世界の肥満臨床管理市場：2007〜2015年

Abstract

The report is a detailed market and technology assessment and forecast of the products and technologies in the clinical management of obesity. The report describes the current and projected patient population in obesity, detailing their incidence in the U.S., Europe, and Rest of World, and the clinical practices in obesity management encompassing surgical approaches, medical supervised severely restricted diets, drug therapies, OTC treatments, biopharmaceuticals, non-pharmacologic approaches and weight maintenance approaches. The report describes clinical trends in the management of the obese. The report details 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 provides current and forecast of the market for these products in the U.S., Europe and Rest of World. The report profiles key companies in the market, detailing the current products, products in development, market position and overall businesses in obesity management.

Table of Contents

Section 1: Clinical background

• 1.1 BMI
• 1.2 Growth of Obesity Worldwide
  • 1.2.1 Prevalence of Obesity in the US Population
  • 1.2.2 Obesity in the European Union
  • 1.2.3 Japan' s Rising Obesity
  • 1.2.4 Prevalence of Obesity in China
• 1.3 Why Treat Obesity?
• 1.4 Overweight, Obesity and Morbidity
  • 1.4.1 The Multifactorial Causes of Obesity
    • 1.4.1.1 Role of the Weight Regulatory System
      • 1.4.1.1.1 Ghrelin
      • 1.4.1.1.2 Peptide YY (PYY) & the Y2 receptor
    • 1.4.1.2 Adipose Tissue
    • 1.4.1.3 Abdominal Girth
    • 1.4.1.4 Metabolic Syndrome
    • 1.4.1.5 Obesity and Diabetes
    • 1.4.1.6 Binge Eating Disorder (BED) and Surgery
  • 1.4.2 Infectobesity: Fat Viruses and Microbes?
  • 1.4.3 Genetic Roots of Obesity
    • 1.4.3.1 Fat as Survival Mechanism: the Thrifty-Genotype
    • 1.4.3.2 Leptin
    • 1.4.3.3 Metabolic Liver Enzyme Defect
    • 1.4.3.4 The Gene CD-38
    • 1.4.3.5 The Gene FTO
  • 1.4.4 The Obesogenic Picture: Body & Environment
  • 1.4.5 Patient Population Segmentation
    • 1.4.5.1 The Elderly
    • 1.4.5.2 Children and Adolescents

Section 2: Weight Loss Management Approaches

• 2.1 Medically Supervised Diet, Behavior Modification and Nutritional Counseling Programs
  • 2.1.1 Healthy Living Academies for Adolescents and Young Adults
  • 2.1.2 Duke University' s Rice Dieta program
  • 2.1.3 Medically Supervised Low Calorie and Very Low Calorie Diets (LCDs and VLCDs)
  • 2.1.4 Behavior Modification Programs
• 2.2 Surgical Approaches
  • 2.2.1 Restrictive Bariatric surgery
  • 2.2.2 Malabsorptive Bariatric Surgery
  • 2.2.3 Combination Restrictive-Malabsorptive bariatric surgery
  • 2.2.4 Roux-en-Y gastric bypass surgery
  • 2.2.5 Laparoscopic surgery
  • 2.2.6 The Post-Op Period
  • 2.2.7 Medical Device Implantation (Gastric Stimulation Device)
  • 2.2.8 Gastric Balloon
  • 2.2.9 Other Invasive Approaches Currently Under Development
    • 2.2.9.1 Disabling the vagus nerve
    • 2.2.9.2 Trans-Oral Stapling Device
• 2.3 Current Drug Developments
  • 2.3.1 Cannabinoid (CB1) Receptor Agonists
  • 2.3.2 Lipase Inhibitors
  • 2.3.3 RNAi (RNA Interference)
  • 2.3.4 Serotonin Receptor Agonists
  • 2.3.5 Compounds Based on Intestinal Peptides

Section 3: Impact of Obesity

• 3.1 Obesity Treatments, Related Costs and Reimbursement
  • 3.1.1 Difficulty of Calculating Costs and Morbidity
  • 3.1.2 Real Costs, Real Morbidity
• 3.2 Impact on Businesses/Economies
  • 3.2.1 Increase in Workers' Compensation Costs
• 3.3 Government Approaches to the Health Problem of Obesity
  • 3.3.1 United States
    • 3.3.1.1 The NIH: a Strategic Plan for Obesity Research
    • 3.3.1.2 Other US Agency Efforts
    • 3.3.1.3 Changes in Medicare policy
    • 3.3.1.4 “F as in Fat”
    • 3.3.1.5 IRS and Deduction of Obesity Treatments
  • 3.3.2 European Union
    • 3.3.2.1 The ‘European Charter' to Halt Obesity
    • 3.3.2.2 The UK: NHS, NICE and the Costs of Treating Obesity
    • 3.3.2.3 SCOPE Internet-Based Physician Training
    • 3.3.2.4 France: the Caisse Nationale d' Assurance Maladie (CNAM)
  • 3.3.3 Latin America & the Caribbean

Section 4: Clinical Trends

• 4.1 Prevention and Intervention
• 4.2 Drug Developments
  • 4.2.1 Utilizing Combinations of Drugs
  • 4.2.2 CNS Versus Gastrointestinal Action
  • 4.2.3 Stumble of CB1 Receptor Agonist Class
  • 4.2.4 OTC alli
• 4.3 Tailoring the Strategy to the Patient
• 4.4 Bariatric Surgery
  • 4.4.1 Gastric Bypass Versus Banding
  • 4.4.2 Bariatric Surgery for Teens
  • 4.4.3 Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS)

Section 5: Products & Technologies

• 5.1 Medical Devices
  • 5.1.1 Bariatric Surgery Devices in Use and Under Development
  • 5.1.2 Restrictive Stomach Banding Devices
  • 5.1.3 Restrictive Device Delivered Transorally
  • 5.1.4 Gastric Stimulation Devices
  • 5.1.5 Disabling the vagus nerve
  • 5.1.6 Oral device
• 5.2 Drug development
  • 5.2.1 CB-1 cannabinoid receptor agonists
  • 5.2.2 Lipase inhibitors
  • 5.2.3 RNAi
  • 5.2.4 Serotonin receptor agonists
  • 5.2.5 Intestinal peptide compounds
  • 5.2.6 Ghrelin-based vaccine
• 5.3 Genetic therapy

Section 6: Market Assessment

• 6.1 Bariatric Surgery Devices
  • 6.1.1 United States and Canada
    • 6.1.1.1 Medicare Coverage Decision
    • 6.1.1.2 US & Canada Market Shares
  • 6.1.2 European Union
    • 6.1.2.1 United Kingdom
    • 6.1.2.2 France
    • 6.1.2.3 Germany
    • 6.1.2.4 Italy
    • 6.1.2.5 Spain
    • 6.1.2.6 Scandinavia
  • 6.1.3 Rest of World
• 6.2 Pharmaceuticals
  • 6.2.1 Rimonabant
  • 6.2.2 PYY3-36
  • 6.2.3 Pharmaceutical Market Assessment
    • 6.2.3.1 United States & Canada
    • 6.2.3.2 European Union & Scandinavia
      • 6.2.3.2.1 United Kingdom
      • 6.2.3.2.2 France
      • 6.2.3.2.3 Germany
      • 6.2.3.2.4 Italy
      • 6.2.3.2.5 Spain
      • 6.2.3.2.6 Scandinavia
    • 6.2.3.3 Rest of World
• 6.3 Genetic Therapies
• 6.4 Obesity vaccines

Section 7: Opportunities

• 7.1 Pharmaceutical Opportunities
• 7.2 Device Opportunities
  • 7.2.1 Acquire or Partner with a Company with a Promising Device
  • 7.2.2 Continue to develop Devices for Treatment
  • 7.2.3 Off-Label Uses of Current Devices
• 7.3 Market a Bundled Communication Package
• 7.4 Target the Market for Overweight & Obesity, Not Just Morbid Obesity
• 7.5 Working the Reimbursement Angle

Section 8: Company Profiles

Appendix: List of Companies

List of Exhibits

• Exhibit ES-1: Selected Countries Ranked by Percentage of Overweight or Obese (BMI >25), 2006.
• Exhibit ES-2: Co-Morbidities Linked to Obesity
• Exhibit ES-3: Clinical Management of Obesity, Total World Revenue Market Forecast, 2004-2015 (US$M)
• Exhibit 1-1: Calculation of Body Mass Index (English or Metric)
• Exhibit 1-2: Selected Countries Ranked by Percentage of Population (Age 15+) Overweight or Obese, 2005
• Exhibit 1-3: Selected Countries Ranked by Percentage of Overweight or Obese (BMI >25), 2006
• Exhibit 1-4: WHO Graph of Mortality, Obesity (per 1 million people), Jan 2004
• Exhibit 1-5: USA: Percentage of Children Ages 6-17 Who Are Overweight by Gender, and Race, and Hispanic Origin, 1976-1980 and 2003-2004
• Exhibit 1-6: Co-Morbidities Linked to Obesity
• Exhibit 1-7: Diagram of the Weight Regulatory Pathways
• Exhibit 1-8: Leptin' s Role in the Body
• Exhibit 3-1: Examples of Annual National Costs of Obesity (US$ Millions)
• Exhibit 3-2: A Selection of Federal Agencies and Their Involvement in Obesity Policy
• Exhibit 5-1: Bariatric Treatment Devices on Market and in Development
• Exhibit 5-2: Bariatric Device Company Market Shares, 2007
• Exhibit 6-1: Clinical Management of Obesity, Global Revenue Market Forecast, 2004-2015 (US$M)
• Exhibit 6-2: Clinical Management of Obesity, Total World Revenue Market Forecast, 2004-2015 (US$M)
• Exhibit 6-3: Clinical Management of Obesity, Global Pharmaceutical Revenue Market Share vs. Device Revenue Market Share, 2004-2015 (US$M)
• Exhibit 6-4: Bariatric Surgery Devices, Total World Revenue Market Forecast, 2004-2015 (US$M)
• Exhibit 6-5: Bariatric Surgery Devices, Total World Revenue Market Forecast, 2004-2015 (US$M)
• Exhibit 6-6: Bariatric Surgery Devices, Regional Share of Total World Revenues, 2004-2015 (US$M)
• Exhibit 6-7: Bariatric Surgery Devices, Market Forecast, United States and Canada, 2004-2015
• Exhibit 6-8: Bariatric Surgery Devices, Market Forecast, United States and Canada, 2004-2015
• Exhibit 6-9: Bariatric Surgery Devices, Market Shares, United States and Canada, 2015
• Exhibit 6-10: Bariatric Surgery Devices, Market Forecast, European Union, 2004-2015
• Exhibit 6-11: Bariatric Surgery Devices, Revenue Forecast, European Union, 2004-2015
• Exhibit 6-12: Bariatric Surgery Device Revenues by Country Share, EU & Scandinavia, 2007
• Exhibit 6-13: Bariatric Surgery Device Revenues by Country Share, EU & Scandinavia, 2015
• Exhibit 6-14: Bariatric Surgery Device Market, United Kingdom, 2004-2015
• Exhibit 6-15: Bariatric Surgery Device Market, United Kingdom, 2004-2015
• Exhibit 6-16: Bariatric Surgery Device Market, France, 2004-2015
• Exhibit 6-17: Bariatric Surgery Device Market, France, 2004-2015
• Exhibit 6-18: Bariatric Surgery Device Company Market Shares, France, 2007
• Exhibit 6-19: Bariatric Surgery Device Market, Germany, 2004-2015
• Exhibit 6-20: Bariatric Surgery Device Market, Germany, 2004-2015
• Exhibit 6-21: Bariatric Surgery Device Company Market Shares, Germany, 2007
• Exhibit 6-22: Bariatric Surgery Device Market, Italy, 2004-2015
• Exhibit 6-23: Bariatric Surgery Device Market, Italy, 2004-2015
• Exhibit 6-24: Bariatric Surgery Device Company Market Shares, Italy, 2007
• Exhibit 6-25: Bariatric Surgery Device Market, Spain, 2004-2015
• Exhibit 6-26: Bariatric Surgery Device Market, Spain, 2004-2015
• Exhibit 6-27: Bariatric Surgery Device Company Market Shares, Spain, 2007
• Exhibit 6-28: Bariatric Surgery Device Market, Scandinavia, 2004-2015
• Exhibit 6-29: Bariatric Surgery Device Market, Scandinavia, 2004-2015
• Exhibit 6-30: Bariatric Surgery Device Market, Rest of World, 2004-2015
• Exhibit 6-31: Bariatric Surgery Device Market, Rest of World, 2004-2015
• Exhibit 6-32: Pipeline of Selected Anorectic Pharmaceuticals, 2007
• Exhibit 6-33: Global Anorectic Pharmaceutical Market, 2004-2015
• Exhibit 6-34: Global Anorectic Pharmaceutical Market, 2004-2015
• Exhibit 6-35: Anorectic Pharmaceutical Market, USA & Canada, 2004-2015
• Exhibit 6-36: Anorectic Pharmaceutical Market, USA & Canada, 2004-2015
• Exhibit 6-37: Anorectic Pharmaceutical Market, EU & Scandinavia, 2004-2015
• Exhibit 6-38: Anorectic Pharmaceutical Market, EU & Scandinavia, 2004-2015
• Exhibit 6-39: Anorectic Pharmaceutical Market, United Kingdom, 2004-2015
• Exhibit 6-40: Anorectic Pharmaceutical Market, United Kingdom, 2004-2015
• Exhibit 6-41: Anorectic Pharmaceutical Market, France, 2004-2015
• Exhibit 6-42: Anorectic Pharmaceutical Market, France, 2004-2015
• Exhibit 6-43: Anorectic Pharmaceutical Market, Germany, 2004-2015
• Exhibit 6-44: Anorectic Pharmaceutical Market, Germany, 2004-2015
• Exhibit 6-45: Anorectic Pharmaceutical Market, Italy, 2004-2015
• Exhibit 6-46: Anorectic Pharmaceutical Market, Italy, 2004-2015
• Exhibit 6-47: Anorectic Pharmaceutical Market, Spain, 2004-2015
• Exhibit 6-48: Anorectic Pharmaceutical Market, Spain, 2004-2015
• Exhibit 6-49: Anorectic Pharmaceutical Market, Scandinavia, 2004-2015
• Exhibit 6-50: Anorectic Pharmaceutical Market, Scandinavia, 2004-2015
• Exhibit 6-51: Anorectic Pharmaceutical Market, ROW, 2004-2015
• Exhibit 6-52: Anorectic Pharmaceutical Market, ROW, 2004-2015
• Exhibit 7-1: Company Alliance Options