A diabetes epidemic is under way. According to the World Health Organization (WHO), an estimated 30m people worldwide had some form of diabetes in 1985; by 2000, the number had increased to 177m. WHO projections suggest that the number of people suffering from the disease will increase to some 370m by 2030.
Diabetes is the name given to a group of chronic diseases caused by inherited and/or acquired deficiency in the production of insulin by the pancreas, or by the ineffectiveness of the insulin produced. Such a deficiency results in increased concentrations of glucose in the blood, which in turn damage many of the body's systems, in particular the blood vessels and nerves.
A report by Research and Markets focuses on 10 key countries, providing coverage of the market in North America, Europe, Japan and Latin America. These countries accounted for 86% of the global market in 2002. The largest market by a huge margin is the US, which, at close to $7bn in 2002, was well over five times larger than the secondranked market, Japan. Although 2002 was a relatively poor year in the US (with little increase in overall sales), the American market has grown rapidly in recent years, to account for 57% of world sales, compared with less than 50% in 1998. In contrast, relatively steady sales increases in Japan and thirdranked Germany have resulted in a loss of market share for these countries, in global terms. This has also happened elsewhere in Europe, such as in France, Italy and Spain. In contrast, the markets in Canada and Mexico have expanded rapidly.
The costs involved in the care and management of diabetes are increasing rapidly. The WHO estimates that, on a global basis, 45% of health budgets is spent on diabetes and diabetesrelated illnesses. As discussed in this report, a person with diabetes incurs medical costs that are two to five times higher than those of a person without diabetes. Diabetes incurs considerable indirect costs due to the number of patients who may not be able to continue working or work as effectively as they could before the onset of their condition. Factoring in such indirect costs, the American Diabetes Association calculated that the total cost of diabetes in the US was $132bn in 2002.
The second largest class, human insulin/analogues, has also shown strong growth, at 14% per year to just over $4bn in 2002, cannibalising sales of animal insulins, the market for which contracted by almost a quarter each year, on a CAGR basis. The animal insulins class is now very small, with global sales of only $50m in 2002. Other drugs for diabetes (Class A10X) showed virtually no movement over the period reviewed in this report, to stand at $266m in 2002.
The diabetes market is concentrated in the hands of six key players, which between them account for threequarters of sales. In 2002, the market was headed by Lilly, with sales of $2bn and a 16% share. Second ranked Takeda made sales of over $1.8bn, to account for almost 15%. This put the increasingly focused Japanese pharmaceutical company just ahead of Novo Nordisk, which is something of a specialist in the diabetes market. The next three companies in the rankings were the major multinationals, GlaxoSmithKline (GSK), Bristol Myers Squibb (BMS) and Aventis.