Wednesday, May 22, 2013

Cancer Diagnostics: Expect More Mergers and Partnerships

Mergers partnerships and licensing agreements will flourish in the nearly five billion-dollar cancer testing industry, according to Kalorama Information.   The healthcare market research firm says that  newer protein and molecular cancer tests and test devices are more complex and no one company has all of these solutions.  This is one of many findings in Kalorama Information’s report, The World Market for Cancer Diagnostics.

Newer protein and molecular cancer tests and test devices are more complex and use a mix of various technologies including: sample preparation, microfluidics, more sensitive labels, imaging tools and bioinformatics.  No company, big or small, owns all of the technology needed to develop these new tests and systems.

Instead, Rosen argues, companies will have to get the pieces they do not have from partners.   Kalorama has found the industry for cancer diagnostics is beginning to see more and more consolidation, and collaboration between the major players and emerging companies, and between innovators.  Mergers, such as the combo of Gen-Probe and Hologic or the announced Life Technologies acquisition by Thermo Fisher, allow companies to complete their product development by providing missing pieces.  

 But mergers aren’t the most common solution, according to the report.   There has also has been a significant movement of collaborations and licensing agreements: Philips using NEC digital pathology technology, Agilent working with BGI for sequencing,  Abbott using Rubicon's MethylPlex technology, Roche licensing Response Genetics' HER2 gene expression technology, or Qiagen using Insight Genetics' ALK gene, lung cancer to cite just a few.    The activity covers molecular techniques, information technology software, probes and antibodies. They also are evidence of the increasing globalization diagnostics. 

 For the past few years acquisition activity has been extraordinary, Kalorama estimates that there were some 100 such agreements.

        According to Kalorama, this trend is very different from the distribution agreements between larger IVD firms and smaller test developers of the 1980s and 1990s.  The new agreements are struck much earlier in the product life cycle and sometimes even in the discovery stage for new markers.  The goal is to shorten time to market by outsourcing strategic areas of its analyte research, development and validation effort to larger and smaller companies as the fit seems right.  In the past few years IVDs and cancer testing technologies and tests in particular have become more sophisticated - involving biochips, patterns of proteins and genetic markers, disease algorithms and bioinformatics to name a few.

        These cross-pollinating events are very significant; the result will be more precise and more effectively marketed new tests.  A number of totally disparate phenomena have come together to advance cancer diagnostics.  Decreases in life science grants has encouraged companies active in this space to migrate their technologies for clinical applications.  The result is the entry of companies such as Caliper Life Sciences, Illumina, Affymetrix and Life Technologies to the diagnostics market with products and test services for cancer management.

Competition is fierce in the industry. All of the top IVD companies are represented. Kalorama's report details more than 200 companies that are involved in cancer testing, from top tier IVD giants such as Abbott, Novartis and Roche, device giants such as Becton Dickinson and Siemens, to molecular-focused companies such as Gen-Probe, Bio-Rad. Then there are legions of specialist cancer testing companies. The report contains market sizes and forecasts for a wide array of technology segments. Kalorama's report also discusses trends and provides analyst conclusions about the market. The report can be purchased at Kalorama Information at

Tuesday, May 21, 2013

Pain Management: An Important Market for Drug and Device Makers

Pain is a universal, complex, subjective, multidimensional phenomenon. Pain is responsible for discomfort, sleep disturbance, and interference with daily activities and quality of life.  The understanding of this phenomenon is evolving as scientists from many disciplines conduct research. Increased knowledge provides health care professionals with many strategies for pain management.  Markets for these strategies, including those that are drug-based and device-based are included in the full-study report, The World Market for Pain Management and Devices from Kalorama Information.

Pain is defined as whatever the person experiencing the pain says it is, existing whenever the person says it does. This clinical definition recognizes pain as a personal private experience. Scientists at the International Association for the Study of Pain (IASP) have proposed another definition. This definition states that pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or it is described in terms of such damage.

In considering the IASP definition, it is important to note that not all potentially tissue-damaging stimuli result in pain. Nociception is the activation of the primary afferent nerves with peripheral terminals that respond differently to noxious stimuli. Nociceptors function primarily to sense and transmit pain signals. Nociception may or may not be perceived as pain, depending on a complex interaction within the nociceptive pathways. If nociceptive stimuli are blocked, pain is not perceived.

Finally, it is important to distinguish pain, or nociception, from suffering. Suffering is the state of severe distress associated with events that threaten the intactness of the person. Suffering is an emotion. Pain and suffering are not the same phenomenon. The person who complained of pain in the heart because of the death of a loved one is suffering rather than experiencing pain as it is defined by the IASP. It is clear that three conditions could exist: 1) suffering occurs in the presence of pain, 2) suffering occurs when pain is not present, and 3) pain occurs when suffering is not present. For example, the woman awaiting breast biopsy may suffer because of anticipated loss of her breast. After the biopsy, she may have pain without suffering if the biopsy is negative or pain with suffering if the biopsy is positive for malignancy. Interventions aimed at relieving pain and suffering may have some commonalities, but clearly some interventions for suffering will be inadequate for pain just as some interventions for pain are inadequate for suffering. Therefore, it is crucial to pain management to understand the alterations in comfort that result from suffering and to use the correct term when referring to pain and suffering and to not interchange them.

Pain is one of the most common reasons individuals seek health care. More than 100 million Americans experience pain – both acute and chronic. A significant number of individuals with pain are disabled by their pain, resulting in a serious economic problem in society as well as a major health problem. Adding to the problems of patients with acute pain, especially cancer pain is a tendency for physicians to prescribe small, insufficient doses of analgesics to control the pain.
The world pain management market for drugs and devices encompasses a wide variety of products that treat and ease pain. The field of pain management is currently experiencing a busy and interesting period; and as a result, the range of therapeutic options available to physicians and other clinicians has expanded. Solutions to pain disorders are still elusive but continued human and animal studies will help to further identify the biochemical and neurophysiological factors that influence pain. The future of pain management will likely involve multidisciplinary departments dedicated to finding treatments that manage pain. The need is great worldwide for management of pain and there are still many facets of pain management that need to be explored.

Faced with intensifying competition and increasingly price sensitive markets, manufacturers in the area of pain management therapeutics are trying to differentiate their products to avoid price competition and to increase profits. However, there are a number of issues and trends that have a direct influence on this market and the manufacturer’s ability to successfully operate in the market. A keen awareness of all facets of the industry including barriers will enable manufacturers to effectively challenge these issues and formulate plans to reduce or eliminate barriers in the treatment of pain.

The driving forces for this market include growth and aging of the global population, new products and technology, and increasing interest in multidisciplinary approaches to pain management.
This report, The World Market for Pain Management Drugs and Devices, provides market estimates and forecasts for the following therapeutic categories:
•    Burn Pain
•    Cancer Pain
•    Dental/Facial Pain
•    Migraine Headache Pain
•    Musculoskeletal Pain
•    Neuropathic Pain
•    Obstetrical Pain
•    Pediatric Pain
•    Surgical and Trauma Pain

Kalorama has recently conducted a full length study on pain management.  The report shows significant growth.   can be found at:

Monday, May 20, 2013

Watch Epic in EMR Market

      Six companies lead the market for EMR, according to Kalorama Information.   McKesson, Cerner and Siemens, Epic, Allscripts and GE Healthcare led the market for electronic medical record systems, the healthcare market research publisher noted.    But last year one company in particular demonstrated 28% increase in market growth.   
      The company signaled out Epic Systems of Verona, WI as a game changer in the market. 
      “Epic was like a steamroller in this industry in 2012,” said Mary Ann Crandall, author of the report.  "Part of the strategy is that they court the hospitals and convince them to buy - then the doctors clinics affiliated with that hospital follow suit because of no interoperability with Epic systems.”
       Epic built on its market position with 7.3% of the market.  While still far lower than market leaders, Epic grew from 5.7% in 2011 according to Kalorama’s report while its mid-size rival Allscripts had flat revenues.         
       Allscripts has a better direction now and that it is working diligently on internal problems that had hurt the company in the past. They still have some organizational issues to address but overall they are moving in the right direction.  Internal struggles hampered growth in 2012. With its new management staff, the company hopes to start gaining ground again.  Allscripts Healthcare Solutions is one of the leaders in the physician based EMR solutions. 
         The market  Leaders in the market of EMR providers include large and small companies.  McKesson is a large player the healthcare market and therefore is well-positioned to expand its offerings.  Paragon, Horizon, HERM, Star and Series. Ambulatory offerings include Practice Partners, Practice Point Plus, Fusion and others.       Cerner is continuing to add to its services by adding CernerITWorks, a suite of services that improve the ability of hospital IT departments to meet their organization’s needs.   Siemens offers is the Soarian MedSuite. Soarian MedSuite is a comprehensive and scalable HIS solution that helps organizations to orchestrate complex administrative, clinical and financial processes as well as support critical business activities across the healthcare enterprise.  
      Kalorama Information's report on EMR Markets contains more information on competitive activity in the market, trends, geographic factors and more.  The report can be found at: