Oncology Market Leaders – Analyses and Outlook – 2010-2025
Cancer treatment is a global healthcare priority, one with rising therapeutic and commercial importance. Over 20 million new cases of cancer are predicted in 2025, compared with 12 million in 2008 (WHO). Furthermore, anti-cancer drug sales exceeded $50bn worldwide in 2009. The oncology drug market has grown impressively, driven by rising disease prevalence, expanding patient populations and technological advances, especially in biomolecular medicine. Current treatments are better-tolerated, more- effective and more-commercially-successful than ever before, our latest report shows.
The aging of populations, lifestyle changes in the developing world, together with significant advances in pharmacotherapy and diagnostics, will drive the cancer treatments market from 2010 onwards. Increasing disease prevalence and a strong R&D pipeline make the anti-cancer sector dynamic and highly promising for pharmaceutical and biotechnology companies worldwide. Our new report, Oncology Market Leaders – Analyses and Outlook – 2010-2025, explains why and to what extent, revealing where the most-exciting and lucrative developments will lie from 2010 onwards. There, you will find detailed sales predictions and supporting discussions.
This report examines commercial prospects for the following therapy types in particular:
• Traditional cytotoxic chemotherapies
• Hormone therapies
• Immunotherapies
• Novel antineoplastic drugs.
What new agents are likely to enter the cancer treatments market from 2010 onwards? Do they hold the potential to dominate this market area? What issues are shaping the anti-cancer market? Where will the best commercial opportunities lie from 2010 onwards? What are the most-crucial drivers and restraints in the cancer treatments sector? This report will provide you with the information that you need to understand current trends and future commercial possibilities there. In particular, Oncology Market Leaders – Analyses and Outlook – 2010-2025 analyses sales prospects for the following products:
• Avastin
• MabThera
• Herceptin
• Glivec/Gleevec
• Taxotere
• Eloxatin
• Arimidex
• Gemzar
• Erbitux
• Alimta
Also included is analysis of the leading companies in the anti-cancer drug sector. There, we discuss major portfolio and pipeline products, as well as their future therapeutic and commercial prospects.
Comprehensive analysis of the oncology market sector
Oncology Market Leaders – Analyses and Outlook – 2010-2025 examines the cancer treatments market critically, through a comprehensive review of information sources. We harness both primary and secondary research. This report provides detailed sales forecasts, market share analyses, discussions of pipeline developments and analyses of commercial drivers and restraints, including SWOT analyses. The report contains over 140 tables and figures, as well as three full interviews with relevant authorities. You will discover a comprehensive market- and industry-centred study, one with detailed analyses and informed opinion to benefit your work.
Why you should buy Oncology Market Leaders – Analyses and Outlook – 2010-2025
This report will provide you with the following benefits, in particular:
• You will assess the current market for pharmacological cancer treatments
• You will review the overall anti-cancer drug market, including our global sales forecast for 2010 to 2025, and a geographical breakdown of relevant sales revenues
• You will receive our sales forecasts for the leading therapy classes from 2010 to 2025, with detailed discussions
• You will receive our sales forecasts for the leading products in this market from 2010 to 2025, with detailed discussions of market potential and competition
• You will obtain informed analyses of the leading companies’ portfolios, pipelines and commercial prospects in the sector
• You will examine commercial drivers and restraints in depth, exploring their significance from 2010 onwards
• You will discover the most-exciting R&D pipeline developments in the sector, with informed commentary
• You will read expert opinions from our original survey of the sector, with contributions from industry and academia
• You will view discussion of under-met needs in cancer treatment.
Table of Contents
1. Executive Summary
2. The Global Burden of Cancer
- 2.1 The Impact of Cancer
- 2.2 Incidence: Which Cancers Are The Most Commonly Diagnosed?
- 2.3 Mortality: Which Cancers Kill the Most People?
- 2.3.1 The Developed World
- 2.3.2 The Developing World
3. The Physiology of Cancer and the Pharmacology of Treatments
- 3.1 Uncontrolled Growth
- 3.1.1 Oncogenes and Tumour Suppressor Genes
- 3.1.2 Immortality
- 3.1.3 Apoptosis
- 3.1.4 Angiogenesis
- 3.1.5 Dedifferentiation
- 3.1.6 Invasiveness and Metastasis
- 3.2 Treating Tumours
- 3.3 Chemotherapy
- 3.4 Traditional Antineoplastics
- 3.4.1 Alkylating Agents
- 3.4.1.1 Traditional Alkylating Agents
- 3.4.1.2 Platinum Compounds
- 3.4.2 Antimetabolites
- 3.4.3 Plant Derivatives
- 3.4.4 Cytotoxic Antibiotics
- 3.4.5 Adjuvant Therapies
- 3.5 Novel Antineoplastics
- 3.5.1 Monoclonal Antibodies
- 3.5.2 Kinase Receptor Antagonists
- 3.5.3 Other Novel Antineoplastics
- 3.6 Hormone Therapies
- 3.7 Immunotherapies
4. The Global Cancer Drug Market, 2010-2025
- 4.1 The Scope of this Report
- 4.1.1 Drugs Excluded from this Report
- 4.2 The Worldwide Oncology Market
- 4.3 Oncology Revenues by Geographical Area
- 4.4 Leading Markets and Emerging Markets
- 4.4.1 The Seven Leading Markets
- 4.4.2 The Five Emerging Markets
- 4.5 Oncology Market Break-Down by Category
- 4.5.1 Oncology Market Break-Down by Mechanism of Action
- 4.6 Oncology Market Sales Forecast, 2010-2025
- 4.7 Traditional Antineoplastics
- 4.7.1 Sales Forecast for Traditional Antineoplastics, 2010-2025
- 4.8 Novel Antineoplastics
- 4.8.1 Sales Forecast for Novel Antineoplastics, 2010-2025
- 4.9 Hormone Therapies
- 4.9.1 Sales Forecast for Hormone Therapies, 2010-2025
- 4.10 Immunotherapies
- 4.10.1 Sales Forecast for Immunotherapy Market, 2010-2025
- 4.11 How Market Shares of Each Category will Change, 2010-2025
5. The Market Leaders: Top Ten Anti-Cancer Drugs
- 5.1 The Costs of The Top Ten Drugs
- 5.2 Important Notes on the Top Ten Drugs
- 5.3 Avastin (bevacizumab) - Roche
- 5.3.1 Overview
- 5.3.2 Recent Performance
- 5.3.3 Forecast
- 5.3.4 Comment
- 5.4 MabThera (rituxamab) – Roche
- 5.4.1 Overview
- 5.4.2 Recent Performance
- 5.4.3 Forecast
- 5.4.4 Comment
- 5.5 Herceptin (trastuzumab) - Roche
- 5.5.1 Overview
- 5.5.2 Recent Performance
- 5.5.3 Forecast
- 5.5.4 Comment
- 5.6 Glivec/Gleevec (imatinib) - Novartis
- 5.6.1 Overview
- 5.6.2 Recent Performance
- 5.6.3 Forecast
- 5.6.4 Comment
- 5.7 Taxotere (docetaxel) - Sanofi-Aventis
- 5.7.1 Overview
- 5.7.2 Recent Performance
- 5.7.3 Forecast
- 5.7.4 Comment
- 5.8 Eloxatin (oxaliplatin) - Sanofi-Aventis
- 5.8.1 Overview
- 5.8.2 Recent Performance
- 5.8.3 Forecast
- 5.8.4 Comment
- 5.9 Arimidex (anastrazole) - AstraZeneca
- 5.9.1 Overview
- 5.9.2 Recent Performance
- 5.9.3 Forecast
- 5.9.4 Comment
- 5.10 Gemzar (gemcitabine) - Eli Lilly
- 5.10.1 Overview
- 5.10.2 Recent Performance
- 5.10.3 Forecast
- 5.10.4 Comment
- 5.11 Erbitux (cetuximab) - Eli Lilly/BMS/Merck KGaA
- 5.11.1 Overview
- 5.11.2 Recent Performance
- 5.11.3 Forecast
- 5.11.4 Comment
- 5.12 Alimta (pemetrexed) - Eli Lilly
- 5.12.1 Overview
- 5.12.2 Recent Performance
- 5.12.3 Forecast
- 5.12.4 Comment
6. The Market Leaders: The Top Five Companies
- 6.1 Roche
- 6.1.1 Key Oncology Products
- 6.1.2 Pipeline
- 6.1.3 Comment
- 6.2 Novartis
- 6.2.1 Key Oncology Products
- 6.2.2 Pipeline
- 6.3 Sanofi-Aventis
- 6.3.1 Key Oncology Products
- 6.3.2 Pipeline
- 6.3.3 Comment
- 6.4 AstraZeneca
- 6.4.1 Key Oncology Products
- 6.4.2 Pipeline
- 6.4.3 Comment
- 6.5 Eli Lilly
- 6.5.1 Key Oncology Products
- 6.5.2 Pipeline
- 6.5.3 Comment
7. Major Issues Shaping the Oncology Drugs Market
- 7.1 SWOT Analysis of the Oncology Market, 2010-2025
- 7.2 The Main Factors Driving the Growth of the Oncology Market
- 7.2.1 High Profile
- 7.2.2 The Price of Drugs
- 7.2.3 Patient Power
- 7.2.4 Incremental Improvements in Treatment in the Absence of a Complete Cure
- 7.2.5 Effect of Generics
- 7.2.6 Drug Development
- 7.2.7 Live Licensing
- 7.2.8 Increase in Cancer Incidence
- 7.2.8.1 Aging Populations
- 7.2.8.2 Smoking
- 7.2.8.3 Dietary Trends in Industrialised Nations
- 7.2.8.4 Obesity
- 7.2.9 The Developing World
- 7.2.9.1 Industrialisation
- 7.2.9.2 The Emerging Middle Class
- 7.2.9.3 Diseases of Affluence
- 7.2.9.4 Prioritisation by Individuals
- 7.2.9.5 Informed Populations
- 7.2.9.6 Prioritisation by Governments
- 7.2.10 Screening and Diagnosis
- 7.2.11 Understanding Cancer Physiology
- 7.2.12 Personalised Medicine
- 7.2.13 Drug Delivery Systems
- 7.2.14 Nanotechnology
- 7.2.14.1 Diagnostics
- 7.2.14.2 Drug Delivery
- 7.2.14.3 Surgery
- 7.2.15 Off-Label Prescriptions
- 7.3 The Main Factors Restraining the Growth of the Oncology Market
- 7.3.1 The Cost-Effectiveness Debate
- 7.3.2 Governmental Payers and the Maximum Cost of Drugs
- 7.3.2.1 Healthcare Reform in the US
- 7.3.2.2 The Implications of Price-Capping Cancer Drugs
- 7.3.2.3 A Two-Tier System?
- 7.3.3 Pricing-Out the Developing World?
- 7.3.4 Risk Sharing
- 7.3.5 Research Bias and 'Me-Too' Drugs?
- 7.3.6 Public Health Initiatives
- 7.3.7 Efficacy, Toxicity and Alternative Treatments
- 7.3.8 The Patent Cliff
- 7.4 Unmet Needs in the Oncology Market
- 7.4.1 Tolerable Drugs
- 7.4.2 Convenient Drugs
- 7.4.3 Shift in Perceptions for the Goal of Cancer Treatment
- 7.4.4 Tumour Resistance
- 7.4.5 Greater Use of Pharmacogenomics
- 7.4.6 A Comprehensive Database of Biomarkers
- 7.4.7 Rigorous Endpoints in Clinical Trials
- 7.4.8 Is There a Research Bias?
- 7.4.9 Early Detection
- 7.4.10 Over-Treatment and Active Surveillance
- 7.4.11 Access to Treatment in Developing Nations
8. Interviews with Relevant Experts
- 8.1 Dr Hilmar Warenius
- 8.1.1 Current Work
- 8.1.2 Heterogeneity of Tumours
- 8.1.3 Normal Gene Products
- 8.1.4 Diagnostics and Pharmacogenomics
- 8.1.5 The Efficacy of New Treatments
- 8.1.6 Targeted Antineoplastics and Traditional Chemotherapy
- 8.1.7 Vaccines and Screening
- 8.1.8 Therapeutic Vaccines
- 8.1.9 Conclusions
- 8.2 Dr Howard McLeod
- 8.2.1 The Importance of Pharmacogenomics
- 8.2.2 Drivers
- 8.2.3 Restraints
- 8.2.4 Effective Drugs Missed by Clinical Trials
- 8.2.5 Major Breakthroughs
- 8.2.6 One Size Fits All?
- 8.2.7 Blood Tests
- 8.2.8 Ethics
- 8.3 Dr Lawrence Tamarkin
- 8.3.1 Impact of Nanotechnology on Oncology
- 8.3.1.1 Cancer as a Lifetime Chronic Condition
- 8.3.1.2 The Developing World
- 8.3.2 Timeframes
- 8.3.3 Difficulties and Limits
- 8.3.4 Further Applications
- 8.3.5 Drivers
- 8.3.6 Public Relations
9. Conclusions
- 9.1 Cancer Will Become an Even More Important Healthcare Priority, Especially in the Developing World
- 9.2 Of the Wide Range of Oncology Treatments Available, Novel Therapies are Most Important
- 9.3 The Global Oncology Market Will Continue to Achieve Strong Growth
- 9.4 The US Oncology Market Leads
- 9.5 In Terms of Revenue, Monoclonal Antibodies Dominate the Oncology Market
- 9.6 The Top Ten Drugs Owe Their Successes to Different Factors
- 9.7 Will Roche Continue to Lead the Global Anti-Cancer Drugs Market?
- 9.8 The Most Important Drivers of the Oncology Market
- 9.9 The Greatest Restraint on the Oncology Market
- 9.10 The Greatest Unmet Need in Cancer Treatment and Concluding Remarks
List of Tables
- Table 2.1 Leading Causes of Death Worldwide, 2008
- Table 2.2 Cancer Incidence and Mortality, 2008-2025
- Table 2.3 The Ten Most Common Cancers by Incidence, 2008
- Table 2.4 Five-Year Survival Rates of Nine Cancers in the UK
- Table 3.1 Categories of Oncology Drug, 2010
- Table 3.2 Common Side-Effects of Traditional Antineoplastic Chemotherapy
- Table 4.1 Global Pharmaceutical Sales by Disease Area, 2009
- Table 4.2 Oncology Drug Sales by Region, 2009
- Table 4.3 Comparison of the Oncology Revenues of the Seven Leading Markets and Five Emerging Markets, 2009
- Table 4.4 Comparison of the Oncology Revenues of the US, Six Other Leading Markets and Five Emerging Market Groups, 2009
- Table 4.5 The Seven Leading National Markets: Oncology Sales, 2009
- Table 4.6 The Five Emerging Markets: Oncology Sales, 2009
- Table 4.7 Oncology Market by Therapy Type: World Sales, 2009
- Table 4.8 Oncology Market Break-Down by Mechanism of Action: World Sales and Market Shares, 2009
- Table 4.9 Oncology Drug Market: World Sales Forecast, 2010-2025
- Table 4.10 Oncology R&D Pipelines by Category, 2009
- Table 4.11 Traditional Antineoplastics: World Sales and Market Shares by Category, 2009
- Table 4.12 Traditional Antineoplastics Market: World Sales Forecast, 2010-2025
- Table 4.13 Novel Antineoplastics Market Categories: World Sales and Market Shares, 2009
- Table 4.14 Novel Antineoplastics Market: World Sales Forecast, 2010-2025
- Table 4.15 Hormone Therapy Subtypes: World Sales and Market Shares, 2009
- Table 4.16 Hormone Therapy Market: World Sales Forecast, 2010-2025
- Table 4.17 Immunotherapy Subtypes: World Sales, 2009
- Table 4.18 Immunotherapy Market: World Sales Forecast, 2010-2025
- Table 4.19 Overall Categories: Market Shares, 2010-2025
- Table 5.1 The Top Ten Oncology Drugs Ranked by Total World Sales, 2009
- Table 5.2 Costs of the Top Ten Anti-Cancer Drugs in the UK, 2009
- Table 5.3 Avastin Sales Information, 2009
- Table 5.4 Avastin Approvals, 2009
- Table 5.5 Potential Indications for Avastin, 2009
- Table 5.6 Avastin World Sales, 2005-2009
- Table 5.7 Avastin World Sales Forecast, 2010-2025
- Table 5.8 SWOT Analysis for Avastin, 2010
- Table 5.9 MabThera Sales Information, 2009
- Table 5.10 MabThera Approvals, 2009
- Table 5.11 MabThera World Sales 2005-2009
- Table 5.12 MabThera World Sales Forecast, 2010-2025
- Table 5.13 SWOT Analysis for MabThera, 2010
- Table 5.14 Herceptin Sales Information, 2009
- Table 5.15 Potential Indications for Herceptin, 2009
- Table 5.16 Herceptin World Sales, 2005-2009
- Table 5.17 Herceptin World Sales Forecast, 2010-2025
- Table 5.18 SWOT Analysis for Herceptin, 2010
- Table 5.19 Glivec/Gleevec Sales Information, 2009
- Table 5.20 Glivec/Gleevec Approvals, 2009
- Table 5.21 Glivec/Gleevec World Sales, 2005-2009
- Table 5.22 Glivec/Gleevec World Sales Forecast, 2010-2025
- Table 5.23 SWOT Analysis for Glivec/Gleevec, 2010
- Table 5.24 Taxotere Sales Information, 2009
- Table 5.25 Taxotere Approvals, 2009
- Table 5.26 Taxotere World Sales, 2005-2009
- Table 5.27 Taxotere World Sales Forecast, 2010-2025
- Table 5.28 SWOT Analysis for Taxotere, 2010
- Table 5.29 Eloxatin Sales Information, 2009
- Table 5.30 Eloxatin World Sales, 2005-2009
- Table 5.31 Eloxatin World Sales Forecast, 2010-2025
- Table 5.32 SWOT Analysis for Eloxatin, 2010
- Table 5.33 Arimidex Sales Information, 2009
- Table 5.34 Arimidex World Sales, 2005-2009
- Table 5.35 Arimidex World Sales Forecast, 2010-2025
- Table 5.36 SWOT Analysis for Arimidex, 2010
- Table 5.37 Gemzar Sales Information, 2009
- Table 5.38 Gemzar Approvals, 2009
- Table 5.39 Potential Indications for Gemzar, 2009
- Table 5.40 Gemzar World Sales, 2005-2009
- Table 5.41 Gemzar World Sales Forecast, 2010-2025
- Table 5.42 SWOT Analysis for Gemzar, 2010
- Table 5.43 Erbitux Sales Information, 2009
- Table 5.44 Marketing of Erbitux: Revenue Split, 2009
- Table 5.45 Erbitux Approvals, 2009
- Table 5.46 Potential Indications for Erbitux, 2009
- Table 5.47 Erbitux World Sales, 2005-2009
- Table 5.48 Erbitux World Sales Forecast, 2010-2025
- Table 5.49 SWOT Analysis for Erbitux, 2010
- Table 5.50 Alimta Sales Information, 2009
- Table 5.51 Alimta Approvals, 2009
- Table 5.52 Potential Indications for Alimta, 2009
- Table 5.53 Alimta World Sales, 2005-2009
- Table 5.54 Alimta World Sales Forecast, 2010-2025
- Table 5.55 SWOT Analysis for Alimta, 2010
- Table 6.1 The Top Five Oncology Companies: Relevant World Sales, 2009
- Table 6.2 Roche’s Oncology Revenue, 2009
- Table 6.3 Key Products in Roche’s Oncology Portfolio: World Sales, 2009
- Table 6.4 Roche’s Oncology Pipeline, 2009
- Table 6.5 Novartis’ Oncology Revenue, 2009
- Table 6.6 Key Products in Novartis’ Oncology Portfolio: World Sales, 2009
- Table 6.7 Novartis’ Oncology Pipeline, 2009
- Table 6.8 Sanofi-Aventis’ Oncology Revenue, 2009
- Table 6.9 Key Products in Sanofi-Aventis’ Oncology Portfolio: World Sales, 2009
- Table 6.10 Sanofi-Aventis’ Oncology Pipeline, 2009
- Table 6.11 AstraZeneca’s Oncology Revenue, 2009
- Table 6.12 Key Products in AstraZeneca’s Oncology Portfolio: World Sales, 2009
- Table 6.13 AstraZeneca’s Oncology Pipeline, 2009
- Table 6.14 Eli Lilly’s Oncology Revenue, 2009
- Table 6.15 Key Products in Eli Lilly’s Oncology Portfolio: World Sales, 2009
- Table 6.16 Eli Lilly’s Oncology Pipeline, 2009
- Table 7.1 SWOT Analysis of the Global Anti-Cancer Drugs Market, 2010-2025
- Table 7.2 The Importance of Personalised Medicine in Oncology
- Table 7.3 Disadvantages of Intravenous Chemotherapy
- Table 7.4 Disadvantages of Oral Administration
- Table 7.5 How the NCI Allocated its Cancer Research Budget in 2008
- Table 7.6 Estimated GDP per Capita for BRICT and the US, 2010-2025
List of Figures
- Figure 2.1 Global Cancer Incidence and Mortality, 2010-2025
- Figure 2.2 The Ten Most Common Cancers by Incidence, 2008
- Figure 2.3 Five-Year Survival Rates of Nine Cancers in the UK
- Figure 4.1 Oncology Drug Sales by Region, 2009
- Figure 4.2 Oncology Market Shares of the Seven Major Markets and Five Emerging Markets, 2009
- Figure 4.3 Comparison of the Oncology Revenues of the US, Six Other Leading Markets and Five Emerging Market Groups, 2009
- Figure 4.4 The Seven Leading National Markets: Market Shares, 2009
- Figure 4.5 The Five Emerging Markets: Market Shares, 2009
- Figure 4.6 Oncology Market by Therapy Type: Market Shares, 2009
- Figure 4.7 Oncology Drug Market: World Sales Forecasts, 2010-2025
- Figure 4.8 Traditional Antineoplastics: World Sales and Market Shares, 2009
- Figure 4.9 Traditional Antineoplastics Market: World Sales Forecast, 2010-2025
- Figure 4.10 Novel Antineoplastics Market Categories: Market Shares, 2009
- Figure 4.11 Novel Antineoplastics Market: World Sales Forecast, 2010-2025
- Figure 4.12 Hormone Therapy Subtypes: World Sales and Market Shares, 2009
- Figure 4.13 Hormone Therapy Market: World Sales Forecast, 2010-2025
- Figure 4.14 Immunotherapy Subtypes: Market Shares, 2009
- Figure 4.15 Immunotherapy Market: World Sales Forecast, 2010-2025
- Figure 4.16 Overall Categories: Market Shares, 2010-2025
- Figure 5.1 Top Ten Drugs by Category and Subcategory, 2009
- Figure 5.2 Costs of the Top Ten Anti-Cancer Drugs in the UK, 2009
- Figure 5.3 Avastin World Sales Forecast, 2010-2025
- Figure 5.4 MabThera World Sales Forecast, 2010-2025
- Figure 5.5 Herceptin World Sales Forecast, 2010-2025
- Figure 5.6 Glivec/Gleevec World Sales Forecast, 2010-2025
- Figure 5.7 Taxotere World Sales Forecast, 2010-2025
- Figure 5.8 Eloxatin World Sales Forecast, 2010-2025
- Figure 5.9 Arimidex World Sales Forecast, 2010-2025
- Figure 5.10 Gemzar World Sales Forecast, 2010-2025
- Figure 5.11 Marketing of Erbitux: Revenue Split, 2009
- Figure 5.12 Erbitux World Sales Forecast, 2010-2025
- Figure 5.13 Alimta World Sales Forecast, 2010-2025
- Figure 6.1 Top Five Companies: Relevant Market Shares, 2009
- Figure 6.2 How Oncology Products Contributed to Roche’s Pharmaceutical Revenue, 2009
- Figure 6.3 Key Products in Roche’s Oncology Portfolio by Share of Oncology Revenue, 2009
- Figure 6.4 How Oncology Products Contributed to Novartis’ Pharmaceutical Revenue, 2009
- Figure 6.5 Key Products Novartis’ Oncology Portfolio by Share of Oncology Revenues, 2009
- Figure 6.6 How Oncology Products Contributed to Sanofi-Aventis’ Pharmaceutical Revenue, 2009
- Figure 6.7 Key Products in Sanofi-Aventis’ Oncology Portfolio by Share of Oncology Revenue, 2009
- Figure 6.8 How Oncology Products Contributed to AstraZeneca’s Pharmaceutical Revenue, 2009
- Figure 6.9 Key Products in AstraZeneca’s Oncology Portfolio by Share of Oncology Revenue, 2009
- Figure 6.10 How Oncology Products Contributed to Eli Lilly’s Pharmaceutical Revenue, 2009
- Figure 6.11 Key Products in Eli Lilly’s Oncology Portfolio by Share of Oncology Revenue, 2009
- Figure 7.1 NCI Research Spend, Incidence and Mortality for Different Cancers
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