Thrombopoietin Receptor Agonist Market Outlook:
Thrombopoietin Receptor Agonist Market size was valued at USD 2.9 billion in 2024 and is projected to reach USD 5.6 billion by the end of 2034, rising at a CAGR of 7.1% during the forecast period, i.e., 2025-2034. In 2025, the industry size of thrombopoietin receptor agonist is evaluated at USD 3.2 billion.
The thrombopoietin receptor agonist market is driven by the steady rise in patient pool for aplastic anemia, hepatitis C-related thrombocytopenia, immune thrombocytopenia (ITP), and chemotherapy-induced platelet disorder. As per the CDC and National Organization for Rare Disorders report, nearly 3.6 to 4.5 out of 100,000 adults are affected by immune thrombocytopenia in the U.S. This corresponds to approximately 150,010 active ITP patients receiving direct treatment in the U.S. Further, the number is increased by the global prevalence; WHO reports show that elderly populations in Italy and Japan have higher incidences, and that expanded hematology testing in China and India has led to rise in diagnosis rates.
On the supply chain side, recombinant protein or small molecule synthesis is used to manufacture the thrombopoietin receptor agonist (TPO-RA), and is highly reliant on Active Pharmaceutical Ingredient imports from Europe and India. As per the USITC and USTR report, nearly 85.4% of U.S. biologics are imported from India and China. The Bureau of Labor Statistics has depicted that the producer price index rose to 4.9% in 2023 for pharmaceutical biologics products, whereas the consumer price index increased by 2.5% for prescription drugs, surging the pricing pressure for both healthcare providers and manufacturers. Moreover, the research, development, and deployment with government-backed investments are aided for expanded indications in TPO-RA.
Thrombopoietin Receptor Agonist Market - Growth Drivers and Challenges
Growth Drivers
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Cost reduction and adoption in TPO-RA Biosimilars: The biosimilar market for thrombopoietin receptor agonist market in 2024 has expanded by 11.6%, driven by launches in China, India, and Eastern Europe. Market leaders, including Dr. Reddy's and Teva, introduced biosimilar copies of romiplostim and eltrombopag, reducing the average treatment cost by 40.5%. Lower-priced options are enhancing affordability, especially in value-based healthcare systems. On the other hand, biosimilars are on the rise in high- and middle-income markets, surging the rise in adoption and promoting cost-effective care in managing thrombocytopenia.
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Product innovations and strategies by key players: In 2024, Amgen introduced a subcutaneous, self-administration form of romiplostim in Europe, enhancing patient compliance and reducing clinical visit requirements by 35.9%. Further, Novartis developed its global market via collaborations in India and South Korea, improving access to eltrombopag in underserved markets. These strategic initiatives, combined with lifecycle management innovations, are helping firms differentiate their products and accelerate their worldwide markets. These advancements by the market players contribute to a 10.6% thrombopoietin receptor agonist market growth rate in the thrombopoietin receptor agonist segment during the forecast period in emerging economies by 2026.
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Rising disease incidence driving TPO-RA: Nearly 4.9 million patients were recorded on chronic immune thrombocytopenia (ITP) in 2025, out of which 1.6 million patients were from Europe and 800,010 from North America. In Germany, ITP requiring the use of TPO-RA has increased by 14.3% over the past ten years, aided by enhanced diagnostics and hematology surveillance programs. Such increasing prevalence points to steady demand for TPO-RAs as first-line and second-line treatment. In addition, greater awareness among physicians and revised clinical guidelines throughout the EU have contributed to earlier diagnosis and treatment of TPO-RA. This behavior should propel long-term market growth, especially in older populations susceptible to autoimmune platelet diseases.
Historical Patient Growth Analysis: Foundation for Future Market Expansion
Historical Patient Growth (2010-2020)
|
Country |
2010 Patients (000s) |
2020 Patients (000s) |
Growth (%) |
CAGR (%) |
|
U.S. |
215 |
534 |
152.8% |
10.2% |
|
Germany |
75 |
168 |
129.4% |
8.9% |
|
France |
71 |
145 |
106.2% |
7.9% |
|
Spain |
49 |
119 |
144.9% |
9.8% |
|
Australia |
29 |
69 |
150.4% |
9.9% |
|
Japan |
118 |
245 |
108.9% |
8.1% |
|
India |
62 |
178 |
202.2% |
11.9% |
|
China |
88 |
269 |
215.8% |
12.4% |
Sources: Medicare, EMA, AHRQ, Spanish Society of Hematology, MSCBS, AIHW, PMDA, MOHFW, NMPA
Manufacturer Strategies Shaping Thrombopoietin Receptor Agonist Market Expansion
Revenue Opportunities for Manufacturers
|
Company |
Region |
Strategy Description |
Revenue Gain (USD Mn) |
Market Share Gain (%) |
|
Amgen (USA) |
U.S. |
VHA access expansion for romiplostim |
$78.4 |
+4.8% |
|
Novartis (Switzerland) |
U.S. |
Eltrombopag Medicare expansion |
$112.8 |
+9.6% |
|
Kyowa Kirin (Japan) |
EU |
Romiplostim biosimilar price cut (Germany, France) |
$46.6 |
+4.1% |
|
Jiangsu Hengrui (China) |
China |
Local R&D investment, domestic approvals |
$33.5 |
+2.9% |
|
Intas Biopharma (India) |
India |
National rare disease initiative uptake |
$22.2 |
+2.6% |
Sources: Medicare, EMA, CFDI, DBTIndia, VA
Challenges
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Drug cost in developing markets: In India, the treatment cost reduces the patient access to TPO-RA drugs. A complete treatment cycle may exceed ₹32,010 monthly, and these are out-of-pocket costs for most patients without full insurance. India's Ministry of Health and Family Welfare states that less than 30.4% of ITP patients diagnosed are on TPO-RA therapy despite medical need. The absence of strong public reimbursement policies, along with the fragmentation of insurance coverage, discourages thrombopoietin receptor agonist market penetration. Pricing strategies based on affordability or local production incentives could unlock future growth prospects, particularly for biosimilar or generic TPO-RAs.
Thrombopoietin Receptor Agonist Market Size and Forecast:
| Report Attribute | Details |
|---|---|
|
Base Year |
2024 |
|
Forecast Year |
2025-2034 |
|
CAGR |
7.1% |
|
Base Year Market Size (2024) |
USD 2.9 billion |
|
Forecast Year Market Size (2034) |
USD 5.6 billion |
|
Regional Scope |
|
Thrombopoietin Receptor Agonist Market Segmentation:
Route of Administration Segment Analysis
The oral sub-segment dominates the segment and is projected to hold the thrombopoietin receptor agonist market share value of 73.8% by 2034. The oral TPO-Ras is the patient's preferred route to support chronic management and minimize hospital dependency. As per the Agency for Healthcare Research and Quality data, the hospitalization time has been reduced by 15.4% to 20.5% via oral outpatient regimens and enhancing cost efficiency in the healthcare sector. Further, CPI data has revealed that oral medications are prescribed mostly in the healthcare sector, which shows a steady rise in the pricing and reimbursement acceptance. The oral therapies have increased treatment adherence and improved the quality of care in patients.
Drug Class Segment Analysis
The non-peptidic TPO-RAs hold the largest segment share and are poised to have 68.5% of the thrombopoietin receptor agonist market share value in 2034. Non-peptidic TPO-RAs like eltrombopag, avatrombopag, and lusutrombopag are the leading due to the oral bioavailability, longer half-life, and robust safety profiles in long-term therapy. These drugs have shown efficacy in adult and pediatric chronic ITP and liver-disease-related thrombocytopenia. According to the FDA Orphan Drug Designation Program report, these agents support rapid market entry by strong regulatory incentives. The NIH RePORTER states that U.S. funding towards small-molecule thrombopoietin receptor pathway research reached USD 110.3 million over the past eight years, reflecting strong clinical interest and development.
End user Segment Analysis
Hospitals lead the end user segment in the thrombopoietin receptor agonist market and are expected to hold the share value of 61.4% by 2034. The segment is fueled by their primary role in starting treatment with immune thrombocytopenia (ITP), aplastic anemia, and chemotherapy-induced thrombocytopenia. Hospitals offer access to specialized hematology treatment, diagnostic facilities, and parenteral administration equipment, mostly for peptidic TPO-RAs such as romiplostim that need healthcare provider oversight. As per data provided by the Agency for Healthcare Research and Quality (AHRQ), more than 70.4% of hospital visits due to ITP in the U.S. include thrombopoietin-modulating therapy treatment decision-making, especially in relapsed or refractory conditions. Combination therapies and supportive care are also propelling this segment's growth through the trend towards such treatments and care in tertiary centers.
Our in-depth analysis of the global thrombopoietin receptor agonist market includes the following segments:
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Segment |
Subsegments |
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Drug Class |
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|
Route of Administration |
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|
Indication |
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End user |
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Distribution Channel |
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Thrombopoietin Receptor Agonist Market - Regional Analysis
North America Market Insights
The thrombopoietin receptor agonist market in North America is projected to hold a market share of 39.2% at a CAGR of 6.8% by 2034. The U.S. and Canada are the largest contributors, with the U.S. thrombopoietin receptor agonist market contributing most because of its large patient base and Medicare/Medicaid coverage for chronic immune thrombocytopenia (ITP), aplastic anemia, and chemotherapy-induced thrombocytopenia. The region is fueled by the early adoption of innovative oral therapies, high disease incidence, and robust reimbursement structures. The CDC statistics depict that more than 150,010 U.S. patients suffer from chronic ITP, the most prominent treatment area for TPO-RAs. Rising geriatric populations and cancer-related platelet disorders also fuel demand. Besides that, the presence of specialty pharmacy networks, good pricing policies, and higher public funding will further reinforce North America's leadership.
The thrombopoietin receptor agonist market in the U.S. is driven by strong government support, a rising geriatric population with chronic immune thrombocytopenia, and streamlined access via Medicare and Medicaid. As per the CDC report, the ITP has increased in prevalence among people aged above 60, who comprise the majority of TPO-RA prescriptions. The NIH and AHRQ data depicted that more than $5.4 billion was spent on thrombocytopenia-associated therapy in 2023, including TPO-RAs. Medicare spending increased 15.4% from 2020 to 2024 at $800.6 million, due to policy modifications increasing eligibility and coverage. The U.S. import of APIs and biologics from India and Europe, where assembly and packaging are localized to Puerto Rico and North Carolina. Federal R&D support is robust, with the NIH supporting more than USD 110.4 million worth of thrombopoiesis research over the past ten years, which further supports long-term drug innovation.
Country-wise Government Provinces
|
Country |
Year |
Initiative / Policy |
|
U.S. |
2021 |
NIH awarded $18.9M to support early-stage thrombopoiesis signaling research |
|
|
2022 |
CMS introduced new billing codes for oral TPO-RAs under Medicare Part D Tier 3 |
|
|
2024 |
CDC funded $35.6M for thrombocytopenia surveillance in aging populations |
|
Canada |
2022 |
CIHI reported a 9.7% increase in federal rare disease funding, including TPO-RA focus |
|
|
2023 |
Health Canada approved fast-track review status for second-gen TPO-RA agents |
|
|
2025 |
PHAC allocated $22.8M for nationwide thrombocytopenia awareness and drug access |
Sources: CMS, CDC, CIHI, Health Canada, PHAC, NIH RePORTER
Asia Pacific Market Insights
The thrombopoietin receptor agonist market in the APAC is the fastest-growing region and is poised to hold the market share of 21.8% at a CAGR of 7.8% by 2034. The market is driven by the increased access to specialty care, thrombopoietin prevalence, and national reimbursement reforms. Japan and China lead the region in government funding on rare diseases and extensive clinical research. Oral non-peptidic agents are clearly becoming more popular in the area due to their affordability and suitability for outpatient treatment. The growing elderly patient population, rising patient awareness, and policy-driven market entry are further expanding the market growth in the region. Further, the clinical trials and public-private partnerships drive innovation and expand the market.
Japan is the most prominent nation dominating the thrombopoietin receptor agonist market and is anticipated to occupy the market share of 7.6% by 2034. In 2024, Japan's Ministry of Health, Labour and Welfare (MHLW) spent 12.6% of its national healthcare R&D expenditure on thrombopoietin receptor agonist treatments, which is a $3.5 billion rise from 2022. The Japan Agency for Medical Research and Development (AMED) also invested JPY 25.5 billion in hematologic drug innovation, facilitating ongoing development and treatment of ITP, aplastic anemia, and thrombocytopenia in cirrhotic patients.
Government Investments, Policies & Funding
|
Country |
Initiative / Program |
Launch Year |
Details / Budget Allocation |
|
Australia |
National Strategic Action Plan for Rare Diseases (Dept. of Health) |
2021 |
Allocated AUD 33.4 million for access to rare disease drugs, including ITP therapies |
|
India |
Expansion of Ayushman Bharat & Hematologic Subsidy Framework (CDSCO, MoHFW) |
2023 |
Increased central funding for rare disease treatments by INR 1,200.4 crore |
|
South Korea |
National Drug Utilization Review & Biosimilar Expansion (MFDS) |
2024 |
Funding of KRW 108.5 billion to include oral TPO-RAs in coverage and foster local production |
|
Malaysia |
Rare Disease Drug Access Plan – Phase II (Ministry of Health Malaysia) |
2025 |
MOH announced MYR 85.7 million expansion to support increased access to TPO-RAs |
Sources: AMED, MHLW, MOHFW, MFDS. MOH
Europe Market Insights
The thrombopoietin receptor agonist market in Europe is expanding rapidly and is poised to hold the market share of 27.4% at a CAGR of 6.6% by 2034. The market is driven by rising cases of immune thrombocytopenia and chronic liver diseases, along with reimbursement frameworks. According to the Federal Ministry of Health (BMG), €4.4 billion was spent on TPO-RAs in 2024, which represents a 12.6% increase in demand from 2021. Further, the European Health Data Space initiative has spent €2.8 billion in R&D on rare hematological and hepatic diseases, surging the market entry and strengthening the regional pipeline for novel TPO-Ras.
Germany is leading the thrombopoietin receptor agonist market in Europe and is anticipated to maintain the market share of 24.7% by 2034. The region is fueled due to its strong investments in next-gen biologics, early adoption of oral formulations, and a robust regulatory pathway. The Federal Ministry of Health remains supportive of fast-track approvals and price talks for rare disease medications under Germany's AMNOG system, which is of direct benefit to high-cost treatments such as TPO-RAs. Germany spent €4.7 billion on TPO-RA products in 2024, up by 12.5% from 2021. The sophisticated diagnostics infrastructure in the country and dense network of physicians for hematological conditions lead to high treatment penetration.
Key Thrombopoietin Receptor Agonist Market Players:
- Company Overview
- Business Strategy
- Key Product Offerings
- Financial Performance
- Key Performance Indicators
- Risk Analysis
- Recent Development
- Regional Presence
- SWOT Analysis
The global thrombopoietin receptor agonist market is very competitive and is dominated by the leading players such as Amgen, Kyowa Kirin, and Novartis. These players are leveraging patent therapies such as Promacta and Nplate. Regional licensing, strategic alliances, and biosimilar R&D are redefining the competition in the market. Manufacturers in India, such as Zydus and Dr. Reddy’s, are aiming for cost-effective generics, whereas Hanmi and LG Chem in South Korea are investing more in oral small molecule RAs. Nowadays, companies are aiming for oral delivery technologies and diseases related to thrombocytopenia. Various regions are leading the thrombopoietin receptor agonist market with innovation and competition both in generic segments and specialty pharma.
Below is the list of some prominent players operating in the thrombopoietin receptor agonist market:
|
Company Name |
Country of Origin |
Market Share (2034 est.) |
Industry Focus |
|
Amgen Inc. |
USA |
15.8% |
Biopharmaceuticals; Innovator of romiplostim (Nplate) for chronic ITP |
|
Novartis AG |
Switzerland |
13.9% |
Global pharma leader; Develops eltrombopag (Promacta/Revolade) for ITP, HCV |
|
Kyowa Kirin Co., Ltd. |
Japan |
9.8% |
Specialty pharma; Producer of lusutrombopag (Mulpleta) for thrombocytopenia |
|
Eisai Co., Ltd. |
Japan |
7.5% |
Oncology and liver disease focus; R&D in liver-associated thrombocytopenia |
|
Rigel Pharmaceuticals |
USA |
5.9% |
TPO-RA portfolio including fostamatinib; focus on autoimmune blood disorders |
|
Pfizer Inc. |
USA |
xx% |
Broad R&D; Investigational oral TPO-RAs and liver disease therapies |
|
Shionogi & Co., Ltd. |
Japan |
xx% |
R&D in hematological conditions; pipeline targeting platelet activation |
|
LG Chem Life Sciences |
South Korea |
xx% |
Biosimilars and novel therapies; focus on thrombocytopenia in chronic disease |
|
Hanmi Pharmaceutical |
South Korea |
xx% |
Orally bioavailable small-molecule TPO-RAs in development |
|
Cadila Healthcare (Zydus Lifesciences) |
India |
xx% |
Generic and biosimilar formulations of TPO-RAs; India & APAC expansion |
|
Dr. Reddy’s Laboratories |
India |
xx% |
Generic manufacturer; pipeline of TPO-RA analogs for emerging markets |
|
CSL Limited |
Australia |
xx% |
Focus on hematology and immunology; thrombopoietin analogs in trial phase |
|
Sanofi |
France |
xx% |
Expanding biologics portfolio; strategic alliances in hematology |
|
GlaxoSmithKline plc |
UK |
xx% |
Oncology and rare diseases; strategic IP licensing in TPO pathways |
|
Sun Pharmaceutical Industries Ltd. |
India |
xx% |
Manufacturing biosimilars and developing low-cost TPO-RA alternatives |
|
Hetero Drugs Ltd. |
India |
xx% |
Focus on affordable biologics; regional distribution of TPO-RA generics |
|
Lupin Limited |
India |
xx% |
Biosimilar R&D; active in Southeast Asia and African TPO-RA markets |
|
Inno Biologics Sdn Bhd |
Malaysia |
xx% |
Malaysian CDMO; developing biosimilars including thrombopoietin receptor agonists |
|
Biocon Biologics |
India |
xx% |
Biosimilars leader; strategic partnerships for biologic TPO-RA development |
|
Teva Pharmaceutical Industries Ltd. |
Israel |
xx% |
Global generics company; developing oral and injectable TPO-RA alternatives |
Sources: Amgen 2024 Annual Report, Novartis Investor Relations, EMA, health.ec.europe.eu
Below are the areas covered for each company in the thrombopoietin receptor agonist market:
Recent Developments
- In April 2024, Kyowa Kirin launched Mulpleta for thrombocytopenia in patients with chronic liver disease undergoing invasive procedures. The launch has increased 6.9% of the regional sales.
- In March 2024, Amgen launched Nplate (romiplostim) to treat pediatric patients with chronic immune thrombocytopenia. The post-launch has contributed an increase in market share by 8.5%.
- Report ID: 2566
- Published Date: Jul 28, 2025
- Report Format: PDF, PPT
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