I am constantly amazed (and sometimes amused) by the "science" of futurology. This is, as the name suggests, the willingness of experts to predict what will happen in the future by applying probabilities and other scientific methods. Basically, it is extrapolation from the current state of affairs and, as such, much beloved of those who engage in the "art" of marketing.

This April sees the publication of a new report by PharmiWeb (2002) Ltd. It sets out to predict which current or future products will be significant contributors to the market to treat sleep disorders over the next ten years — an ambitious timescale for anyone without a reliable crystal ball. This is actually a market in transition. In April last year, ambien lost its patent protection in the United States. Although a generic version sold under the name of zolpidem (tartrate) will be launched, Ambien is almost certain to maintain its brand dominance because the world market is predicted to grow. Indeed, the most recent data on the number of prescriptions for ambien continues a trend of upward demand.

To understand the market, we need to factor in two other factors:
• the public is growing more aware of the treatments for "insomnia" which will drive further market growth for sleeping medications, and
• the pharmaceutical companies are investing in research and development to produce new products for the sleep disorders market.

This second point requires clarification. Never one to skimp, the medical profession has identified some eighty different sleep disorders. Such exuberance is extraordinary to describe a condition in which people cannot get to sleep or sleep for very long. But, of course, that is only insomnia. When we get started on the other disorders, we include narcolepsy (involuntary sleep), sleep apnoea (brief periods when you stop breathing while asleep), bruxism (grinding your teeth while asleep), night terrors, and so on.

On the basis of current medical research, it is estimated that some 200m people around the world may be affected by sleep disorders. If that is the case, pharmaceutical companies working in the sleep field have only just begun to scratch the surface of the total market. As the public become more aware of the range of these disorders and of the existing and pending treatments, demand should continue to grow. For the insomnia market, the focus remains on the existing medications with the fewest side effects, i.e. the benzodiazepines and nonbenzodiazepine hypnotics such as ambien. But even that market is likely to continue growing because:

• more countries are relaxing their advertising rules to allow the direct marketing of prescription medications to the general public;
• more pharmacies are coming online and they are likely to boost the market because no prescription is required; and
• new technologies will allow new products to emerge.

As it stands, ambien is the brand to beat for insomnia. Which new medications will emerge to treat the other sleep disorders is difficult to predict.