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Health The Great Market

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Title: Health The Great Market


1
Health The Great Market
  • With the increase in global welfare level,
    medical care became widespread and a further
    essential need. Countries economical efforts grew
    but they did so at such a pace that there is a
    growing pressure for this heavy burden to be
    significantly reduced, on the consumers side many
    are complaining about the excessively high prices
    and demand that the current level of healthcare
    prices to be reduced.

2
Current Situation
  • As marketing exclusivity periods for first
    in-class drugs decline, drug developers are
    facing incresing pressure to improve productivity
    in their drug development activities to help
    bolster return on investment.
  • RD strategies that strive to attain a best
    in-class status for new drugs or, at the least,
    clear advantages over existing therapies with
    patient subgroups or particular indications will
    dominate.
  • They are also suffering growing pressures to
    contain costs from managed care organizations and
    pricing and reimbursement.
  • Authorities are increasing pressure on firms to
    get new drugs to market sooner, preferably with
    clear advantages in safety, efficacy, or economic
    value.

3
Market Size
  • The health market makes millions and many more as
    expected as more and more people have access to
    medical care. Also the population aging in
    developed countries, with the many health
    implications it has, causes that a new set of
    needs arise. As more elderly people demand for
    attention and preventive care the market will
    continue to grow. The world goes on with its
    globalization trend and diseases stop being local
    or regional to become wide spreading at a world
    level. The transmission of diseases also becomes
    more and more quickly.
  • Despite the economic downturn, the pharmaceutical
    industry has grown 7 globally with an estimated
    value of 390 billion. The US market alone is
    valued at 189 billion. Several factors have
    contributed to this growth and the increased
    revenues. The price of drugs has increased 4. A
    growing baby boomer population has led to an
    increased demand for medicines, and the number of
    medications being prescribed for treating a
    disease has also increased in recent years.

4
Market Evolution
  • There have been significant changes in the
    pharmaceutical business environment with several
    mergers and acquisitions in the past few years,
    which has resulted in a consolidated, fiercely
    competitive market with fewer players. The
    biggest change to come over the next 4 years is
    that the industry in the US alone stands to lose
    more than 36 billion in sales when several
    branded drugs come off patent. This is a
    formidable challenge for the pharmaceutical
    industry and boosts the opportunities for
    manufacturers of generics.
  • Another factor that has changed the business
    environment is the patent life (years that offer
    a market exclusivity to the manufacturer sell the
    drug) for drugs, which has been decreasing. The
    patent life, which symbolizes the period when
    companies usually recover their RD costs and
    generate profits is currently about 12 years and
    is expected to drop to 10 years within the next
    decade. Hence, with the shrinking patent life,
    the companies are under more pressure to curtail
    costs and increase RD efficiencies. With the
    entry of me-too drugs, companies also have to
    increase their marketing budgets to better
    differentiate their products.

5
Market Changes
  • Companies looking for synergies and for
    developing healthy pipelines account for several
    mergers that have occurred in recent years.
    Several factors can be attributed to this
    scenario. The drug development time has increased
    from 8 years during the 1960s to about 14 years.
    The obvious opportunities in well-characterized
    disease areas have already been exploited and
    scientists now have to explore diseases that are
    not so well understood to come up with superior
    and innovative drugs. The RD involved in this
    process is very challenging and time-intensive.
    Hence, RD costs have gone up about 213 in the
    last decade. It is estimated that it now costs
    almost 800 million to bring a new drug to
    market. The payoffs generated by the genomics
    revolution have been slow and have not met
    expectations.

6
Market Future Trends
  • The profiles of the diseases being targeted have
    evolved over the years along with the changing
    population dynamics. A decade ago, infectious
    diseases and development of antibiotics were a
    large RD focus. Today with the aging population,
    the fastest growing and highest selling market is
    the one for statins - the cholesterol lowering
    drugs. What was once considered a niche and small
    disease market is now offering a large
    undiagnosed patient population with a large unmet
    medical need and a huge commercial opportunity.
    Although this changing disease profile has not
    been sudden, it still presents a formidable
    challenge because not all companies have aligned
    their business model to address this issue.
    Statins for lowering cholesterol, glitazones for
    diabetes, monoclonal antibodies for cancer, and
    COX-2 inhibitors for pain management are
    targeting some of these new markets.
  • Companies are investing billions in developing
    immunotherapy drugs, designed to selectively and
    optimally use the bodys own immune system to
    prevent or fight disease. Among these
    immunotherapies are monoclonal antibodies and
    therapeutic vaccines. The development of
    therapeutic vaccines for the treatment of
    HIV/AIDS, cancer, and other major diseases holds
    tremendous promise as adjunctive therapies to
    conventional treatments.

7
Drugs Prices
  • The increasing healthcare expenditure, shrinking
    healthcare funding and the growing consumer
    outcry has resulted in mounting pressure on drug
    companies to lower drug prices. The rising
    healthcare expenditure on prescription drugs can
    be attributed to the pharmaceutical companies
    endeavor to shift the patients to newer, more
    expensive products, as older products mature and
    give way to generic competition. The increase in
    the use of drugs in chronic diseases, such as
    cardiovascular, diabetes, gastrointestinal, and
    CNS has also contributed to this increase. Due to
    the presence of multiple products within the same
    class, there is a pressure to lower costs. The
    industry is also under fire for the high drug
    inflation rate, which over the past five years
    has far exceeded the average rate of inflation.
    The average cost of prescription drugs has
    increased by 4 every year during the past
    several years. Escalating product development
    costs and a shorter market exclusivity period on
    one hand, and the increasing pressure to curtail
    costs on the other, puts the pharmaceutical
    manufacturers in a tight spot. In addition, the
    consistent pressure from the managed-care
    organizations also counteracts the premium
    pricing strategies employed in the marketplace.

8
Life Expectancy
9
Life Expectancy
The longest documented human life span is 122
years. Though a life span that long is rare,
improvements in medicine, science and technology
over the last century have helped more people
live longer, healthier lives. If you were born in
the early 1900s in the United States, your life
expectancy was only about 50 years. Today it's
around 77. The aging boom is upon us. Since 1900,
the number of Americans age 65 and older has
increased 10-fold. The oldest-old, people age 85
and older, constitute the fastest growing segment
of the U.S. population. By 2050, this population,
currently about 4 million people, could top 19
million. Living to 100 likely will become more
commonplace. In 1950, only about 3,000 Americans
were centenarians by 2050, there could be nearly
one million. This remarkable burst of longevity,
unprecedented in human history, has been possible
because of equally remarkable improvements in
sanitation, health care, and lifestyle. Some
gerontologists suspect an average life expectancy
of 85 years or more may be possible in the near
future.
10
Life Expectancy
  • Worldwide population ageing is a public health
    challenge affecting many aspects of human life
    and societies in developed and developing nations
    alike. Population ageing has a great impact on
    individuals health and social needs, family
    structures, health systems and overall
    socioeconomic development. The birth rate has
    been decreasing compared to the elders increase
    so that we face a future society of fewer
    children and more elderly persons. In the very
    near future this will give way to a super-aged
    society. As a result, in looking at health on
    a national basis, the health of the elderly
    persons, their medical treatment, welfare, and
    care, are among the most pressing issues the
    world faces.
  • The percentage of the population who are in the
    older age groups (gt65 years) will increase in all
    countries in the next few decades. This process
    of population ageing will take place more rapidly
    in developing countries than it did in developed
    countries. Ageing of the population will present
    two major challenges. First, health care systems
    must reorient themselves to preventing and
    treating the conditions, such as increased
    chronic diseases and functional impairments that
    characterize an older population and second,
    countries must mobilize the additional resources
    that will be required to meet the increase in
    needs.

11
Consequences of Higher Life Span
  • As Europes population grows older and demands
    for healthcare provision increase, the developed
    world is facing a nightmare scenario of rapidly
    increasing healthcare costs.
  • According to studies from the EU Economic Policy
    Committee, on the Budgetary challenges posed by
    ageing populations, due to the growing number of
    elderly people amongst Europes population, the
    number of working age citizens contributing to
    social service funds is rapidly diminishing,
    while conversely, the number of elderly citizens
    is rising. It is estimated that by 2050 there
    will be only two working age citizens for each
    elderly person in the EU, instead of the current
    four.
  • One readily available solution to these problems
    is to be found, in part, in increasing the use of
    generic medicines. These competitively priced
    therapeutic equivalents to patent expired
    originator pharmaceuticals have demonstrated they
    possess the same quality, safety, and efficacy as
    their originator products, and they go through
    the same regulatory procedures. The only
    difference is their price, which is typically 20
    to 80 below that of brand-name originator
    pharmaceuticals.

12
Death Causes
13
Problems For Old People
  • Cardiovascular system High blood pressure
    (hypertension)
  • Bones, muscles and joints Osteoporosis
  • Digestive system Healthy digestion
  • Constipation
  • Kidneys, bladder and urinary tract
    Urinary incontinence
  • Prostate gland enlargement
  • Brain and nervous system How to keep your
    mind sharp
  • Eyes Dry eyes
  • Cataracts
  • Glaucoma
  • Macular degeneration
  • Presbyopia
  • Ears Hearing loss

14
Problems For Old People
  • Teeth Dry mouth
  • Oral and throat cancer
  • Dentures
  • Dental implants
  • Skin, nails and hair Skin cancer
  • Hair loss
  • Gray hair
  • Nail ridging
  • Skin tags
  • Sleep Sleep and seniors
  • Weight Menopause and weight gain
  • Sexuality Medecines
  • Food Exercise Exercise regularly
  • Eat nutritious food

15
Cardiovascular
  • Over time, the heart muscle becomes a less
    efficient pump, working harder to pump the same
    amount of blood through the body. In addition,
    blood vessels become less elastic. Hardened fatty
    deposits may form on the walls of the arteries
    (atherosclerosis), narrowing the passageway
    through the vessels. The natural loss of
    elasticity, in combination with atherosclerosis,
    makes arteries stiffer, causing the heart to work
    even harder to pump blood through them. This can
    lead to high blood pressure (hypertension).
  • High blood pressure (hypertension) is often
    called a silent killer because people can have it
    for years without knowing it. Blood pressure is
    determined by the amount of blood the heart pumps
    and the amount of resistance to blood flow in the
    arteries. Blood pressure normally varies during
    the day. It can even vary slightly with each beat
    of the heart. It increases during activity and
    decreases with rest. Many people may not view
    high blood pressure as life-threatening. But
    uncontrolled high blood pressure can increase the
    risk of serious health problems.

16
Bones, Muscels and Joints
  • Bones reach their maximum mass between ages 25
    and 35. As people age, their bones shrink in size
    and density. One consequence is that they might
    become shorter. Gradual loss of density weakens
    the bones and makes them more susceptible to
    fracture. Muscles, tendons and joints generally
    lose some strength and flexibility as people age.
  • Osteoporosis, which means "porous bones," causes
    bones to become weak and brittle - so brittle
    that even mild stresses like bending over,
    lifting a vacuum cleaner or coughing can cause a
    fracture. In most cases, bones weaken when people
    have low levels of calcium, phosphorus and other
    minerals in their bones. Osteoporosis can also
    accompany endocrine disorders or result from
    excessive use of drugs such as corticosteroids.
  • Although it is often thought of as a women's
    disease, osteoporosis affects many men as well.
    Even children are not immune.

17
Digestive Sistem
  • Swallowing and the motions that automatically
    move digested food through the intestines slow
    down as people get older. The amount of surface
    area within the intestines diminishes slightly.
    The flow of secretions from the stomach, liver,
    pancreas and small intestine may decrease. These
    changes generally do not disrupt the digestive
    process but constipation conditions are more
    frequent.
  • The digestive system can adjust to a wide variety
    of foods, tolerate an astonishing amount of
    emotional stress and put up with hurried meals of
    questionable nutritional value. But over time a
    poor diet, bad eating habits and other unsavory
    lifestyle habits can take their toll. The
    possible results? Distressing bouts of heartburn,
    nausea, cramps, diarrhea or constipation.

18
Kidneys, Bladder and Urinary Trackt
  • With age, kidneys become less efficient in
    removing waste from the bloodstream. Chronic
    conditions, such as diabetes or high blood
    pressure, and some medications can damage kidneys
    further.
  • About 30 percent of people age 65 and older
    experience urinary incontinence. Incontinence can
    be caused by a number of health problems, such as
    obesity, frequent constipation and chronic cough.
    Women are more likely than men to have
    incontinence. Women who have been through
    menopause might experience stress incontinence as
    the muscles around the opening of the bladder
    lose strength and bladder reflexes change. Pelvic
    muscles become weaker, reducing bladder support.
    In older men, incontinence is sometimes caused by
    an enlarged prostate, which can block the
    urethra. This makes it difficult to empty the
    bladder and can cause small amounts of urine to
    leak. Urinary incontinence is an all too common,
    often embarrassing and frustrating problem for
    millions of people.
  • Prostate enlargement affects about half of men in
    their 60s and up to 90 percent of men in their
    70s and 80s.

19
Brain and Nervous Sistem
  • The number of cells (neurons) in brain decreases
    with age, and memory becomes less efficient.
    However, in some areas of the brain, the number
    of connections between the cells increases,
    perhaps helping to compensate for the aging
    neurons and maintain brain function. Reflexes
    tend to become slower. There is also a tendency
    to become less coordinated. To try to slow down
    or even revert this process occupational
    therapies are advised so as to stimulate their
    intelect to remain active.

20
Eyes
  • With age, eyes are less able to produce tears,
    your retinas thin and lenses gradually turn
    yellow and become less clear. During the 40s,
    focusing on objects that are close up may become
    more difficult. Later, the irises stiffen, making
    pupils less responsive. This can make it more
    difficult to adapt to different levels of light.
    Other changes to lenses can make people sensitive
    to glare, which presents a problem when driving
    at night. Cataracts, glaucoma and macular
    degeneration are the most common problems of
    aging eyes.
  • Healthy eyes are continuously covered by a tear
    film - a constant layer of fluid designed to
    remain stable between blinks. A stable tear film
    prevents irritation of the nerves of the cornea,
    the clear front surface of eyes, and allows the
    eye to maintain clear, comfortable vision. The
    tear film protects the eyes and lubricates them.
    It also reduces the risk of eye infection and,
    with each blink of the eyelids, helps clear eyes
    of any debris. When the eyes become irritated
    from dust or are bothered by wind, smoke or
    fumes, extra tears form to help wash away the
    foreign material. Decreased production of fluids
    from tear glands can destabilize the tear film,
    allowing it to break down rapidly and creating
    dry spots on the cornea that cause irritation and
    diminished vision. An imbalance in the substances
    that make up the tear film also can make eyes
    become dry. For most people who have dry eyes,
    it's a chronic condition.

21
Eyes
  • A cataract is a clouding of the normally clear
    lens of eyes. Clouded vision can make it more
    difficult to read, drive a car or see the
    expression on a friend's face. Cataracts commonly
    affect distance vision and cause problems with
    glare. They generally do not cause pain, double
    vision with both eyes open or abnormal tearing.
    Clouding of the lens is a normal part of getting
    older. About half of people older than 65 have
    some degree of clouding of the lens. After age
    75, as many as 70 percent have cataracts that are
    significant enough to impair their vision. Most
    cataracts develop slowly and do not disturb
    eyesight early on. But as the clouding
    progresses, the cataract eventually interferes
    with vision. In the early stages, stronger
    lighting and eyeglasses can help to deal with the
    vision problems. But at some point, if impaired
    vision jeopardizes normal lifestyle, it might
    need surgery.
  • Glaucoma is sometimes called the silent thief
    because it can slowly steal your sight before
    people realize anything's wrong. The most common
    form of glaucoma, primary open-angle glaucoma,
    develops gradually, giving no warning signs. Many
    people are not even aware they have an eye
    problem until their vision is extensively
    compromised. Glaucoma is the second most common
    cause of vision loss in the United States as it
    affects approximately 3 million Americans.
    Glaucoma is not just one disease, but a group of
    them. The common feature of these diseases is
    damage to the optic nerve that usually is
    accompanied by an abnormally high pressure inside
    the eyeball. If left untreated, glaucoma may lead
    to blindness in both eyes.

22
Eyes
  • Age-related macular degeneration is a chronic eye
    disease that occurs when tissue in the macula,
    deteriorates. Degeneration of the macula causes
    blurred central vision or a blind spot in the
    center of your visual field. The first sign of
    macular degeneration may be a need for more light
    when doing close-up work. Fine newsprint may
    become harder to read and street signs more
    difficult to recognize. Eventually people may
    notice that when they are looking at a grid, some
    of the straight lines appear distorted or
    crooked. Gray or blank spots may mask the center
    of the visual field. The condition usually
    develops gradually, but may sometimes progress
    rapidly, leading to severe vision loss in one or
    both eyes. Macular degeneration is the leading
    cause of severe vision loss in people age 60 and
    older.
  • Presbyopia is the gradual loss of the eye's
    ability to focus actively on nearby objects. It
    is a natural part of aging that usually begins to
    affect people after age 40. For most people,
    presbyopia becomes apparent when they need to
    hold print at arm's length in order to read it.

23
Ears
  • Hearing loss is one of the most common conditions
    affecting adults who are middle-aged and older.
    One in three people older than 60 and half of all
    people older than 85 have significant hearing
    loss. Over the years, sounds and noise can damage
    the hair cells of the inner ears. In addition,
    the walls of the auditory canals thin, and
    eardrums thicken. People may have difficulty
    hearing high frequencies. Some people find it
    difficult to follow a conversation in a crowded
    room. Changes in the inner ear or in the nerves
    attached to it, earwax buildup and various
    diseases can all impact hearing.
  • The gradual hearing loss that occurs as people
    age (presbycusis) is a common condition. An
    estimated one-third of the peolple older than age
    60 and one-half of those older than age 85 have
    some degree of hearing loss. Over time, the wear
    and tear on ears from noise contributes to
    hearing loss by damaging the cochlea, a part of
    your inner ear. It is believed that heredity and
    chronic exposure to loud noises are the main
    factors that contribute to hearing loss. Other
    factors, such as earwax blockage, can prevent
    ears from conducting sounds as well as they
    should.

24
Teeth
  • How teeth and gums respond to age depends on how
    well people cared for them over the years. But
    even if they were meticulous about brushing and
    flossing, may notice that their mouth feels drier
    and gums have receded. Teeth may darken slightly
    and become more brittle and easier to break. Most
    adults can keep their natural teeth all of their
    lives. But with less saliva to wash away
    bacteria, teeth and gums become slightly more
    vulnerable to decay and infection.
  • Some older adults experience dry mouth
    (xerostomia), which can lead to tooth decay and
    infection. Dry mouth can also make speaking,
    swallowing and tasting difficult. Oral cancer is
    more common among older adults. Lack of saliva is
    a common problem that may seem little more than a
    nuisance, but it can affect both enjoyment of
    food and the health of teeth.
  • Missing teeth can make it difficult to eat and
    can cause discomfort in social situations.
    Implants or dentures may help people once again
    to chew, talk and smile with teeth that look and
    feel like their own.
  • The American Cancer Society estimates more than
    28,000 new cases of oral and throat
    (oropharyngeal) cancer occur annually in the
    United States an estimated more than 7,000
    Americans die of these cancers annually. The
    worldwide market for implant-based dental
    reconstruction products will approach nearly 3.5
    billion by 2010.

25
Skin, Nails and Hair
  • With age, skin thins and becomes less elastic and
    more fragile. It is also likely to bruise more
    easily. Decreased production of natural oils may
    make skin drier and more wrinkled. Age spots can
    occur, and skin tags are more common. Nails grow
    at about half the pace they once did. Hair may
    gray and thin. In addition, older people are
    likely to perspire less, making it harder to stay
    cool in high temperatures and putting them at
    increased risk of heat exhaustion and heat
    stroke. Skin cancer is also a concern as people
    age. There is a 40 to 50 chance of getting
    skin cancer at least once by the time people
    reach 65.
  • Skin cancer is the most common form of cancer
    diagnosed. Doctors diagnose skin cancer in
    approximately 1 million Americans each year, and
    about 9,800 Americans die annually of skin
    cancer. Fair-skinned people who live in areas
    that get a lot of sunshine are at greatest risk.
    But anyone can develop skin cancer, which is most
    commonly caused by overexposure to ultraviolet
    (UV) radiation from the sun.
  • Baldness typically refers to excessive hair loss
    from your scalp and can be the result of
    heredity, certain medications or an underlying
    medical condition. Anyone - men, women and
    children - can experience hair loss. The most
    common type is pattern baldness (androgenetic
    alopecia). It accounts for about 95 percent of
    hair loss from the scalp. It's typically
    permanent and can be attributed to heredity.
    Another type of alopecia, alopecia areata, can be
    temporary.

26
Skin, Nails and Hair
  • Hair typically turns gray as a result of aging.
    Pigment in the hair shaft comes from special
    cells at the root (base) of the hair. These cells
    are genetically programmed to make a certain
    amount of pigment (melanin) at specific ages. At
    some point in the aging process, these cells make
    less and less pigment until the hair has very
    little pigment. White hair has no pigment, and
    gray hair has some but not as much as a red,
    black or brown hair.
  • Vertical nail ridges, which run from the cuticle
    to the tip of the nail, are fairly common. They
    do not indicate serious illness and typically
    increase with age.
  • Skin tags are small, soft, flesh-colored growths
    that protrude from your skin. They most often
    occur in fold areas of the body, such as on the
    sides of the neck, armpit or groin. Skin tags
    typically appear in middle age.

27
Sleep
  • Sleep needs change little throughout adulthood.
    However, as people age, they will likely find
    that they sleep less soundly, meaning they will
    need to spend more time in bed to get the same
    amount of sleep. By age 75, some people find that
    they are waking up several times each night.
    Having difficulty getting to sleep and staying
    asleep is common as people age. But that does not
    mean insomnia cannot be avoided. Some medicines
    and therapies can help reduce or even eliminate
    these conditions.

28
Weight
  • As people age, maintaining a healthy weight - or
    losing weight if they are overweight - may be
    more difficult. This because metabolism generally
    slows, meaning that their body burns fewer
    calories. Calories that were once used to meet
    the daily energy needs instead are stored as fat.
    Also the level of activity may decrease,
    resulting in unwanted weight gain. There is also
    the tendency that the weight gain tends to
    accumulate around the stomach, rather than hips
    and thighs.

29
Sexuality
  • With age, sexual needs, patterns and performance
    may change. Impotence becomes more common in men
    as they age. By the time they are 65, up to 25
    percent of men have difficulty getting or keeping
    an erection about one in every four times they
    have sex. In others, it may take longer to get an
    erection, and it may not be as firm as it used to
    be.

30
Opportunities
  • The demand for medical products related to
    cardiovascular, bones, muscles, joints, digestive
    system, kidneys, brain, eyes, teeth, skin, nails,
    hair sleeping disorders, overweight or sexual
    problems are meant to rise as the population
    requiring them is meant to increase. The previous
    conditions that we saw before are just some of
    the new opportunities that derive from the
    population ageing. These conditions will
    represent a greater share of the diseases
    affecting mankind. They have, therefore, a great
    potential for the health industry and should be
    regarded with special attention as they represent
    a potential market of million consumers.
    Therefore the development or generic production
    of medicines related to these conditions
    represent a very important niche that should be
    regarded as a strategically one.

31
Stem Cells
  • Stem cells can be derived from an embryo or an
    adult. Unlike most cells in the body, such as
    skin or heart cells, which are dedicated to
    perform a specific function, stem cells are not
    specialists. But under certain circumstances,
    they can differentiate into specialized cells.
    Another unique characteristic of stem cells is
    their ability to replicate for indefinite periods
    without becoming senescent. It is not clear,
    however, if adult stem cells can fully match
    embryonic stem cells capacity to differentiate
    into vast arrays of replacement cells and
    tissues. In animal studies, certain adult stem
    cells have shown some potential to develop into
    multiple cell types, suggesting that both
    embryonic and adult stem cells could have
    therapeutic applications. Still, the discovery of
    human stem cells is an important scientific
    breakthrough that clearly has the potential to
    improve the quality and length of life.

32
Geriatric Care
  • As the senior will be a significant part of the
    population and they demand specific treatment,
    geriatric care will be a area of greater
    importance and with a growing demand.
    Additionally this segment of the population will
    posses a considerable income, due to the social
    welfare, to spend in this kind of care. Therefore
    geriatric care services will meet a great
    expansion and some of the retirees will move to
    countries where the cost of living is lesser than
    in their own to enjoy their retirement.

33
Generics Vs Brand Name
  • There are basically two forms of drug -
    proprietary (or 'brand-named') drugs that are
    developed and produced by large multinational
    pharmaceutical companies, and generic drugs that
    are either copies, or the basic form of a
    proprietary drug. Paracetamol for example is the
    generic form of Panadol or Tylenol. The companies
    that make these brand-names may spend thousands
    on marketing and inventing new formulations, but
    the basic active ingredient in their tablets is
    just standard paracetamol which can be bought
    without the label for far less money. Paracetamol
    can be made generically because there is no
    longer a patent on it. However, drugs that are in
    patent can also be copied under certain
    conditions, and are also known as generics.
  • A generic medicine is an equivalent of an
    originator pharmaceutical product. It contains
    the same active substance as, is essentially
    similar to, and is therefore interchangeable
    with, the originator product.
  • A generic medicine is marketed in compliance with
    international patent law. It is identified either
    by its internationally approved non-proprietary
    scientific name (INN) or by its own brand name.
    Generic medicines are widely used in many EU
    countries in cost-effective treatment programmes,
    and are increasingly prescribed by doctors as
    effective alternatives to higher-priced
    originator pharmaceuticals.

34
Generics
  • Also governments, as the number of retired people
    starts to get too close to the number of workers,
    will try to find cheaper ways to supply the
    surging medical with the minimum possible costs.
    This effort will lead them to incentive the
    increase usage of such type of medicines as they
    are significantly cheaper and provide the same
    results.

35
Generics
  • Increasing patient access to generic medicines
    generates four main public health benefits. It
  • Reduces Prices.
  • Generic medicines are themselves more
    economically priced than originator products
    selling at 20-80 less than original prices
  • Competition from these generic rivals forces
    originators to reduce their own prices after, or
    even before patent expiry.
  • 2. Stimulates Competition
  • A permanent monopoly on pharmaceutical products
    would provide little incentive to originator
    companies to discover new medicines. As in all
    sectors, competition is a major stimulation to
    innovation.
  • 3. Creates Budget Headroom for Innovation.
  • The billion dollars saved annually in the world
    by buying equivalent generic medicines allows
    healthcare budgets and personal budgets the
    capacity to buy the newer, more expensive
    treatments when required.
  • 4. Encourages new pharmaceutical companies.
  • This ensures less dependency on large
    multinational firms for the provision of
    medicines worldwide.

36
Generics
  • In the end of 2004, 35 of top selling
    pharmaceuticals were patent expired, creating a
    major opportunity over the next few years for
    increasing the purchase of generic medicines,
    both in community prescription and in hospital
    sectors. This poses good perspectives for the
    generics industry as the increasing trend is
    supposed to continue with more and more
    applications for generic patents being made.

37
Global Warming
  • Areas like the North America and Europe are
    reconsidering their previous position on tropical
    diseases as their range is moving up north and
    south and are threatening to hit those areas.
    They are doing so by filling their stocks with
    supplies of available medicines to fight those
    diseases to prevent possible epidemics. Global
    warming will cause a significant increase in
    human mortality due to extreme weather and
    infectious disease. No country, even
    industrialized nations will escape these impacts.
    Scientists project that as warmer temperatures
    spread north and south from the tropics, and to
    higher elevations, malaria-carrying mosquitoes
    will spread with them. They conclude that global
    warming will likely put as much as 65 of the
    world's population at risk of infection and that
    means an increase of 20. Spreading infectious
    disease, longer and hotter heat waves, and
    extreme weather will all claim thousands of
    additional lives nationwide each year. Doctors
    and scientists around the world are becoming
    increasingly alarmed over global warnings impact
    on human health. Abnormal and extreme weather,
    which scientists have long predicted would be an
    early effect of global warming, have claimed
    hundreds of lives across the world in recent
    years. Our warming climate is also creating the
    ideal conditions for the spread of infectious
    disease, putting millions of people at risk.

38
Global Warming
  • Malaria, generally does not afflict regions with
    annual average temperatures below 16C, because
    lower temperatures inhibit the parasite. As
    minimum temperatures climb, the disease could
    spread into previously malaria free regions. Yet
    the predicted consequences of global warming
    would fall most heavily on tropical regions,
    where malaria could spread in both latitude and
    altitude. A relatively small increase in winter
    (minimum) temperature would likely facilitate the
    spread of malaria into large urban highland
    populations that are currently malaria free and
    immunologically naive, such as Nairobi, Kenya,
    and Harare, Zimbabwe.
  • Future trouble will also come from the seas as
    the global warming should make the oceans a more
    hospitable home for cholera and harmful algal
    blooms.

39
New Diseases
  • New diseases will show up in areas previously
    safe not only because of the global warming
    effects but also as new strains of virus and
    bacterias will emerge. With the growing
    population density of cities and villages and the
    sometimes poor sanitation conditions, diseases
    thrive and evolve. Also the irresponsible usage
    of current drugs is helping mutations in the
    antibiotics situation the scenario is alarming as
    many are ceasing to be effective and stronger
    ones are being put to general use. This creates
    many problems as current available drugs, unlike
    diseases, are ceasing to be effective and deaths
    are more frequent. Also previous deaths whose
    causes were unexplained may on the future have
    their causes met what will enable new research
    fields.
  • This presents itself as an opportunity for
    pharmaceuticals, as diseases that were under
    control will no longer be and drugs that
    previously were controlling the market will cease
    to, as they will need to be replaced by new, more
    effective ones.

40
Human Genome Project
  • All diseases have a genetic component, whether
    inherited or resulting from the body's response
    to environmental stresses like viruses or toxins.
    The successes of the human genome project have
    even enabled researchers to pinpoint errors in
    genes - the smallest units of heredity - that
    cause or contribute to disease. 
  • The ultimate goal is to use this information to
    develop new ways to treat, cure, or even prevent
    the thousands of diseases that afflict humankind.
    But the road from gene identification to
    effective treatments is long and fraught with
    challenges. In the meantime, biotechnology
    companies are racing ahead with commercialization
    by designing diagnostic tests to detect errant
    genes in people suspected of having particular
    diseases or of being at risk for developing
    them. 
  • An increasing number of gene tests are becoming
    available commercially, although the scientific
    community continues to debate the best way to
    deliver them to the public and medical
    communities that are often unaware of their
    scientific and social implications. While some of
    these tests have greatly improved and even saved
    lives, scientists remain unsure of how to
    interpret many of them. 

41
Human Genome Project
  • Explorations into the function of each human gene
    - a major challenge extending far into the 21st
    century - will shed light on how faulty genes
    play a role in disease causation. With this
    knowledge, commercial efforts are shifting away
    from diagnostics and toward developing a new
    generation of therapeutics based on genes. Drug
    design is being revolutionized as researchers
    create new classes of medicines based on a
    reasoned approach to the use of information on
    gene sequence and protein structure function
    rather than the traditional trial-and-error
    method. Drugs targeted to specific sites in the
    body promise to have fewer side effects than many
    of today's medicines.
  • The potential for using genes themselves to treat
    disease - gene therapy - is the most exciting
    application of DNA science. This rapidly
    developing field holds great potential for
    treating or even curing genetic and acquired
    diseases, using normal genes to replace or
    supplement a defective gene or to bolster
    immunity to disease.

42
The Genome
  • Rapid progress in genome science and a glimpse
    into its potential applications have spurred
    observers to predict that biology will be the
    foremost science of the 21st century. Technology
    and resources generated by the Human Genome
    Project and other genomics research are already
    having a major impact on research across the life
    sciences. The potential for commercial
    development of genomics research presents the
    health industry with a wealth of opportunities,
    and sales of DNA-based products and technologies
    in the biotechnology industry are projected to
    exceed 45 billion by 2009. Those opportunities
    can derive from
  • Molecular Medicine
  • Improved diagnosis of disease
  • Earlier detection of genetic
  • predispositions to disease
  • Rational drug design
  • Gene therapy and control
  • systems for drugs
  • Pharmacogenomics "custom
  • drugs"
  • DNA Forensics (Identification)
  • Identify potential suspects whose DNA may match
    evidence left at crime scenes
  • Identify crime and catastrophe victims
  • Establish paternity and other family
    relationships
  • Identify endangered and protected species as an
    aid to wildlife officials (could be used for
    prosecuting poachers)
  • Detect bacteria and other organisms that may
    pollute air, water, soil, and food
  • Match organ donors with recipients in transplant
    programs
  • Determine pedigree for seed or livestock breeds

43
Anti-Aging Products
  • Demand for anti-aging products is expected to
    reach 30 billion in 2009, propelled by a stream
    of new and improved products offering health
    maintenance and appearance enhancing benefits to
    a largely untapped customer base of middle-aged
    and elderly consumers. The value of chemicals
    used to manufacture these products will reach
    3.8 billion. New product introductions and the
    passage of the relatively affluent baby boomer
    generation through middle age (when age related
    changes become more apparent) will stimulate
    demand for formulated appearance anti-aging
    products. Strong growth will arise from various
    products that reduce the visibility of wrinkles
    and age spots, such as wrinkle removal injections
    and age-defying lotions. However, gains will be
    limited by fierce price competition among the
    large number of over-the counter brands
    continuing to emerge. Hair growth stimulants will
    also record robust gains.
  • Chemicals expected to benefit from rapid gains in
    anti-aging products include memory-enhancing
    neurological and ophthalmic agents botulinum
    toxin for wrinkle-reducing applications and a
    host of small volume herbal extracts, including
    lutein, lycopene and black cohosh, used in both
    dietary supplements and cosmeceuticals.

44
Tobacco Addiction
  • Tobacco addiction is widespread and its prejudice
    is also widely known. As governments from the
    developed countries start to tax at a higher rate
    these products the incentives for a change of
    habits are bigger. The economical and health
    advantages of quitting to smoke will be greater
    and people will be willing to spend a greater
    amount of money in recovering from their
    condition.
  • Cigarette smoking is a major preventable cause of
    disease worldwide, and it is the major cause of
    premature death in North America. The important
    causes of mortality are atherosclerotic vascular
    disease, cancer, and chronic obstructive
    pulmonary disease (COPD). Smoking also can
    contribute to other diseases, eg, histiocytosis
    X, respiratory bronchiolitis, obstructive sleep
    apnea, idiopathic pneumothorax, low birth weight,
    and perinatal mortality.
  • Factors influencing smoking initiation differ
    from those of smoking behavior maintenance.
    Nicotine dependence, genetic factors, and
    psychosocial factors influence maintenance of
    smoking behavior.
  • Nicotine meets the criteria of a highly addictive
    drug. Nicotine is a potent psychoactive drug that
    induces euphoria, serves as a reinforcer of its
    use, and leads to nicotine withdrawal syndrome
    when it is absent. Nicotine in cigarette smoke
    affects mood and performance and is the source of
    addiction to tobacco. Smoking may begin as a
    voluntary habit, but eventually it becomes an
    addiction.

45
Cancer
  • One in every eight deaths worldwide is due to
    cancer, which claims twice as many lives as AIDS.
    By 2020, three out of every five new cancer cases
    will be found in the developing world. In these
    countries, 80 to 90 of cancer patients already
    suffer from advanced and incurable cancers at the
    time of diagnosis. Also in 2020, regions with
    traditionally low numbers of cancer deaths could
    see alarming increases in mortality rates.
    Regions including Northern Africa and Western
    Asia, South America, the Caribbean, and South
    East Asia could face sharp increases of over 75
    in the number of cancer deaths in 2020 as
    compared to 2000.
  • The knowledge about prevention and treatment of
    cancer is increasing, yet the number of new cases
    grows every year. If current trends continue, 15
    million people will discover they have cancer in
    2020, two-thirds of them in newly-industrialized
    and developing countries.

46
AIDS
  • The AIDS epidemic caught scientists off guard.
    The medical community has been unable to find
    ways to cure or even vaccinate against infection.
    AIDS is an acronym that stands for acquired
    immunodeficiency syndrome and is an infectious
    disease in which the immune system collapses.
    This disease is caused by the human
    immunodeficiency virus (HIV). Most HIV infections
    are sexually transmitted however, another
    cluster of infections has come from IV-drug users
    sharing needles. HIV infections are atypical of
    other viral infections in several ways HIV
    typically kills its host around a decade after
    infection yet is virtually asymptomatic during
    the first several years the viral infection is
    not, by itself, the cause of death the virus
    specifically infects key cells of the immune
    system and thereby ultimately destroys the immune
    response the virus can "hide-out" inside cells
    for years and then emerge long after any
    treatment has stopped.
  • The number of cases grew rapidly in just a few
    years. From blood samples and autopsy reports,
    the first case dates to the 1950s. But it was not
    until nearly 1980 that it became common enough to
    be noticed. Today, 30 million people are infected
    worldwide. A huge fraction of Africa's population
    in some countries is infected, the epidemic is
    spreading exponentially in Asia. (Five years ago,
    it was estimated that 10 of Thailand's military
    was infected.) Drugs are available that prolong
    the life of infected individuals, but the regimen
    is rigorous (daily doses of several drugs), and
    the virus has been able to evolve resistance to
    every drug tried.

47
Plastic Curgery
  • Recent surveys discovered that over 69 of women
    are concerned with the visible signs of aging,
    including fine lines, wrinkles, and dryness. 47
    want to improve the look of the skin around their
    eyes, and 18 want to improve the look of the
    area around their mouths.

48
Influenza
  • Strains of flu virus differ from one another
    largely in the genes that code for surface
    molecules called glycoproteins, which are the
    primary targets of the body's immune system in
    defending against flu viruses. Evolutionary
    changes in immune response against such antigen
    molecules are the reason that new vaccines must
    be developed against emerging strains of virus.
    Vaccines remain the mainstays in our
    armamentarium against influenza but they must be
    constantly updated to meet with the new strain of
    virous that are constantly appearing.

49
SARS
  • Severe acute respiratory syndrome (SARS) is a
    viral respiratory illness caused by a
    coronavirus, called SARS-associated coronavirus
    (SARS-CoV). SARS was first reported in Asia in
    February 2003. Over the next few months, the
    illness spread to more than two dozen countries
    in North America, South America, Europe, and Asia
    before the SARS global outbreak of 2003 was
    contained. According to the World Health
    Organization (WHO), a total of 8,098 people
    worldwide became sick with SARS during the 2003
    outbreak. Of these, 774 died.
  • The main way that SARS seems to spread is by
    close person-to-person contact. The virus that
    causes SARS is thought to be transmitted most
    readily by respiratory droplets (droplet spread)
    produced when an infected person coughs or
    sneezes. Droplet spread can happen when droplets
    from the cough or sneeze of an infected person
    are propelled a short distance (generally up to 3
    feet) through the air and deposited on the mucous
    membranes of the mouth, nose, or eyes of persons
    who are nearby. The virus also can spread when a
    person touches a surface or object contaminated
    with infectious droplets and then touches his or
    her mouth, nose, or eye(s).

50
Drug Addictions
  • Drug addiction is a complex illness. It is
    characterized by compulsive, at times
    uncontrollable drug craving, seeking, and use
    that persist even in the face of extremely
    negative consequences. For many people, drug
    addiction becomes chronic, with relapses possible
    even after long periods of abstinence.
  • The compulsion to use drugs can take over the
    individual's life. Addiction often involves not
    only compulsive drug taking but also a wide range
    of dysfunctional behaviors that can interfere
    with normal functioning in the family, the
    workplace, and the broader community. Addiction
    also can place people at increased risk for a
    wide variety of other illnesses. These illnesses
    can be brought on by behaviors, such as poor
    living and health habits, that often accompany
    life as an addict, or because of toxic effects of
    the drugs themselves. Because addiction has so
    many dimensions and disrupts so many aspects of
    an individual's life, treatment for this illness
    is never simple.
  • Effective drug abuse and addiction treatment
    programs typically incorporate many components,
    each directed to a particular aspect of the
    illness and its consequences Three decades of
    scientific research and clinical practice have
    yielded a variety of effective approaches to drug
    addiction treatment.
  • Medications, such as antidepressants, mood
    stabilizers, or neuroleptics, may be critical for
    treatment success when patients have co-occurring
    mental disorders, such as depression, anxiety
    disorder, bipolar disorder, or psychosis.

51
Blood Substitutes
  • Blood is an essential body fluid. It is
    responsible for the transport of oxygen to body
    tissues, and for carrying away wastes such as
    carbon dioxide. It performs important functions
    such as clotting to stop bleeding. It is the
    major vehicle for transport of nutrients and
    antibodies. Blood is literally a river of life.
    Blood is one of the world's most vital medical
    commodities The liquid and its derivatives save
    millions of lives every year. Yet blood is a
    complex resource not completely understood,
    easily contaminated, and bearing more than its
    share of cultural baggage. Physicians and
    scientists alike recognized that a blood
    substitute would bypass the risk of a blood-borne
    pathogen being passed to a patient during
    transfusion. Further advantages to using a blood
    substitute in place of normal blood include an
    increased shelf life, the elimination of the need
    to crossmatch blood types from donor to
    recipient, and the ability to transfuse in an
    ambulance. The estimated market for a blood
    substitute is now between 2 and 12 billion
    dollars. the world market for blood and its
    derivatives probably does not exceed 18.5
    billion per year. About 4.5 million units of
    human blood are transfused every year, at a price
    of 200 to 350 a pint, a market of 8 billion to
    10 billion. Unlike human blood, the synthetic
    stuff doesnt have a limited shelf life, and is
    free of viruses such as HIV and hepatitis that
    can be present in human blood.

52
Diabetes
  • Diabetes mellitus is a group of diseases
    characterized by high levels of blood glucose
    resulting from defects in insulin production,
    insulin action, or both. Diabetes can be
    associated with serious complications and
    premature death, but people with diabetes can
    take steps to control the disease and lower the
    risk of complications.
  • Type 1 diabetes was previously called
    insulin-dependent diabetes mellitus (IDDM) or
    juvenile-onset diabetes. Type 1 diabetes develops
    when the body's immune system destroys pancreatic
    beta cells, the only cells in the body that make
    the hormone insulin that regulates blood glucose.
  • Type 2 diabetes was previously called
    non-insulin-dependent diabetes mellitus (NIDDM)
    or adult-onset diabetes. Type 2 diabetes may
    account for about 90 to 95 of all diagnosed
    cases of diabetes. It usually begins as insulin
    resistance, a disorder in which the cells do not
    use insulin properly. Type 2 diabetes is
    associated with older age, obesity, family
    history of diabetes, history of gestational
    diabetes, impaired glucose metabolism, physical
    inactivity, and race/ethnicity. Type 2 diabetes
    is increasingly being diagnosed in children and
    adolescents.

53
Diabetes
  • With this new tendency to be obese our society is
    becoming more prone to diabetes. This cronical
    disease is growing every day and not only adults
    and elders are struck by its effects. Nowadays
    children due to their habits are more prone to be
    diabetic.
  • Diabetes can affect many parts of the body and
    can lead to serious complications such as
    blindness, kidney damage, and lower-limb
    amputations.
  • In the US alone about 210,000 people under 20
    years of age have diabetes. This represents 0.26
    of all people in this age group. Approximately
    one in every 400 to 500 children and adolescents
    has type 1 diabetes. Over the age of 20 years
    old 18.0 million 8.7 of all people in this age
    group have diabetes. Over 60 years old 8.6
    million 18.3 of all people in this age group
    have diabetes.

54
Healthy Holidays
  • As people get older the preoccupation with their
    physical welfare increases and their life is most
    of the times planned around this need. This means
    that holidays that can help them take care of
    their body as well as their spirit are welcomed.
    Izmir has a fine example in the usage of fish to
    help cure psoriasis condition.
  • In a further reflection of consumers' growing
    inclination to choose products that are good for
    their health, travel packages that combine
    medical checkups or treatment with fun and
    relaxing activities are enjoying a steady growth
    in popularity. A typical package of this sort
    involves the traveler being given an extensive
    medical checkup at a hospital before enjoying a
    relaxing and therapeutic stay at a hot spring
    resort. Witnessing a particular boom in
    popularity are medical travel package tours
    offering positron emission tomography (PET)
    scans, a technology that is being used
    increasingly in the detection of cancer, with
    hotel accommodation included. These packages,
    which also include hotel accommodation, are the
    result of alliances between travel agencies and
    medical institutions in cities throughout Japan.
    Such packages offer benefits not only for
    consumers - it is well known that early detection
    is vital in the treatment of many diseases - but
    also for medical institutions and the travel
    industry. Hospitals and clinics are also able to
    use the expensive medical equipment they own to
    derive commercial revenue, while travel agencies
    are able to tap a new and expanding market. More
    and more medical travel packages are expected to
    appear in the years ahead. Many industry analysts
    predict that medical tourism will be an
    increasingly important element of the travel
    industry, because people's awareness of the
    importance of preventative health and their
    willingness to spend time and money on it are
    likely to continue to grow.

55
Genetic Testing
  • With the development of new areas of the genetic
    field new sorts of test as well as the accuracy
    of the current ones increase. Also people become
    more confident in the reliability of the results.
    New applications of these techniques arise. Not
    only for police research purposes, even though
    that will happen at a higher rate, but also
    university laboratories and other medical
    laboratories that can not afford or do not have
    the skills or machines to do these tests.
  • Despite still being in its infancy, the genetic
    testing market has the potential for strong
    growth in the future, genetic testing generated
    revenues totaling 319.9 million in 2000 and is
    estimated to reach 877.2 million by 2006 at a
    compound annual growth rate of 20.4. Tests that
    were uncommon, if not unheard of, a short while
    ago are now routinely performed at genomic
    testing labs all over the world.

56
Genetic Testing
  • The use of genetic tests to measure a persons
    predisposition to blood clots, for example, is
    increasing at a rate of 150 per year.
    Gynecologists are expected to recommend that many
    couples planning to have a child be tested for
    the cystic fibrosis gene. While the
    prenatal-screening area is projected to increase
    at an annual rate of 8, the cancer and
    predisposition testing markets are expected to
    grow at rates of 30 and 29.8, respectively.
    Analysts attribute such high growth rates in the
    cancer and predisposition testing segments to
    continuing developments in genetic research.

57
Health Tecnical Machines
  • The market for pre-hospital emergency and trauma
    equipment is really healthy, and is expected to
    remain that way well through century.
    Nevertheless the hospital market for emergency
    equipment is in a downturn. That segment of the
    market is considered saturated, with revenues
    derived primarily from replacement sales.
    Understandably, manufacturers have targeted
    pre-hospital prospects. As pre-hospital emergency
    and trauma equipment becomes increasingly
    automated, accurate and user-friendly, it is
    being put into the hands of an expanding end-user
    base of pre-hospital lay persons and minimally
    trained practitioners. That expanded user base,
    plus the rapid development and deployment of new,
    cost-effective equipment, gives the pre-hospital
    emergency market tremendous growth potential.
    Manufacturers and marketers are scrambling for
    position in the cost-conscious, highly
    competitive industry. As prices fall, products
    become more accessible, leading to increasing
    end-user demand creating a new hot prospects
    market.

58
Fitness Machines
  • The culture of the body is increasing, as people
    get more conscious that their body is a machine
    that requires maintenance to work properly. They
    also care more about their looks and fitness and
    the way how other people see them. This new
    concept has driven people to the gym and to buy
    devices that enable them to pursue these two
    goals, Looking good and being good.
  • Of course this option has opened a new branch of
    the health industry thats the production of such
    devices that can help people exercising. This
    already significant and growing market presents a
    great opportunity for high margins goods.

59
Childhood Obesity
  • The rising obesity epidemic reflects the profound
    changes in society and in the behavioral patterns
    of communities over the last 20 - 30 years.
    Individuals may become obese, partly because they
    have a genetic predisposition to gain weight
    readily when they are exposed to unhealthy diets
    and lifestyles. Nevertheless, the fundamental
    cause of the obesity epidemic is the change in
    behaviors and lifestyles, especially with regard
    to diet and physical activity patterns.
    Furthermore, for childhood obesity, there is
    increasing evidence from a range of studies
    indicating the important role of early life
    environment in the later risk of obesity.
    Intrauterine life, infancy, and the pre-school
    period, have all been considered as possible
    critical periods during which the regulation of
    energy balance may be programmed for the long
    term. Obesity is a complex, multi-factorial
    disorder and coherent and comprehensive
    strategies are needed for its effective and
    sustainable prevention and management.
  • Obesity is now well recognized as a disease in
    its own right, one, which is largely preventable
    through changes in lifestyle, especially diet and
    physical activity. Obesity is a major risk factor
    associated with increased morbidity and mortality
    from chronic noncommunicable diseases. In many
    parts of the world, obesity rates are doubling
    every 5 to 10 years and increasing the financial
    burden of providing medical care due to resulting
    health problems. World Health Statistics 2005
    published last month indicate
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