International Hyaluronic Acid Viscosupplementation Physician Survey 2011

• Publication date: July 2011

Over 100 orthopedic specialists were surveyed regarding their perceptions and usage of hyaluronic acid viscosupplementation during the 2011 American Academy of Orthopaedic Surgeons (AAOS) conference. This survey report compares usage patters and perceptions of orthopedic specialists regarding hyaluronic acid viscosupplement product, including single injection, 3-injection and 5-injection therapy regimes. Satisfaction with current offerings is exa...

Over 100 orthopedic specialists were surveyed regarding their perceptions and usage of hyaluronic acid viscosupplementation during the 2011 American Academy of Orthopaedic Surgeons (AAOS) conference. This survey report compares usage patters and perceptions of orthopedic specialists regarding hyaluronic acid viscosupplement product, including single injection, 3-injection and 5-injection therapy regimes. Satisfaction with current offerings is examined in detail, along with the market penetration of single injection products. The data presented describes practice experience, practice volume and the attitudes of the respondents to the product, as well as how these factors interact. In addition to physician brand preference, this survey report describes the proportion of doctors who would be willing to switch to a single injection product like Genzyme’s Synvisc-One®. The results of the survey indicated a high degree of familiarity with the product within the physician community. There is a general divide in the U.S. medical community between HA brands that are used for a majority of procedures within a practice. The respondents were asked to rate their satisfaction with the various injection products. This in term was compared to the probability of switching brands, and the possible motivating reasons for doing so.

The executive summary of this report is also available for purchase.

Orthopedic Industry

TABLE OF CONTENTS

TABLE OF CONTENTS .I
LIST OF FIGURES.IV
LIST OF CHARTS VII
EXECUTIVE SUMMARY 1
1.1 OVERVIEW .. 1
1.2 RESPONDENT PRACTICE LOCATION 2
1.3 COMPETING BRANDS . 3
1.4 PURCHASING CHANNELS . 4
1.5 IMPORTANCE OF PRICING 5
1.6 SATISFACTION WITH SINGLE INJECTION.. 6
1.7 PURCHASING DECISIONS.. 7
1.8 TIME TO PAIN RELIEF AFTER HA TREATMENT 8
SURVEY HIGHLIGHTS 9
2.1 RESPONDENT CHARACTERISTICS 9
2.1.1 Doctor Profile 9
2.1.2 Purchasing Channel 10
2.2 RESPONSE SUMMARY . 10
2.2.1 Attitudes Towards Products. 10
2.2.2 Product Incentives 10
2.2.3 Patient Profile. 11
2.2.4 Brand Preferences 11
RESEARCH METHODOLOGY 12
3.1 RESEARCH OVERVIEW 12
3.2 RESEARCH SERVICES .. 12
3.3 SURVEY METHODOLOGY.. 13
Step 1: Project Initiation & Team Selection 13
Step 2: Sample Population Preparation 15
Step 3: Preparation, Questionnaire Design & Administration.. 16
Step 4: Reporting and Analysis.. 18
Step 5: Customer Feedback . 18
HYALURONIC ACID VISCOSUPPLEMENTATION SURVEY RESULTS.. 19
4.1 QUESTION 1: YEARS OF PRACTICE .. 19
4.1.1 Practice Experience by Global Region.. 19
4.1.2 Country of Origin.. 21
4.2 QUESTION 2: HYALURONIC ACID (HA) VISCOSUPPLEMENT PATIENTS PER MONTH. 28
4.2.1 HA Patients per Month .. 28
4.2.2 Monthly HA Patients by Practice Experience. 30
4.3 QUESTION 3: HA UTILIZATION BY BRAND.. 32
4.4 QUESTION 4:REASONS FOR CHOOSING HA BRAND. 39
4.4.1 Reasons for Choosing Brand .. 39
4.4.2 Reasons for Choosing Brand by Brand Preference . 41
4.5 QUESTION 5: LIKELIHOOD OF INCREASING SINGLE INJECTION USE .. 48
4.6 QUESTION 6: SATISFACTION WITH SINGLE INJECTION PRODUCTS.. 50
4.6.1 Satisfaction with Single Injection.. 50
4.6.2 Likelihood of Increasing Single Injection Use by Satisfaction .. 52
4.7 QUESTION 7: PERCENTAGE OF HA PATIENTS THAT SUBSEQUENTLY GO ON TO TOTAL
KNEE ARTHROPLASTY (TKA) 57
4.8 QUESTION 8: TIME TO TKA AFTER HA AND CONSERVATIVE TREATMENTS. 59
4.8.1 Time to TKA. 59
4.8.2 Time to TKA by Surgical Volume.. 61
4.9 QUESTION 9: HA INJECTION TYPES USED BEFORE TKA.. 66
4.10 QUESTION 10: PERCEIVED BRAND PURCHASING INCENTIVES 70
4.11 QUESTION 11: NATURE OF INCENTIVES RECEIVED .. 72
4.12 QUESTION 12: REASONS TO SWITCH TO DIFFERENT HA BRAND.. 74
4.12.1 General Reasons to Switch Brands 74
4.12.2 Reasons to Switch Brands by Brand Attribute Preference. 76
4.13 QUESTION 13: PATIENT GROUPS RECEIVING THE MOST BENEFIT FROM HA.. 78
4.14 QUESTION 14: IMPORTANCE OF PRICING 80
4.15 QUESTION 15: NATURE OF PURCHASING CHANNELS .. 82
4.15.1 Purchasing Channels 82
4.15.2 Importance of Pricing by Purchasing Channel .. 84
4.16 QUESTION 16: RESPONDENT CLINICAL SETTING 86
4.17 QUESTION 17 TO 18: TIME TO RELIEF AFTER TREATMENT .. 88
4.17.1 Question 17: Time to Relief After Single Injection Treatment. 88
4.17.2 Question 18: Time to Relief After 3-Injection Treatment 89
4.17.3 Question 19: Time to Relief After 5-Injection Treatment 90
APPENDIX 1: SURVEY QUESTIONS.. 91


LIST OF FIGURES

EXECUTIVE SUMMARY. 1
SURVEY HIGHLIGHTS 9
RESEARCH METHODOLOGY 12
HYALURONIC ACID VISCOSUPPLEMENTATION SURVEY RESULTS . 19
Figure 4-1: Years of Practice, 2011. 19
Figure 4-2: Country of Origin, Asia, 2011 21
Figure 4-3: Country of Origin, Europe, 2011.. 21
Figure 4-4: Country of Origin, Latin America, 2011 22
Figure 4-5: Country of Origin, Africa, Middle East and Caribbean, 2011 .. 22
Figure 4-6: HA Patients Treated per Month, 2011 28
Figure 4-7: Monthly HA Patients Seen by Years of Practice, 2011 30
Figure 4-8: Weighted Average for HA Brand Frequency of Use, Asia, 2011 32
Figure 4-9: Weighted Average for HA Brand Frequency of Use, Europe, 2011 .. 33
Figure 4-10: Weighted Average for HA Brand Frequency of Use, Latin America,
2011 34
Figure 4-11: Weighted Average for HA Brand Frequency of Use, Other, 2011 34
Figure 4-12: Reasons for Choosing a HA Brand, 2011 39
Figure 4-13: Reasons for Choosing Brand by Brand Choice, Asia, 2011 41
Figure 4-14: Reasons for Choosing Brand by Brand Choice, Europe, 2011 .. 42
Figure 4-15: Reasons for Choosing Brand by Brand Choice, Latin America, 2011. 42
Figure 4-16: Reasons for Choosing Brand by Brand Choice, Middle East, Africa and
Caribbean . 43
Figure 4-17: Likelihood of Switching to Single Injection, 2011 . 48
Figure 4-18: Satisfaction with Single Injection Products, 2011 .. 50
Figure 4-19: Likelihood of Increasing Single Injection Usage as a Function of Single
Injection Satisfaction, 2011.. 52
Figure 4-20: Percentage of HA Patients that Subsequently Go on to Total Knee
Arthroplasty (TKA), 2011 . 57
Figure 4-21: Time to TKA After HA and Conservative Treatments, Months, 2011 59
Figure 4-22: Time to TKA in Months per Percentage of Patients that Require TKA,
2011 61
Figure 4-23: HA Injection Types Used Before TKA, Weighted Average, 2011 66
Figure 4-24: HA Injection Types Used Before TKA by Response Distribution, Asia 66
Figure 4-25: HA Injection Types Used Before TKA by Response Distribution, Europe,
2011 67
Figure 4-26: HA Injection Types Used Before TKA by Response Distribution,
Latin America, 2011 67
Figure 4-27: HA Injection Types Used Before TKA by Response Distribution, Other,
2011 68
Figure 4-28: Perceived Brand Purchasing Incentives, 2011.. 70
Figure 4-29: Nature of Incentives Received, 2011 72
Figure 4-30: Reasons to Switch to Different HA Brand, 2011 . 74
Figure 4-31: Nature of Incentives Received by Brand Selection Preferences, Asia,
2011 76
Figure 4-32: Nature of Incentives Received by Brand Selection Preferences, Europe,
2011 76
Figure 4-33: Nature of Incentives Received by Brand Selection Preferences,
Latin America, 2011 77
Figure 4-34: Nature of Incentives Received by Brand Selection Preferences,
Middle East, Africa and Caribbean, 2011 .. 77
Figure 4-35: Patient Groups Receiving the Most Benefit from HA, 2011 .. 78
Figure 4-36: Importance of Pricing, 2011. 80
Figure 4-37: Purchasing Channels, 2011 .. 82
Figure 4-38: Importance of Pricing by Purchasing Channel, Asia, 2011 . 84
Figure 4-39: Importance of Pricing by Purchasing Channel, Europe, 2011 84
Figure 4-40: Importance of Pricing by Purchasing Channel, Latin America, 2011 . 85
Figure 4-41: Importance of Pricing by Purchasing Channel, Middle East Africa and
Caribbean, 2011. 85
Figure 4-42: Respondent Clinical Setting, 2011 86
Figure 4-43: Time to Relief After Single Injection Treatment, Weeks, 2011 88
Figure 4-44: Time to Relief After 3-Injection Treatment, Weeks, 2011 .. 89
Figure 4-45: Time to Relief After 5-Injection Treatment, Weeks, 2011 .. 90
APPENDIX 1: SURVEY QUESTIONS . 91

LIST OF CHARTS

EXECUTIVE SUMMARY. 1
Chart 1-1: Hyaluronic Acid Usage Among Survey Respondents, Latin America, 2011 .. 1
Chart 1-2: Respondent Location by Region, 2011 2
Chart 1-3: Brand Preference Among, Africa, Middle East and Caribbean, 2011 3
Chart 1-4: Purchasing Channels, Global, 2011 . 4
Chart 1-5: Perceived Importance of Pricing, Global, 2011 .. 5
Chart 1-6: Likelihood of Increasing Single Injection Use as a function of Satisfaction
Rating, Asia, 2011 .. 6
Chart 1-7: Reasons for Choosing a HA Brand, Europe, 2011 . 7
Chart 1-8: Time to Pain Relief in Weeks, 3-Injection Therapy, 2011 . 8
SURVEY HIGHLIGHTS 9
RESEARCH METHODOLOGY 12
HYALURONIC ACID VISCOSUPPLEMENTATION SURVEY RESULTS . 19
Chart 4-1: Years of Practice, 2011 .. 20
Chart 4-2: Respondents by Global Region, 2011 .. 23
Chart 4-3: Country of Origin, Asia, 2011 . 24
Chart 4-4: Country of Origin, Europe, 2011 25
Chart 4-5: Country of Origin, Latin America, 2011 . 26
Chart 4-6: Country of Origin, Africa, Middle East and Caribbean, 2011 27
Chart 4-7: HA Patients per Month, 2011 .. 29
Chart 4-8: Monthly HA Patients Seen by Years of Practice, 2011 . 31
Chart 4-9: Weighted Average for HA Brand Frequency of Use, Asia, 2011 .. 35
Chart 4-10: Weighted Average for HA Brand Frequency of Use, Europe, 2011 .. 36
Chart 4-11: Weighted Average for HA Brand Frequency of Use, Latin America,
2011 37
Chart 4-12: Weighted Average for HA Brand Frequency of Use, Other, 2011 . 38
Chart 4-13: Reasons for Choosing a HA Brand, 2011 . 40
Chart 4-14: Reasons for Choosing Brand by Brand Choice, Asia, 2011 .. 44
Chart 4-15: Reasons for Choosing Brand by Brand Choice, Europe, 2011 . 45
Chart 4-16: Reasons for Choosing Brand by Brand Choice, Latin America, 2011 .. 46
Chart 4-17: Reasons for Choosing Brand by Brand Choice, Middle East, Africa and
Caribbean . 47
Chart 4-18: Likelihood of Switching to Single Injection, 2011 .. 49
Chart 4-19: Satisfaction with Single Injection Products . 51
Chart 4-20: Likelihood of Increasing Single Injection Usage as a Function of Single
Injection Satisfaction, 2011.. 53
Chart 4-21: Likelihood of Increasing Single Injection Usage as a Function of Single
Injection Satisfaction, 2011.. 54
Chart 4-22: Likelihood of Increasing Single Injection Usage as a Function of Single
Injection Satisfaction, 2011.. 55
Chart 4-23: Likelihood of Increasing Single Injection Usage as a Function of Single
Injection Satisfaction, 2011.. 56
Chart 4-24: Percentage of HA Patients that Subsequently Go on to Total Knee
Arthroplasty (TKA), 2011 . 58
Chart 4-25: Time to TKA After HA and Conservative Treatments, 2011 60
Chart 4-26: Time to TKA in Months per Percentage of Patients that Require TKA,
Asia, 2011 62
Chart 4-27: Time to TKA in Months per Percentage of Patients that Require TKA,
Europe, 2011 .. 63
Chart 4-28: Time to TKA in Months per Percentage of Patients that Require TKA,
Latin America, 2011 64
Chart 4-29: Time to TKA in Months per Percentage of Patients that Require TKA,
Africa, Middle East and Caribbean, 2011 .. 65
Chart 4-30: HA Injection Types Used Before TKA, Weighted Average, 2011 . 69
Chart 4-31: Perceived Brand Purchasing Incentives, 2011 71
Chart 4-32: Nature of Incentives Received, 2011 . 73
Chart 4-33: Reasons to Switch to Different HA Brand, 2011 .. 75
Chart 4-34: Patient Groups Receiving the Most Benefit from HA, 2011 . 79
Chart 4-35: Importance of Pricing, 2011 .. 81
Chart 4-36: Purchasing Channels, 2011. 83
Chart 4-37: Respondent Clinical Setting, 2011 .. 87
APPENDIX 1: SURVEY QUESTIONS . 91