AstraZeneca's $5B Hypertension Blockbuster Baxdrostat Advances Toward Commercialization Following Positive Phase III Results

Jul 27, 2025 07:31 CST Updated 07:31

AstraZeneca

Biopharmaceutical Manufacturer

AstraZenecaLekang adds another blockbuster drug.

Recently, AstraZeneca's new mechanism antihypertensive drugBaxdrostatThe Phase III BaxHTN study achieved positive results,Means starting to sprint towards the submission of the listing application。

Notably, this is just one of AstraZeneca's potential blockbuster drugs in the CVRM field (cardiovascular, renal, and metabolic diseases).As the second largest pillar of AstraZeneca's performance, a new chapter in the CVRM field has begun.

$5 Billion Big Pharma Emerges

In recent years, AstraZeneca has been capturing new opportunities in the CVRM field, with the novel mechanism antihypertensive drug Baxdrostat being one of them.

BaxdrostatIt is a highly selective and potent oral small-molecule inhibitor targeting aldosterone synthase (ALDOS) developed by CinCor Pharma, aimed at reducing aldosterone levels by inhibiting the last three rate-limiting steps of aldosterone synthesis in the adrenal glands. In 2023,AstraZenecaInvested $1.8 billionAcquisition of CinCor Pharma Brings Baxdrostat into the Fold.

AstraZeneca's acquisition of Baxdrostat at a high price is due to, firstly, the huge potential of the hypertension market, and secondly,Baxdrostat is expected to become a new mechanism drug in the field of hypertension treatment in more than 20 years.

Statistics show that there are 1.3 billion people worldwide suffering from hypertension, a staggering number, with approximately 25% of hypertension cases caused by aldosterone imbalance. Despite the availability of various types of antihypertensive drugs on the market, about half of the patients still face significant unmet clinical needs. This undoubtedly offers immense potential for Baxdrostat.

As Sharon Barr, Executive Vice President of Biopharmaceuticals R&D at AstraZeneca, stated: "We are very excited about the results of the Phase III BaxHTN study, which showed a statistically and clinically significant reduction in systolic blood pressure (in patients treated with Baxdrostat). These findings provide compelling evidence,Baxdrostat has the potential to address a critical unmet need by targeting aldosterone dysregulation, bringing a novel mechanism to a field that has seen little innovation in over two decades.”

According to the results of the BaxHTN Phase III study of Baxdrostat for patients with uncontrolled or resistant hypertension, both doses of Baxdrostat significantly reduced mean seated systolic blood pressure (SBP) at 12 weeks compared to the placebo group, successfully achieving the primary and all secondary endpoints, with good overall tolerability and safety.

Source of the image: Minsheng Securities Research Report

In addition,Besides hypertension,Baxdrostat has entered Phase III clinical trials for multiple indications.，Including heart failure, chronic kidney disease, reduction of cardiovascular risk, primary aldosteronism, renal failure, etc., with huge market potential.AstraZeneca Expects Baxdrostat Annual Sales Peak to Exceed $5 Billion.

It is worth mentioning that, in addition to Baxdrostat, there are currently four other selective ALDOS inhibitors under development globally, including those from Mineralys Therapeutics.Lorundrostat(Already in Phase III clinical trials), Boehringer Ingelheim's BI 690517 (Phase III clinical trials), etc. However, Lorundrostat is mainly positioned for third- and fourth-line treatment of hypertension patients, as well as chronic kidney disease, heart failure, and obstructive sleep apnea syndrome (OSA).

According to a Phase III clinical study, Launch-HTN, published in JAMA, Lorundrostat effectively reduced blood pressure in patients with uncontrolled hypertension (including resistant hypertension) and demonstrated good safety.UBS predicts that Lorundrostat's peak sales in the resistant hypertension field could reach $2 billion.

It can be seen that, whether from the perspective of market prospects, clinical research data, or market competition, Baxdrostat will become a significant boost for AstraZeneca in the CVRM field.

Turn on "Buy Buy Buy" Mode

CVRM (Cardiovascular, Renal, and Metabolic Diseases) is AstraZeneca's second-largest business segment.，Generated revenue of $12.517 billion in 2024 (a year-on-year increase of 20%), second only to the oncology business ($22.353 billion), and continued to grow by 13% year-on-year to $3.322 billion in the first quarter of this year.

Specifically, the CVRM business segment is mainly driven by several blockbuster drugs, including the pillar product.Farxiga (Dapagliflozin), AnticoagulantsBrilinta (Ticagrelor)、Lipid-lowering drugsCrestor (Rosuvastatin)In 2024, the sales revenue reached USD 7.717 billion (+29%), USD 1.333 billion (+1%), and USD 1.155 billion (+4%), respectively.

It can be seen that AstraZeneca's CVRM field is overly reliant on a single product: 2024DapagliflozinAchieved revenue accounted for 14.27% of the company's total revenue (54.073 billion USD),Contributes over 60% of CVRM business segment revenue.

Although dapagliflozin isA product that has been on the market for more than a decade, yet remains AstraZeneca's top flagship product. With its coverage of three major chronic diseases—type 2 diabetes, chronic kidney disease, and heart failure—which have large patient populations, its sales have continued to grow rapidly in recent years. In the first quarter of this year,Dapagliflozin Achieved Revenue Growth of 8% Year-over-Year to $2.057 BillionContinues to firmly hold the top position as AstraZeneca's best-selling drug.

Image Source:Huachuang SecuritiesResearch Report

However, the formulation patent and crystal form patent of dapagliflozin will expire in 2027-2028. Currently, more than 10 generic dapagliflozin tablets have been approved for marketing in China, making the market competition increasingly fierce. This means that time is running out for dapagliflozin.

Moreover, the SGLT2 inhibitor market has a powerful competitor eyeing it eagerly — Jardiance (empagliflozin) from Eli Lilly/Boehringer Ingelheim, which achieved sales of up to $11.8 billion in 2024.

In order to balance its product portfolio, AstraZeneca has embarked on a "buy-buy-buy" mode in the CVRM field in recent years:

In January 2023, an investment of 1.8 billion US dollarsAcquisition of CinCor Pharma, secured the novel mechanism antihypertensive drug Baxdrostat;

In November 2023, AstraZeneca PLC invested over 1.8 billion US dollars to introduce the small molecule GLP-1 receptor agonist from Chengyi Bio.ECC5004（AZD5004）；

2024Three Degrees of Intervention, the introduction of heart failure drugsION826, Invested over 2 billion US dollars to introduce the lipid-lowering drug from Shijiazhuang Pharmaceutical GroupYS2302018, as well as the type 1 diabetes cell therapy introduced from Quell TherapeuticsQEL-002。

In March 2025, AstraZeneca announced the acquisition of FibroGen's China business for $160 million, securing the renal anemia drug.RoxadustatExclusive rights in China.

It is important to note that oncology has become AstraZeneca's largest revenue pillar, contributing over 40% of the company’s income, due to the development of six "blockbuster drugs."

Among them, the sales of Osimertinib, Durvalumab, Acalabrutinib, Olaparib, Enhertu (Trastuzumab Deruxtecan), and Goserelin in 2024 were $6.58 billion, $4.717 billion, $3.129 billion, $3.672 billion, $1.982 billion, and $1.097 billion, respectively, all achieving double-digit year-on-year growth.

"How Effective is the 'Later Move'?"

What Is the Value of AstraZeneca's Frequent Acquisitions and Pipeline Expansion?

Take a look firstLipid-lowering drugsYS2302018，Discovered by a small molecule design platform driven by AI from CSPC Pharmaceutical Group, it is an innovative small molecule lipoprotein(a) inhibitor.

AstraZeneca's Heavy Bet:AspectTargeting the vast number of patients for supportFocusThe lipid-lowering drug market with great potential. According to publicly available informationDisplay,More than 8 million people worldwide suffer from elevated Lp(a) levels and cardiovascular disease.，Causes 2.6 million deaths annuallyDatamonitor Healthcare expects that by 2025, the global lipid-lowering drug market will grow to nearly 30 billion US dollars.

On the other hand, elevated Lp(a) is closely associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD), ischemic stroke, and calcific aortic valve stenosis.Targeting Lp(a) lipid-lowering therapy is one of the popular research and development directions in the field of blood lipids, attracting the attention of MNC giants such as Novartis, Eli Lilly, and Amgen.。

Currently，GlobalThere are currently no approved drugs specifically for lowering Lp(a) levels.，ButMore than 10 Lp(a)-targeting lipid-lowering drug pipelines are under development,CoverageTechnical routes include siRNA therapy, ASO therapy, and small molecule drugs.. And YS2302018Still in the preclinical stage, looking forward to the subsequent clinical research data readout.

Source of the image: Orient Securities Research Report

In recent years, AstraZeneca has been accelerating its entry into the cell therapy field, successively acquiring Neogene, Gracell Biotechnologies, and EsoBiotec. Currently, it has more than 10 cell therapies in clinical stages for the treatment ofType 1 DiabetesTheCell TherapyQEL-002Is one of them.

Compared to the fiercely competitive 2Type diabetes, currentlyType 1 DiabetesThere is still a significant unmet clinical need. According to the 11th edition of the IDF Diabetes Atlas,The Total Number of Type 1 Diabetes Patients Worldwide is Approximately 9.2 MillionAmong them, the number of people under 20 years old with type 1 diabetes is approximately 7.4 million.It remains to be seen whether QEL-002 will yield positive clinical data moving forward.

AstraZeneca Takes the LeadTheRoxadustat, is the world's first hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI),AlsoThe first new drug in China's renal anemia field in 30 years, currently ranking first in market share (with sales exceeding 2 billion yuan in 2023).，Has become the leading drug in the field of anemia treatment for chronic kidney disease (CKD), and can be taken by both dialysis and non-dialysis patients. According to statistics,China has approximately 120 million CKD patients.，The market has enormous room for imagination. This year, Roxadustat is also expected to secure a new indication for chemotherapy-induced anemia (CIA), which could potentially drive its sales to new heights.

More imaginative is the oral GLP-1 drug that AstraZeneca has heavily invested in.ECC5004（AZD5004）The proposed indications for development include obesity, type 2 diabetes, and other related comorbidities. Among these, after 4 weeks of treatment with AZD5004 in obese patients with type 2 diabetes, patient weight was reduced by 5.8%, and blood glucose levels were improved. The drug is currently in Phase II.

In addition, AstraZeneca also plans to combine AZD5004 with its flagship product dapagliflozin for the treatment of type 2 diabetes, chronic kidney disease, and heart failure, as well as to combine it with the small-molecule oral PCSK9 inhibitor AZD0780 for the treatment of high-risk cardiovascular diseases.

Currently,AZD0780Three Phase III studies are ongoing, with indications including heterozygous familial hypercholesterolemia (HeFH), ASCVD, and cardiovascular benefits in ASCVD patients.According to forecasts, the annual sales peak of AZD0780 may exceed 5 billion US dollars.

Conclusion

AstraZeneca is advancing with a "dual-driven" strategy of "innovation + mergers and acquisitions,"“$80 Billion Revenue by 2030”The goal is to move forward at full speed. While the oncology business continues to lead, the CVRM field is accelerating its expansion through a combination of "repurposing old drugs + breakthrough new drugs."

This transformation from "single-product support" to "matrix-driven" is at the core of AstraZeneca's confidence in striving for $80 billion in revenue. This goal not only drives revenue but also reflects its strategic response to unmet global healthcare needs.

References

1. Financial reports, announcements, and official WeChat accounts of various companies

2. Research reports from Minsheng Securities, Huachuang Securities, and Orient Securities

*Disclaimer: This article only introduces the research progress in the pharmaceutical and disease fields, briefly describes the research overview, or shares pharmaceutical-related information. It does not recommend any treatment or diagnostic plans, nor does it constitute any advice on related investments. If there are any omissions in the content, please feel free to communicate and point them out!

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