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MediPoint: Viscosupplementation-Global Analysis Market Forecasts

MediPoint: Viscosupplementation-Global Analysis Market Forecasts


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Executive Summary

MediPoint: Viscosupplementation-Global Analysis and Market Forecasts

Osteoarthritis (OA) constitutes a growing public health burden, and is the most common cause of musculoskeletal disability across the globe. Intra-articular viscosupplementation with hyaluronic acid (HA) has become an increasingly accepted therapeutic alternative to knee replacement surgery in the symptomatic management of OA over the past decade. Going forward, palliative pain treatments are likely to continue to fare well as healthcare reform kicks in and lag times for knee replacement become the norm. Growth of the viscosupplementation market will be highest in the US and the Asia-Pacific (APAC) region, where there is a significant pent-up demand for early intervention in the management of OA.

The increasing prevalence of OA and the lower cost of prescribing viscosupplementation compared with knee replacement surgery have prompted the medical community to take a closer look at this therapy. However, there is a growing concern among physicians that the updated American Academy of Orthopaedic Surgeons (AAOS) and Osteoarthritis Research Society International (OARSI) treatment guidelines for knee OA will result in increased insurance denials for viscosupplementation. Moving forward, industry consolidation and intense competition in the viscosupplementation arena will cause increasing numbers of companies to augment their research efforts to differentiate their products from the lower-end competitors. The motivation to incorporate the favorable properties of different agents into a more effective viscosupplementation product has led to the manipulation and development of next-generation HA formulations consisting of not only HAs, but also pharmaceuticals, such as corticosteroids.

Highlights

Key Questions Answered

Future growth in the viscosupplementation market lies in the one-injection segment. What are the current adoption trends in different geographies? How will one-injection segment drive the market revenue growth in the upcoming years?

In the US, some commercial insurers have completely excluded viscosupplementation treatment from their coverage. Even when the criteria for coverage have clearly been met by the patient, denials are common. Has this impacted the procedure volume growth in the US viscosupplementation market?

Reimbursement is the single greatest barrier to the market growth for viscosupplementation procedures. How does the current payer mix look like in different countries?

In recent years, there has been an expansion in the use of intra-articular HA viscosupplementation for treating OA at hips, shoulders, and other small joints. What are the current adoption trends in different regions?

Because the most prevalent treatment regimen varies from region to region, the competitive landscape in the viscosupplementation space can be quite different across the geographies covered in this report. Who are the leading players in the viscosupplementation market in different countries?

Reasons To Buy

"What Do Physicians Think quotes provide a unique insight into how healthcare professionals are reacting to events within the industry, and what their responses could mean for industry strategists. This information is essential for all strategic decision makers in every organization allowing them to act on high quality information.

1 Table of Contents

1 Table of Contents 8

1.1 List of Tables 13

1.2 List of Figures 17

2 Introduction 20

2.1 Catalyst 20

2.2 Related Reports 20

3 Treatment Modalities Overview 22

3.1 Treatment Paradigm 22

3.1.1 Physical Therapies 22

3.1.2 Medications 22

3.1.3 Hyaluronic Acid Viscosupplementation 23

3.1.4 Surgical Intervention 25

4 Industry Overview 26

4.1 Procedural Trends 26

4.1.1 Overview 26

4.1.2 US 30

4.1.3 5EU 33

4.1.4 Asia-Pacific 37

4.1.5 South America 42

4.2 Market Access 45

4.2.1 US 45

4.2.2 5EU 46

4.2.3 Asia-Pacific 47

4.2.4 South America 47

4.3 Reimbursement 48

4.3.1 US 48

4.3.2 5EU 52

4.3.3 Asia-Pacific 58

4.3.4 South America 61

4.4 Mergers and Acquisitions/Key Partnerships 62

4.4.1 Meda AB Acquires Rottapharm|Medaus for USD 3.1 Billion (October 2014) 62

4.4.2 Founders of Anteis Establish Aptissen (March 2014) 63

4.4.3 Bioventus Acquires Durolane Assets from Galderma (February 2014) 63

4.4.4 Zimmer to Combine with Biomet in a Transaction Valued at USD 13.35 Billion (April 2014) 63

4.4.5 Johnson & Johnson Acquires Synthes for USD 19.7 Billion (June 2012) 64

5 Market Drivers, Opportunities, and Barriers 65

5.1 Driver: Rising Prevalence of OA 65

5.2 Driver: Multimodal Treatment Paradigm for OA 66

5.3 Driver: Viscosupplementation Delays Total Knee Replacement 67

5.4 Driver: Side Effects of NSAIDs, Corticosteroids, and Narcotics 68

5.5 Driver: Direct-To-Consumer Marketing 70

5.6 Opportunity: Expanding Indications 71

5.7 Opportunity: New-Generation HA Derivatives 72

5.8 Opportunity: Increased Use After Arthroscopic Surgeries 74

5.9 Opportunity: Self-Pay Market 74

5.10 Opportunity: Emerging Countries 76

5.11 Barrier: Unfavorable Reimbursement Scenario 76

5.12 Barrier: Pricing Erosion 77

5.13 Barrier: Cost-Effective Pharmacological Therapies 78

5.14 Barrier: Will The Rising Popularity of PRP Injection Impact the Viscosupplementation Market? 78

5.15 Barrier: Cost-Conscious Patients in Emerging Countries 81

6 Unmet Needs 83

6.1 Lack of Consensus on Clinical Efficacy of Viscosupplementation in Knee OA 83

6.2 Insufficient Evidence to Prove the Clinical Efficacy of Viscosupplementation in Other Joints 85

6.3 Better Understanding of the Basic Science 87

6.4 Ultrasound-Guided Injection 90

7 Competitive Assessment 92

7.1 Major Viscosupplementation Products 92

7.1.1 Adant 92

7.1.2 Arthrum 93

7.1.3 Curavisc 93

7.1.4 Durolane 94

7.1.5 Euflexxa 95

7.1.6 Fermathron 96

7.1.7 Gel-One 97

7.1.8 Go-On 98

7.1.9 Hyalgan 99

7.1.10 Hyalubrix and HyalOne 100

7.1.11 Jonexa 101

7.1.12 NeoVisc 102

7.1.13 Orthovisc and Monovisc 103

7.1.14 Ostenil 104

7.1.15 Recosyn 105

7.1.16 RenehaVis 106

7.1.17 Supartz/ARTZ 107

7.1.18 Suplasyn 108

7.1.19 Suvenyl 109

7.1.20 Synocrom 110

7.1.21 Synolis V-A 110

7.1.22 Synovial 111

7.1.23 Synvisc and Synvisc-One 112

7.2 Other Viscosupplementation Products 114

8 Pipeline Products 116

8.1 Overview 116

8.2 Gel-Syn (IBSA Institut Biochimique S.A.) 117

8.3 Cingal (Anika Therapeutics) 117

8.4 Hydros-TA (Carbylan Therapeutics) 118

8.5 Additional Indication for Synvisc-One (Sanofi) 119

8.6 Hymovis (Fidia Farmaceutici S.p.A.) 119

8.7 HA-NSAID Conjugates (Seikagaku Corporation) 119

8.8 Additional Indication for Supartz/ARTZ (Seikagaku Corporation) 120

8.9 Clodronate-HA Conjugates (Abiogen Pharma) 120

9 Current and Future Players 121

9.1 Trends in Corporate Strategy 121

9.2 Major Manufacturers 122

9.2.1 Anika Therapeutics 122

9.2.2 Chugai Pharmaceutical 124

9.2.3 Ferring Pharmaceuticals 126

9.2.4 Fidia Farmaceutici S.p.A. 128

9.2.5 Meda AB 130

9.2.6 Sanofi 132

9.2.7 Seikagaku Corporation 135

9.3 Major Marketing Partners 137

9.3.1 Bioventus 137

9.3.2 DePuy Synthes 139

9.3.3 Zimmer-Biomet 141

10 Market Outlook 144

10.1 Market Share Analysis by Country 144

10.1.1 US Market 144

10.1.2 5EU Market 145

10.1.3 Asia-Pacific Market 148

10.1.4 Brazil Market 150

10.2 By Market Segment 150

10.2.1 One-Injection Segment 150

10.2.2 Three-Injection Segment 151

10.2.3 Five-Injection Segment 152

10.3 By Geography 154

10.3.1 Overview 154

10.3.2 US 158

10.3.3 France 161

10.3.4 Germany 163

10.3.5 Italy 165

10.3.6 Spain 167

10.3.7 UK 169

10.3.8 Japan 171

10.3.9 Brazil 173

10.3.10 China 175

10.3.11 India 178

11 Appendix 181

11.1 Bibliography 181

11.2 Abbreviations 187

11.3 Report Methodology 191

11.3.1 Overview 191

11.3.2 Coverage 191

11.3.3 Secondary Research 191

11.3.4 Forecasting Methodology 192

11.3.5 Primary Research Key Opinion Leader Interviews 193

11.3.6 Expert Panel Validation 193

11.4 Physicians and Specialists Included in This Study 194

11.5 About the Authors 197

11.5.1 Analysts 197

11.5.2 Jim Coutcher, MS, Global Head of Healthcare 198

11.6 About MediPoint 199

11.7 About GlobalData 199

11.8 Disclaimer 200

1.2 List of Figures

Figure 1: US Physician Adoption Trend for Viscosupplementation, by Specialty 26

Figure 2: US Procedure Trends for Viscosupplementation, by Joint Type, 2014 32

Figure 3: US Adoption Trend for Viscosupplementation, by Treatment Regimen, 2014 33

Figure 4: US Procedure Trends for Viscosupplementation, by Treatment Regimen, 2012-2021 33

Figure 5: 5EU Procedure Trends for Viscosupplementation, by Joint Type, 2014 35

Figure 6: 5EU Adoption Trends for Viscosupplementation, by Treatment Regimen, 2014 36

Figure 7: 5EU Procedure Trends for Viscosupplementation, by Treatment Regimen, 2012-2021 37

Figure 8: APAC Procedure Trends for Viscosupplementation, by Joint Type, 2014 39

Figure 9: APAC Adoption Trend for Viscosupplementation, by Treatment Regimen, 2014 41

Figure 10: APAC Procedure Trends for Viscosupplementation, by Treatment Regimen, 2012-2021 42

Figure 11: Brazil Procedure Trends for Viscosupplementation, by Joint Type, 2014 43

Figure 12: Brazil Adoption Trend for Viscosupplementation, by Treatment Regimen, 2014 44

Figure 13: Brazil Procedure Trends for Viscosupplementation, by Treatment Regimen, 2012-2021 45

Figure 14: US Medicare Reimbursement Trend for Viscosupplementation, 2014-2015* 49

Figure 15: Payer Mix for Viscosupplementation in the US, 2014 50

Figure 16: Payer Mix for Viscosupplementation in France, 2014 53

Figure 17: Payer Mix for Viscosupplementation in Germany, 2014 55

Figure 18: Payer Mix for Viscosupplementation in Italy, 2014 56

Figure 19: Payer Mix for Viscosupplementation in Spain, 2014 57

Figure 20: Payer Mix for Viscosupplementation in the UK, 2014 58

Figure 21: Payer Mix for Viscosupplementation in Japan, 2014 59

Figure 22: Payer Mix for Viscosupplementation in China, 2014 60

Figure 23: Payer Mix for Viscosupplementation in India, 2014 61

Figure 24: Payer Mix for Viscosupplementation in Brazil, 2014 62

Figure 25: US Viscosupplementation Market Share, by Product, 2014 145

Figure 26: France Viscosupplementation Market Share, by Product, 2014 145

Figure 27: Germany Viscosupplementation Market Share, by Product, 2014 146

Figure 28: Italy Viscosupplementation Market Share, by Product, 2014 146

Figure 29: Spain Viscosupplementation Market Share, by Product, 2014 147

Figure 30: UK Viscosupplementation Market Share, by Product, 2014 147

Figure 31: Japan Viscosupplementation Market Share, by Product, 2014 148

Figure 32: China Viscosupplementation Market Share, by Product, 2014 149

Figure 33: India Viscosupplementation Market Share, by Product, 2014 149

Figure 34: Brazil Viscosupplementation Market Share, by Product, 2014 150

Figure 35: Global Viscosupplementation One-Injection Market Revenue (USD m), by Region, 2012-2021 151

Figure 36: Global Viscosupplementation Three-Injection Market Revenue (USD m), by Region, 2012-2021 152

Figure 37: Global Viscosupplementation Five-Injection Market Revenue (USD m), by Region, 2012-2021 153

Figure 38: Global Viscosupplementation Market Revenue (USD m), by Segment, 2012-2021 155

Figure 39: Global Viscosupplementation Market Revenue (USD m), by Segment, 2014 and 2021 156

Figure 40: Global Viscosupplementation Market Revenue (USD m), by Geography, 2014 and 2021 158

Figure 41: US Viscosupplementation Market Revenue (USD m), 2012-2021 159

Figure 42: US Viscosupplementation Market Revenue Distribution, 2014 and 2021 160

Figure 43: France Viscosupplementation Market Revenue (USD m), 2012-2021 162

Figure 44: France Viscosupplementation Market Revenue Distribution, 2014 and 2021 163

Figure 45: Germany Viscosupplementation Market Revenue (USD m), 2012-2021 164

Figure 46: Germany Viscosupplementation Market Revenue Distribution, 2014 and 2021 165

Figure 47: Italy Viscosupplementation Market Revenue (USD m), 2012-2021 166

Figure 48: Italy Viscosupplementation Market Revenue Distribution, 2014 and 2021 167

Figure 49: Spain Viscosupplementation Market Revenue (USD m), 2012-2021 168

Figure 50: Spain Viscosupplementation Market Revenue Distribution, 2014 and 2021 169

Figure 51: UK Viscosupplementation Market Revenue (USD m), 2012-2021 170

Figure 52: UK Viscosupplementation Market Revenue Distribution, 2014 and 2021 171

Figure 53: Japan Viscosupplementation Market Revenue (USD m), 2012-2021 172

Figure 54: Japan Viscosupplementation Market Revenue Distribution, 2014 and 2021 173

Figure 55: Brazil Viscosupplementation Market Revenue (USD m), 2012-2021 174

Figure 56: Brazil Viscosupplementation Market Revenue Distribution, 2014 and 2021 175

Figure 57: China Viscosupplementation Market Revenue (USD m), 2012-2021 177

Figure 58: China Viscosupplementation Market Revenue Distribution, 2014 and 2021 178

Figure 59: India Viscosupplementation Market Revenue (USD m), 2012-2021 179

Figure 60: India Viscosupplementation Market Revenue Distribution, 2014 and 2021 180

Figure 61: Breakdown of Physician Survey Participants by Geography (N=61) 196

Figure 62: Breakdown of Other Primary Research Participants by Geography (N=50) 196

1.1 List of Tables

Table 1: US Procedure Trends for Viscosupplementation, by Joint Type, 2012-2021 31

Table 2: US Procedure Trends for Viscosupplementation, by Treatment Regimen, 2012-2021 32

Table 3: 5EU Procedure Trends for Viscosupplementation, by Joint Type, 2012-2021 34

Table 4: 5EU Procedure Trends for Viscosupplementation, by Treatment Regimen, 2012-2021 37

Table 5: APAC Procedure Trends for Viscosupplementation, by Joint Type, 2012-2021 39

Table 6: APAC Procedure Trends for Viscosupplementation, by Treatment Regimen, 2012-2021 42

Table 7: Brazil Procedure Trends for Viscosupplementation, by Joint Type, 2012-2021 43

Table 8: Brazil Procedure Trends for Viscosupplementation, by Treatment Regimen, 2012-2021 44

Table 9: Differences Between US FDA Approval and EU CE Marking of Medical Devices 46

Table 10: US Medicare ASPs* for Viscosupplementation Products (2014-2015) 49

Table 11: Potential Clinical Benefits of HA-NSAIDs Conjugates 73

Table 12: Current CPGs on the Use of Viscosupplementation in Joints Other Than the Knee 86

Table 13: Product Profile-Adant 92

Table 14: Product Profile-Arthrum 93

Table 15: Product Profile-Curavisc 94

Table 16: Product Profile-Durolane 95

Table 17: Product Profile-Euflexxa 96

Table 18: Product Profile-Fermathron 97

Table 19: Product Profile-Gel-One 98

Table 20: Product Profile-Go-On 99

Table 21: Product Profile-Hyalgan 100

Table 22: Product Profile-Hyalubrix and HyalOne 101

Table 23: Product Profile-Jonexa 102

Table 24: Product Profile-NeoVisc 103

Table 25: Product Profile-Orthovisc and Monovisc 104

Table 26: Product Profile-Ostenil 105

Table 27: Product Profile-Recosyn 106

Table 28: Product Profile-RenehaVis 107

Table 29: Product Profile-Supartz/ARTZ 108

Table 30: Product Profile-Suplasyn 109

Table 31: Product Profile-Suvenyl 109

Table 32: Product Profile-Synocrom 110

Table 33: Product Profile-Synolis V-A 111

Table 34: Product Profile-Synovial 112

Table 35: Product Profile-Synvisc and Synvisc-One 113

Table 36: Other Viscosupplementation Products in the Global Market, 2015 114

Table 37: Major Pipeline Products in the Viscosupplementation Market, 2015 116

Table 38: Company Profile-Anika Therapeutics 122

Table 39: Anika Therapeutics' Viscosupplementation Portfolio Assessment, 2015 123

Table 40: SWOT Analysis-Anika Therapeutics 124

Table 41: Company Profile-Chugai Pharmaceutical 125

Table 42: Chugai Pharmaceutical's Viscosupplementation Portfolio Assessment, 2015 126

Table 43: SWOT Analysis-Chugai Pharmaceutical 126

Table 44: Company Profile-Ferring Pharmaceuticals 127

Table 45: Ferring Pharmaceutical's Viscosupplementation Portfolio Assessment, 2015 127

Table 46: SWOT Analysis-Ferring Pharmaceuticals 128

Table 47: Company Profile-Fidia Farmaceutici S.p.A. 129

Table 48: Fidia Farmaceutici S.p.A.'s Viscosupplementation Portfolio Assessment, 2015 130

Table 49: SWOT Analysis-Fidia Farmaceutici S.p.A. 130

Table 50: Company Profile-Meda AB 131

Table 51: Meda AB's Viscosupplementation Portfolio Assessment, 2015 132

Table 52: SWOT Analysis-Meda AB 132

Table 53: Company Profile-Sanofi 133

Table 54: Sanofi's Viscosupplementation Portfolio Assessment, 2015 134

Table 55: SWOT Analysis-Sanofi 134

Table 56: Company Profile-Seikagaku Corporation 135

Table 57: Seikagaku Corporation's Viscosupplementation Portfolio Assessment, 2015 136

Table 58: SWOT Analysis-Seikagaku Corporation 137

Table 59: Company Profile-Bioventus 138

Table 60: Bioventus' Viscosupplementation Portfolio Assessment, 2015 138

Table 61: SWOT Analysis-Bioventus 139

Table 62: Company Profile-DePuy Synthes 140

Table 63: DePuy Synthes' Viscosupplementation Portfolio Assessment, 2015 141

Table 64: SWOT Analysis-DePuy Synthes 141

Table 65: Company Profile-Zimmer-Biomet 142

Table 66: Zimmer-Biomet's Viscosupplementation Portfolio Assessment, 2015 143

Table 67: SWOT Analysis-Zimmer-Biomet 143

Table 68: Global Viscosupplementation One-Injection Market Revenue (USD m), by Region, 2012-2021 151

Table 69: Global Viscosupplementation Three-Injection Market Revenue (USD m), by Region, 2012-2021 152

Table 70: Global Viscosupplementation Five-Injection Market Revenue (USD m), by Region, 2012-2021 153

Table 71: Global Viscosupplementation Market Revenue (USD m), by Segment, 2011-2020 154

Table 72: Global Viscosupplementation Market Revenue (USD m), by Geography, 2012-2021 157

Table 73: US Viscosupplementation Market Revenue (USD m), 2012-2021 159

Table 74: France Viscosupplementation Market Revenue (USD m), 2012-2021 161

Table 75: Germany Viscosupplementation Market Revenue (USD m), 2012-2021 164

Table 76: Italy Viscosupplementation Market Revenue (USD m), 2012-2021 166

Table 77: Spain Viscosupplementation Market Revenue (USD m), 2012-2021 168

Table 78: UK Viscosupplementation Market Revenue (USD m), 2012-2021 170

Table 79: Japan Viscosupplementation Market Revenue (USD m), 2012-2021 172

Table 80: Brazil Viscosupplementation Market Revenue (USD m), 2012-2021 174

Table 81: China Viscosupplementation Market Revenue (USD m), 2012-2021 176

Table 82: India Viscosupplementation Market Revenue (USD m), 2012-2021 179

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