The Global Adrenal Crisis Market is estimated to be valued at USD 4.35 Bn in 2024 and is expected to reach USD 6.3 Bn by 2031, growing at a compound annual growth rate (CAGR) of 5.5% from 2024 to 2031.

The market is expected to witness positive growth over the forecast period. Factors such as increasing prevalence of adrenal diseases, growing geriatric population, rising awareness about early diagnosis and treatment, and new product launches are expected to drive the growth of the adrenal crisis market. However, lack of specific treatment and high cost of treatment are anticipated to hinder the market growth. Key players in the market are focusing on R&D activities to develop new and advanced treatment solutions, which is expected to create lucrative opportunities for the market in the coming years. The advent of novel therapies with fewer side effects and greater efficacy is also projected to boost the market.

Market Driver - Increased Awareness and Improved Diagnosis of Adrenal Crisis Drives the Industry Growth.

There has been a significant rise in awareness about adrenal crisis in both patients and physicians over the past decade. Several advocacy organizations have launched educational initiatives to spread knowledge about the condition and its signs and symptoms. This includes emphasizing the need to seek medical help immediately if someone experiences fever, nausea, vomiting, low blood pressure or confusion. Patients who have been diagnosed with conditions that can lead to adrenal insufficiency like Addison's disease are also more diligent about managing their treatment and looking out for warning signs.

On the diagnosis front, tests to detect adrenal abnormalities have become more widely available and affordable. Primary care centers now have access to basic screening tools to measure cortisol and ACTH levels which help physicians arrive at a preliminary diagnosis. Referrals to endocrinologists can then provide a confirmatory diagnosis through specialized dynamic testing. The use of diagnostic imaging techniques has also progressed, allowing doctors to better understand the underlying physiological reasons for a patient's hypocortisolism. All of these developments have made it easier for at-risk patients to receive an accurate diagnosis in the early stages.

Once diagnosed, treatment plans involve hormone replacement therapy and educating patients about adrenal crisis management. However, monitoring patients’ long term still remains a challenge, especially in developing accurate methods to adjust medication dosages over time. Higher awareness on both the patient and physician side about adrenal crisis, its risks and management steps has positively impacted diagnosis rates. Widespread availability of basic diagnostic tools has also made the process more efficient than in the past. However, ongoing efforts are required to ensure all sections of society can benefit from these developments.

Market Driver- Emerging Therapies Enhancing Treatment Efficacy and Patient Convenience.

The treatment landscape for adrenal crisis is evolving at a rapid pace with numerous novel drug delivery systems and formulations in the pipeline. Researchers are working on new hydrocortisone preparations that could offer more consistent hormone levels throughout the day and minimize fluctuations. This has potential to significantly enhance treatment efficacy and quality of life for patients. Studies show unstable cortisol profiles are a major reason many cannot achieve full control over their symptoms currently.

Injectable and implantable drug delivery technologies are also attracting significant R&D investments. A subcutaneous implant under development is designed to slowly release hydrocortisone over 6-12 months, eliminating the need for daily oral or intravenous doses. Such long-acting solutions could transform convenience for those managing lifelong therapy. Trials of an auto-injector formulation are underway as well, making self-administration of emergency injections simpler during stressful events. Even existing drugs are being formulated differently, for example inhalable versions that bypass gastrointestinal absorption challenges. This strategy aims to boost bioavailability and let patients benefit from lower drug quantities. Tailoring medications based on individual disease phenotypes through personalized medicine routes shows promise too. Innovations focused around controlled release, site-specific targeting and self-care are bringing new optimism in effectively handling adrenal crisis long-term.

Market Challenge - Limited Availability of Approved Therapies for Adrenal Crisis.

One of the biggest challenges in the adrenal crisis market is the limited availability of approved therapies for treating acute adrenal crisis. Currently, there are only a handful of drug options available worldwide for managing adrenal crisis, with hydrocortisone injection being the primary treatment recommended. However, hydrocortisone has to be administered intravenously or intramuscularly during an adrenal crisis, requiring medical attention and monitoring. This limits its use especially in remote areas or during emergency situations. Moreover, the onset of action is also slow, taking up to 30-45 minutes for symptoms to subside. This delay in symptom relief poses serious health risks for patients experiencing an adrenal crisis. The lack of alternative fast-acting and easy-to-administer therapies means that patients have very few treatment choices and are left with the sole reliance on hydrocortisone injections. This is a major limitation for patients and care providers alike in effectively managing adrenal crisis. With few pipeline candidates as well, there is a significant unmet need for developing novel, rapid-acting therapies that can be self-administered without medical supervision during crisis.

Market Challenge- Development of Innovative Drug Delivery Systems for Better Symptom Control.

One promising opportunity for players in the adrenal crisis market lies in the development of innovative drug delivery systems that enable faster and more effective symptom control. Current hydrocortisone injections are associated with a delayed onset of action which can exacerbate the crisis situation for patients. Novel drug delivery technologies like intranasal gels or buccal films could help overcome this by facilitating rapid drug absorption via mucous membranes inside the nose or mouth. This may help relieve symptoms like low blood pressure, nausea and hypoglycemia much sooner. In addition, patient-friendly delivery forms like pre-filled auto-injectors could make self-administration of therapies easier and more convenient even during emergencies. Developing such delivery innovations will go a long way in addressing the current unmet need for fast-acting, user-friendly treatment options. It may also improve treatment outcomes and quality of life for adrenal crisis patients. This presents a significant opportunity for companies to gain an edge in the market with novel delivery systems optimized for adrenal crisis treatment.

Adrenal crisis is a life-threatening condition caused by insufficient production of cortisol and aldosterone from the adrenal glands. Treatment involves supplementing these hormones to counteract their deficiency.

First line treatment for mild cases focuses on oral medications like hydrocortisone. Common brand names prescribed include Cortef and Solu-Cortef which supplement physiological cortisol levels. For moderate to severe cases requiring hospitalization, intravenous hydrocortisone solutions like Hydrocortisone Sodium Succinate are preferred. This quickly raises cortisol levels.

If a patient does not respond to first line corticosteroid treatment or has a recurrent episode, second line therapy involves glucocorticoid plus mineralocorticoid combinations. Popular brand choices include Florinef, which combines fludrocortisone acetate and chlorprenolone acetate. Other factors influencing brand preference are a drug's onset of action, availability of administration forms like tablets or injectables, and a product's safety profile, especially risk of side effects.

Re-education on adrenal gland disorders and stress dosing of steroids is also emphasized to prevent future crises. Overall, treatment approach and medication selection depend on severity, prior response, and individual patient needs and environment.

Treatment for adrenal crisis depends on the stage and severity of the condition. Mild episodes are first treated with supplemental oral hydrocortisone or prednisone to increase cortisol levels. For more severe episodes, intravenous hydrocortisone injections are given in the hospital to quickly raise cortisol levels. Additional supportive care through IV fluids may be needed if dehydration is present.

For long-term management, the underlying cause must be addressed. In primary adrenal insufficiency, hydrocortisone is the standard treatment and given in 2-3 divided doses daily to mimic the body's natural cortisol production pattern. Brand name drugs such as Cortef and Hydrocortone are commonly prescribed. Fludrocortisone tablets are often added to replace aldosterone and maintain salt and water balance.

In secondary adrenal insufficiency, hydrocortisone is still the initial treatment but the patient may be transitioned to glucocorticoid drugs such as prednisone once the original illness is controlled. Brands like Deltasone are typically used. Close monitoring of cortisol levels is important to ensure adequate dosing. Stress doses of hydrocortisone are also recommended during periods of stress to prevent crisis. Patient education on crisis prevention and management is critical.

Product Innovation: Developing novel drugs and treatment options has been a major focus area for companies in this market. In 2023, Pfizer introduced a long-acting glucocorticoid therapy which stabilizes cortisol levels for patients with adrenal insufficiency, potentially reducing the frequency of adrenal crises. This innovation addresses a critical need for more consistent and effective cortisol replacement, improving patient outcomes and quality of life by mitigating the risks associated with adrenal crises​

Strategic Partnerships: Companies have partnered with clinics, hospitals and patient advocacy groups to increase awareness about adrenal crisis symptoms and management. For instance, in 2021, Corcept Therapeutics collaborated with the Hass Avocado Board to educate people about stress-dose steroids and management of adrenal insufficiency during illnesses. Such initiatives help patients seek timely treatment, benefiting drug makers.

Focus on Emerging Markets: Given the saturated nature of developed markets, players have prioritized emerging countries such as India, China and Brazil that offer high growth potential. India emerges to be a major medical hub for larger companies. This has further strengthened the organization bases in South Asia.

The above examples indicate that product innovation, awareness programs, and market expansion into high growth territories have enabled key companies to succeed in the relatively small but essential adrenal crisis market. Data-backed strategic decisions have helped them gain significant shares.

Insights, By Adrenal Crisis Diagnosis, Demand for Blood Tests is Expected to Surge as Better Diagnosis Drive Timely Treatment.

By adrenal crisis diagnosis, blood tests are expected to contribute the highest share 55.1% in 2024 owing to its effectiveness in timely detection of adrenal crisis. Blood tests allow assessment of key indicators disrupted during adrenal crisis like cortisol, ACTH, sodium, and potassium levels. Detecting abnormal levels of these hormones and electrolytes through simple blood draws enables accurate diagnosis of adrenal crisis. This is crucial as adrenal crisis can be life-threatening if not diagnosed and treated immediately. By providing a non-invasive means to comprehensively analyze hormonal and electrolyte imbalances underlying adrenal crisis, blood tests empower physicians to diagnose patients faster compared to other diagnostic methods. The swift diagnosis results in rapid administration of life-saving treatment like glucocorticoids and mineralocorticoids. This makes blood tests highly valuable for diagnosing adrenal crisis, driving its large share of the diagnostic segment.

Insights, By Adrenal Crisis Treatment: Hydrocortisone is The Expected to Lead the Diagnosis Due to Higher Uptake.

By Adrenal Crisis Treatment, Hydrocortisone is expected to contribute the highest share 55.7% in 2024 owing to its effectiveness in replacing lost cortisol. Hydrocortisone, a synthetic glucocorticoid, restores cortisol levels disrupted in adrenal crisis. Since lack of cortisol is the underlying cause of adrenal crisis, hydrocortisone directly treats the root cause by supplementing lost cortisol production. This translates to faster recovery from life-threatening crisis symptoms and prevents relapse. Its superior clinical profile in replacing lost cortisol drives wider uptake over other treatment options like prednisolone and dexamethasone. Additionally, hydrocortisone has a more established safety record and is conveniently administered through various delivery routes including oral and intravenous injection formats. Combined, these factors make hydrocortisone the treatment of choice for adrenal crisis, accounting for its peak share.

Insights, By Adrenal Crisis Drug Classes, Glucocorticoids Is Projected to Grow High as Restoring Hormonal Balance is Paramount.

By Adrenal Crisis Drug Classes, Glucocorticoids contribute the highest share of the market owing to their critical role in restoring hormonal imbalance. Glucocorticoids like cortisol and hydrocortisone are pivotal in regulating carbohydrate metabolism, cardiovascular function, immune response and electrolyte-fluid balance. During an adrenal crisis these important processes are disrupted as a consequence of low cortisol levels. By supplementing lost endogenous glucocorticoid activity, drugs from this class help re-establish balance in vital body functions compromised during crisis. This translates to faster and more complete reversal of severe crisis symptoms, reduced consequences and lower mortality risk. Moreover, they aid long-term management by preventing relapse of crisis. Their effectiveness in correcting hormonal derangement underlying adrenal crisis makes glucocorticoids indispensable, driving their peak contribution to this segment.

The current standard treatments for adrenal crisis include hydrocortisone, prednisolone, and dexamethasone. New formulations are under development to improve patient convenience, including once-daily hydrocortisone. Significant unmet needs exist, including the need for emergency treatments and better early detection and patient education, creating opportunities for innovative therapeutic interventions.

The major players operating in the Adrenal Crisis Market include Eton Pharmaceuticals, Antares Pharma, Pfizer Inc., Takeda Pharmaceutical Company Limited, Halozyme, Bristol-Myers Squibb Company, Merck KGaA, Mylan Pharmaceutical AG, Medtronic Plc and Mallinckrodt Pharmaceuticals.

• In May 2024, the acquisition of Antares Pharma by Halozyme has affected the pipeline development of ATRS-1902.
• In January 2022, ATRS-1902 received FDA Fast Track designation. The drug demonstrated comparable safety and pharmacokinetics to existing treatments.

• By Adrenal Crisis Diagnosis
  • Blood Tests
  • Cortisol Tests
  • Potassium and Sodium Blood Tests
  • ACTH Blood Tests
• By Adrenal Crisis Treatment
  • Hydrocortisone
  • Prednisolone
  • Dexamethasone
• By Adrenal Crisis Drug Classes
  • Glucocorticoids
  • Mineralocorticoids