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Viscosupplementation - US Analysis and Market Forecasts

Summary

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.

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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.

Table Of Contents

Viscosupplementation - US Analysis and Market Forecasts
1 Table of Contents
1.1 List of Tables
1.2 List of Figures
2 Introduction
2.1 Catalyst
2.2 Related Reports
3 Treatment Modalities Overview
3.1 Treatment Paradigm
3.1.1 Physical Therapies
3.1.2 Medications
3.1.3 Hyaluronic Acid Viscosupplementation
3.1.4 Surgical Intervention
4 Industry Overview
4.1 Procedural Trends
4.1.1 Overview
4.1.2 US
4.2 Market Access
4.2.1 US
4.3 Reimbursement
4.3.1 US
4.4 Mergers and Acquisitions/Key Partnerships
4.4.1 Meda AB Acquires Rottapharm|Medaus for $3.1 Billion (October 2014)
4.4.2 Founders of Anteis Establish Aptissen (March 2014)
4.4.3 Bioventus Acquires Durolane Assets from Galderma (February 2014)
4.4.4 Zimmer to Combine with Biomet in a Transaction Valued at $13.35 Billion (April 2014)
4.4.5 Johnson and Johnson Acquires Synthes for $19.7 Billion (June 2012)
5 Market Drivers, Opportunities, and Barriers
5.1 Driver: Rising Prevalence of OA
5.2 Driver: Multimodal Treatment Paradigm for OA
5.3 Driver: Viscosupplementation Delays Total Knee Replacement
5.4 Driver: Side Effects of NSAIDs, Corticosteroids, and Narcotics
5.5 Driver: Direct-To-Consumer Marketing
5.6 Opportunity: Expanding Indications
5.7 Opportunity: New-Generation HA Derivatives
5.8 Opportunity: Increased Use After Arthroscopic Surgeries
5.9 Opportunity: Self-Pay Market
5.10 Opportunity: Emerging Countries
5.11 Barrier: Unfavorable Reimbursement Scenario
5.12 Barrier: Pricing Erosion
5.13 Barrier: Cost-Effective Pharmacological Therapies
5.14 Barrier: Will The Rising Popularity of PRP Injection Impact the Viscosupplementation Market?
5.15 Barrier: Cost-Conscious Patients in Emerging Countries
6 Unmet Needs
6.1 Lack of Consensus on Clinical Efficacy of Viscosupplementation in Knee OA
6.2 Insufficient Evidence to Prove the Clinical Efficacy of Viscosupplementation in Other Joints
6.3 Better Understanding of the Basic Science
6.4 Ultrasound-Guided Injection
7 Competitive Assessment
7.1 Major Viscosupplementation Products
7.1.1 Euflexxa
7.1.2 Gel-One
7.1.3 Hyalgan
7.1.4 Orthovisc and Monovisc
7.1.5 Supartz/ARTZ
7.1.6 Synvisc and Synvisc-One
7.2 Other Viscosupplementation Products
8 Pipeline Products
8.1 Overview
8.2 Gel-Syn (IBSA Institut Biochimique S.A.)
8.3 Cingal (Anika Therapeutics)
8.4 Hydros-TA (Carbylan Therapeutics)
8.5 Additional Indication for Synvisc-One (Sanofi)
8.6 Hymovis (Fidia Farmaceutici S.p.A.)
8.7 HA-NSAID Conjugates (Seikagaku Corporation)
8.8 Additional Indication for Supartz/ARTZ (Seikagaku Corporation)
8.9 Clodronate-HA Conjugates (Abiogen Pharma)
9 Current and Future Players
9.1 Trends in Corporate Strategy
9.2 Major Manufacturers
9.2.1 Anika Therapeutics
9.2.2 Ferring Pharmaceuticals
9.2.3 Fidia Farmaceutici S.p.A.
9.2.4 Sanofi
9.2.5 Seikagaku Corporation
9.3 Major Marketing Partners
9.3.1 Bioventus
9.3.2 DePuy Synthes
9.3.3 Zimmer-Biomet
10 Market Outlook
10.1 Market Share Analysis by Country
10.1.1 US Market
10.2 By Market Segment
10.2.1 One-Injection Segment
10.2.2 Three-Injection Segment
10.2.3 Five-Injection Segment
10.3 By Geography
10.3.1 Overview
10.3.2 US
11 Appendix
11.1 Bibliography
11.2 Abbreviations
11.3 Report Methodology
11.3.1 Overview
11.3.2 Coverage
11.3.3 Secondary Research
11.3.4 Forecasting Methodology
11.3.5 Primary Research — Key Opinion Leader Interviews
11.3.6 Expert Panel Validation
11.4 Physicians and Specialists Included in This Study
11.5 About the Authors
11.5.1 Analysts
11.5.2 Jim Coutcher, MS, Global Head of Healthcare
11.6 About MediPoint
11.7 About GlobalData
11.8 Contact Us
11.9 Disclaimer

1.1 List of Tables
Table 1: US Procedure Trends for Viscosupplementation, by Joint Type, 2012-2021
Table 2: US Procedure Trends for Viscosupplementation, by Treatment Regimen, 2012-2021
Table 3: Differences Between US FDA Approval and EU CE Marking of Medical Devices
Table 4: US Medicare ASPs* for Viscosupplementation Products (2014-2015)
Table 5: Potential Clinical Benefits of HA-NSAIDs Conjugates
Table 6: Current CPGs on the Use of Viscosupplementation in Joints Other Than the Knee
Table 7: Product Profile - Euflexxa
Table 8: Product Profile - Gel-One
Table 9: Product Profile - Hyalgan
Table 10: Product Profile - Orthovisc and Monovisc
Table 11: Product Profile - Supartz/ARTZ
Table 12: Product Profile - Synvisc and Synvisc-One
Table 13: Major Pipeline Products in the Viscosupplementation Market, 2015
Table 14: Company Profile - Anika Therapeutics
Table 15: Anika Therapeutics' Viscosupplementation Portfolio Assessment, 2015
Table 16: SWOT Analysis - Anika Therapeutics
Table 17: Company Profile - Ferring Pharmaceuticals
Table 18: Ferring Pharmaceutical's Viscosupplementation Portfolio Assessment, 2015
Table 19: SWOT Analysis - Ferring Pharmaceuticals
Table 20: Company Profile - Fidia Farmaceutici S.p.A.
Table 21: Fidia Farmaceutici S.p.A.'s Viscosupplementation Portfolio Assessment, 2015
Table 22: SWOT Analysis - Fidia Farmaceutici S.p.A.
Table 23: Company Profile - Sanofi
Table 24: Sanofi's Viscosupplementation Portfolio Assessment, 2015
Table 25: SWOT Analysis - Sanofi
Table 26: Company Profile - Seikagaku Corporation
Table 27: Seikagaku Corporation's Viscosupplementation Portfolio Assessment, 2015
Table 28: SWOT Analysis - Seikagaku Corporation
Table 29: Company Profile - Bioventus
Table 30: Bioventus' Viscosupplementation Portfolio Assessment, 2015
Table 31: SWOT Analysis - Bioventus
Table 32: Company Profile - DePuy Synthes
Table 33: DePuy Synthes' Viscosupplementation Portfolio Assessment, 2015
Table 34: SWOT Analysis - DePuy Synthes
Table 35: Company Profile - Zimmer-Biomet
Table 36: Zimmer-Biomet's Viscosupplementation Portfolio Assessment, 2015
Table 37: SWOT Analysis - Zimmer-Biomet
Table 38: US Viscosupplementation Market Revenue ($m), 2012-2021

1.2 List of Figures
Figure 1: US Physician Adoption Trend for Viscosupplementation, by Specialty
Figure 2: US Procedure Trends for Viscosupplementation, by Joint Type, 2014
Figure 3: US Adoption Trend for Viscosupplementation, by Treatment Regimen, 2014
Figure 4: US Procedure Trends for Viscosupplementation, by Treatment Regimen, 2012-2021
Figure 5: US Medicare Reimbursement Trend for Viscosupplementation, 2014-2015*
Figure 6: Payer Mix for Viscosupplementation in the US, 2014
Figure 7: US Viscosupplementation Market Share, by Product, 2014
Figure 8: US Viscosupplementation Market Revenue ($m), 2012-2021
Figure 9: US Viscosupplementation Market Revenue Distribution, 2014 and 2021
Figure 10: Breakdown of Physician Survey Participants by Geography (N=61)
Figure 11: Breakdown of Other Primary Research Participants by Geography (N=50)

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