肥満の臨床管理：製品、技術、および市場

This report will be a detailed market and technology assessment and forecast of the products and technologies in the clinical management of obesity. The report will describe the current and projected patient population in obesity, detailing their incidence worldwide, the clinical practices in their management to encompass surgical approaches, medical supervised severely restricted diets, drug therapies, OTC treatments, biopharmaceuticals, non-pharmacologic approaches and weight maintenance approaches.

The report will describe clinical trends in the management of the obese. The report will detail the products on the market and the status of those in development for bariatric surgery, drug therapy, gastric stimulation devices, brain stimulation devices, combination therapies and genetic therapy, and will provide current and forecast of the market for these products in the U.S. and separately for Europe. The report will profile at least 25 companies in this market, detailing the current products, products in development, market position and overall businesses in obesity management.

Executive Summary

Section 1: Introduction

1.1 Overview

1.2 Definitions

1.3 Clinical Background

1.3.1 Prevalence in the US Population

1.3.2 Prevalence of Obesity Worldwide

1.3.2.1 Europe

1.3.2.2 Japan

1.3.2.3 China

1.3.2.4 Developed Nations vs. Developing Nations

1.4 Patient Population Segmentation

1.4.1 Adults

1.4.2 Adolescents

1.4.3 Children

1.5 Overweight, Obesity and Morbidity

1.5.1 The Multifactorial Causes of Obesity

1.5.1.1 The Appetite Regulatory System?Facts and Theories

1.5.1.1.1 Insulin

1.5.1.1.2 Leptin: The Ups and Downs of a Promising Lead

1.5.1.1.3 Ghrelin

1.5.1.1.4 Peptide YY & the Y2 Receptor

1.5.1.1.5 AMPK

1.5.1.1.6 Role of the Hypothalamus

1.5.1.1.7 Melanocortins & Serotonin

1.5.1.2 The Body’s Fight to Retain Fat

1.5.1.3 Body Mass Index (BMI)

1.5.1.4 Genetic Roots of Obesity

1.5.1.4.1 Congenital Leptin Deficiency

1.5.1.4.2 Genetic Association Studies

1.5.1.4.3 Genetic Testing For Obesity

1.5.2 Obesity, Lifestyle and the ‘Obesogenic’ Environment

1.5.2.1 Feeding Control

1.5.2.2 Energy Efficiency

1.5.2.3 Adipose Tissue Biology

1.5.2.4 Abdominal Girth as a Warning Sign

1.5.3 Metabolic Syndrome, or Syndrome X

1.5.4 Binge Eating Disorder (BED)

1.5.5 Night Eating Syndrome (NES)

1.5.6 Why Treat Obesity?

Section 2: Weight loss management approaches

2.1 Surgical Approaches

2.1.1 Background and Professional Certification Efforts

2.1.2 Gastric Bypass, Mini Gastric Bypass and Laparoscopic Surgery

2.1.2.1 Gastric Bypass, or Roux-en-Y Surgery

2.1.2.2 Mini Gastric Bypass

2.1.2.3 Laparoscopic Surgery

2.1.3 Biliopancreatic Diversion/Duodenal Switch (BPD/DS)

2.1.4 Two-Stage Weight Loss Surgery

2.1.5 Vertical Banded Gastroplasty (VBG)

2.1.6 Adjustable Gastric Band (AGB) Surgery

2.1.7 Internal or Implantable Gastric Stimulation (IGS) Device

2.1.8 Gastric Balloon

2.1.9 Radio-frequency Antralplasty

2.2 Pharmaceutical Therapies

2.2.1 Pancreatic Lipase Inhibitors

2.2.2 Serotonin and Norepinephrine Reuptake Inhibitors

2.2.3 Noradrenergic Anorectic Agents

2.3 Non-pharmacological Approaches

2.4 Medically Supervised Very Low Calorie Diets (VLCDs), Behavior Modification and Residential Programs

2.5 Weight Maintenance Approaches

Section 3: Impact of obesity

3.1 Obesity Treatments, Related Costs and Reimbursement

3.2 Impact Upon Business/Economy

3.2.1 United Kingdom

3.2.2 Impact Upon Insurance Costs

3.2.3 Cost of Treatment of Obesity, versus Long-term Cost to Treat Related Conditions

3.3 The Government Enters the Fray

3.3.1 USA

3.3.1.1 Insurance and Mandated Coverage Bills

3.3.1.2 Medicare Debates Gastric Bypass Surgery

3.3.2 United Kingdom: NICE & Weight Management at the Primary Care Level

3.3.3 France: The Caisse Nationale d’Assurance Maladie (CNAM)

Section 4: Market Assessment

4.1 Bariatric Surgery Devices

4.1.1 United States and Canada

4.1.2 Canada

4.1.3 European Union

4.1.3.1 United Kingdom

4.1.3.2 France

4.1.3.3 Germany

4.1.3.4 Italy

4.1.3.5 Spain

4.1.3.6 Scandinavia

4.1.4 Japan

4.1.5 Rest of World (ROW)

4.2 Pharmaceuticals

4.2.1 United States and Canada

4.2.2 Pharmaceutical treatments in the Europe Union

4.2.2.1 United Kingdom

4.2.2.2 France

4.2.2.3 Germany

4.2.2.4 Italy

4.2.2.5 Spain

4.2.2.6 Scandinavia

4.2.3 Japan

4.2.4 Rest of World (ROW)

4.2.5 Developing Drugs for Tomorrow, While Maximizing Profits Today

Section 5: Opportunities

5.1 Drug & Device Market Opportunities

5.2 Durable Medical Equipment for the Bariatric Patient

5.3 Creating Mutually Beneficial Relationships

5.4 Focus on Education and Practice Consulting

Section 6: Selected Company Profiles

6.1 Abbott Laboratories

6.2 AdipoGenix

6.3 Amgen

6.4 Amylin Pharmaceuticals

6.5 AstraZeneca

6.6 Athersys, Inc.

6.7 Bayer AG

6.8 Biovitrum AB

6.9 CuraGen Corporation

6.10 DeCODE Genetics

6.11 DeveloGen AG

6.12 Ethicon Endo-Surgery/Johnson & Johnson

6.13 GenWay Biotech, Inc.

6.14 GlaxoSmithKline

6.15 Inamed Corporation

6.16 Ingenium Pharmaceuticals AG

6.17 IntraPace, Inc.

6.18 Johnson & Johnson

6.19 Manhattan Pharmaceuticals, Inc.

6.20 Merck & Co., Inc.

6.21 Metabolic Pharmaceuticals Ltd

6.22 Millennium Pharmaceuticals

6.23 Myriad Genetics

6.24 Nastech Pharmaceutical Company, Inc.

6.25 Pfizer, Inc.

6.26 Regeneron Pharmaceuticals

6.27 Roche (F Hoffman-La Roche Ltd)

6.28 Sanofi-Aventis

6.29 Speedel Group AG

6.30 Synovis Life Technologies Inc.

6.31 Transneuronix, Inc.

6.32 Vista Medical Technologies, Inc.

6.33 Wyeth Pharmaceuticals

Appendix: List of Companies

Appendix: List of ORGANIZATIONS

List of Exhibits

Exhibit 1-1: Elements Contributing to the Obesity Epidemic

Exhibit 1-2: Prevalence of Obesity, Percent of Population (2003)

Exhibit 1-3: WHO Graph of Obesity, 2004

Exhibit 1-4: Worldwide Total, Obese and Morbidly Obese, 2002-2013

Exhibit 1-5: Examples of Definitions Used and Age Groups Included in Surveys Reporting Prevalence of Obesity

Exhibit 1-6: Examples of Human Pleiotropic Obesity Syndromes

Exhibit 1-7: Leptin’s Role in the Body

Exhibit 1-8: Candidate Genes for Control of Appetite, Energy Expenditure, Usage of Nutrients and Body Fat Distribution

Exhibit 2-1: IFSO and Minimum Professional Requirements for Practicing Bariatric Surgeon

Exhibit 2-2: Gastric Bypass Surgery

Exhibit 4-1: Clinical Management of Obesity, Total World Revenue Market Forecast, 2002-2013 (US$M)

Exhibit 4-2: Clinical Management of Obesity, Total World Revenue Market Forecast, 2002-2013 (US$M)

Exhibit 4-3: Bariatric Surgery Devices, Total Market Forecast, 2002-2013

Exhibit 4-4: Medical Devices, Market Forecast, United States and Canada, 2002-2013

Exhibit 4-5: Bariatric Surgery Devices, Market Forecast, US and Canada, 2002-2013

Exhibit 4-6: US Obesity Treatment Medical Device Company Market Shares, 2013

Exhibit 4-7: Medical Devices, Market Forecast, European Union, 2002-2013

Exhibit 4-8: Medical Devices, Market Forecast, United Kingdom, 2002-2013

Exhibit 4-9: Bariatric Surgery Devices, Market Forecast, United Kingdom 2002-2013

Exhibit 4-10: Medical Devices, Market Forecast, France, 2002-2013

Exhibit 4-11: Bariatric Surgery Devices, Market Forecast, France, 2002-2013

Exhibit 4-12: Adjustable Gastric Band Device Market Shares, France, 2004

Exhibit 4-13: Medical Devices, Market Forecast, Germany, 2002-2013

Exhibit 4-14: Bariatric Surgery Devices, Market Forecast, Germany 2002-2013

Exhibit 4-15: Medical Devices, Market Forecast, Italy, 2002-2013

Exhibit 4-16: Bariatric Surgery Devices, Market Forecast, Italy 2002-2013

Exhibit 4-17: Medical Devices, Market Forecast, Spain, 2002-2013

Exhibit 4-18: Bariatric Surgery Devices, Market Forecast, Spain 2002-2013

Exhibit 4-19: Medical Devices, Market Forecast, Scandinavia, 2002-2013

Exhibit 4-20: Bariatric Surgery Devices, Market Forecast, Scandinavia 2002-2013

Exhibit 4-21: Medical Devices, Market Forecast, Japan, 2002-2013

Exhibit 4-22: Bariatric Surgery Devices, Market Forecast, Japan 2002-2013

Exhibit 4-23: Medical Devices, Market Forecast, Rest of World, 2002-2013

Exhibit 4-24: Bariatric Surgery Devices, Market Forecast, ROW 2002-2013

Exhibit 4-25: Total Pharmaceutical Sales, Market Forecast, 2002-2013

Exhibit 4-26: Obesity Drugs, Market Forecast, USA and Canada, 2002-2013

Exhibit 4-27: Obesity Drugs, Market Forecast, USA and Canada, 2002-2013

Exhibit 4-28: Obesity Drugs, Market Forecast, European Union, 2002-2013

Exhibit 4-29: Obesity Drugs, Market Forecast, United Kingdom, 2002-2013

Exhibit 4-30: Obesity Drugs, Market Forecast, United Kingdom, 2002-2013

Exhibit 4-31: Obesity Drugs, Market Forecast, France, 2002-2013

Exhibit 4-32: Obesity Drugs, Market Forecast, France, 2002-2013

Exhibit 4-33: Obesity Drugs, Market Forecast, Germany, 2002-2013

Exhibit 4-34: Obesity Drugs, Market Forecast, Germany, 2002-2013

Exhibit 4-35: Obesity Drugs, Market Forecast, Italy, 2002-2013

Exhibit 4-36: Obesity Drugs, Market Forecast, Italy, 2002-2013

Exhibit 4-37: Obesity Drugs, Market Forecast, Spain, 2002-2013

Exhibit 4-38: Obesity Drugs, Market Forecast, Spain, 2002-2013

Exhibit 4-39: Obesity Drugs, Market Forecast, Scandinavia, 2002-2013

Exhibit 4-40: Obesity Drugs, Market Forecast, Scandinavia, 2002-2013

Exhibit 4-41: Obesity Drugs, Market Forecast, Japan, 2002-2013

Exhibit 4-42: Obesity Drugs, Market Forecast, Japan, 2002-2013

Exhibit 4-43: Obesity Drugs, Market Forecast, ROW, 2002-2013

Exhibit 4-44: Obesity Drugs, Market Forecast, ROW, 2002-2013

Exhibit 5-1: Potential Market Alliances in Obesity

Exhibit 6-1: Abbott Laboratories 2003 Sales by Division

Exhibit 6-2: Aventis 2003 Consolidated Sales