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Extending its line of therapeutic class research, NOP World Health has added Diabetes Patient Market Study to its portfolio of disease state research. The staff of diabetes experts who support the study, which has been produced by NOP World Health’s sister com pany, RoperASW since 1989, will be integrated into Market Mea sures/Cozint, one of the three healthcare research leaders that comprise NOP World Health. The Diabetes Patient Market Study is the latest addition to Mar ket Measures/Cozint’s line of thera peutic class research, conducted with physicians, patients, and man agedcare executives across more than 50 disease categories. “RoperASW’s Diabetes Patient Market Study has been the industry’s gold standard for understanding every facet of diabetes — from patient attitudes and demographics to product usage and sources of care — for 13 years,”says Elaine Riddell,CEO of NOPWorld Health.“By bringing it under the NOP World Health banner, we will supplement the RoperASW diabetes group with a full team of knowledge leaders across a diverse range of therapeutic categories, enabling us to expand the study into other major disease areas. “Within the year, we will have Patient Market Studies available in both the asthma and the choles terollowering classes — providing the same world wide view of patient perceptions, treatment pat terns and market trends that the industry has come to depend on in our diabetes report,” she says. “Clients will benefit from an expanding suite of glob al patient studies that helps them strengthen their competitive positions, uncover new opportunities, and strengthen marketing and communication strategies in the categories most important to their businesses.” The 2002 U.S. Diabetes Patient Market Study — conducted from August through October 2001 — is based on a nationally representative sample of 2,000 diagnosed patients, and covers all types of diabetes. Results can be compared with findings from Dia betes Patient Market Studies in other major regions around the world — including Europe,Canada,Latin America,and the Asia Pacific — for a complete glob al perspective. David Jacobson, Ph.D, VP and director of the Roper Global Diabetes Program, spoke to Phar maVOICE about some of the key findings in the study. “The size of the diabetes population in the U.S. is 10.7 million and is growing at approximately 7.5% overall based on 2001 figures,” says Dr. Jacobson, who pulled the study together. “One of the biggest findings was a dramatic change in therapy, with the PHARMA TRAX SALES, MARKETING, AND R&D TRENDS AFFECTING THE HEALTHCARE INDUSTRY Diabetes Patient Market Study JOINS NOPWORLDHEALTH PORTFOLIO Growth in DEVICESTO OUTPACE DRUGS in CHF Market The market for medical devices designed to address congestive heart failure (CHF) is growing at an explosive rate in all major healthcare markets, according to a study from Kalorama Information.The device sector is expanding at nearly three times the rate of the pharmaceutical sector, which is expand ing at about 10% . The study — Congestive Heart Failure: World wide Pharmaceutical and Medical Device Markets — predicts that the growing prevalence of this cost ly disease, estimated to be more than $38 billion in the U.S alone, and the remarkable technological breakthroughs in device technology will only accel erate this trend for the next few years. “With the expanded use of devices, such as left ventricular assist devices, the available market will increase significantly,” predicts Ken Kruhl, Ph.D., an analyst for Kalorama and author of the study. “ This means more money to go around, and that attracts competition.” Despite less aggressive growth,though,pharmaceuti cal treatments still will account for the larger share of the CHF therapeutic market for the foreseeable future.Furthermore,the pharmaceu tical market will continue to be dominated by the major pharmaceutical companies already serving this category. “There appears to be little interest in standard pharmaceuticals for CHF outside big phar ma,”Dr. Kruhl says. exclusive use of oral therapy rising to 54% in 2001 from 48% in 2000.” A troubling find ing, Dr. Jacobson says, is the proportion of U.S. patients who are morbidly obese. “We found that 24% of U.S. diabetes patients are morbidly obese, and for comparison purposes, in our 2000 Western Europe study, we found that 9% of the diabetes population was morbidly obese,” he explains. “ This is a serious problem in the U.S., and it correlates, unfortunately, with a high prevalence of cardiovascular disease among diabetes patients.” Obesity is far more common with patients suf fering fromType 2 diabetes,and patients withType 1 diabetes are more likely to be underweight than Type 2 patients, Dr. Jacobson explains. But he adds that only 7% of the diagnosed diabetes population is Type 1. Companies can choose to purchase the entire study package or individual sections. Dr. David Jacobson, VP and director of Roper Global Diabetes Program, says the U.S. diabetes population is growing at about 7.5%. The size and growth of the overall market,as well as of key treatment segments, such as insulin,oral antidiabetic agents (OAAs),diet only and blood glucose selfmonitoring Multiyear trending of market expansion and diabetes care patterns Detailed daily therapeutic and monitoring behavior, including types and volume of insulin used,brands of OAAs,and blood glucose monitoring frequency Manufacturer and brand competitive positions Product/brand switching behavior Patient attitudes toward the control and management of diabetes Sources of care and condition information The doctor/patient relationship — including the extent to which patients influence or initiate changes in care Diabetes prevalence and proportion of Type 1 and Type 2 patients The relationship between testing, mealtime, and insulin and/or OAA dosing Patient characteristics, including age when diagnosed, body mass index (BMI), concomitant conditions, sex,education, employment status,marital status, income, ethnicity, Internet usage, and insurance coverage DIABETES PATIENTMARKET STUDYPROVIDES INSIGHTTO: PHARMA trax 89 PharmaVOICE M a y / J u n e 2 0 02 Disease Managers Say Spending on Prescription Drugs REDUCES INPATIENT COSTS Diseasemanagement organizations, represent ing more than half of the people in the U.S. partici pating in diseasemanagement programs, say increased spending on prescription drugs reduces hospital inpatient costs, according to the Tufts Cen ter for the Study of Drug Development. “Since prescription drugs account for less than 10% of total current U.S. healthcare spending, while inpatient care accounts for 32%,the increased use of appropri ate pharmaceutical therapies may help moderate or even reduce growth in the costliest component of the U.S. healthcare system,” says Kenneth I. Kaitin,director,Tufts Center. According to the Tufts Center study, 42% of dis ease managers surveyed claimed that increased pharmaceutical spending leads to netcost savings across cost components. Another 21% said increased drug spending leads to greater total healthcare costs, while 37% said increased drug spending has no effect on total healthcare spending. Separately, 75% of those participating in the sur vey said increased drug use increases outpatient and physician costs while lower ing inpatient costs. The Tufts Center survey cov ered 19 of the 25 leading disease management organizations in the U.S., representing 55% of the 1.5 million people covered by dis easemanagement programs. Mr. Kaitin notes that use of pharmaceuticals is likely to grow in the Medicare program, where many beneficiaries suffer from multiple, chronic diseases. Medi care accounts for about 17% of total U.S. healthcare spending and about 60% of total U.S. spending on chronic care. The Tufts Center survey, the second in the past two years to focus on disease management organizations, also found that feefor service contracts, the least risky contract type used by disease managers, account for more than two thirds (68%) of payment plans, reflecting the indus try’s move away from capitated contracts. Disease management, as practiced in the U.S., seeks to manage and improve the health status of a carefully defined patient population over the entire course of a disease. It often targets highrisk, high cost patients with chronic conditions whoseoptimal treatment depends on appropriate medication use. Longitudinal Prescription Data Gives Users KEY INSIGHTS Into PRODUCTUSE A comprehensive new source of longitudinal prescription data,available from IMS Health,provides insights into U.S.physician prescribing dynamics and patient group profiles over time. Revealing detailed information about physicians’ switching behaviors, new therapy starts, firstline and secondline therapy decisions, and many other details, IMS’ longitudinal data help pharmaceutical companies build more effective strategies for reaching target physicians. “Longitudinal data are an important competitive edge for drug companies,helping them understand not only what is happening with their drugs,but also why it’s happening,” says Gary Noon,president, IMS U.S. “IMS will leverage these data to create exciting, innovative new solutions that help our clients address their most critical marketing and sales chal lenges.” The data provide some perspective on prescrip tions that previously was unknown. “ The vast majority of new prescriptions for most products are simply new refills,” says Bill Henderson, marketing group director at IMS. “For example, If there are 100 new prescriptions in the proton pump inhibitor (PPI) market, 50 may be a prescription refill. But the other 50 may be very significant. In the PPI market there is a lot of switching, so data could be useful to know which of those prescriptions were switched from one product to another. “Pharmaceutical companies or physicians using the data also will be able to find out details about concomitant therapy,” Mr. Henderson continues. “It’s impor tant for doctors or drug compa nies to know whether patients are on other medications, such as therapies for highblood pressure and high cholesterol. Some com panies are coming up with prod ucts that are dual therapy and using the data available they can see how many patients are on two drugs that could be replaced with a single treatment.The data enable companies to really get beneath the surface and see what’s happening on the prescriptionside of the business.” In addition to fueling new solutions, longitudinal data are expected to be integrated into many of the company’s leading marketing effectiveness and salesmanagement solutions, as well as new Web based applications and custom consulting projects. The IMS longitudinal data source is based on mil lions of deidentified prescription and physician records received from retail pharmacy and pharma cy benefit manager channels. By the end of 2002, IMS expects its longitudinal data to cover more than 40% of the U.S. pharmaceutical market. “Our primary goal is to make this strategic new information immediately useful to all of our cus tomers, regardless of their size,” Mr. Henderson says. “By infusing longitudinal data into our existing solu tions and consulting offerings, we’re able to offer this valuable information in a format familiar to sales managers, product managers, and market researchers for instant impact.” Several major pharmaceutical firms began receiving IMS longitudinal data in late 2001, and today the information is available to clients through IMS Global Consulting. In upcoming months, the data will be integrated into an easytouse, Webbased query tool for mar keting effectiveness applications and into popular IMS sales optimization services such as IMS Ear lyView, which delivers actionable, prescriberlevel insights directly to pharmaceutical field representa tives’ laptops. Separately, IMSHealth has announced an alliance with subsidiary firm CognizantTechnology Solutions — a provider of custom software development, inte gration and application management services — to help pharmaceutical companies better leverage their technology and data investments to support sales, marketing, and clinical activities. The alliance combines IMS’ pharmaceutical industry consulting expertise with Cognizant’s tech nical strengths and manpower to deliver clienttai lored technology solutions. The IMS information management consulting team helps pharmaceutical companies refine and improve their sales and marketing IT infrastructures, ensuring a strategic alignment between their busi ness goals and their information systems and pro cesses.Through the Cognizant alliance, IMS can offer a more complete range of tailored consulting and technology solutions. Among the solutions are diagnostic assess ments, data warehousing, integration of internal client and sales management systems with IMS ser vices, and implementation of complete software packages such as SAP, Oracle, and Siebel. PHARMACEUTICAL SALES:DoubleDigit Growth for Sixth Consecutive Year NDCHealth,a health information services compa ny, has unveiled its 2001 yearinreview data for the pharmaceutical industry — PharmaTrends 2001, which offers a comprehensive view of sales and pur chasing trends. The report provides insight into drugpurchasing patterns, including the impact of September11relat ed terrorist threats. It delivers historical analyses of 2001 sales against those of previous years and pro files the industry’s leading products and companies, 42% of disease managers say increased pharmceuti cal spending leads to net cost savings across cost components 37% say increased drug spending has no effect on total healthcare spending 21% of disease manages say increased spending leads to greater total healthcare costs DISEASE MANAGERSON HEALTHCARE COSTS PHARMA trax as well as launches,drug approvals,patent expirations and research and development.The report also cov ers merger and acquisitions over the year, and explores managed care. “PharmaTrends 2001 presents comprehensive sales data important to decisionmaking in the phar maceutical manufacturing and investment communities,” com ments Walter M.Hoff,president and CEO of NDCHealth. “We’re pleased to deliver PharmaTrends 2001 as a valuable and timely information resource. We think PharmaTrends will help to drive the rapid dissemi nation of knowledge to the indus try at large. We intend for Pharma Trends to be the premier source for leadingedge data on prescription sales, purchasing trends, and other industryshaping events.” In its research into the impact of September 11, the study finds some increase in antianxiety med ications and sleep aids in the month following the attacks, level ing out thereafter.Use of antibiotics rose in October, with use of Cipro peaking during that month before declining sharply. Among the key market events, according to the report, were that 2001 saw a sixth consecutive year of doubledigit growth, with total pharmaceutical sales reaching $207.9 billion, a 17.9% increase over 2000 sales of $176.4 billion. Other sig nificant findings were that promotion spending slowed — rising just 5.9% to $12.5 billion in 2001 com pared with a rise of 19.2% to $11.8 billion in 2000 — Medicare remained at a standstill,Prozac went gener ic, dropping sharply from fourth place in terms of total sales to 10th place. Pfizer’s Lipitor, meanwhile, snagged the No. 1 product spot from AstraZeneca’s Prilosec. Of the newly launched products for 2001, Glaxo