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This report has been updated by Report #S825,
September 2007
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Products, Technologies and Markets Worldwide in the
Clinical Management of Obesity
Report S800
s 268 pages
s 81 Exhibits
s 34 Company Profiles
s Published
October
2004 s
Report #S800
This
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 worldwide population in obesity, detailing
their incidence, 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 describes 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 provides current and forecast of the
market for these products worldwide. The report profiles 34
companies in this market, detailing the current products, products in
development, market position and overall businesses in obesity management.
Table of
Contents
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 (PYY) & 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
Predisposition Towards 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 Obesity and Cancer
1.5.5 Binge Eating Disorder (BED)
1.5.6 Night Eating Syndrome (NES)
1.5.7 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) and Mini-SRVG
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
2.2.1.1 The XENDOS Study
2.2.1.2 ATL-962
2.2.2 Serotonin and Norepinephrine Reuptake Inhibitors
2.2.2.1 Sibutramine
2.2.2.2 5-HT2C Agonists
2.2.3 Noradrenergic Anorectic Agents
2.2.4 Other Pharmaceutical Therapies Under Development
2.3 Non-pharmacological Approaches
2.3.1 Medically Supervised Low Calorie and Very Low
Calorie Diets (LCDs and VLCDs)
2.3.2 Behavior Modification
2.3.3 Residential and Intensive Programs
2.3.3.1 The Aimin Fat Reduction Hospital, Tianjin,
China
2.3.3.2 Carnegie International Weight Loss Camp,
Leeds, United Kingdom
2.4 False Starts, Fads and Empty Promises
2.4.1 The FDA’s Withdrawal of ‘Fen-Phen’ From the US
Market
2.4.2 Ephedra and the USFDA
2.5 Weight Maintenance Approaches
Section 3: Impact
of obesity
3.1 Obesity Treatments, Related Costs and Reimbursement
3.1.1 Impact Upon Insurance Costs
3.1.2 Cost of Treatment of Obesity, versus Long-term
Cost to Treat Related Conditions
3.2 Impact Upon Business/Economy
3.2.1 US
3.2.2 United Kingdom
3.3 The Government Enters the Fray
3.3.1 USA
3.3.1.1 Medicare Debates Gastric Bypass Surgery
3.3.1.2 Insurance and Mandated Coverage Bills
3.3.1.3 IRS and Deduction of Obesity Treatments
3.3.1.4 FDA Changing Approval Process of Obesity
Drugs
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: Clinical
trends
4.1 Pharmaceuticals: Gastrointestinal
versus CNS Targets
4.1.1 Anti-Absorption Therapeutics
4.1.2 Appetite and Satiety Therapeutics
4.1.3 Gastrointestinal versus Central Nervous System
Targets
4.2 Surgical Treatment
4.3 Tailoring the Strategy to the Patient
4.4 Other Clinical Trends
Section 5: Products
& Technologies
5.1 Bariatric Surgery Devices
5.1.1 Bariatric Surgery Devices in Use and Under
Development
5.2 Drug Development
5.2.1 Pharmaceutical Products Currently on the Market
and Under Development
5.2.2 Sanofi-Aventis’s Rimonabant
5.2.3 The Hormone Oleoyl-Estrone for Morbid Obesity
5.2.4 Johnson & Johnson’s Topamax®
5.2.5 Biopharmaceuticals
5.2.5.1 5-HT2C Agonists
5.2.5.2 ATL-962
5.3 Gastric Stimulation Devices
5.3.1 Gastric Stimulation Devices Currently on the
Market and Under Development
5.4 Brain Stimulation Devices
5.4.1 Brain Stimulation Devices Currently on the Market
and Under Development
5.5 Radio-Frequency Antralplasty Device
5.5.1 Radio-Frequency Antralplasty Devices Currently on
the Market and Under Development
5.6 Combination Therapies
5.6.1 Combination Therapies Currently on the Market and
Under Development
5.6.2 Combination of Surgery and Drugs
5.6.3 Combinations of Drugs
5.7 Genetic Therapies
5.7.1 Genetic Therapies Currently on the Market and
Under Development
Section 6: Market
Assessment
6.1 Bariatric Surgery Devices
6.1.1 United States and Canada
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 Japan
6.1.4 Rest of World (ROW)
6.2 Pharmaceuticals
6.2.1 United States and Canada
6.2.2 Pharmaceutical Treatments in the European Union
6.2.2.1 United Kingdom
6.2.2.2 France
6.2.2.3 Germany
6.2.2.4 Italy
6.2.2.5 Spain
6.2.2.6 Scandinavia
6.2.3 Japan
6.2.3.1 Healthcare reform
6.2.4 Rest of World (ROW)
6.2.5 Developing Drugs for Tomorrow, While Maximizing
Profits Today
Section 7:
Opportunities
7.1 Focus on Pharmaceuticals
7.2 Focus on Medical Devices
7.3 Durable Medical Equipment for the Bariatric Patient
7.4 Strategic Mergers and Acquisitions
7.5 Focus on Education and Practice Consulting
7.6 A Key to Success: Working With Government Healthcare Systems,
Insurance Programs and Medicare
Section 8: Company
Profiles
8.1 Abbott Laboratories
8.2 AdipoGenix
8.3 Alizyme plc
8.4 Amgen
8.5 Amylin Pharmaceuticals
8.6 AstraZeneca
8.7 Athersys, Inc.
8.8 Bayer AG
8.9 Biovitrum AB
8.10 CuraGen Corporation
8.11 DeCODE Genetics
8.12 DeveloGen AG
8.13 Ethicon Endo-Surgery/Johnson & Johnson
8.14 GenWay Biotech, Inc.
8.15 GlaxoSmithKline
8.16 Inamed Corporation
8.17 Ingenium Pharmaceuticals AG
8.18 IntraPace, Inc.
8.19 Johnson & Johnson
8.20 Manhattan Pharmaceuticals, Inc.
8.21 Merck & Co., Inc.
8.22 Metabolic Pharmaceuticals Ltd
8.23 Millennium Pharmaceuticals
8.24 Myriad Genetics
8.25 Nastech Pharmaceutical Company, Inc.
8.26 Pfizer, Inc.
8.27 Regeneron Pharmaceuticals
8.28
Roche (F Hoffman-La Roche Ltd)
8.29 Sanofi-Aventis
8.30 Speedel Group AG
8.31 Synovis Life Technologies Inc.
8.32 Transneuronix, Inc.
8.33 Vista Medical Technologies, Inc.
8.34 Wyeth Pharmaceuticals
Appendix: List of
Companies
ABBREVIATIONS
Exhibit ES-1: Worldwide Obesity Devices Market Forecast, 2002-2013 (US$M)
Exhibit 1-1: Relationship Between BMI and Risk of Disease
Exhibit 1-2: Elements Contributing to the Obesity Epidemic
Exhibit 1-3: Prevalence of Obesity, Percent of Population (2003)
Exhibit 1-4: WHO Graph of Obesity, 2004
Exhibit 1-5: Worldwide Total, Obese and Morbidly Obese, 2002-2013
Exhibit 1-6: Examples of Definitions Used and Age Groups Included in
Surveys Reporting Prevalence of Obesity
Exhibit 1-7: Examples of Human Pleiotropic Obesity Syndromes
Exhibit 1-8: Leptin’s Role in the Body
Exhibit 1-9: Candidate Genes for Control of Appetite, Energy Expenditure,
Usage of Nutrients and Body Fat Distribution
Exhibit 2-1: IFSO and Minimum Professional Requirements for the Practicing
Bariatric Surgeon
Exhibit 2-2: Gastric Bypass Surgery
Exhibit 3-1: Examples of Annual National Costs of Obesity (US$ Millions)
Exhibit 3-2: Examples of US Insurance Company Obesity Coverage Policies
Exhibit 5-1: Bariatric Surgery Procedures in Use and Under Development
Exhibit 5-2: Market Shares of Companies in Bariatric Surgery Devices
Exhibit 5-3: Pharmaceutical Products Currently on the Market and Under
Development
Exhibit 5-4: Market Shares of Meridia and Xenical, 2004
Exhibit 5-5: Gastric Stimulation Devices Currently on the Market and Under
Development
Exhibit 5-6: Brain Stimulation Devices Currently on the Market and Under
Development
Exhibit 5-7: Radio-Frequency Antralplasty Devices Currently on the Market
and Under Development
Exhibit 5-8: Combination Therapies Currently on the Market and Under
Development
Exhibit 5-9: Genetic Therapies Currently on the Market and Under
Development
Exhibit 6-1: Clinical Management of Obesity, Total World Revenue Market
Forecast, 2002-2013 (US$M)
Exhibit 6-2: Clinical Management of Obesity, Total World Revenue Market
Forecast, 2002-2013 (US$M)
Exhibit 6-3: Bariatric Surgery Devices, Total Market Forecast, 2002-2013
Exhibit 6-4: Total Bariatric Surgery Devices Market Forecast, 2002-2013 (US$M)
Exhibit 6-5: Bariatric Surgery Devices, Market Forecast, United States and
Canada, 2002-2013
Exhibit 6-6: Bariatric Surgery Devices, Market Forecast, US and Canada,
2002-2013
Exhibit 6-7: US Obesity Treatment Medical Device Company Market Shares,
2013
Exhibit 6-8: Bariatric Surgery Devices, Market Forecast, European Union,
2002-2013
Exhibit 6-9: Bariatric Surgery Devices, Country Market Shares, European
Union, 2004
Exhibit 6-10: Bariatric Surgery Devices, Market Forecast, United Kingdom,
2002-2013
Exhibit 6-11: Bariatric Surgery Devices, Market Forecast, United Kingdom
2002-2013
Exhibit 6-12: Bariatric Surgery Devices, Market Forecast, France, 2002-2013
Exhibit 6-13: Bariatric Surgery Devices, Market Forecast, France, 2002-2013
Exhibit 6-14: Bariatric Surgery Device Market Shares, France, 2004
Exhibit 6-15: Bariatric Surgery Devices, Market Forecast, Germany,
2002-2013
Exhibit 6-16: Bariatric Surgery Devices, Market Forecast, Germany 2002-2013
Exhibit 6-17: Bariatric Surgery Device Market Shares, Germany, 2004
Exhibit 6-18: Bariatric Surgery Devices, Market Forecast, Italy, 2002-2013
Exhibit 6-19: Bariatric Surgery Devices, Market Forecast, Italy 2002-2013
Exhibit 6-20: Bariatric Surgery Devices, Market Forecast, Spain, 2002-2013
Exhibit 6-21: Bariatric Surgery Devices, Market Forecast, Spain 2002-2013
Exhibit 6-22: Bariatric Surgery Devices, Market Forecast, Scandinavia,
2002-2013
Exhibit 6-23: Bariatric Surgery Devices, Market Forecast, Scandinavia
2002-2013
Exhibit 6-24: Bariatric Surgery Devices, Market Forecast, Japan, 2002-2013
Exhibit 6-25: Bariatric Surgery Devices, Market Forecast, Japan 2002-2013
Exhibit 6-26: Bariatric Surgery Devices, Market Forecast, Rest of World,
2002-2013
Exhibit 6-27: Bariatric Surgery Devices, Market Forecast, ROW 2002-2013
Exhibit 6-28: Total Pharmaceutical Sales, Market Forecast, 2002-2013
Exhibit 6-29: Obesity Drugs, Market Forecast, USA and Canada, 2002-2013
Exhibit 6-30: Obesity Drugs, Market Forecast, USA and Canada, 2002-2013
Exhibit 6-31: Obesity Drugs, Market Forecast, European Union, 2002-2013
Exhibit 6-32: Obesity Drugs, Market Forecast, United Kingdom, 2002-2013
Exhibit 6-33: Obesity Drugs, Market Forecast, United Kingdom, 2002-2013
Exhibit 6-34: Obesity Drugs, Market Forecast, France, 2002-2013
Exhibit 6-35: Obesity Drugs, Market Forecast, France, 2002-2013
Exhibit 6-36: Obesity Drugs, Market Forecast, Germany, 2002-2013
Exhibit 6-37: Obesity Drugs, Market Forecast, Germany, 2002-2013
Exhibit 6-38: Obesity Drugs, Market Forecast, Italy, 2002-2013
Exhibit 6-39: Obesity Drugs, Market Forecast, Italy, 2002-2013
Exhibit 6-40: Obesity Drugs, Market Forecast, Spain, 2002-2013
Exhibit 6-41: Obesity Drugs, Market Forecast, Spain, 2002-2013
Exhibit 6-42: Obesity Drugs, Market Forecast, Scandinavia, 2002-2013
Exhibit 6-43: Obesity Drugs, Market Forecast, Scandinavia, 2002-2013
Exhibit 6-44: Obesity Drugs, Market Forecast, Japan, 2002-2013
Exhibit 6-45: Obesity Drugs, Market Forecast, Japan, 2002-2013
Exhibit 6-46: Obesity Drugs, Market Forecast, ROW, 2002-2013
Exhibit 6-47: Obesity Drugs, Market Forecast, ROW, 2002-2013
Exhibit 7-1: Alliance Opportunities
Exhibit 8-1: Abbott Laboratories 2003 Sales by Division
Exhibit 8-2: Johnson & Johnson and Subsidiaries, Division of Sales by
Segment, 2003
Exhibit 8-3: Inamed Corporation Sales, 2003
Exhibit 8-4: Johnson & Johnson Worldwide Sales, 2003
Exhibit 8-5: Johnson & Johnson Sales by Geographic Region, 2003
Exhibit 8-6: Pfizer Divisions by Revenues, Fourth Quarter 2003
Exhibit 8-7: Pfizer Drug Division Revenues as Percent of Total Human
Pharmaceutical Revenues, Fourth Quarter 2003
Exhibit 8-8: Roche Sales by Region, 2003
Exhibit 8-9: Sanofi-Aventis 2003 Consolidated Sales
Exhibit 8-10: Synovis Life Technologies Sales by Product Group, 2003
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