PUBLISHER: DelveInsight | PRODUCT CODE: 2023866
PUBLISHER: DelveInsight | PRODUCT CODE: 2023866
Eosinophilic Esophagitis Insights and Trends
Eosinophilic Esophagitis Market size and forecast
DelveInsight's "Eosinophilic Esophagitis (EoE) - Market Insight, Epidemiology, and Market Forecast - 2036" report delivers an in-depth understanding of the Eosinophilic Esophagitis historical and forecasted epidemiology as well as the Eosinophilic Esophagitis market trends in the United States, EU4 (Germany, France, Italy, and Spain) and the United Kingdom, and Japan.
The Eosinophilic Esophagitis market report provides current treatment practices, emerging drugs, Eosinophilic Esophagitis market share of individual therapies, and current and forecasted Eosinophilic Esophagitis market size from 2022 to 2036, segmented by seven major markets. The report also outlines key unmet medical needs and maps the competitive and clinical landscape to identify high-value opportunities, offering a clear view of the future growth potential of the EoE market.
Key Factors Driving the Eosinophilic Esophagitis Market
Improved Diagnostics and Awareness
Advancements in diagnostic techniques such as endoscopy and biopsy, along with increasing awareness among healthcare professionals, are enabling earlier and more accurate diagnosis, expanding the treated patient population.
Increased Adoption of Biologic Therapies
The shift toward biologics for moderate-to-severe cases due to better efficacy and targeted action is a key driver, especially in patients unresponsive to conventional therapies.
Growing Burden of Allergic Disorders
The surge in food and environmental allergies key triggers of EoE is significantly fueling market demand. Conditions like atopic disorders and chronic respiratory diseases further increase susceptibility, driving diagnosis and treatment rates.
Eosinophilic Esophagitis Overview
Eosinophilic Esophagitis (EoE) is an emerging chronic inflammatory disease of the esophagus characterized by upper gastrointestinal symptoms, including dysphagia and esophageal food impaction. The histopathological manifestations involve intraepithelial infiltration of eosinophils (=15 Eos/HPF) and remodeling of the esophageal epithelium, including Basal Zone Hyperplasia (BZH) and Dilated Intercellular Spaces (DIS), which can lead to strictures and narrow-caliber esophagus. EoE is a complex disease characterized by heterogeneous clinical presentation (age of onset, symptomology, varying clinical manifestations and comorbidities, natural history, and responsiveness to therapy). Despite challenges in disease diagnosis and management, there is corroborative clinical and experimental evidence to suggest that EoE is driven by an underlying CD4+ T helper type 2 (Th2) allergic inflammatory response to dietary food allergens in the esophageal mucosa.
Eosinophilic Esophagitis Treatment Landscape
The treatment of EoE seeks to relieve symptoms, improve histopathology, reverse existing disease complications, and prevent future disease consequences. The primary approach involves treatment with Proton pump inhibitors, swallowed topical steroids, and diet therapy. Medical and diet therapies that significantly reduce esophageal inflammation may not effectively reverse existing esophageal strictures. In contrast, esophageal dilation can effectively manage esophageal strictures, thereby alleviating dysphagia in the absence of improvement in esophageal inflammation. Endoscopic features, as delineated by the EREFS system, identify remodeling aspects of the disease, including esophageal rings and strictures that are associated with symptom outcomes of dysphagia and food impaction risk.
Eosinophilic Esophagitis Unmet Needs
The section "unmet needs of eosinophilic esophagitis" outlines the critical gaps between the current state of patient care, diagnosis, and the ideal & effective management of the disease. It highlights the obstacles experienced by patients, clinicians, and researchers and identifies potential solutions for future progress.
The Eosinophilic Esophagitis epidemiology chapter in the report provides historical as well as forecasted epidemiology segmented by the Total Diagnosed Prevalent Cases of Eosinophilic Esophagitis, Gender-specific Cases of Eosinophilic Esophagitis, Age-specific Cases of Eosinophilic Esophagitis, Treated Cases of Eosinophilic Esophagitis in the 7MM covering the United States, EU4 (Germany, France, Italy, and Spain) and the United Kingdom, and Japan from 2022 to 2036.
Eosinophilic Esophagitis Drug Analysis & Competitive Landscape
The drug chapter segment of the Eosinophilic Esophagitis report encloses a detailed analysis of the marketed, late-stage (Phase III), and mid-stage (Phase II) pipeline drugs. The marketed drugs segment encloses DUPIXENT, EOHILIA, JORVEZA. Furthermore, the current key players for emerging drugs and their respective drug candidates include Astrazeneca and Amgen (Tezspire), Ellodi pharmaceuticals (APT-1011), Revolo Biotherapeutics (IRL201104), EsoCap (ESO-101) and others. The drug chapter also helps understand the Eosinophilic Esophagitis clinical trial details, expressive pharmacological action, agreements and collaborations, approval and patent details, and the latest news and press releases.
Approved Therapies for Eosinophilic Esophagitis
Dupilumab (DUPIXENT): Sanofi/Regeneron Pharmaceuticals
Dupilumab, which was invented using Regeneron's proprietary VelocImmune technology, is a fully human monoclonal antibody that inhibits the signaling of the interleukin-4 (IL4) and interleukin-13 (IL13) pathways and is not an immunosuppressant. The DUPIXENT development program has shown significant clinical benefit and a decrease in type 2 inflammation in phase 3 studies, establishing that IL4 and IL13 are two of the key and central drivers of the type 2 inflammation that plays a major role in multiple related and often co-morbid diseases.
Budesonide (JORVEZA): Dr. Falk Pharma GmbH
Budesonide is a non-halogenated glucocorticosteroid, which acts primarily anti-inflammatory via binding to the glucocorticoid receptor. In treating EoE with JORVEZA, budesonide inhibits the antigen-stimulated secretion of many proinflammatory signal molecules, such as thymic stromal lymphopoietin, IL-13, and eotaxin-3 in the esophageal epithelium, which results in a significant reduction of the esophageal eosinophilic inflammatory infiltrate. Additionally, the EMA granted ODD to budesonide for the treatment of EoE. The usual duration of treatment is 6 weeks.
In June 2021, the National Institute for Health and Care Excellence (NICE) has recommended JORVEZA budesonide orodispersible tablet for the treatment of EoE in adults.
Eosinophilic Esophagitis Pipeline Analysis
Tezepelumab (TEZSPIRE): AstraZeneca and Amgen
Tezepelumab is being developed by AstraZeneca in collaboration with Amgen as a first-in-class human monoclonal antibody that inhibits the action of TSLP. This key epithelial cytokine sits at the top of multiple inflammatory cascades. It is critical in the initiation and persistence of allergic, eosinophilic, and other types of airway inflammation associated with severe asthma, including airway hyperresponsiveness. In October 2021, tezepelumab was granted an Orphan Drug Designation (ODD) by the FDA for the treatment of EoE.
In its Q3 2025 presentation in November 2025, AstraZeneca anticipates that data from the CROSSING trial for the treatment of EoE will be available in the second half of 2026.
APT-1011 (fluticasone propionate): Ellodi Pharmaceuticals
APT-1011 is a novel, once-daily, ODT designed specifically to deliver fluticasone propionate to the esophageal mucosa to exert local anti-inflammatory effects with low systemic absorption. The successful completion of FLUTE 1 (Phase IIb study) and FLUTE 2 (Phase III study) has facilitated the initiation of FLUTE 3 (ongoing second Phase III study). APT-1011 has received ODD from the FDA and the EMA, and also received Fast Track Designation (FTD) from the FDA in 2021.
In May 2024, Ellodi Pharmaceuticals presented an oral presentation at the Digestive Disease Week (DDW) 2024 Annual Scientific Meeting. It highlighted the results of APT-1011 in the FLUTE-2 Phase III clinical study in EoE.
Eosinophilic Esophagitis Key Players, Market Leaders and Emerging Companies
Eosinophilic Esophagitis Drug Updates
EoE is a chronic, progressive condition, and without treatment, patients experience persistent symptoms and risk of disease progression. Early intervention is critical to control symptoms, reduce esophageal inflammation, and prevent fibrostenotic complications. Current management strategies include dietary, pharmacologic, and endoscopic interventions, with the primary goals of symptom control, histologic remission, and, in pediatric patients, restoration of normal growth and development. Food-elimination diets, PPIs, and topical corticosteroids remain first-line anti-inflammatory therapies, while esophageal dilation is used in selected patients with strictures, although it carries a risk of complications such as esophageal perforation. Currently, three drugs are approved for EoE treatment, including dupilumab (DUPIXENT), Budesonide ODT (JORVEZA), and Budesonide oral suspension (EOHILIA).
JORVEZA (budesonide orodispersible tablet) is the first approved oral corticosteroid specifically developed for EoE. Approved by the EMA in 2018 and granted orphan drug designation, JORVEZA is the first and only licensed oral steroid globally and in the UK for adult EoE, establishing a clear first-mover advantage in this segment. The therapy is positioned for adult patients with confirmed EoE who have had an inadequate response to PPIs.
Dupilumab (DUPIXENT)'s evolution in eosinophilic esophagitis reflects a rapid and impactful regulatory trajectory. Recognized early with FDA BTD in 2020, the therapy advanced through Priority Review in 2022, leading to its first-ever FDA approval for EoE in adolescents and adults, establishing DUPIXENT as the first targeted treatment for EoE in the US. Subsequent approvals in the EU (2023) reinforced its global positioning. The landmark expansion into pediatric EoE in 2024, covering children as young as one year in both the US and EU, addressed a critical unmet need where many patients remained uncontrolled on standard care.
EOHILIA (budesonide oral suspension) from Takeda Pharmaceuticals faced a rocky path to approval. After an initial FDA rejection in late 2021 due to requests for additional clinical data, EOHILIA's launch was delayed, jeopardizing its prospect of becoming the first FDA-approved therapy for patients aged 11 years and older for EoE.
Companies, including AstraZeneca/Amgen, Ellodi Pharmaceuticals, Revolo Biotherapeutics, EsoCap, Phathom Pharmaceuticals, Uniquity Bio, Eupraxia Pharmaceuticals, and others, are investigating potential drug candidates that can significantly change the market landscape during the forecast period. Approaches include anti-TSLP pathway (Tezepelumab and Solrikitug), Glucocorticoid receptor agonists (APT-1011, ESO-101, and EP-104GI), and Immunomodulator (IRL201104), Potassium-competitive Acid Blocker (Vonoprazan), and others.
Key Findings
Drug Class/Insights into Leading Emerging and Marketed Therapies in Eosinophilic Esophagitis (2022-2036 Forecast)
The EoE market comprises of different mechanism class, including IL-4 and IL-13 inhibitor, glucocorticoid receptor agonists, and TSLP inhibitors, each designed to target distinct inflammatory pathways underlying disease pathophysiology.
Market & Strategic Analysis:
This section focuses on the uptake rate of potential drugs expected to be launched in the market during 2026-2036, which depends on the competitive landscape, safety, and efficacy data along with order of entry. It is important to understand that the key players evaluating their novel therapies in the pivotal and confirmatory trials should remain vigilant when selecting appropriate comparators to stand the greatest chance of a positive opinion from regulatory bodies, leading to approval, smooth launch, and rapid uptake.
The EoE market shows a clear uptake split between established therapies and newer targeted agents. PPIs, swallowed topical corticosteroids, and dietary therapy remain dominant in first-line use due to guideline support and long-standing clinical experience, while biologics such as DUPIXENT have seen rapid uptake in refractory patients driven by strong efficacy and disease-targeted mechanisms. Emerging pipeline agents are expected to experience more gradual adoption as clinical evidence matures and guideline integration evolves.
Market Access and Reimbursement Key Developments in 2025
The report further provides detailed insights on the country-wise accessibility and reimbursement scenarios, cost-effectiveness scenario of approved therapies, programs making accessibility easier and out-of-pocket costs more affordable, insights on patients insured under federal or state government prescription drug programs, etc.
The United States
Dupilumab (DUPIXENT)
DUPIXENT MyWay is a patient support program designed to help you get access to DUPIXENT and stay on track while providing helpful tools and resources.
With the DUPIXENT MyWay Co-pay Card, eligible patients with commercial health insurance may pay as little as USD 0 in copay per fill of DUPIXENT. Terms and conditions apply. Eligible patients will receive their cards by email.
Budesonide oral suspension (EOHILIA)
The EOHILIA Patient Support and Co-pay Program
The EOHILIA Patient Support and Co-pay Program is designed to help guide you along your EoE treatment journey. Eligible commercial patients may qualify for Head Start, providing EOHILIA at no cost (for up to 3 months or until coverage is approved). If coverage is approved, eligible patients may participate in the EOHILIA Copay Offer to pay as little as USD 0 for EOHILIA.
Eligible patients may pay as little as USD 0 if EOHILIA (budesonide oral suspension) is covered by their commercial insurance, with a max annual benefit of up to USD 5000 off their copay or out-of-pocket expenses. A valid Prescriber ID is required on the prescription. Offer not valid for cash-paying patients. One must be 18 years or older to use the EOHILIA Copay Offer.
Reimbursement is a crucial factor that affects the drug's access to the market. Often, the decision to reimburse comes down to the price of the drug relative to the benefit it produces in treated patients. To reduce the healthcare burden of these high-cost therapies, many payment models are being considered by payers and other industry insiders.
Further Details are provided in the final report....
Eosinophilic Esophagitis Therapies Price Scenario and Trends
The pricing landscape for therapies in EoE reflects regimen cost variability, payer value assessments, and the balance between clinical efficacy and affordability. This section summarizes the cost of approved treatments, benchmarks expected pricing for emerging therapies, and analyzes how pricing influences market access, adherence, and long-term uptake.
Pricing of Approved Therapies
Approved therapies generally adopt premium WAC pricing, supported by high unmet need and limited competition. Annual treatment cost, dosing intensity, and administration setting shape payer coverage and patient affordability.
EOHILIA is administered orally at a recommended dose of 2 mg for a 12-week treatment course. The WAC is approximately USD 1,875 per month, resulting in an estimated total treatment cost of about USD 5,625 for a 3-month course.
DUPIXENT is a prescription injectable biologic, with pricing driven by its complex manufacturing process. For uninsured patients, the list price is approximately USD 3,803.20 per carton. Recommended dosing is weight-based: 200 mg every two weeks (Q2W) for patients 15 to <30 kg, 300 mg Q2W for 30 to <40 kg, and 300 mg weekly (QW) for patient's =40 kg. Based on this regimen, the estimated annual treatment cost is approximately USD 74,500.
Benchmarking Emerging Therapies
The estimated cost assumptions for the emerging drugs have been considered based on the competitive pricing of the therapies currently available.
TEZSPIRE is priced at approximately USD 4,368.96 per 210 mg/mL prefilled syringe. Approved for asthma, it is administered at a recommended dose of 210 mg once every four weeks. Based on this regimen, the estimated annual treatment cost is approximately USD 55,620.
For emerging therapies, Solrikitug is priced at USD 68,406, benchmarked against TEZSPIRE. IRL201104 is estimated at USD 22,350 and benchmarked to DUPIXENT, reflecting its peptide-based modality, which is generally less complex and less costly to manufacture than monoclonal antibodies.
Overall, pricing will significantly influence early adoption, competitive positioning, and long-term penetration across the 7MM EoE market.
Industry Experts and Physician Views of Eosinophilic Esophagitis
To keep up with current market trends, we take KOLs and SME's opinions working in the domain through primary research to fill the data gaps and validate our secondary research. Industry Experts were contacted for insights on the EoE emerging therapies, evolving treatment landscape, patient adherence to conventional therapies, therapy switching trends, drug adoption and uptake, accessibility challenges, and epidemiology and prevalence patterns in rare mitochondrial disorders, including MD, PhD, Instructor, Postdoctoral Researcher, Professor, Researcher, and others.
DelveInsight's analysts connected with 15+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. Centers such as the National Institutes of Health, Cincinnati Children's Hospital Medical Center, Boston Children's Hospital, Great Ormond Street Hospital, etc. were contacted. Their opinion helps understand and validate current and emerging EoE therapies, highlight unmet medical needs, provide epidemiological context, and support strategic decisions for market access, therapy adoption, and pipeline prioritization in EoE.
Qualitative Analysis: SWOT and Conjoint Analysis
We perform qualitative and market Intelligence analysis using various approaches, such as SWOT analysis and conjoint analysis.
In the SWOT analysis EoE, strengths, weaknesses, opportunities, and threats in terms of disease diagnosis, patient awareness, patient burden, competitive landscape, cost-effectiveness, and geographical accessibility of therapies are provided. These pointers are based on the analyst's discretion and assessment of the patient burden, cost analysis, and existing and evolving treatment landscape.
Conjoint analysis analyzes emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry. Scoring is given based on these parameters to analyze the effectiveness of therapy.
The analyst analyzes multiple emerging therapies based on relevant attributes such as safety, efficacy, frequency of administration, route of administration, and order of entry. In efficacy, the trial's primary and secondary outcome measures are evaluated.
Further, the therapies' safety is evaluated, wherein the acceptability, tolerability, and adverse events are majorly observed, and it sets a clear understanding of the side effects posed by the drug in the trials. In addition, the scoring is also based on the route of administration, order of entry and designation, probability of success, and the addressable patient pool for each therapy. According to these parameters, the final weightage score and the ranking of the emerging therapies are decided.
Market Insights