generate rigorous evidence that would comply with modern scientific standards. This is all changing now, and Scientific evidence in cough scioence is starting to pile in
    3. Patient adherence and education: The lack of available treatments has led many chronic cough sufferers to seek alternative medicine solutions, necessitating patient education and adherence efforts to ensure the adoption of newly developed antitussive drugs. Even more exciting, the potential of combination regimes – basically combining traditional drugs with digital therapeutic products is very powerful. In fact, there are randomized controlled trials showing exactly this impact in chronic cough.


    The chronic cough market presents a compelling investment opportunity, driven by the high prevalence of the condition, the lack of effective treatments and the development of a new class of antitussives which will all enter the market over the next few years. Additional drivers include an aging population and advances in drug delivery systems. The significant investments made by major pharmaceutical companies recently show that things will change in the near future. The additional value that comes from things like digital therapeutics – either as an alternative or as a complement to new molecules – may mean that there is finally hope for chronic coughers.

    In any case, the chronic cough market is poised for rapid growth, offering substantial returns for early investors and companies operating in the chronic cough market will probably experience significant growth potential in the coming years. In fact, after the GSK/ Bellus deal, Motley Fool issued a very rare “All In” Buy Alert

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