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Worldwide Market for the Clinical Management of Obesity, 2007-2015
Report S825
188 pages
70 Exhibits
38 Company Profiles
September
2007
Report #S825
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
Executive Summary
Section 1: Clinical
background
1.1 Body Mass Index
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
8.1
Abbott Laboratories
8.2
Alizyme plc
8.3
Allergan, Inc.
8.4
Amylin
8.5
Athersys, Inc.
8.6
Arena Pharmaceuticals
8.7
Bayer HealthCare
8.8
BioLineRx, Ltd.
8.9
Cousin Biotech SAS
8.10
Cyberonics
8.11
Cytos Biotechnology AG
8.12 EndoGastric Solutions
8.13
Ethicon Endo-Surgery
8.14
EnteroMedics
8.15
Genaera Corporation
8.16
GlaxoSmithKline
8.17
Ingenium Pharmaceuticals AG
8.18
IntraPace
8.19
Manhattan Pharmaceuticals, Inc.
8.20
Merck & Co., Inc.
8.21
Metabolic Pharmaceuticals
8.22
Millennium Pharmaceuticals
8.23
Nastech Pharmaceutical Company
8.24
Neurosearch AS
8.25
Oragenics
8.26 Orexigen Therapeutics
8.27 Peptimmune
8.28 Pfizer
8.29 Regeneron Pharmaceuticals
8.30 Roche
8.31 Sanofi-Aventis
8.32 Satiety, Inc.
8.33 Sirtris Pharmaceuticals
8.34 Speedel Pharmaceuticals
8.35 Thiakis Pharmaceuticals
8.36 Vitae Pharmaceuticals
8.37 Vivus, Inc.
8.38 Wyeth Pharmaceuticals
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$M)
Exhibit 1-1: Calculation of Body Mass Index
(English or Metric)
Exhibit 1-2: Selected Countries Ranked by
Percentage of Population (Age 15+) Overweight or Obese, 2005
Exhibit 1-3: Selected Countries Ranked by
Percentage of Overweight or Obese (BMI >25), 2006
Exhibit 1-4: WHO Graph of Mortality, Obesity
(per 1 million people), Jan 2004
Exhibit 1-5: USA: Percentage of Children
Ages 6–17 Who Are Overweight by Gender, and Race, and Hispanic Origin,
1976–1980 and 2003–2004
Exhibit 1-6: Co-Morbidities Linked to
Obesity
Exhibit 1-7: Diagram of the Weight
Regulatory Pathways
Exhibit 1-8: Leptin’s Role in the Body
Exhibit 2-1: Current Market Status of Bariatric Surgery Medical Devices
Exhibit 2-2: Current Market Status of Pharmaceutical Treatments of Obesity
Exhibit 3-1: Examples of Annual National
Costs of Obesity (US$ 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
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