X-ray contrast media: where are we now, and where are we going?

The U.S. market for x-ray contrast media (XCM) has grown from $103,000,000 in 1985 to approximately +f41 billion today. The increase in market size represents a moderate increase in number of procedures (5% to 7% per year) and a large increase in the cost per milliliter of solution. The number of XCM available continues to increase, and three are currently in clinical trials in the United States. Clinically significant increases in either efficacy or safety are unlikely with these agents; however, increased competition may cause some slight erosion in the price per milliliter. The development of new XCM focuses on strategies to target different distribution spaces and new or simplified syntheses.