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Major World Markets for Stents and The Economics of Drug-Eluting Technology

 

Since the arrival of drug-eluting (called drug-eluding by some) technology a few years ago with the promise of reducing restenosis, questions abound surrounding the future of the stent market: After numerous clinical studies and mixed cost-effectiveness results, how is drug-eluding technology expected to peform in the future? What can companies do to best market this technology in the healthcare system of the US and 6 other major world markets? What are the market trends to watch that will determine growth in this field in the coming years? What companies have already established a leadership position in stents and what do start ups have to do to join them? Major World Markets for Stents and The Economics of Drug Eluding Technology, takes a hard look at these questions with economic analysis unmatched by any resource.

The field of drug-eluting stents remains an exciting technological innovation that will be a major part of cardiovascular intervention technologies over the next ten years. This report provides a complete market assessment for coronary stents broadly, with emphasis on the economics of drug-eluting stents. Markets sizes and forecasts are divided in two product segments:

• Bare Metal (BMS)
• Drug Eluding Stents (DES)

As a world market analysis, the report covers markets in the following countries:

• U.S.
• France
• Germany
• UK
• Italy
• Spain
• Japan

This report considers the options that the current technologies present, the progress that is being made in these fields, and the reception these new products are likely to experience in the marketplace. In its brief lifetime (BMSs having only emerged fully in the mid-1990s), the field of coronary stents has shown that it can hold many surprises. Among the information in this complete survey of the coronary stent market, the report contains:

 

• Discussion of Restenosis and its Implications
• Major World Market Size for BMS and DES
• Statistics Driving Stent Usage
• Forecasts in Major World Markets to 2012
• The Economic Case for Drug-Eluting Stent Technologies and Applications
• Successful Marketing Strategies
• Profiles of Key Stent Companies
• Most Favorable Markets for Stent Manufacturers
• Nine Strategic Conclusions Essential to The Market

The analysis presented in this report is based on data from a combination of company, government, industrial, institutional and private sources. It includes information from extensive literature reviews, as well as interviews and discussions with experts in the field, including experts in cardiology and cardiac surgery, as well as pathologists, public health experts, research scientists, and business development and marketing managers engaged in the field.

Table of Contents

TABLE OF CONTENTS

CHAPTER ONE: : EXECUTIVE SUMMARY

• Background
• Scope and Methodology
• Size and Growth of Market

CHAPTER TWO: OVERVIEW OF CARDIOVASCULAR DISEASE AND CORONARY STENTS

• Background
• Stents, Coatings and Subacute Thrombosis
• Drug Eluting Stent Technology
• Problems
• Alternatives to Drug -Eluting Stents
  • Branchytherapy
  • Biochemical Approaches
  • Pharmaceutical Approaches

CHAPTER THREE: THE ECONOMICS OF CORONARY STENTS

• Direct and Indirect Costs of Stents
• ACC Study
• Factors behind Drug Eluding Stent Adoption
• Price of Stents
• Restenosis and Mortality

CHAPTER FOUR: MARKET SUMMARY

• Demographics
  • Population
  • Age
  • Sex
  • Race and Ethnicity
• Public Health Issues
  • Obesity
  • Smoking
  • Hypertension
• Economics
• Political Factors
• Market Estimates
• The Upstarts

CHAPTER FIVE: COMPANY SUMMARIES

• Overview
• Abbott Vascular
• Atrium Medical Corporation
• Boston Scientific
• CeloNova Biosciences
• Conor Medsystems (A Johnson & Johnson Company)
• Cordis Corporation (A Johnson & Johnson Company)
• Medinol Ltd.
• Medtronic, Inc.
• MIV Therapeutics, Inc.
• OrbusNeich
• Stentys S.A.S.
• Terumo Medical Corporation
• XTENT, Inc.

CHAPTER SIX: CONCLUSIONS AND STRATEGIC IMPLICATIONS

• First Conclusion
  • Implications
• Second Conclusion
  • Implications
• Third Conclusion
  • Implications
• Fourth Conclusion
  • Implications
• Fifth Conclusion
  • Implications
• Sixth Conclusion
  • Implications
• Seventh Conclusion
  • Implications
• Eighth Conclusion
  • Implications
• Ninth Conclusion
  • Implications

TABLE OF EXHIBITS

CHAPTER ONE: EXECUTIVE SUMMARY

• Table 1-1: Projected Deaths from Ischemic Heart Disease (IHD) and Acute Myocardial Infarction (AMI) in the Seven Major World Healthcare Markets: 2008

 

• Table 1-2: The Estimated Total Market for Coronary Stents in the Seven Major World Healthcare Markets: 2008, 2013 and 2018

 

• Table 1-3: The Estimated Market for Bare Metal Coronary Stents in the Seven Major World Healthcare Markets: 2008, 2013 and 2018

 

• Table 1-4: The Estimated Market for Drug-Eluting Coronary Stents in the Seven Major World Healthcare Markets: 2008, 2013 and 2018

 

• Figure 1-1: Trending in the Estimated Total Market for Coronary Stents in the Seven Major World Healthcare Markets: 2008, 2013 and - 2018

 

• Figure 1-2: Trending in the Estimated Market for Bare Metal Coronary Stents in the Seven Major World Healthcare Markets: 2008, 2013 and 2018

 

• Figure 1-3: Trending in the Estimated Market for Drug-Eluting Coronary Stents in the Seven Major World Healthcare Markets: 2008, 2013 and 2018

CHAPTER TWO: OVERVIEW: CARDIOVASCULAR DISEASE AND CORONARY STENTS

• Table 2-1: Top Ten Major Causes of Death in the World By Region

 

• Table 2-2: Top Ten Major Causes of Death in the World By Regional Development Level: (Developing Countries, Developed Countries) 2001

 

• Table 2-3: Top Ten Major Causes of Death in the World By Income Level: 2001

 

• Figure 2-1: Percentages of Deaths related to Cardiovascular Diseases in theSeven Major World Healthcare Markets: 2001

 

• Table 2-4:Projected Deaths from Ischemic Heart Disease (IHD) and Acute Myocardial Infarction (AMI) in the Seven Major World Healthcare Markets: 2008

 

• Figure 2-2: Distribution of Projected Ischemic Heart Disease Fatalities in the Seven Major World Healthcare Markets: 2008

 

• Figure 2-3: Distribution of Projected Acute Myocardial Infarction Fatalities in the Seven Major World Healthcare Markets: 2008

CHAPTER THREE: THE ECONOMICS OF CORONARY STENTS

• Table 3-1: Economic Burden (Direct Costs) of Restenosis

 

• Table 3-2: Medicare Trends in Coronary Revascularization Therapy

 

• Figure 3-1: Projected Two-Year Cardiovascular Cost Impact of Background Restenosis Rate

 

• Figure 3-2: Cost Per Quality-Adjusted Year of Life Saved for Some Healthcare Investments: Preventive and Therapeutic

 

• Table 3-3: Cost Per Repeated Revascularization Avoided

 

• Table 3-4: Willingness to Pay for Restenosis Prevention Technology

 

• Table 3-5: Predicted Clinical Restenosis Rates Following PTCA and Stent

 

• Table 3-6: Expected Cost-Effectiveness of Drug-Eluting Stents

CHAPTER FOUR: MARKET SUMMARY

• Table 4-1: IHD/CHD Heart Disease Age-Standardized Mortality Rates* for Both Sexes

   

• Figure 4-1: Projected IHD/CHD Cases: 2008

   

• Table 4-2: Projected Populations of the Seven Major World Markets: 2008 - 2018

   

• Figure 4-2(a): Trending in the Populations of the Five Major European Healthcare Markets: 2008 - 2018

   

• Figure 4-2(b): Trending in the Populations of Japan and the United States: 2008 - 2018

   

• Table 4-3: Ranking of the Major Causes of Death by Age Group in the United States: 2003

   

• Table 4-4: Trends in the Older (60+) Populations of the Seen Major World Healthcare Markets: 1950 - 2050

   

• Figure 4-3: Trending in the 60+ Year Old Population of the Seven Major World Healthcare Markets: 1950 - 2050

   

• Figure 4-4: Trending in the Percentage of the General Population that is 60+ Years Old in the Seven Major World Healthcare Markets: 1950 - 2050

   

• Table 4-5: Increases in IHD/CHD Incidence* with Age

   

• Table 4-6: Crude Death Rates* Associated with CVD: 2004

   

• Table 4-7: Crude Death Rates* Associated with IHD/CHD: 2006

   

• Table 4-8: Expected Death Rates* from IHD/CHD and AMI for Men and Women in the Seven Major World Healthcare Markets: 2008

   

• Table 4-9: Death Rates* for CVD for Men by Race and Ethnicity in the United States: 1985 - 2002

   

• Table 4-10: Death Rates* for CVD for Women by Race and Ethnicity in the United States: 1985 - 2002

   

• Table 4-11: Major Causes of Death for White, Black, American Indian and Hispanic Males in the United States: 2004

   

• Table 4-12: Major Causes of Death for White, Black, American Indian and Hispanic Females in the United States: 2004

   

• Table 4-13: Deaths from CVD for White and Black Men in the United States by Age Group: 2004

   

• Table 4-14: Deaths from CVD for White and Black Women in the United States by Age Group: 2004

   

• Figure 4-5: Trending in the Percentage Differences in CVD Deaths of Black Men and Women over those of White Men and Women by Age Group: 2004

   

• Table 4-15: Percentage of Obesity in the Seven Major World Healthcare Markets: 2005

   

• Table 4-16: Prevalence of Obesity in the Seven Major World Healthcare Markets: 2004

   

• Figure 4-6: Age-Adjusted Prevalence of Obesity* in Adult Americans (Ages 20 to 74) by Sex: 1960 - 2004

   

• Table 4-17: Smoking Prevalence in the Seven Major World Healthcare Markets (Standardized Data - % of Population)

   

• Figure 4-7: Prevalence of Hypertension in Americans Age 20 Years and Older by Age and Sex

   

• Table 4-18: Cost Estimates of Revascularization Using Drug-Eluting Stents versus Bare Metal Stents: 2003

   

• Table 4-19: The Estimated Total Market for Coronary Stents in the Seven Major World Healthcare Markets: 2008 - 2018

   

• Table 4-20: The Estimated Market for Bare Metal Coronary Stents in the Seven Major World Healthcare Markets: 2008 - 2018

   

• Table 4-21: The Estimated Market for Drug-Eluting Coronary Stents in the Seven Major World Healthcare Markets: 2008 - 2018

   

• Figure 4-8: Trending in the Estimated Total Market for Coronary Stents in the Seven Major World Healthcare Markets: 2008 - 2018

   

• Figure 4-9: Trending in the Estimated Market for Bare Metal Coronary Stents in the Seven Major World Healthcare Markets: 2008 - 2018

   

• Figure 4-10: Trending in the Estimated Market for Drug-Eluting Coronary Stents in the Seven Major World Healthcare Markets: 2008 - 2018

   

• Figure 4-11: Estimated Coronary Stent Market Average Annual Growth Rates in the Seven Major World Healthcare Markets: 2008 - 2018

   

• Figure 4-12: Distribution of the Estimated Total Market for Coronary Stents in the Seven Major World Healthcare Markets: 2008 - 2018

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