Disposable Syringe Markets - October 2009 Edition

Disposable Syringe Markets - October 2009 Edition

This report examines the disposable syringe markets as well as the supplies utilized in clinics and by patients directly in their homes to diagnose and monitor disease and to administer medications. This analysis is intended to provide basic market data pertaining to the U.S. and worldwide market segments. Each market segment is analyzed to determine size, growth rates, sales projections and factors influencing growth in the U.S. and internationally. Unit and dollar volume are used to indicate market sizes. Additionally, this review examines industry challenges and potential threats to syringe and needle supplies manufacturers and makes strategic recommendations for boosting market share. The emphasis is on those companies actively developing and marketing products to hospitals, physicians and the general public for medically related uses. The disposable syringe market segments are identified as: 1) total reusable needle and syringe market; 2) total disposable needle and syringe market; 3) prefilled syringes; 4) safety syringes; 5) insulin injector pens; 6) needleless injectors; 7) vaccination injectors; 8) blood collection needles and syringes; 9) hypodermic needles and syringes market; 10) insulin needles and syringes market; 11) specialty needles and syringes market; and 12) needleless injector market.

TABLE OF CONTENTS

1. Introduction 11

1.1 Statement of Report 11
1.2 About this Report 11
1.3 Scope of the Report 11
1.4 Objectives 12
1.5 Methodology 13
1.6 Executive Summary 14

2. Disposable Syringe Markets 16

2.1 Overview 16
2.2 Infection Control and Safety 17
2.2.1 Needlestick Injuries 17
2.2.2 Availability of Safety Syringes in the U.S. Healthcare Facilities 19
2.3 Cost of Safety Syringe 19
2.4 Market Expansion 20
2.5 Unsafe Injection Practices 20
2.6 Hospital Consolidations Pressure Companies to Reduce Prices 20
2.7 Strategic Alliance of Needleless Injector Manufacturers 21
2.8 Technological Advancements in Disposable Syringes 21
2.8.1 Reconstitution inside Sterile Syringes 21
2.8.2 Plungerless Prefilled Syringes 22
2.8.3 The Disposable UniJect™ 22
2.9 Award Winning Syringes 22
2.9.1 Episure AutoDetect Epidural Syringe 23
2.9.2 ConfiDose Disposable Autoinjector 23
2.9.3 Humatrope Reconstitution Device 24
2.9.4 Vasceze Plungerless Syringe 24

3. Disposable Syringe Market Segments 25

3.1 Overview 25
3.1.1 World Market for Disposable Syringes 25
3.1.2 U.S. Market for Disposable Syringes 27
3.1.3 Disposable Syringe Market in India 29

4. Insulin Syringes 32

4.1 Insulin Strengths: U-40 and U-100 32
4.2 Market for Insulin Pen 33
4.3 Shelf Life of Insulin Pen Cartridges 34
4.4 An Update on Insulin Injection Devices 35
4.4.1 Insulin Injection Devices Currently Available in the U.S. 35
4.4.2 Disposable Pens 36
4.4.3 Refillable Pens 36
4.4.4 Pen Needles 36
4.4.5 Benefits and Patient Preferences 37
4.4.6 Disadvantages of Pen Syringes 37
4.4.7 Insulin Pens and the Hospital Bills 38
4.5 Insulin Pens for Indian Market from IDC 38
4.6 Expansion of Facilities for Insulin Pens by Eli Lilly and Rexam 39
4.7 Major Players in Insulin Pens and Syringes 39
4.7.1 Sanofi-Aventis 39
4.7.1.1 Sanofi-Aventis' Business in Diabetes Care Segment 39
4.7.2 Novo Nordisk 41
4.7.2.1 Novo Nordisk's Diabetes Care Business in North America 41
4.7.2.2 Novo Nordisk's International Operations 42
4.7.2.3 Novo Nordisk's Business in Diabetes Care in Europe 42
4.7.3 Eli Lilly & Co. 43
4.7.3.1 Byetta 43
4.7.3.2 Humulin 44
4.7.3.3 Humalog 45

5. Safety Syringes 46

5.1 Available Safety Syringe Technologies 46
5.1.1 Retrofitted Syringes 46
5.1.2 Automatically Retractable Syringes 46
5.1.3 Manually Retractable Syringes 46
5.2 Safety Syringe Market 47
5.3 Drivers of Safety Syringes 47

6. Prefilled Syringes 48

6.1 Types of Prefilled Syringes (PFS) 48
6.2 Market for Prefilled Syringes 48
6.3 The Rise of Prefilled Syringes 49
6.4 Needle Safety for Prefilled Syringes 50
6.4.1 V-OVS NS® 51
6.4.2 Preventis™ 51
6.4.3 UltraSafe Passive® Delivery System/ERYPROSafe™ and NUFILSafe™ 51
6.5 Sterility Maintenance of Prefilled Syringes 52
6.6 Compatibility of Drugs with the Components of Prefilled Syringes 52
6.7 Some of the Drugs Available in Prefilled Syringes 53
6.7.1 Ovidrel® PreFilled Syringe 53
6.7.2 Enbrel Prefilled Syringes 53
6.7.3 Biocon's Prefilled Safety Syringes 53
6.7.4 Relistor® Prefilled Syringes 54
6.7.5 PEGASYS® 54
6.7.6 Afluria® 54
6.7.7 Enzira® 55
6.7.8 FluZone® Prefilled Syringe for Children 55
6.7.9 Novolin® N FlexPen Prefilled Insulin Syringe 55
6.7.10 NovoLog® Insulin Prefilled Syringe 55
6.7.11 GlaxoSmithKline's Vaccines in Prefilled Syringes 56
6.8 U.S. Production of Unilife's Prefilled Syringes 56
6.9 Some of the Major Providers of Syringe-Prefilling Services and Products 57
6.9.1 Althea Technologies, Inc. 57
6.9.1.1 Althea's Clinical Manufacturing 57
6.9.1.2 Althea's Fill/Finish Services 58
6.9.1.3 Althea's Contract Manufacturing 58
6.9.2 Baxter International, Inc. 59
6.9.2.1 Baxter's Contract Manufacturing 60
6.9.2.2 Baxter's Fill and Finish Capabilities 60
6.9.2.3 Baxter's Prefilled Syringes Capability 60
6.9.2.4 Baxter's Vials 61
6.9.2.5 Baxter's Cartridges 61
6.9.3 Becton, Dickinson and Company 61
6.9.3.1 BD's Prefilled Syringe Services 62
6.9.3.2 BD Hypak SCF™ Glass Prefillable Syringes 62
6.9.3.3 BD Sterifill SCF™ Plastic Prefillable Syringe Systems 63
6.9.3.4 BD Physioject™ Disposable AutoInjector 63
6.9.3.5 BD™ MicroInfusor™ Automatic Injection System 64
6.9.3.6 BD™ Liquid Dry Injector Disposable Pen Injector 64
6.9.3.7 BD™ Pens Customized Self-Injection Systems 65
6.9.3.8 BD Soluvia™ Prefillable Microinjection System 65
6.9.3.9 BD Preventis™ Shielding System for Prefilled Syringes 66
6.9.4 Catalent Pharma Solutions, Inc. 68
6.9.4.1 The Protector Safety Shield System™ 69
6.9.4.2 The ASI™ Autoinjector and Ultra-Compact ASI Mini™ Autoinjector 69
6.9.5 Hyaluron Contract Manufacturing (HCM) 69
6.9.5.1 Hyaluron's Syringe Filling 69
6.9.6 Vetter Pharma Fertigung GmbH 70
6.10 Features of Prefilled Syringes 71
6.10.1 Dual Chamber Prefilled Syringes 71

7. Pen Syringes 72

7.1 Pen Devices for Insulin Delivery 73
7.2 Technical Advances in Insulin Pens 73
7.3 Pen Types and Styles 74
7.4 Prefilled Pens 74
7.5 Reusable Pens 74
7.6 Prefilled Autoinjecting Disposable Syringes 74
7.7 Uniject™ Injection Device 75

8. Microneedle 76

8.1 Electronic Mosquito 76

9. Needle-free Injectors 77

9.1 Needle-free Delivery of Liquids 77
9.2 Needle-free Delivery of Solid Formulations 78
9.3 Needleless Injector from Injex 79
9.4 Jet Syringe from Injex 79
9.5 Syrijet 79
9.6 PenJet 80
9.7 Needle-free Injector for Human Growth Hormone 80

10. Needle and Syringe Market Trends 81

10.1 Market Segments 81
10.2 Customer Needs 82
10.3 Competitor Analysis 82
10.3.1 Automatic Safety Syringes 82
10.3.2 Manually Locking Safety Syringes 83
10.4 Third Party Reimbursement 84
10.5 Regulation 84
10.6 Drug Discovery Trends 85
10.7 Demographic Shifts 85
10.8 Growth in Home Healthcare 85

11. Technological Developments 87

11.1 Auto-Disable Syringes 87
11.1.1 AD Syringes with Needle Retraction/Disposal Feature 88
11.1.2 AD Syringe with No Needle Retraction Feature 88
11.1.3 Needlestick Prevention Syringes 88
11.1.4 Automatic Needlestick Prevention Feature 89
11.1.4.1 UltraSafe®Passive™ Delivery System 89
11.1.4.2 Sterimatic Sleeve® 89
11.1.4.3 K3 Safety Cap 89
11.2 Manual Needlestick Prevention Feature 90
11.2.1 Safety Lok™ Syringe 90
11.2.2 Monoject®Magellan™ 90

12. Business Trends 91

12.1 Market Drivers 91
12.2 Market Prospects 92
12.3 Marketing and Distribution 93
12.4 Competitive Landscape 93
12.5 Future Technologies 94
12.5.1 Glide Solid Dose Injector (SDI™) 94
12.5.2 BD Physioject™ 94

13. Regulatory Measures 95

13.1 Safety Syringes in Europe 95

14. Company Profiles 96

14.1 Abbott Laboratories 96
14.1.1 HUMIRA® Prefilled Syringe 96
14.1.2 HUMIRA® Pen 97
14.1.3 Precision Sure-Dose® Insulin Syringes 97
14.2 Albert David Limited 98
14.3 Alshifa Medical Syringes Manufacturing Company Ltd. 99
14.4 Althea Technologies, Inc. 99
14.5 Avitro, Inc. 100
14.6 Baxter International, Inc. 100
14.6.1 Baxter's Medication Delivery 100
14.6.2 Baxter's IV Therapies 101
14.6.3 Baxter's Global Injectables 101
14.6.4 Baxter's Infusion Systems 102
14.6.5 Baxter's IV Infusion Pumps and Infusion Sets 103
14.6.6 Baxter's Pharma Partnering 103
14.7 Becton, Dickinson and Company (BD) 103
14.7.1 BD's Role in Designing Devices for Safe and Effective Injections and Infusions 103
14.7.2 BD's Products 103
14.8 Boston Scientific Corporation 113
14.9 B. Braun 113
14.9.1 The Hospital Care Division 113
14.9.2 The Aesculap Division 114
14.9.3 The Out Patient Market (OPM) Division 114
14.9.4 The B. Braun Avitum Division 115
14.9.5 B. Braun's Syringe Products 116
14.10 Bioject Medical Technologies, Inc. 122
14.10.1 Biojector® 2000 124
14.10.2 Drug Reconstitution System 125
14.10.3 Vitajet® 125
14.10.4 Cool.click™ 125
14.10.5 SeroJet™ 126
14.11 Catalent Pharma Solutions, Inc. 126
14.11.1 Catalent's Oral Technologies Segment 127
14.11.2 Catalent's Sterile Technologies Segment 128
14.11.3 Catalent's Packaging Services Segment 129
14.11.4 Catalent's Manufacturing Capabilities 130
14.11.5 Catalent's Employee Strength 130
14.11.6 Catalent's Syringes 131
14.12 C.R. Bard, Inc. 131
14.12.1 Bard's Vascular Business 131
14.12.2 Bard's Urology Business 132
14.12.3 Bard's Oncology Business 133
14.12.4 Bard's Business in Surgical Specialties 134
14.12.5 Bard's Overseas Expansion 134
14.12.6 Bard's Bulb Syringes and Trays 135
14.12.7 Bard's Piston Syringes and Trays 135
14.13 Coeur, Inc. 136
14.13.1 Angiographic Syringes from Coeur, Inc. 136
14.13.2 CT Syringes from Coeur, Inc. 137
14.14 Covidien Ltd. 137
14.14.1 Covidien's Medical Devices Segment 138
14.14.2 Covidien's R&D 139
14.14.3 Covidien's Competitors in Medical Devices 139
14.14.4 Covidien's Syringes 140
14.15 Henke-Sass, Wolf GmbH 144
14.15.1 Two-Part Disposable Syringes 1-50(60) ml 144
14.15.2 Three-Part Disposable Syringes 1-30 ml 144
14.15.3 Disposable Needles HSW FINE-JECT® 145
14.16 Hindustan Syringes & Medical Devices, Ltd. (HMD) 145
14.16.1 Insulin Syringes from HMD 145
14.16.2 HMD's Single Use Needles 146
14.16.3 HMD's Single Use Syringes 147
14.17 Hi-Tech Medical Products Ltd. 147
14.18 Hyaluron Contract Manufacturing 148
14.18.1 HCM's Major Markets 148
14.18.2 HCM's Facility 148
14.19 International Medication System Ltd. 149
14.19.1 Delivery Systems from IMS 149
14.19.2 PCA Products from IMS 151
14.19.3 Phytonadione Injection USP 151
14.19.4 Lidocaine HCl Jelly, USP 2% (Preservative-free) 152
14.20 Life-Shield Products, Inc. 152
14.21 Merit Medical Systems, Inc. 154
14.21.1 Merit's Products 154
14.21.2 Merit's Vascular Access Products 154
14.21.3 Merit's Business in the U.S. 155
14.21.4 Merit's International Business 156
14.21.5 Merit's Customers 156
14.21.6 Merit's R&D 156
14.21.7 Merit's Manufacturing Facilities 157
14.22 Milestone Scientific 157
14.22.1 Milestone Scientific's Product Platform 158
14.22.2 Milestone Scientific's Investment in R&D 159
14.22.3 Milestone Scientific's Business Performance 160
14.23 Novo Nordisk A/S 161
14.23.1 Novo Nordisk's Business in Diabetes Care Segment 161
14.23.2 Novo Nordisk's Modern Insulins, Human Insulins and Insulin-related Products 162
14.23.3 Novo Nordisk's Geographic Performance in Diabetes Care Products 163
14.23.4 Pipeline Progress in Nova Nordisk 163
14.23.5 Novo Nordisk's Modern Insulin Portfolio 164
14.24 Owen Mumford Ltd. 166
14.24.1 Owen Mumford's Global Locations 166
14.24.2 Owen Mumford's Products 168
14.25 Plas-Pak Industries, Inc. 170
14.25.1 Dial-A-Dose® Disposable Veterinary Syringes 170
14.25.2 Dual Syringe and Dental Syringe from Plas-Pak 170
14.25.3 Mini Dual Syringe 170
14.25.4 Manual Dual Syringes 171
14.26 Retractable Technologies, Inc. 172
14.26.1 Retractable Technologies' Principal Products 173
14.26.2 Retractable Technologies' Principal Markets 173
14.26.3 Retractable Technologies' R&D 174
14.26.4 Retractable Technologies' VanishPoint Products 175
14.27 Revolutions Medical Corporation 176
14.27.1 Rev Vac Safety Syringe 177
14.28 Safety Syringes, Inc. 177
14.28.1 Custom Engineering from Safety Syringes, Inc. 178
14.28.2 Syringe Products from Safety Syringes, Inc. 178
14.29 Smiths Medical International/Medex, Inc. 180
14.29.1 Smiths Medical's Markets 180
14.29.2 Smiths Medical's Medication Delivery Segment 181
14.29.3 Smiths Medical's Vital Care Segment 182
14.29.4 Smiths Medical's Safety Devices Segment 182
14.29.5 Smiths Medical's Business Performance 182
14.29.6 Smiths Medical's Business Performance on Geographic Basis 182
14.29.7 Smiths Medical's R&D 183
14.29.8 Syringes from Smiths Medicals 183
14.30 Specialized Health Products International, Inc. 188
14.30.1 SHPI's Products and Services 189
14.30.2 SHPI's Licensed Products 190
14.31 Star Syringe Ltd. 190
14.31.1 Star Alliances 191
14.31.2 Preoducts from Star Syringe Ltd. 192
14.32 Terumo's Medical Corporation 193
14.32.1 Terumo's General Hospital Products 193
14.32.2 Terumo's Diabetes Care Products 194
14.32.3 Terumo's Syringe Products 195
14.33 UltiMed, Inc. 203
14.33.1 UltiCare™ Insulin Syringes 204
14.33.2 UltiCare™ Pen Needles 204
14.34 Unilife Medical Solutions, Ltd. 205
14.34.1 Pharmaceutical Market for Unilife's Prefilled Syringes 205
14.34.2 Unilife Partnership with Sanofi-Aventis 205
14.34.3 Unilife's Licensing Agreement with Sanofi-Aventis 206
14.34.4 Unilife's Partnership with Gerresheimer Bünde 206
14.34.5 Unilife's Portfolio of Safety Syringes 207
14.34.6 Unilife's Prefilled Syringes 207
14.34.7 Unilife's Contract Manufacturing Activities 207
14.34.8 Unilife's Performance in Syringe Market 208
14.35 Vetter Pharma-Fertigung GmbH & Co., KG 208
14.35.1 Vetter Services and Solutions 208
14.35.2 Dual-Chamber Technology 209
14.36 Vita Needle Company, Inc. 209
14.36.1 Disposable Stainless Steel Needle Blunts from Vita Needle 209
14.36.2 Teflon® Dispensing Needles 210
14.36.3 Vita Needle's Polypropylene Needles 210
14.36.4 Vita Needle's Taper Tip Needles 211
14.37 West Pharmaceutical Services, Inc. 211
14.37.1 West's Pharmaceutical Systems Segment 211
14.37.2 West's Tech Group Segment 212
14.37.3 West's R&D Activities 213
14.37.4 West's Syringe Products 214
14.38 Wuxi Yushou Medical Appliances Co., Ltd. 217
14.39 Ypsomed Holding AG 217
14.39.1 Ypsomed's Injection Systems 218
14.39.2 Ypsomed's Insulin Delivery Systems 218
14.39.3 Additional Indication Areas for Pen Systems 218
14.39.4 Ypsomed's Innovative Injection Systems at a Glance 219
14.39.5 Ypsomed's Complete Product Range for Insulin Suppliers 219
14.39.6 Ypsomed's New Dual-Chamber Injecting Systems 220
14.39.7 Ypsomed's ServoPen 220
14.39.8 Growth of Ypsomed's Pen Needles 220
14.39.9 Ypsomed's Performance in 2008/2009 222
14.39.10 Ypsomed's R&D 223
14.40 The Medical House PLC (TMH) 224
14.40.1 TMH's Products 224

LIST OF APPENDIX

Appendix 1: U.S. Healthcare Expenditure Projections, 2008-2018 228
Appendix 2: Syringe Needle Terminology 234
Appendix 3: Medication Errors and Syringe Safety 236
Appendix 3.1: Injectable Medication Errors 236
Appendix 3.2: Frequency of Syringe Usage 236
Appendix 3.3: Labeling Injectable Medications 236
Appendix 3.4: Challenges of Labeling 236
Appendix 3.5: Benefits of a Write-On Stripe 236
Appendix 3.6: Nurses Influence on Selection of Sharp Devices 237
Appendix 3.7: Needlestick Injuries 237
Appendix 3.8: Prevention of Needlestick Injuries 237
Appendix 3.9: Protection from Needlestick Injuries 238

INDEX OF FIGURES

Figure 2.1: Principal Causes of Needlestick Injuries 17
Figure 2.2: Availability of Safety Syringes in the U.S. Healthcare Facilities, 2008 19
Figure 3.1: Worldwide Unit Market for Syringes and Needles, 2004-2012 26
Figure 3.2: Global Syringe Market, 2009 26
Figure 3.3: Worldwide Market for Disposable Syringes and Needles, 2004-2012 27
Figure 3.4: U.S. Market for Disposable Syringes and Needles, 2006-2013 28
Figure 3.5: Market Segments of the U.S. Syringe Market, 2009 28
Figure 3.6: E.U. Market for Syringes, Needles and Catheters, 2007 and 2008 29
Figure 3.7: Worldwide Market Share for Hypodermic Syringes, 2009 29
Figure 3.8: Disposable Syringe Market in India, 2008-2012 30
Figure 3.9: Market Share for Disposable Syringes in India, 2008 30
Figure 3.10: Market Share for Disposable Needles in India, 2008 31
Figure 4.1: Market Growth for Insulin Pen, 2007-2014 33
Figure 4.2: Market Growth for Insulin Pens in Europe, 2007-2014 34
Figure 4.3: Global Sales Performance of Sanofi-Aventis' Lantus, 2007 and 2008 40
Figure 4.4: Global Sales Performance of Sanofi-Aventis' Amaryl, 2007 and 2008 40
Figure 4.5: Sales Performance of Sanofi-Aventis' Lantus by Geography, 2008 41
Figure 4.6: Novo Nordisk's Business Performance in Diabetes Care by Geography, 2008 41
Figure 4.7: Novo Nordisk's Performance in Diabetes Care, 2004-2008 42
Figure 4.8: Eli Lilly's Business Performance in Byetta, 2006 and 2007 43
Figure 4.9: Eli Lilly's Business Performance in Humulin, 2006-2008 44
Figure 4.10: Eli Lilly's Sales Performance in Humalog, 2006-2008 45
Figure 5.1: Growth of Safety Syringe Market, 2008-2012 47
Figure 6.1: Market Growth for Prefilled Syringes, 2009-2013 48
Figure 6.2: Growth of Prefilled Syringes Market in E.U., 2008-2012 49
Figure 10.1: Breakdown of U.S. Syringe Market, 2009 81
Figure 10.2: U.S. Home Healthcare Products Market, 2007-2012 85
Figure 14.1: Abbott's Global Business Performance by Country, 2008 96
Figure 14.2: Abbott's Global Business Performance, 2004-2008 98
Figure 14.3: Baxter's Performance in Medication Delivery Segment, 2008 101
Figure 14.4: Baxter's Performance in IV Therapies, 2006-2008 101
Figure 14.5: Baxter's Performance in Injectables, 2006-2008 102
Figure 14.6: Baxter's Performance in Infusion Systems, 2006-2008 102
Figure 14.7: BD's Performance in Safety-engineered Devices, 2007 and 2008 106
Figure 14.8: BD's International Performance in Safety-engineered Devices, 2007 and 2008 106
Figure 14.9: Business Performance by B. Braun's Hospital Care Division, 2006-2008 113
Figure 14.10: Business Performance by B. Braun's Aesculap Division, 2006-2008 114
Figure 14.11: Business Performance by B. Braun's Out Patient Market Division, 2006-2008 115
Figure 14.12: Business Performance by B. Braun's Avitum Division, 2006-2008 115
Figure 14.13: B. Braun's Business Performance by Geographic Region, 2008 116
Figure 14.14: Share of Bioject's Business with its Prominent Customers, 2007 123
Figure 14.15: Bioject's Business Performance by Product Line, 2007 123
Figure 14.16: Biotech's Business Performance in the U.S. and Other Countries, 2007 124
Figure 14.17: Catalent's Business Performance, 2004-2008 127
Figure 14.18: Catalent's Business Performance in its Oral Technologies Segment, 2007 and 2008 128
Figure 14.19: Catalent's Business Performance in its Sterile Technologies Segment, 2007 and 2008 129
Figure 14.20: Catalent's Business Performance in its Packaging Services Segment, 2007 and 2008 130
Figure 14.21: Catalent's Employee Strength by Region, 2008 131
Figure 14.22: Bard's Business Performance in its Vascular Segment, 2004-2008 132
Figure 14.23: Bard's Business Performance in its Urology Segment, 2004-2008 133
Figure 14.24: Bard's Business Performance in its Oncology Segment, 2004-2008 133
Figure 14.25: Bard's Business Performance in its Surgical Specialties Segment, 2004-2008 134
Figure 14.26: Business Performance of Covidien's Medical Device Segment, 2006-2008 138
Figure 14.27: Covidien's Investment in R&D, 2006-2008 139
Figure 14.28: Covidien's Business Performance in Syringes (Sharp Safety Products), 2006-2008 140
Figure 14.29: Merit's Business Performance, 2004-2008 156
Figure 14.30: Merit's Investment in R&D, 2004-2008 157
Figure 14.31: Milestone Scientific's Investment in R&D, 2007 and 2008 160
Figure 14.32: Milestone Scientific's Domestic Business Performance, 2007 and 2008 160
Figure 14.33: Milestone Scientific's International Business Performance, 2007 and 2008 161
Figure 14.34: Novo Nordisk's Sales Performance of Diabetes Care Products, 2004-2008 162
Figure 14.35: Novo Nordisk's Sales Performance in Modern Insulins (Insulin Analogues), 2004-2008 162
Figure 14.36: Retractable Technologies' Business Performance, 2004-2008 173
Figure 14.37: Retractable Technologies' Domestic Business Performance, 2006-2008 174
Figure 14.38: Retractable Technologies' International Business Performance, 2006-2008 174
Figure 14.39: Retractable Technologies' Investment in Research and Expenditure, 2006-2008 175
Figure 14.40: Smiths Medical's Business Performance, 2007 and 2008 181
Figure 14.41: Smiths Medical's Business Performance by Segment, 2007 181
Figure 14.42: SHPI's Sales Performance, 2006 and 2007 188
Figure 14.43: SHPI's Revenue from Royalties, 2006 and 2007 189
Figure 14.44: Terumo's Business Performance in Prefilled Syringes, 2005-2007 194
Figure 14.45: Terumo's Business Performance in Diabetes Care, 2003-2007 94
Figure 14.46: West's Business Performance in Pharmaceutical Systems Segment, 2006-2008 212
Figure 14.47: West's Business Performance in Tech Group Segment, 2006-2008 213
Figure 14.48: West's Investment in R&D in Pharmaceutical Systems Segment, 2006-2008 213
Figure 14.49: West's Investment for R&D in Tech Group Segment, 2006-2008 214
Figure 14.50: Global Prevalence of Diabetes, 2008-2025 220
Figure 14.51: Prevalence of Diabetes in India, 2008-2025 221
Figure 14.52: Prevalence of Diabetes in China, 2008-2025 222
Figure 14.53: Ypsomed's Sales Performance, 2006/2007 and 2008/2009 223
Figure 14.54: Ypsomed's Sales Performance by Geography, 2008/2009 223
Figure 14.55: Ypsomed's R&D Expenditure, 2006/2007 and 2008/2009 224
Figure 14.56: TMH's Business Performance, 2006-2008 226
Figure 14.57: TMH's Business Performance by Geography, 2008 227
Figure A1.1: National Health Expenditure in the U.S., 2009-2014 228
Figure A1.2: National Health Expenditure as a Percent of GDP, 2009-2014 228
Figure A1.3: Health Expenditure Per Capita, 2009-2014 229
Figure A1.4: Home Healthcare Expenditure, 2009-2014 229
Figure A1.5: Prescription Drug Expenditure, 2009-2014 230
Figure A1.6: Other Non-Durable Medical Products Expenditure, 2009-2014 230
Figure A1.7: Nursing Home Care Expenditure, 2009-2014 231
Figure A1.8: Dental Service Expenditure, 2009-2014 231
Figure A1.9: Hospital Care Expenditure, 2009-2014 232
Figure A1.10: Physician and Clinical Services Expenditure, 2009-2014 232
Figure A1.11: Personal Healthcare Expenditure, 2009-2014 233
Figure A3.1: Timing of Needlestick Injuries 237

INDEX OF TABLES

Table 4.1: Shelf Life of Insulin Pen Cartridges 34
Table 4.2: Major Insulin Pen Devices Currently Available in the U.S., 2008 35
Table 10.1: Highlights of Several Leaders in the Disposable Safety Syringe Market 84
Table 14.1: Albert David's Syringes with Needles, 2009 98
Table 14.2: Albert David's Needles, 2009 99
Table 14.3: BD's Auto-Disable Syringes 105
Table 14.4: Insulin Syringes from BD, 2009 107
Table 14.5: BD's Allergy Syringes 107
Table 14.6: BD's Tuberculin Syringes 108
Table 14.7: BD's Syringes and Needles (Sterile, Single-Use) 108
Table 14.8: BD's Safety-Lok™ Safety-Syringes 110
Table 14.9: BD's SafetyGlide Syringes 110
Table 14.10: BD's Eclipse Syringes 111
Table 14.11: BD's Integra Syringes 111
Table 14.12: BD's PosiFlush Prefilled Syringes 112
Table 14.13: Bard's Piston Syringes and Trays, 2009 135
Table 14.14: Bard's Bulb Syringes and Trays, 2009 135
Table 14.15: Angiographic Syringes from Coeur, Inc., 2009 136
Table 14.16: CT Syringes from Coeur, Inc., 2009 137
Table 14.17: HMD's Dispovan Insulin Syringes, 2009 146
Table 14.18: HMD's Single Use Needles, 2009 146
Table 14.19: HMD's Single Use Syringes, 2009 147
Table 14.20: Hi-Tech Single-Use Syringes, 2009 147
Table 14.21: Hi-Tech's Single Use Insulin Syringes, 2009 148
Table 14.22: HCM's Contract Manufacturing Categories, 2009 149
Table 14.23: Syringes from IMS, 2009 150
Table 14.24: PCA Syringe from IMS, 2009 151
Table 14.25: Phytonadione Injection USP from IMS, 2009 151
Table 14.26: Lidocaine Prefilled Syringes from IMS, 2009 152
Table 14.27: Life-Shield's Syringe Products, 2008 153
Table 14.28: Autopen Products from Owen Mumford, 2008 168
Table 14.29: Unifine Products from Owen Mumford, 2008 169
Table 14.30: Autoject Products from Owen Mumford, 2008 169
Table 14.31: Retractable Technologies' VanishPoint Syringes, 2009 176
Table 14.32: Smiths' Pro Fixed Needle TB Syringe, 2009 183
Table 14.33: Smiths' Needle-Pro® Needle with Needle Protection Device 184
Table 14.34: Smiths' Needle-Pro® Syringe and Needle with Needle Protection Device, 2009 186
Table 14.35: Smiths' Needle-Pro® Needle Protection Device for Insulin Injections, 2009 187
Table 14.36: Smiths' Needle-Pro® Fixed Needle Insulin Syringe 187
Table 14.37: SurGard2 Syringes with Safety Needle, 2009 195
Table 14.38: Terumo's SurGuard2 Safety Needles, 2009 196
Table 14.39: Terumo's Hypodermic Needles, 2009 197
Table 14.40: Terumo's Hypodermic Syringes without Needle, 2009 198
Table 14.41: Terumo's Tuberculin Syringes, 2009 199
Table 14.42: Terumo's Hypodermic Syringes with Needle 200
Table 14.43: Terumo's SurSaver 1 cc Syringes with Low Dead Space, 2009 200
Table 14.44: Terumo's Dental Needles, 2009 201
Table 14.45: Terumo's Spinal Needles, 2009 201
Table 14.46: Terumo's SurGuard Safety Insulin Syringes, 2009 202
Table 14.47: Terumo's Insulin Syringes, 2009 203
Table 15.48: Thinpro's Insulin Syringes, 2009 203
Table 15.49: UltiMed's UltiCare Insulin Syringes, 2009 204
Table 14.50: UltiCare Pen Needles, 2009 205
Table 14.51: Vita Needle's Stainless Steel Needle Blunts, 2009 210
Table 14.52: Vita Needle's Teflon Dispensing Needles, 2009 210
Table 14.53: Vita Needle's Polypropylene Needles, 2009 211
Table 14.54: Vita Needle's Taper Tip Needles, 2009 211
Table 14.55: Ypsomed's Product Roadmap, 2009-2013 218
Table 14.56: Ypsomed's Innovative Platforms 219