Ageing is one of pharma’s most predictable demand drivers. Turning that demand into growth is harder.

Longer lives are expanding need across neurodegeneration, retinal disease, inflammation, bone health and mobility. But prevalence alone does not create a commercial market.

Growth will depend on timely diagnosis, practical delivery and evidence that reflects the realities of older people living with multiple conditions.

In this week’s Market Watch: Healthcare, Pharma & Biotech, we examine how ageing is changing portfolio decisions, market access and long-term treatment economics.

Reflecting the wider commercial impact of population ageing, Visiongain forecasts the global longevity market to grow from US$746.00bn in 2026 to US$1,700.64bn by 2036, at a CAGR of 8.6%.

Visiongain Top Takeaways

• Alzheimer’s therapies are advancing faster than the diagnostic, monitoring and specialist capacity needed to support wider use.
• Retinal competition is shifting towards treatment frequency, alternative delivery and cost as biosimilars challenge established franchises.
• In inflammation, older and higher-risk patients are increasing the value of safety, patient-selection and sequencing evidence.
• Mobility remains fragmented across medicines, surgery, devices and rehabilitation, leaving major unmet need but an uneven drug-development opportunity.
• Demographic exposure alone does not make an asset attractive. Commercial value depends on removing a clear barrier to diagnosis, treatment or continued use.

Demographics Become a Portfolio Question

By 2030, one in six people worldwide will be aged 60 or over. By 2050, that population is expected to reach 2.1 billion.

The commercial opportunity lies in the growing number of years people spend managing chronic disease. Forecasts must therefore account for diagnosis, eligibility, treatment capacity and persistence, rather than treating prevalence as revenue.

Alzheimer’s Disease: Infrastructure Sets the Ceiling

The Alzheimer’s therapeutics market has the strongest growth outlook of the markets examined here, but it also faces the greatest difficulty in converting eligible patients into treated patients.

Visiongain forecasts the global market to grow from US$6.75bn in 2026 to US$35.76bn by 2036, at an 18.2% CAGR.

Leqembi, developed by Eisai and Biogen, and Eli Lilly’s Kisunla have brought disease-modifying treatment to early symptomatic Alzheimer’s disease. Their commercial reach depends on whether healthcare systems can confirm amyloid pathology, assess safety risks, provide MRI monitoring and oversee treatment at scale.

Blood testing could make amyloid assessment more accessible. The FDA cleared Fujirebio’s Lumipulse test in May 2025, although certain lots were recalled in February 2026 because of the risk of inaccurate results. The test is not intended for screening or use as a standalone diagnosis.

The two medicines follow different delivery models. Kisunla is infused every four weeks, with stopping considered once amyloid plaques have fallen to minimal levels. In July 2026, the FDA approved an at-home subcutaneous starting regimen for Leqembi, reducing reliance on infusion centres.

Simpler administration does not remove the wider access burden. Diagnostic capacity, MRI availability, specialist oversight, safety monitoring and reimbursement will continue to determine how many patients begin and remain on treatment.

Visiongain Insight: Alzheimer’s disease offers the strongest growth outlook, but commercial scale will be limited by how many patients health systems can diagnose, treat and monitor safely.

Retinal Disease: Durability Becomes the Commercial Test

In retinal disease, efficacy is increasingly the entry requirement. Competitive advantage is shifting towards how long disease control can be maintained before the patient must return to the clinic.

Visiongain forecasts the wider ophthalmic drugs market to grow from US$41.88bn in 2026 to US$89.17bn by 2036, at a 7.9% CAGR. That scale is attracting competing approaches to treatment burden, from longer-acting injections and implants to biosimilars and gene therapy.

Wet age-related macular degeneration and diabetic macular oedema can require repeated injections and frequent monitoring. Roche’s Vabysmo and aflibercept 8 mg, commercialised by Regeneron and Bayer in different markets, can extend dosing intervals for suitable patients.

Aflibercept biosimilars are making the value test more immediate. Samsung Bioepis launched Opuviz across Europe in 2026, while Formycon and its partners began the European rollout of Ahzantive. Originators must show that durability improves persistence, releases clinic capacity or lowers total care costs.

While biosimilars compete on price, gene therapy is testing whether the treatment model itself can be changed.

Lilly’s ixo-vec and 4D Molecular Therapeutics’ 4D-150 are in Phase III development and aim to provide sustained anti-VEGF activity following one administration. Safety, durability and the need for supplemental injections will determine whether that promise translates into market value.

Visiongain Insight: Retinal disease offers the best balance of scale and commercial accessibility, but durability must prove its value against lower-cost competition.

Inflammation: Safety and Sequencing Matter More

A crowded inflammation market leaves little room for evidence that does not change a prescribing decision.

That challenge becomes sharper in older patients, who are more likely to have cardiovascular, renal or infection risks and may be taking several medicines.

Visiongain forecasts the global rheumatoid arthritis drugs market to grow from US$37.20bn in 2026 to US$58.60bn by 2036, at a 4.6% CAGR. The slower profile reflects a mature category facing established competition, biosimilar pressure and tighter safety requirements.

Pfizer’s Xeljanz and AbbVie’s Rinvoq carry US boxed warnings covering serious cardiovascular events, cancer, blood clots and death. The European Medicines Agency advises that JAK inhibitors should be used in patients aged 65 or over only when no suitable alternative is available.

Biosimilars apply a different pressure. Sandoz, Celltrion and Amgen compete in established TNF inhibitor markets, making it harder for originators to defend share through familiarity alone. Celltrion’s subcutaneous infliximab also shows that formulation and administration can influence treatment choice, not only price.

Visiongain Insight: Rheumatoid arthritis offers steadier but slower growth. Value will come from evidence that changes treatment decisions, not from demographic demand alone.

Mobility: A Large Need, a Difficult Drug Market

Few ageing-related needs are as visible as the loss of strength, movement and independence. Yet mobility remains one of the hardest areas to turn into a coherent pharmaceutical market.

Osteoporosis, osteoarthritis, sarcopenia, frailty and chronic pain span medicines, surgery, devices and rehabilitation. That fragmentation has left major gaps in drug development despite substantial patient need.

Osteoporosis is the clearest exception. UCB and Amgen’s Evenity and Amgen’s Prolia have established substantial franchises. Prolia now faces a growing field of denosumab biosimilars, shifting competition towards price, access and lifecycle management.

No disease-modifying osteoarthritis drug has reached approval, and there is no approved medicine specifically for sarcopenia. Products must show more than changes in cartilage, muscle mass or imaging. They need to improve outcomes that matter to patients and payers, including pain, strength, fractures, physical function or the need for surgery.

Obesity treatment is beginning to test the boundary between metabolic and mobility markets. Novo Nordisk’s semaglutide reduced knee osteoarthritis pain and improved physical function in the STEP 9 trial. Lilly is studying bimagrumab with tirzepatide, although whether changes in fat and lean mass translate into better function remains the commercial question.

Visiongain Insight: The investable opportunity lies in assets that turn stronger bone, preserved muscle or reduced pain into fewer fractures, better physical function or delayed surgery.

Where the Opportunity Is Strongest

The four markets offer different risk and return profiles:

1. Alzheimer’s disease: strongest forecast growth, but the highest execution risk.
2. Retinal disease: the best balance of scale and commercial accessibility.
3. Rheumatoid arthritis: an established market with slower growth and biosimilar pressure.
4. Mobility: major unmet need, but limited near-term drug-market maturity outside osteoporosis.

The ranking reflects forecast growth, market scale, competitive pressure and the ability of health systems to move patients through treatment.

What This Means for Portfolio Strategy

The market comparisons point to three practical portfolio decisions.

1. Forecasts should measure the treatable market, with diagnosis, clinical capacity, monitoring and persistence included in the base case.
2. Investment should target the point where patients are lost, whether through limited biomarker access, burdensome delivery or uncertainty over safety and sequencing.
3. Portfolio breadth adds little unless the science, evidence, infrastructure or commercial channels reinforce an existing position.

What to Watch Next

The next 12 to 24 months will test whether these markets can move from demographic promise to commercially accessible growth.

Key indicators include adoption of at-home Leqembi, the reliability and reimbursement of blood-based Alzheimer’s testing, US aflibercept biosimilar entry and Phase III results for ixo-vec and 4D-150.

In inflammation, the test is whether new evidence changes safety and sequencing decisions. In mobility, it is whether metabolic and body-composition treatments improve physical function rather than weight or muscle measures alone.

Visiongain Insight: The fastest-growing market is not automatically the most attractive. Value depends on demand, competition and the capacity to diagnose, fund and sustain treatment.

Latest Reports

Visiongain’s healthcare, pharma and biotech reports provide detailed market forecasts, competitive analysis and sector insight for organisations making decisions across R&D, manufacturing, commercial strategy, business development, M&A and investment.

The following reports examine markets closely linked to population ageing:

• Longevity Market Report 2026–2036
• Alzheimer’s Therapeutics Market Report 2026–2036
• Ophthalmic Drugs Market Report 2026–2036
• Rheumatoid Arthritis Drugs Market Report 2026–2036

Press & Media Enquiries

For commentary, data requests or interview enquiries, please contact: press@visiongain.com