The Middle East low molecular weight heparin market is expected to grow from US$ 151.15 million in 2021 to US$ 209.60 by 2028. It is estimated to grow at a CAGR of 4.8% from 2022 to 2028. The report highlights prevailing trends and factors driving the market growth.

The growth of the Middle East low molecular weight heparin market is attributed to the advantage of low molecular weight heparin anticoagulant over unfractionated heparin . However, the adverse effect of low molecular weight heparin is hindering the overall market growth.

Low molecular weight heparin (LMWH) is a class of anticoagulants. They are used to prevent blood clots and treat venous thromboembolism (deep vein thrombosis and pulmonary embolism) and treat myocardial infarction. LMWHs are defined as heparin salts with an average molecular weight of less than 8,000 Daltons and in which at least 60% of all chains have a molecular weight of less than 8,000 Da. These are obtained by various methods of fractionation or depolymerization of polymeric heparin. Low molecular weight heparin offers advantages over heparin such that it has better bioavailability and longer half-life, simplified dosing, predictable anticoagulant response, and lower risk of osteoporosis.

Advantages of Low Molecular Weight Heparin Anticoagulants over Unfractionated Heparin

The effects of unfractionated heparin (UFH) or standard heparin vary from patient to patient. Therefore, it can only be administered to hospitalized patients under supervision. However, low molecular weight heparins (LMWH) can be subcutaneously administered daily without supervision. In addition, LMWH has predictable pharmacokinetic properties to unfractionated heparin, which allows its administration in fixed doses based on laboratory monitoring without needing dose adjustments. The low molecular weight fractions of heparin have a molecular weight of ~3,500-8,000 Daltons , while unfractionated heparin has a molecular weight of 15,000 Daltons; thus, the former reacts less with platelets than the latter.

Moreover, LMWH is less likely to induce immune allergic thrombocytopenia, which is a severe side effect caused by unfractionated heparin (UFH). This side effect is often complicated for patients suffering from arterial thrombosis. In addition, properties such as better bioavailability, predictable dose-response, and longer plasma half-life than unfractionated heparin make LMWH a preferred choice for anticoagulation therapy.

LMWH anticoagulants prevent the clotting of blood and the growth of existing blood clots in blood vessels. In recent years, the development of prevention methods and pharmacological and surgical treatment of thrombosis have improved considerably. LMWHs have been used in the treatment of antithrombotic diseases for the past two decades. LMWH exhibits anticoagulant properties such as antitumor, anti-inflammatory, and antiproliferative effects, which are useful in the treatment of pathologies such as nephrotic syndrome and Alzheimer's disease. Thus, the advantages of LMWH anticoagulants over unfractionated heparin are driving the Middle East low molecular weight heparin market.

Based on product, the Middle East low molecular weight heparin market is segmented into enoxaparin, dalteparin, tinzaparin, fraxiparine, nadroparin, and others. The enoxaparin segment held the largest market share in 2021. The dalteparin segment is anticipated to register the highest CAGR in the market during the forecast period.

In terms of packaging, the market is bifurcated into multi-vials and pre-filled syringes. The multi-vials segment held a larger share in 2021. The prefilled syringes segment is anticipated to register a higher CAGR during the forecast period.

Based on application, the Middle East low molecular weight heparin market is segmented into deep vein thrombosis, acute coronary syndrome, pulmonary embolism, and others. The deep vein thrombosis segment led the market in 2021. However, the acute coronary syndrome segment is expected to grow at the highest CAGR during the forecast period.

In terms of end user, the market is segmented into hospitals, clinics, ambulatory surgical centers, and others. The hospitals segment accounted for a maximum share in 2021. However, the clinics segment is expected to grow at the highest CAGR during the forecast period.

Based on distribution channel, the market is segmented into hospital pharmacies, retail pharmacies, and others. The hospital pharmacies segment held the maximum share in 2021, and the retail pharmacies segment is expected to grow at the highest CAGR during the forecast period.

Impact of COVID-19 Pandemic on Middle East Low molecular weight heparin Market

In the past several decades, countries in the Middle East have strengthened their health systems, along with upgrading public and commercial healthcare. However, the limited availability of resources (including trained staff and medical equipment) and the burden of noncommunicable diseases harm the overall healthcare system in the region. In 2020, the COVID-19 pandemic had a significant impact on the delivery and accessibility of social services, education, health and nutrition, healthcare spending, and well-being. Owing to the dependence of the region on trade and tourism, and struggles with substantial youth unemployment, the global crisis led to serious long-term effects on the region. Governments in the Middle East allocated funds to prevent the overburdening of their health systems and decelerate the spread of COVID-19 in 2020; a few countries also emphasized on increasing the number of intensive care units and hospital beds.

According to the National Institute of Health (NIH) report (2020), low molecular weight heparin utilization was high during the COVID-19 pandemic. In COVID-19-induced acute respiratory distress syndrome, the lungs could not fill with sufficient air, causing hypoxemia and high mortality among hospitalized patients. Therefore, patients with evidently worst clinical presentation were prescribed low molecular weight heparin via a soft mist inhaler dosing 4000 IU per administration twice daily.

Various organic and inorganic strategies are adopted by companies operating in the Middle East low molecular weight heparin market. The organic strategies mainly include product launches and product approvals. Further, inorganic growth strategies witnessed in the market are acquisitions, collaborations, and partnerships. These growth strategies allow the market players to expand their businesses and enhance their geographic presence, thereby contributing to the overall market growth. Further, acquisition and partnership strategies help the market players strengthen their customer base and expand their product portfolios. A few significant developments by key players in the Middle East low molecular weight heparin market are listed below.

- In April 2022, Hikma Pharmaceuticals PLC announced the acquisition of Custopharm Hikma, which is the second-largest supplier of generic sterile injectable medicines used by hospitals and health care providers in the US. The combination with Custopharm will enhance Hikma's R&D capabilities and pipeline and expand Hikma's differentiated US portfolio to close to 130 commercialized injectable medicines-a more than fivefold increase over the last decade.

- In May 2019, the US Food and Drug Administration (FDA) approved the use of Pfizer's anticoagulant medicine Fragmin (Dalteparin sodium) to minimize the recurrence of symptomatic venous thromboembolism (VTE) in pediatric patients aged one month and above.

- In June 2018, Laboratorios Farmace?ticos Rovi S.A. signed a licensing agreement with Sandoz, a division of Novartis AG and one of the global leaders in generic pharmaceuticals and biosimilars, to distribute and market its Enoxaparin biosimilar.

The American Medical Association, the British Journal of Surgery, and the National Library of Medicine are among the major primary and secondary sources referred to while preparing the report on the Middle East low molecular weight heparin market.