Cardiac Diagnostics - Changing Practices Review of key markets in Europe Sohail Sheikh Frost &...
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Transcript of Cardiac Diagnostics - Changing Practices Review of key markets in Europe Sohail Sheikh Frost &...
Cardiac Diagnostics - Changing Practices
Review of key markets in Europe
Sohail Sheikh
Frost & Sullivan, 2003
The Future of Cardiac Testing
Agenda• Troponins in Europe - end user feedback• Decentralised testing in cardiac diagnostics• New and emerging markers• Questions
Motivation
• Troponin usage - how much, how often and how widespread ?
• Demand for POCt - what factors effect uptake ?• Emerging markers - How widespread will their use be ?
State of Cardiac Markers
Marker dynamics - Applications in cardiac care
Market Interest Market Focus Market Apathy
hsCRP
NPs
cTnmyo CKs
Troponins Usage - 2002
Sw
Fi
Fr % penetrati
on of cTn in
acute hosp.
Monthly usage per site
Dk It
Be Ne
UK
GeNo
Sp
High
Low
0 100
The Cost of Troponin
200
300
400
500
600
700
800
900
1000
2 2.5 3 3.5 4 4.5 5 5.5
Average test price (€)
Vo
lum
e u
sa
ge
(p
er
mo
nth
)
No
Fr
Ge
Ne
Dk
UK
Sw
Sp
It
Fi
Be
Factors to Consider
• COST IMPACT - POCt must have a real impact on cost savings through workflow patterns, ie. impacting on waiting times, hospitalisation and bed stay
• TIME SENSITIVE - POCt which target conditions where a rapid result and response outweighs the high sensitivity/performance of lab tests.
• PATIENT MANAGEMENT BENEFIT - A POCt allowing real benefits through therapeutic programmes, ie, the availability of routine medication following rapid diagnosis or by allowing constant monitoring of a patient drug regime, and or increase of QALY.
What Markers Make Good POC Tests?
COST IMPACTPATIENT MANAGEMENT
TIME SENSITIVE
STREPA
GLUCOSE
HP
TROP
Cardiac POCt - Challenges & Hurdles
• Benefits of troponins still being fully realised
• High up-front costs of POCt NOT offset by potential of cost savings
• Lack of will amongst non-lab staff
• Lack of end user choice
The Future of POC Testing
TAM
End user acceptanceof cardiac POCt
Be
GeFr
Scan
UK
Sp
Ne
It
End Users and New Markers• Lack of implementation practices - hindering usage• Low usage of BNPs not surprising• hs-CRP - widely researched, but less clinical applications so
far• Only one visible company (Mercodia) offering mLDL
0 20 40 60 80 100
hsCRP
BNP
Hoc
mLDL
% of respondants
Usage Awareness
Natriuretic Peptides - The New ‘Troponins’ !
• End users unable to differentiate between BNP and proBNP• Growth of proBNP will outpace BNP• 40% of NP market $ will be proBNP by 2005
• Adoption of NPs dictated by platform in use at lab• Over 50% of end users unable to quickly adopt BNP test
0
10
20
30
40
2001 2002 2003 2004 2005 2006
TA
M (
$m)
BNP proBNP
Others49%
E201022%
Dimen.13%
Centaur6%
Axsym10%
And Finally……..
• Have companies forecasted the impact NP use will have on troponin sales?
• If a troponin - NP double test panel is recommended, will there be end users jumping from one supplier to another?
• What will happen to your supply chain if group purchasing continues?
Thank You - Any Questions?
For further information:
call: +44 (0)20 7343 8383 email: [email protected]
www.biotech.frost.com