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![Page 1: Cardiac Diagnostics - Changing Practices Review of key markets in Europe Sohail Sheikh Frost & Sullivan, 2003.](https://reader036.fdocuments.us/reader036/viewer/2022072011/56649e265503460f94b160e4/html5/thumbnails/1.jpg)
Cardiac Diagnostics - Changing Practices
Review of key markets in Europe
Sohail Sheikh
Frost & Sullivan, 2003
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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 ?
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State of Cardiac Markers
Marker dynamics - Applications in cardiac care
Market Interest Market Focus Market Apathy
hsCRP
NPs
cTnmyo CKs
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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
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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
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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.
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What Markers Make Good POC Tests?
COST IMPACTPATIENT MANAGEMENT
TIME SENSITIVE
STREPA
GLUCOSE
HP
TROP
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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
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The Future of POC Testing
TAM
End user acceptanceof cardiac POCt
Be
GeFr
Scan
UK
Sp
Ne
It
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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
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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%
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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?
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Thank You - Any Questions?
For further information:
call: +44 (0)20 7343 8383 email: [email protected]
www.biotech.frost.com