continuous glucose monitoring in europe: revolutionizing diabetes care

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Continuous Glucose Monitoring in Europe: Revolutionizing Diabetes Care Akanksha Joshi, Senior Research Analyst Healthcare April 22, 2010

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Continuous Glucose Monitoring in Europe: Revolutionizing Diabetes Care

Akanksha Joshi, Senior Research AnalystHealthcare

April 22, 2010

2

Agenda

• Diabetes – A growing concern

• Glucose monitoring

• Continuous Glucose Monitoring

• Market Trends – Growth factors, Restraints

• Market Potential

• Key Focus Points

3

Diabetes – A Growing Concern

As per the International Diabetes Federation, in 2010, the adult population with diabetes is likely to reach 55.2 million in Europe and around 285 million people worldwide will live with diabetes in the same year.

Also the national prevalence rate of diabetes varies from country to country in Europe – 2.1 per cent in Iceland to 12.0 per cent in Germany.

The IDF further indicates that in 2010 the healthcare expenditure on diabetes is likely to be US$ 106 billion in the European region a share of 28 per cent of the global expenditure.

Further it is estimated that 630,000 people would succumb to death due to diabetes in 2010. This number accounts for 11 per cent of deaths in the age group of 20-79.

Source: IDF Diabetes Atlas fourth edition

4

Prevalence percent of Diabetes

0.0

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

9.0

Pe

r c

en

t o

f p

op

ula

tion

Belgium Denmark Finland France Germany Italy LuxembourgNetherlands Norway Spain Sweden United

Kingdom

Country

2009 2012

Germany is the biggest market owing

to the largest diabetic population in

Europe. The diabetic population is

expected to be 7.5 million in 2010.

Source: Frost & Sullivan

5

Glucose Monitoring

An Overview An Overview

•The traditional method of monitoring glucose involves sticking fingerstick to gain access to

glucose. The inconvenience associated with this method makes it difficult for the patient to

maintain tight glycemic level because of the inconvenience involved.

• Episodic monitoring of glucose does not provide information about changes in level of

glucose between two consecutive measurements. Unawareness regarding a patient falling

or rising glycemic level could lead to serious medical condition.

•Continuous Glucose monitoring is of help for patients who have vast fluctuations in their

glycemic level. Using this method the treatment plan of a diabetic can be well adjusted all

through the day. The method also relieves the patient of sticking finger stick and getting rid

of the discomfort caused.

•The traditional method of monitoring glucose involves sticking fingerstick to gain access to

glucose. The inconvenience associated with this method makes it difficult for the patient to

maintain tight glycemic level because of the inconvenience involved.

• Episodic monitoring of glucose does not provide information about changes in level of

glucose between two consecutive measurements. Unawareness regarding a patient falling

or rising glycemic level could lead to serious medical condition.

•Continuous Glucose monitoring is of help for patients who have vast fluctuations in their

glycemic level. Using this method the treatment plan of a diabetic can be well adjusted all

through the day. The method also relieves the patient of sticking finger stick and getting rid

of the discomfort caused.

6

Continuous Glucose Monitoring

A step ahead ..A step ahead ..

•A continuous glucose monitor uses a sensor and transmitter attached to the body that

communicate with a handheld receiver or an insulin pump.

•The calibration of CGM is based on the standard meter. The average number of calibrations

would be two fingertip blood glucose test per 24 hours. Calibrating the CGM on a regular

basis is a must for accurate readings.

•CGM measure glucose in the interstitial fluid so the lag effect seems to be evident when

compared to traditional blood glucose level. CGM is advantageous and accurate as the

glucose level rises in the blood first and then increases in the interstitial fluid.

•A continuous glucose monitor uses a sensor and transmitter attached to the body that

communicate with a handheld receiver or an insulin pump.

•The calibration of CGM is based on the standard meter. The average number of calibrations

would be two fingertip blood glucose test per 24 hours. Calibrating the CGM on a regular

basis is a must for accurate readings.

•CGM measure glucose in the interstitial fluid so the lag effect seems to be evident when

compared to traditional blood glucose level. CGM is advantageous and accurate as the

glucose level rises in the blood first and then increases in the interstitial fluid.

7

Continuous Glucose Monitoring – different technologies involved

Minimally

Invasive

Non – Invasive

Implantable Based on the

Technology

The sensor is placed in the body for minimum period of 6 months to a year. This technology involves a threat from infections during the placement and replacement of sensors. Major issue concerning the research and development team in regards to this technique is the biocompatibility of the sensor.

This technology involves a small

incision in to the body to acquire

blood or Interstitial Fluid (ISF)

through micro channels on the

skin surface. The replacement

period of these sensors varies

from 3 days to 5 days to a

maximum of 7 days. The patient

comfort level is quite low in

treatment for this method.

This technology incorporates optical

methods and the sensor placement

depends on the usage. The accuracy

involved in this approach is debatable

and depends on the size and the optical

method used.

Source: Frost & Sullivan

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In the competition

Company Products

Medtronic Inc. MiniMed Paradigm® Veo™ System

Guardian REAL-Time Continuous

Glucose Monitoring System

Abbott Laboratories Abbott FreeStyle Navigator®

DexCom Inc SEVEN® PLUS

A. Menarini GlucoDay®SSource: Frost & Sullivan

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Integration of insulin pump with the monitoring devices

Awareness regarding diabetes among the people as well as government organisation

Increase in requirement of glucose monitoring devices

Ease of use and better patient comfort likely to spur market growth

Growth Factors: Revolutionising the Market space

Source: Frost & Sullivan

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Roadblocks for the revolution in the CGM Industry

Reimbursement of the device

Clinically benchmarked and affordable technologies available in the market

Lack of awareness and fear of new technology

Reliance on Physicianfor adopting the

technology

Source: Frost & Sullivan

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Market Potential – Glucose Monitoring

....

....

• Market Potential For Blood Glucose Monitoring

• Traditional Blood Glucose Monitors Market

• CGM Market

Total

CGM

Total

SBGM

Market

Potential

Revenue 2009

Per

cent

gro

wth

If the concerns regarding reimbursement

are resolved the CGM market would be

seen replacing the self blood glucose

monitoring market.

The continuous glucose

monitoring market in Europe

has seen increased penetration

in recent times. Competitive

analysis suggests that with the

entry of new market

participants, the dynamics of

the market would change in

2010.

Source : Frost & Sullivan

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Key Focus Points

Source: Frost & Sullivan

Strategic Alliances� Strategic Alliances

� Clinicians Support

� Cost Benefit Evidence

13

Next Steps

� Request a strategic approach document for a Growth Partnership Service or Growth Consulting Service to support you and your team to accelerate the growth of your company.

([email protected]) +44 (0)20 7343 8383

� Join us at our annual Growth, Innovation and Leadership 2010: A Frost & Sullivan Global Congress on Corporate Growth London, United Kingdom

(www.gil-global.com)

� Register for the next Chairman’s Series on Growth:

M&A - Identifying Stealth Opportunities Beneath Your Radar & Other Best Practices

12 May 2010 10:00 AM BST (www.frost.com/growthEU)

� Register for Frost & Sullivan’s Growth Opportunity Newsletter and keep abreast of innovative growth opportunities (www.frost.com/news)

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For Additional Information

Katja Feick

Corporate Communications

Healthcare

0049 (0) 69 7703343

[email protected]

Noel Anderson

European Vice President

New Business Development

+44 (0)207 343 8389

[email protected]

Siddharth Saha

Director of Research

Healthcare

+ 44 (0) 207 343 8374

[email protected]