Health The Great Market

1
Health The Great Market

• With the increase in global welfare level,
  medical care became widespread and a further
  essential need. Countries economical efforts grew
  but they did so at such a pace that there is a
  growing pressure for this heavy burden to be
  significantly reduced, on the consumers side many
  are complaining about the excessively high prices
  and demand that the current level of healthcare
  prices to be reduced.

2
Current Situation

• As marketing exclusivity periods for first
  in-class drugs decline, drug developers are
  facing incresing pressure to improve productivity
  in their drug development activities to help
  bolster return on investment.
• RD strategies that strive to attain a best
  in-class status for new drugs or, at the least,
  clear advantages over existing therapies with
  patient subgroups or particular indications will
  dominate.
• They are also suffering growing pressures to
  contain costs from managed care organizations and
  pricing and reimbursement.
• Authorities are increasing pressure on firms to
  get new drugs to market sooner, preferably with
  clear advantages in safety, efficacy, or economic
  value.

3
Market Size

• The health market makes millions and many more as
  expected as more and more people have access to
  medical care. Also the population aging in
  developed countries, with the many health
  implications it has, causes that a new set of
  needs arise. As more elderly people demand for
  attention and preventive care the market will
  continue to grow. The world goes on with its
  globalization trend and diseases stop being local
  or regional to become wide spreading at a world
  level. The transmission of diseases also becomes
  more and more quickly.
• Despite the economic downturn, the pharmaceutical
  industry has grown 7 globally with an estimated
  value of 390 billion. The US market alone is
  valued at 189 billion. Several factors have
  contributed to this growth and the increased
  revenues. The price of drugs has increased 4. A
  growing baby boomer population has led to an
  increased demand for medicines, and the number of
  medications being prescribed for treating a
  disease has also increased in recent years.

4
Market Evolution

• There have been significant changes in the
  pharmaceutical business environment with several
  mergers and acquisitions in the past few years,
  which has resulted in a consolidated, fiercely
  competitive market with fewer players. The
  biggest change to come over the next 4 years is
  that the industry in the US alone stands to lose
  more than 36 billion in sales when several
  branded drugs come off patent. This is a
  formidable challenge for the pharmaceutical
  industry and boosts the opportunities for
  manufacturers of generics.
• Another factor that has changed the business
  environment is the patent life (years that offer
  a market exclusivity to the manufacturer sell the
  drug) for drugs, which has been decreasing. The
  patent life, which symbolizes the period when
  companies usually recover their RD costs and
  generate profits is currently about 12 years and
  is expected to drop to 10 years within the next
  decade. Hence, with the shrinking patent life,
  the companies are under more pressure to curtail
  costs and increase RD efficiencies. With the
  entry of me-too drugs, companies also have to
  increase their marketing budgets to better
  differentiate their products.

5
Market Changes

• Companies looking for synergies and for
  developing healthy pipelines account for several
  mergers that have occurred in recent years.
  Several factors can be attributed to this
  scenario. The drug development time has increased
  from 8 years during the 1960s to about 14 years.
  The obvious opportunities in well-characterized
  disease areas have already been exploited and
  scientists now have to explore diseases that are
  not so well understood to come up with superior
  and innovative drugs. The RD involved in this
  process is very challenging and time-intensive.
  Hence, RD costs have gone up about 213 in the
  last decade. It is estimated that it now costs
  almost 800 million to bring a new drug to
  market. The payoffs generated by the genomics
  revolution have been slow and have not met
  expectations.

6
Market Future Trends

• The profiles of the diseases being targeted have
  evolved over the years along with the changing
  population dynamics. A decade ago, infectious
  diseases and development of antibiotics were a
  large RD focus. Today with the aging population,
  the fastest growing and highest selling market is
  the one for statins - the cholesterol lowering
  drugs. What was once considered a niche and small
  disease market is now offering a large
  undiagnosed patient population with a large unmet
  medical need and a huge commercial opportunity.
  Although this changing disease profile has not
  been sudden, it still presents a formidable
  challenge because not all companies have aligned
  their business model to address this issue.
  Statins for lowering cholesterol, glitazones for
  diabetes, monoclonal antibodies for cancer, and
  COX-2 inhibitors for pain management are
  targeting some of these new markets.
• Companies are investing billions in developing
  immunotherapy drugs, designed to selectively and
  optimally use the bodys own immune system to
  prevent or fight disease. Among these
  immunotherapies are monoclonal antibodies and
  therapeutic vaccines. The development of
  therapeutic vaccines for the treatment of
  HIV/AIDS, cancer, and other major diseases holds
  tremendous promise as adjunctive therapies to
  conventional treatments.

7
Drugs Prices

• The increasing healthcare expenditure, shrinking
  healthcare funding and the growing consumer
  outcry has resulted in mounting pressure on drug
  companies to lower drug prices. The rising
  healthcare expenditure on prescription drugs can
  be attributed to the pharmaceutical companies
  endeavor to shift the patients to newer, more
  expensive products, as older products mature and
  give way to generic competition. The increase in
  the use of drugs in chronic diseases, such as
  cardiovascular, diabetes, gastrointestinal, and
  CNS has also contributed to this increase. Due to
  the presence of multiple products within the same
  class, there is a pressure to lower costs. The
  industry is also under fire for the high drug
  inflation rate, which over the past five years
  has far exceeded the average rate of inflation.
  The average cost of prescription drugs has
  increased by 4 every year during the past
  several years. Escalating product development
  costs and a shorter market exclusivity period on
  one hand, and the increasing pressure to curtail
  costs on the other, puts the pharmaceutical
  manufacturers in a tight spot. In addition, the
  consistent pressure from the managed-care
  organizations also counteracts the premium
  pricing strategies employed in the marketplace.

8
Life Expectancy
9
Life Expectancy
The longest documented human life span is 122
years. Though a life span that long is rare,
improvements in medicine, science and technology
over the last century have helped more people
live longer, healthier lives. If you were born in
the early 1900s in the United States, your life
expectancy was only about 50 years. Today it's
around 77. The aging boom is upon us. Since 1900,
the number of Americans age 65 and older has
increased 10-fold. The oldest-old, people age 85
and older, constitute the fastest growing segment
of the U.S. population. By 2050, this population,
currently about 4 million people, could top 19
million. Living to 100 likely will become more
commonplace. In 1950, only about 3,000 Americans
were centenarians by 2050, there could be nearly
one million. This remarkable burst of longevity,
unprecedented in human history, has been possible
because of equally remarkable improvements in
sanitation, health care, and lifestyle. Some
gerontologists suspect an average life expectancy
of 85 years or more may be possible in the near
future.
10
Life Expectancy

• Worldwide population ageing is a public health
  challenge affecting many aspects of human life
  and societies in developed and developing nations
  alike. Population ageing has a great impact on
  individuals health and social needs, family
  structures, health systems and overall
  socioeconomic development. The birth rate has
  been decreasing compared to the elders increase
  so that we face a future society of fewer
  children and more elderly persons. In the very
  near future this will give way to a super-aged
  society. As a result, in looking at health on
  a national basis, the health of the elderly
  persons, their medical treatment, welfare, and
  care, are among the most pressing issues the
  world faces.
• The percentage of the population who are in the
  older age groups (gt65 years) will increase in all
  countries in the next few decades. This process
  of population ageing will take place more rapidly
  in developing countries than it did in developed
  countries. Ageing of the population will present
  two major challenges. First, health care systems
  must reorient themselves to preventing and
  treating the conditions, such as increased
  chronic diseases and functional impairments that
  characterize an older population and second,
  countries must mobilize the additional resources
  that will be required to meet the increase in
  needs.

11
Consequences of Higher Life Span

• As Europes population grows older and demands
  for healthcare provision increase, the developed
  world is facing a nightmare scenario of rapidly
  increasing healthcare costs.
• According to studies from the EU Economic Policy
  Committee, on the Budgetary challenges posed by
  ageing populations, due to the growing number of
  elderly people amongst Europes population, the
  number of working age citizens contributing to
  social service funds is rapidly diminishing,
  while conversely, the number of elderly citizens
  is rising. It is estimated that by 2050 there
  will be only two working age citizens for each
  elderly person in the EU, instead of the current
  four.
• One readily available solution to these problems
  is to be found, in part, in increasing the use of
  generic medicines. These competitively priced
  therapeutic equivalents to patent expired
  originator pharmaceuticals have demonstrated they
  possess the same quality, safety, and efficacy as
  their originator products, and they go through
  the same regulatory procedures. The only
  difference is their price, which is typically 20
  to 80 below that of brand-name originator
  pharmaceuticals.

12
Death Causes
13
Problems For Old People

• Cardiovascular system High blood pressure
  (hypertension)
• Bones, muscles and joints Osteoporosis
• Digestive system Healthy digestion
• Constipation
• Kidneys, bladder and urinary tract
  Urinary incontinence
• Prostate gland enlargement
• Brain and nervous system How to keep your
  mind sharp
• Eyes Dry eyes
• Cataracts
• Glaucoma
• Macular degeneration
• Presbyopia
• Ears Hearing loss

14
Problems For Old People

• Teeth Dry mouth
• Oral and throat cancer
• Dentures
• Dental implants
• Skin, nails and hair Skin cancer
• Hair loss
• Gray hair
• Nail ridging
• Skin tags
• Sleep Sleep and seniors
• Weight Menopause and weight gain
• Sexuality Medecines
• Food Exercise Exercise regularly
• Eat nutritious food

15
Cardiovascular

• Over time, the heart muscle becomes a less
  efficient pump, working harder to pump the same
  amount of blood through the body. In addition,
  blood vessels become less elastic. Hardened fatty
  deposits may form on the walls of the arteries
  (atherosclerosis), narrowing the passageway
  through the vessels. The natural loss of
  elasticity, in combination with atherosclerosis,
  makes arteries stiffer, causing the heart to work
  even harder to pump blood through them. This can
  lead to high blood pressure (hypertension).
• High blood pressure (hypertension) is often
  called a silent killer because people can have it
  for years without knowing it. Blood pressure is
  determined by the amount of blood the heart pumps
  and the amount of resistance to blood flow in the
  arteries. Blood pressure normally varies during
  the day. It can even vary slightly with each beat
  of the heart. It increases during activity and
  decreases with rest. Many people may not view
  high blood pressure as life-threatening. But
  uncontrolled high blood pressure can increase the
  risk of serious health problems.

16
Bones, Muscels and Joints

• Bones reach their maximum mass between ages 25
  and 35. As people age, their bones shrink in size
  and density. One consequence is that they might
  become shorter. Gradual loss of density weakens
  the bones and makes them more susceptible to
  fracture. Muscles, tendons and joints generally
  lose some strength and flexibility as people age.
• Osteoporosis, which means "porous bones," causes
  bones to become weak and brittle - so brittle
  that even mild stresses like bending over,
  lifting a vacuum cleaner or coughing can cause a
  fracture. In most cases, bones weaken when people
  have low levels of calcium, phosphorus and other
  minerals in their bones. Osteoporosis can also
  accompany endocrine disorders or result from
  excessive use of drugs such as corticosteroids.
• Although it is often thought of as a women's
  disease, osteoporosis affects many men as well.
  Even children are not immune.

17
Digestive Sistem

• Swallowing and the motions that automatically
  move digested food through the intestines slow
  down as people get older. The amount of surface
  area within the intestines diminishes slightly.
  The flow of secretions from the stomach, liver,
  pancreas and small intestine may decrease. These
  changes generally do not disrupt the digestive
  process but constipation conditions are more
  frequent.
• The digestive system can adjust to a wide variety
  of foods, tolerate an astonishing amount of
  emotional stress and put up with hurried meals of
  questionable nutritional value. But over time a
  poor diet, bad eating habits and other unsavory
  lifestyle habits can take their toll. The
  possible results? Distressing bouts of heartburn,
  nausea, cramps, diarrhea or constipation.

18
Kidneys, Bladder and Urinary Trackt

• With age, kidneys become less efficient in
  removing waste from the bloodstream. Chronic
  conditions, such as diabetes or high blood
  pressure, and some medications can damage kidneys
  further.
• About 30 percent of people age 65 and older
  experience urinary incontinence. Incontinence can
  be caused by a number of health problems, such as
  obesity, frequent constipation and chronic cough.
  Women are more likely than men to have
  incontinence. Women who have been through
  menopause might experience stress incontinence as
  the muscles around the opening of the bladder
  lose strength and bladder reflexes change. Pelvic
  muscles become weaker, reducing bladder support.
  In older men, incontinence is sometimes caused by
  an enlarged prostate, which can block the
  urethra. This makes it difficult to empty the
  bladder and can cause small amounts of urine to
  leak. Urinary incontinence is an all too common,
  often embarrassing and frustrating problem for
  millions of people.
• Prostate enlargement affects about half of men in
  their 60s and up to 90 percent of men in their
  70s and 80s.

19
Brain and Nervous Sistem

• The number of cells (neurons) in brain decreases
  with age, and memory becomes less efficient.
  However, in some areas of the brain, the number
  of connections between the cells increases,
  perhaps helping to compensate for the aging
  neurons and maintain brain function. Reflexes
  tend to become slower. There is also a tendency
  to become less coordinated. To try to slow down
  or even revert this process occupational
  therapies are advised so as to stimulate their
  intelect to remain active.

20
Eyes

• With age, eyes are less able to produce tears,
  your retinas thin and lenses gradually turn
  yellow and become less clear. During the 40s,
  focusing on objects that are close up may become
  more difficult. Later, the irises stiffen, making
  pupils less responsive. This can make it more
  difficult to adapt to different levels of light.
  Other changes to lenses can make people sensitive
  to glare, which presents a problem when driving
  at night. Cataracts, glaucoma and macular
  degeneration are the most common problems of
  aging eyes.
• Healthy eyes are continuously covered by a tear
  film - a constant layer of fluid designed to
  remain stable between blinks. A stable tear film
  prevents irritation of the nerves of the cornea,
  the clear front surface of eyes, and allows the
  eye to maintain clear, comfortable vision. The
  tear film protects the eyes and lubricates them.
  It also reduces the risk of eye infection and,
  with each blink of the eyelids, helps clear eyes
  of any debris. When the eyes become irritated
  from dust or are bothered by wind, smoke or
  fumes, extra tears form to help wash away the
  foreign material. Decreased production of fluids
  from tear glands can destabilize the tear film,
  allowing it to break down rapidly and creating
  dry spots on the cornea that cause irritation and
  diminished vision. An imbalance in the substances
  that make up the tear film also can make eyes
  become dry. For most people who have dry eyes,
  it's a chronic condition.

21
Eyes

• A cataract is a clouding of the normally clear
  lens of eyes. Clouded vision can make it more
  difficult to read, drive a car or see the
  expression on a friend's face. Cataracts commonly
  affect distance vision and cause problems with
  glare. They generally do not cause pain, double
  vision with both eyes open or abnormal tearing.
  Clouding of the lens is a normal part of getting
  older. About half of people older than 65 have
  some degree of clouding of the lens. After age
  75, as many as 70 percent have cataracts that are
  significant enough to impair their vision. Most
  cataracts develop slowly and do not disturb
  eyesight early on. But as the clouding
  progresses, the cataract eventually interferes
  with vision. In the early stages, stronger
  lighting and eyeglasses can help to deal with the
  vision problems. But at some point, if impaired
  vision jeopardizes normal lifestyle, it might
  need surgery.
• Glaucoma is sometimes called the silent thief
  because it can slowly steal your sight before
  people realize anything's wrong. The most common
  form of glaucoma, primary open-angle glaucoma,
  develops gradually, giving no warning signs. Many
  people are not even aware they have an eye
  problem until their vision is extensively
  compromised. Glaucoma is the second most common
  cause of vision loss in the United States as it
  affects approximately 3 million Americans.
  Glaucoma is not just one disease, but a group of
  them. The common feature of these diseases is
  damage to the optic nerve that usually is
  accompanied by an abnormally high pressure inside
  the eyeball. If left untreated, glaucoma may lead
  to blindness in both eyes.

22
Eyes

• Age-related macular degeneration is a chronic eye
  disease that occurs when tissue in the macula,
  deteriorates. Degeneration of the macula causes
  blurred central vision or a blind spot in the
  center of your visual field. The first sign of
  macular degeneration may be a need for more light
  when doing close-up work. Fine newsprint may
  become harder to read and street signs more
  difficult to recognize. Eventually people may
  notice that when they are looking at a grid, some
  of the straight lines appear distorted or
  crooked. Gray or blank spots may mask the center
  of the visual field. The condition usually
  develops gradually, but may sometimes progress
  rapidly, leading to severe vision loss in one or
  both eyes. Macular degeneration is the leading
  cause of severe vision loss in people age 60 and
  older.
• Presbyopia is the gradual loss of the eye's
  ability to focus actively on nearby objects. It
  is a natural part of aging that usually begins to
  affect people after age 40. For most people,
  presbyopia becomes apparent when they need to
  hold print at arm's length in order to read it.

23
Ears

• Hearing loss is one of the most common conditions
  affecting adults who are middle-aged and older.
  One in three people older than 60 and half of all
  people older than 85 have significant hearing
  loss. Over the years, sounds and noise can damage
  the hair cells of the inner ears. In addition,
  the walls of the auditory canals thin, and
  eardrums thicken. People may have difficulty
  hearing high frequencies. Some people find it
  difficult to follow a conversation in a crowded
  room. Changes in the inner ear or in the nerves
  attached to it, earwax buildup and various
  diseases can all impact hearing.
• The gradual hearing loss that occurs as people
  age (presbycusis) is a common condition. An
  estimated one-third of the peolple older than age
  60 and one-half of those older than age 85 have
  some degree of hearing loss. Over time, the wear
  and tear on ears from noise contributes to
  hearing loss by damaging the cochlea, a part of
  your inner ear. It is believed that heredity and
  chronic exposure to loud noises are the main
  factors that contribute to hearing loss. Other
  factors, such as earwax blockage, can prevent
  ears from conducting sounds as well as they
  should.

24
Teeth

• How teeth and gums respond to age depends on how
  well people cared for them over the years. But
  even if they were meticulous about brushing and
  flossing, may notice that their mouth feels drier
  and gums have receded. Teeth may darken slightly
  and become more brittle and easier to break. Most
  adults can keep their natural teeth all of their
  lives. But with less saliva to wash away
  bacteria, teeth and gums become slightly more
  vulnerable to decay and infection.
• Some older adults experience dry mouth
  (xerostomia), which can lead to tooth decay and
  infection. Dry mouth can also make speaking,
  swallowing and tasting difficult. Oral cancer is
  more common among older adults. Lack of saliva is
  a common problem that may seem little more than a
  nuisance, but it can affect both enjoyment of
  food and the health of teeth.
• Missing teeth can make it difficult to eat and
  can cause discomfort in social situations.
  Implants or dentures may help people once again
  to chew, talk and smile with teeth that look and
  feel like their own.
• The American Cancer Society estimates more than
  28,000 new cases of oral and throat
  (oropharyngeal) cancer occur annually in the
  United States an estimated more than 7,000
  Americans die of these cancers annually. The
  worldwide market for implant-based dental
  reconstruction products will approach nearly 3.5
  billion by 2010.

25
Skin, Nails and Hair

• With age, skin thins and becomes less elastic and
  more fragile. It is also likely to bruise more
  easily. Decreased production of natural oils may
  make skin drier and more wrinkled. Age spots can
  occur, and skin tags are more common. Nails grow
  at about half the pace they once did. Hair may
  gray and thin. In addition, older people are
  likely to perspire less, making it harder to stay
  cool in high temperatures and putting them at
  increased risk of heat exhaustion and heat
  stroke. Skin cancer is also a concern as people
  age. There is a 40 to 50 chance of getting
  skin cancer at least once by the time people
  reach 65.
• Skin cancer is the most common form of cancer
  diagnosed. Doctors diagnose skin cancer in
  approximately 1 million Americans each year, and
  about 9,800 Americans die annually of skin
  cancer. Fair-skinned people who live in areas
  that get a lot of sunshine are at greatest risk.
  But anyone can develop skin cancer, which is most
  commonly caused by overexposure to ultraviolet
  (UV) radiation from the sun.
• Baldness typically refers to excessive hair loss
  from your scalp and can be the result of
  heredity, certain medications or an underlying
  medical condition. Anyone - men, women and
  children - can experience hair loss. The most
  common type is pattern baldness (androgenetic
  alopecia). It accounts for about 95 percent of
  hair loss from the scalp. It's typically
  permanent and can be attributed to heredity.
  Another type of alopecia, alopecia areata, can be
  temporary.

26
Skin, Nails and Hair

• Hair typically turns gray as a result of aging.
  Pigment in the hair shaft comes from special
  cells at the root (base) of the hair. These cells
  are genetically programmed to make a certain
  amount of pigment (melanin) at specific ages. At
  some point in the aging process, these cells make
  less and less pigment until the hair has very
  little pigment. White hair has no pigment, and
  gray hair has some but not as much as a red,
  black or brown hair.
• Vertical nail ridges, which run from the cuticle
  to the tip of the nail, are fairly common. They
  do not indicate serious illness and typically
  increase with age.
• Skin tags are small, soft, flesh-colored growths
  that protrude from your skin. They most often
  occur in fold areas of the body, such as on the
  sides of the neck, armpit or groin. Skin tags
  typically appear in middle age.

27
Sleep

• Sleep needs change little throughout adulthood.
  However, as people age, they will likely find
  that they sleep less soundly, meaning they will
  need to spend more time in bed to get the same
  amount of sleep. By age 75, some people find that
  they are waking up several times each night.
  Having difficulty getting to sleep and staying
  asleep is common as people age. But that does not
  mean insomnia cannot be avoided. Some medicines
  and therapies can help reduce or even eliminate
  these conditions.

28
Weight

• As people age, maintaining a healthy weight - or
  losing weight if they are overweight - may be
  more difficult. This because metabolism generally
  slows, meaning that their body burns fewer
  calories. Calories that were once used to meet
  the daily energy needs instead are stored as fat.
  Also the level of activity may decrease,
  resulting in unwanted weight gain. There is also
  the tendency that the weight gain tends to
  accumulate around the stomach, rather than hips
  and thighs.

29
Sexuality

• With age, sexual needs, patterns and performance
  may change. Impotence becomes more common in men
  as they age. By the time they are 65, up to 25
  percent of men have difficulty getting or keeping
  an erection about one in every four times they
  have sex. In others, it may take longer to get an
  erection, and it may not be as firm as it used to
  be.

30
Opportunities

• The demand for medical products related to
  cardiovascular, bones, muscles, joints, digestive
  system, kidneys, brain, eyes, teeth, skin, nails,
  hair sleeping disorders, overweight or sexual
  problems are meant to rise as the population
  requiring them is meant to increase. The previous
  conditions that we saw before are just some of
  the new opportunities that derive from the
  population ageing. These conditions will
  represent a greater share of the diseases
  affecting mankind. They have, therefore, a great
  potential for the health industry and should be
  regarded with special attention as they represent
  a potential market of million consumers.
  Therefore the development or generic production
  of medicines related to these conditions
  represent a very important niche that should be
  regarded as a strategically one.

31
Stem Cells

• Stem cells can be derived from an embryo or an
  adult. Unlike most cells in the body, such as
  skin or heart cells, which are dedicated to
  perform a specific function, stem cells are not
  specialists. But under certain circumstances,
  they can differentiate into specialized cells.
  Another unique characteristic of stem cells is
  their ability to replicate for indefinite periods
  without becoming senescent. It is not clear,
  however, if adult stem cells can fully match
  embryonic stem cells capacity to differentiate
  into vast arrays of replacement cells and
  tissues. In animal studies, certain adult stem
  cells have shown some potential to develop into
  multiple cell types, suggesting that both
  embryonic and adult stem cells could have
  therapeutic applications. Still, the discovery of
  human stem cells is an important scientific
  breakthrough that clearly has the potential to
  improve the quality and length of life.

32
Geriatric Care

• As the senior will be a significant part of the
  population and they demand specific treatment,
  geriatric care will be a area of greater
  importance and with a growing demand.
  Additionally this segment of the population will
  posses a considerable income, due to the social
  welfare, to spend in this kind of care. Therefore
  geriatric care services will meet a great
  expansion and some of the retirees will move to
  countries where the cost of living is lesser than
  in their own to enjoy their retirement.

33
Generics Vs Brand Name

• There are basically two forms of drug -
  proprietary (or 'brand-named') drugs that are
  developed and produced by large multinational
  pharmaceutical companies, and generic drugs that
  are either copies, or the basic form of a
  proprietary drug. Paracetamol for example is the
  generic form of Panadol or Tylenol. The companies
  that make these brand-names may spend thousands
  on marketing and inventing new formulations, but
  the basic active ingredient in their tablets is
  just standard paracetamol which can be bought
  without the label for far less money. Paracetamol
  can be made generically because there is no
  longer a patent on it. However, drugs that are in
  patent can also be copied under certain
  conditions, and are also known as generics.
• A generic medicine is an equivalent of an
  originator pharmaceutical product. It contains
  the same active substance as, is essentially
  similar to, and is therefore interchangeable
  with, the originator product.
• A generic medicine is marketed in compliance with
  international patent law. It is identified either
  by its internationally approved non-proprietary
  scientific name (INN) or by its own brand name.
  Generic medicines are widely used in many EU
  countries in cost-effective treatment programmes,
  and are increasingly prescribed by doctors as
  effective alternatives to higher-priced
  originator pharmaceuticals.

34
Generics

• Also governments, as the number of retired people
  starts to get too close to the number of workers,
  will try to find cheaper ways to supply the
  surging medical with the minimum possible costs.
  This effort will lead them to incentive the
  increase usage of such type of medicines as they
  are significantly cheaper and provide the same
  results.

35
Generics

• Increasing patient access to generic medicines
  generates four main public health benefits. It
• Reduces Prices.
• Generic medicines are themselves more
  economically priced than originator products
  selling at 20-80 less than original prices
• Competition from these generic rivals forces
  originators to reduce their own prices after, or
  even before patent expiry.
• 2. Stimulates Competition
• A permanent monopoly on pharmaceutical products
  would provide little incentive to originator
  companies to discover new medicines. As in all
  sectors, competition is a major stimulation to
  innovation.
• 3. Creates Budget Headroom for Innovation.
• The billion dollars saved annually in the world
  by buying equivalent generic medicines allows
  healthcare budgets and personal budgets the
  capacity to buy the newer, more expensive
  treatments when required.
• 4. Encourages new pharmaceutical companies.
• This ensures less dependency on large
  multinational firms for the provision of
  medicines worldwide.

36
Generics

• In the end of 2004, 35 of top selling
  pharmaceuticals were patent expired, creating a
  major opportunity over the next few years for
  increasing the purchase of generic medicines,
  both in community prescription and in hospital
  sectors. This poses good perspectives for the
  generics industry as the increasing trend is
  supposed to continue with more and more
  applications for generic patents being made.

37
Global Warming

• Areas like the North America and Europe are
  reconsidering their previous position on tropical
  diseases as their range is moving up north and
  south and are threatening to hit those areas.
  They are doing so by filling their stocks with
  supplies of available medicines to fight those
  diseases to prevent possible epidemics. Global
  warming will cause a significant increase in
  human mortality due to extreme weather and
  infectious disease. No country, even
  industrialized nations will escape these impacts.
  Scientists project that as warmer temperatures
  spread north and south from the tropics, and to
  higher elevations, malaria-carrying mosquitoes
  will spread with them. They conclude that global
  warming will likely put as much as 65 of the
  world's population at risk of infection and that
  means an increase of 20. Spreading infectious
  disease, longer and hotter heat waves, and
  extreme weather will all claim thousands of
  additional lives nationwide each year. Doctors
  and scientists around the world are becoming
  increasingly alarmed over global warnings impact
  on human health. Abnormal and extreme weather,
  which scientists have long predicted would be an
  early effect of global warming, have claimed
  hundreds of lives across the world in recent
  years. Our warming climate is also creating the
  ideal conditions for the spread of infectious
  disease, putting millions of people at risk.

38
Global Warming

• Malaria, generally does not afflict regions with
  annual average temperatures below 16C, because
  lower temperatures inhibit the parasite. As
  minimum temperatures climb, the disease could
  spread into previously malaria free regions. Yet
  the predicted consequences of global warming
  would fall most heavily on tropical regions,
  where malaria could spread in both latitude and
  altitude. A relatively small increase in winter
  (minimum) temperature would likely facilitate the
  spread of malaria into large urban highland
  populations that are currently malaria free and
  immunologically naive, such as Nairobi, Kenya,
  and Harare, Zimbabwe.
• Future trouble will also come from the seas as
  the global warming should make the oceans a more
  hospitable home for cholera and harmful algal
  blooms.

39
New Diseases

• New diseases will show up in areas previously
  safe not only because of the global warming
  effects but also as new strains of virus and
  bacterias will emerge. With the growing
  population density of cities and villages and the
  sometimes poor sanitation conditions, diseases
  thrive and evolve. Also the irresponsible usage
  of current drugs is helping mutations in the
  antibiotics situation the scenario is alarming as
  many are ceasing to be effective and stronger
  ones are being put to general use. This creates
  many problems as current available drugs, unlike
  diseases, are ceasing to be effective and deaths
  are more frequent. Also previous deaths whose
  causes were unexplained may on the future have
  their causes met what will enable new research
  fields.
• This presents itself as an opportunity for
  pharmaceuticals, as diseases that were under
  control will no longer be and drugs that
  previously were controlling the market will cease
  to, as they will need to be replaced by new, more
  effective ones.

40
Human Genome Project

• All diseases have a genetic component, whether
  inherited or resulting from the body's response
  to environmental stresses like viruses or toxins.
  The successes of the human genome project have
  even enabled researchers to pinpoint errors in
  genes - the smallest units of heredity - that
  cause or contribute to disease. 
• The ultimate goal is to use this information to
  develop new ways to treat, cure, or even prevent
  the thousands of diseases that afflict humankind.
  But the road from gene identification to
  effective treatments is long and fraught with
  challenges. In the meantime, biotechnology
  companies are racing ahead with commercialization
  by designing diagnostic tests to detect errant
  genes in people suspected of having particular
  diseases or of being at risk for developing
  them. 
• An increasing number of gene tests are becoming
  available commercially, although the scientific
  community continues to debate the best way to
  deliver them to the public and medical
  communities that are often unaware of their
  scientific and social implications. While some of
  these tests have greatly improved and even saved
  lives, scientists remain unsure of how to
  interpret many of them. 

41
Human Genome Project

• Explorations into the function of each human gene
  - a major challenge extending far into the 21st
  century - will shed light on how faulty genes
  play a role in disease causation. With this
  knowledge, commercial efforts are shifting away
  from diagnostics and toward developing a new
  generation of therapeutics based on genes. Drug
  design is being revolutionized as researchers
  create new classes of medicines based on a
  reasoned approach to the use of information on
  gene sequence and protein structure function
  rather than the traditional trial-and-error
  method. Drugs targeted to specific sites in the
  body promise to have fewer side effects than many
  of today's medicines.
• The potential for using genes themselves to treat
  disease - gene therapy - is the most exciting
  application of DNA science. This rapidly
  developing field holds great potential for
  treating or even curing genetic and acquired
  diseases, using normal genes to replace or
  supplement a defective gene or to bolster
  immunity to disease.

42
The Genome

• Rapid progress in genome science and a glimpse
  into its potential applications have spurred
  observers to predict that biology will be the
  foremost science of the 21st century. Technology
  and resources generated by the Human Genome
  Project and other genomics research are already
  having a major impact on research across the life
  sciences. The potential for commercial
  development of genomics research presents the
  health industry with a wealth of opportunities,
  and sales of DNA-based products and technologies
  in the biotechnology industry are projected to
  exceed 45 billion by 2009. Those opportunities
  can derive from
• Molecular Medicine
• Improved diagnosis of disease
• Earlier detection of genetic
• predispositions to disease
• Rational drug design
• Gene therapy and control
• systems for drugs
• Pharmacogenomics "custom
• drugs"

• DNA Forensics (Identification)
• Identify potential suspects whose DNA may match
  evidence left at crime scenes
• Identify crime and catastrophe victims
• Establish paternity and other family
  relationships
• Identify endangered and protected species as an
  aid to wildlife officials (could be used for
  prosecuting poachers)
• Detect bacteria and other organisms that may
  pollute air, water, soil, and food
• Match organ donors with recipients in transplant
  programs
• Determine pedigree for seed or livestock breeds

43
Anti-Aging Products

• Demand for anti-aging products is expected to
  reach 30 billion in 2009, propelled by a stream
  of new and improved products offering health
  maintenance and appearance enhancing benefits to
  a largely untapped customer base of middle-aged
  and elderly consumers. The value of chemicals
  used to manufacture these products will reach
  3.8 billion. New product introductions and the
  passage of the relatively affluent baby boomer
  generation through middle age (when age related
  changes become more apparent) will stimulate
  demand for formulated appearance anti-aging
  products. Strong growth will arise from various
  products that reduce the visibility of wrinkles
  and age spots, such as wrinkle removal injections
  and age-defying lotions. However, gains will be
  limited by fierce price competition among the
  large number of over-the counter brands
  continuing to emerge. Hair growth stimulants will
  also record robust gains.
• Chemicals expected to benefit from rapid gains in
  anti-aging products include memory-enhancing
  neurological and ophthalmic agents botulinum
  toxin for wrinkle-reducing applications and a
  host of small volume herbal extracts, including
  lutein, lycopene and black cohosh, used in both
  dietary supplements and cosmeceuticals.

44
Tobacco Addiction

• Tobacco addiction is widespread and its prejudice
  is also widely known. As governments from the
  developed countries start to tax at a higher rate
  these products the incentives for a change of
  habits are bigger. The economical and health
  advantages of quitting to smoke will be greater
  and people will be willing to spend a greater
  amount of money in recovering from their
  condition.
• Cigarette smoking is a major preventable cause of
  disease worldwide, and it is the major cause of
  premature death in North America. The important
  causes of mortality are atherosclerotic vascular
  disease, cancer, and chronic obstructive
  pulmonary disease (COPD). Smoking also can
  contribute to other diseases, eg, histiocytosis
  X, respiratory bronchiolitis, obstructive sleep
  apnea, idiopathic pneumothorax, low birth weight,
  and perinatal mortality.
• Factors influencing smoking initiation differ
  from those of smoking behavior maintenance.
  Nicotine dependence, genetic factors, and
  psychosocial factors influence maintenance of
  smoking behavior.
• Nicotine meets the criteria of a highly addictive
  drug. Nicotine is a potent psychoactive drug that
  induces euphoria, serves as a reinforcer of its
  use, and leads to nicotine withdrawal syndrome
  when it is absent. Nicotine in cigarette smoke
  affects mood and performance and is the source of
  addiction to tobacco. Smoking may begin as a
  voluntary habit, but eventually it becomes an
  addiction.

45
Cancer

• One in every eight deaths worldwide is due to
  cancer, which claims twice as many lives as AIDS.
  By 2020, three out of every five new cancer cases
  will be found in the developing world. In these
  countries, 80 to 90 of cancer patients already
  suffer from advanced and incurable cancers at the
  time of diagnosis. Also in 2020, regions with
  traditionally low numbers of cancer deaths could
  see alarming increases in mortality rates.
  Regions including Northern Africa and Western
  Asia, South America, the Caribbean, and South
  East Asia could face sharp increases of over 75
  in the number of cancer deaths in 2020 as
  compared to 2000.
• The knowledge about prevention and treatment of
  cancer is increasing, yet the number of new cases
  grows every year. If current trends continue, 15
  million people will discover they have cancer in
  2020, two-thirds of them in newly-industrialized
  and developing countries.

46
AIDS

• The AIDS epidemic caught scientists off guard.
  The medical community has been unable to find
  ways to cure or even vaccinate against infection.
  AIDS is an acronym that stands for acquired
  immunodeficiency syndrome and is an infectious
  disease in which the immune system collapses.
  This disease is caused by the human
  immunodeficiency virus (HIV). Most HIV infections
  are sexually transmitted however, another
  cluster of infections has come from IV-drug users
  sharing needles. HIV infections are atypical of
  other viral infections in several ways HIV
  typically kills its host around a decade after
  infection yet is virtually asymptomatic during
  the first several years the viral infection is
  not, by itself, the cause of death the virus
  specifically infects key cells of the immune
  system and thereby ultimately destroys the immune
  response the virus can "hide-out" inside cells
  for years and then emerge long after any
  treatment has stopped.
• The number of cases grew rapidly in just a few
  years. From blood samples and autopsy reports,
  the first case dates to the 1950s. But it was not
  until nearly 1980 that it became common enough to
  be noticed. Today, 30 million people are infected
  worldwide. A huge fraction of Africa's population
  in some countries is infected, the epidemic is
  spreading exponentially in Asia. (Five years ago,
  it was estimated that 10 of Thailand's military
  was infected.) Drugs are available that prolong
  the life of infected individuals, but the regimen
  is rigorous (daily doses of several drugs), and
  the virus has been able to evolve resistance to
  every drug tried.

47
Plastic Curgery

• Recent surveys discovered that over 69 of women
  are concerned with the visible signs of aging,
  including fine lines, wrinkles, and dryness. 47
  want to improve the look of the skin around their
  eyes, and 18 want to improve the look of the
  area around their mouths.

48
Influenza

• Strains of flu virus differ from one another
  largely in the genes that code for surface
  molecules called glycoproteins, which are the
  primary targets of the body's immune system in
  defending against flu viruses. Evolutionary
  changes in immune response against such antigen
  molecules are the reason that new vaccines must
  be developed against emerging strains of virus.
  Vaccines remain the mainstays in our
  armamentarium against influenza but they must be
  constantly updated to meet with the new strain of
  virous that are constantly appearing.

49
SARS

• Severe acute respiratory syndrome (SARS) is a
  viral respiratory illness caused by a
  coronavirus, called SARS-associated coronavirus
  (SARS-CoV). SARS was first reported in Asia in
  February 2003. Over the next few months, the
  illness spread to more than two dozen countries
  in North America, South America, Europe, and Asia
  before the SARS global outbreak of 2003 was
  contained. According to the World Health
  Organization (WHO), a total of 8,098 people
  worldwide became sick with SARS during the 2003
  outbreak. Of these, 774 died.
• The main way that SARS seems to spread is by
  close person-to-person contact. The virus that
  causes SARS is thought to be transmitted most
  readily by respiratory droplets (droplet spread)
  produced when an infected person coughs or
  sneezes. Droplet spread can happen when droplets
  from the cough or sneeze of an infected person
  are propelled a short distance (generally up to 3
  feet) through the air and deposited on the mucous
  membranes of the mouth, nose, or eyes of persons
  who are nearby. The virus also can spread when a
  person touches a surface or object contaminated
  with infectious droplets and then touches his or
  her mouth, nose, or eye(s).

50
Drug Addictions

• Drug addiction is a complex illness. It is
  characterized by compulsive, at times
  uncontrollable drug craving, seeking, and use
  that persist even in the face of extremely
  negative consequences. For many people, drug
  addiction becomes chronic, with relapses possible
  even after long periods of abstinence.
• The compulsion to use drugs can take over the
  individual's life. Addiction often involves not
  only compulsive drug taking but also a wide range
  of dysfunctional behaviors that can interfere
  with normal functioning in the family, the
  workplace, and the broader community. Addiction
  also can place people at increased risk for a
  wide variety of other illnesses. These illnesses
  can be brought on by behaviors, such as poor
  living and health habits, that often accompany
  life as an addict, or because of toxic effects of
  the drugs themselves. Because addiction has so
  many dimensions and disrupts so many aspects of
  an individual's life, treatment for this illness
  is never simple.
• Effective drug abuse and addiction treatment
  programs typically incorporate many components,
  each directed to a particular aspect of the
  illness and its consequences Three decades of
  scientific research and clinical practice have
  yielded a variety of effective approaches to drug
  addiction treatment.
• Medications, such as antidepressants, mood
  stabilizers, or neuroleptics, may be critical for
  treatment success when patients have co-occurring
  mental disorders, such as depression, anxiety
  disorder, bipolar disorder, or psychosis.

51
Blood Substitutes

• Blood is an essential body fluid. It is
  responsible for the transport of oxygen to body
  tissues, and for carrying away wastes such as
  carbon dioxide. It performs important functions
  such as clotting to stop bleeding. It is the
  major vehicle for transport of nutrients and
  antibodies. Blood is literally a river of life.
  Blood is one of the world's most vital medical
  commodities The liquid and its derivatives save
  millions of lives every year. Yet blood is a
  complex resource not completely understood,
  easily contaminated, and bearing more than its
  share of cultural baggage. Physicians and
  scientists alike recognized that a blood
  substitute would bypass the risk of a blood-borne
  pathogen being passed to a patient during
  transfusion. Further advantages to using a blood
  substitute in place of normal blood include an
  increased shelf life, the elimination of the need
  to crossmatch blood types from donor to
  recipient, and the ability to transfuse in an
  ambulance. The estimated market for a blood
  substitute is now between 2 and 12 billion
  dollars. the world market for blood and its
  derivatives probably does not exceed 18.5
  billion per year. About 4.5 million units of
  human blood are transfused every year, at a price
  of 200 to 350 a pint, a market of 8 billion to
  10 billion. Unlike human blood, the synthetic
  stuff doesnt have a limited shelf life, and is
  free of viruses such as HIV and hepatitis that
  can be present in human blood.

52
Diabetes

• Diabetes mellitus is a group of diseases
  characterized by high levels of blood glucose
  resulting from defects in insulin production,
  insulin action, or both. Diabetes can be
  associated with serious complications and
  premature death, but people with diabetes can
  take steps to control the disease and lower the
  risk of complications.
• Type 1 diabetes was previously called
  insulin-dependent diabetes mellitus (IDDM) or
  juvenile-onset diabetes. Type 1 diabetes develops
  when the body's immune system destroys pancreatic
  beta cells, the only cells in the body that make
  the hormone insulin that regulates blood glucose.
• Type 2 diabetes was previously called
  non-insulin-dependent diabetes mellitus (NIDDM)
  or adult-onset diabetes. Type 2 diabetes may
  account for about 90 to 95 of all diagnosed
  cases of diabetes. It usually begins as insulin
  resistance, a disorder in which the cells do not
  use insulin properly. Type 2 diabetes is
  associated with older age, obesity, family
  history of diabetes, history of gestational
  diabetes, impaired glucose metabolism, physical
  inactivity, and race/ethnicity. Type 2 diabetes
  is increasingly being diagnosed in children and
  adolescents.

53
Diabetes

• With this new tendency to be obese our society is
  becoming more prone to diabetes. This cronical
  disease is growing every day and not only adults
  and elders are struck by its effects. Nowadays
  children due to their habits are more prone to be
  diabetic.
• Diabetes can affect many parts of the body and
  can lead to serious complications such as
  blindness, kidney damage, and lower-limb
  amputations.
• In the US alone about 210,000 people under 20
  years of age have diabetes. This represents 0.26
  of all people in this age group. Approximately
  one in every 400 to 500 children and adolescents
  has type 1 diabetes. Over the age of 20 years
  old 18.0 million 8.7 of all people in this age
  group have diabetes. Over 60 years old 8.6
  million 18.3 of all people in this age group
  have diabetes.

54
Healthy Holidays

• As people get older the preoccupation with their
  physical welfare increases and their life is most
  of the times planned around this need. This means
  that holidays that can help them take care of
  their body as well as their spirit are welcomed.
  Izmir has a fine example in the usage of fish to
  help cure psoriasis condition.
• In a further reflection of consumers' growing
  inclination to choose products that are good for
  their health, travel packages that combine
  medical checkups or treatment with fun and
  relaxing activities are enjoying a steady growth
  in popularity. A typical package of this sort
  involves the traveler being given an extensive
  medical checkup at a hospital before enjoying a
  relaxing and therapeutic stay at a hot spring
  resort. Witnessing a particular boom in
  popularity are medical travel package tours
  offering positron emission tomography (PET)
  scans, a technology that is being used
  increasingly in the detection of cancer, with
  hotel accommodation included. These packages,
  which also include hotel accommodation, are the
  result of alliances between travel agencies and
  medical institutions in cities throughout Japan.
  Such packages offer benefits not only for
  consumers - it is well known that early detection
  is vital in the treatment of many diseases - but
  also for medical institutions and the travel
  industry. Hospitals and clinics are also able to
  use the expensive medical equipment they own to
  derive commercial revenue, while travel agencies
  are able to tap a new and expanding market. More
  and more medical travel packages are expected to
  appear in the years ahead. Many industry analysts
  predict that medical tourism will be an
  increasingly important element of the travel
  industry, because people's awareness of the
  importance of preventative health and their
  willingness to spend time and money on it are
  likely to continue to grow.

55
Genetic Testing

• With the development of new areas of the genetic
  field new sorts of test as well as the accuracy
  of the current ones increase. Also people become
  more confident in the reliability of the results.
  New applications of these techniques arise. Not
  only for police research purposes, even though
  that will happen at a higher rate, but also
  university laboratories and other medical
  laboratories that can not afford or do not have
  the skills or machines to do these tests.
• Despite still being in its infancy, the genetic
  testing market has the potential for strong
  growth in the future, genetic testing generated
  revenues totaling 319.9 million in 2000 and is
  estimated to reach 877.2 million by 2006 at a
  compound annual growth rate of 20.4. Tests that
  were uncommon, if not unheard of, a short while
  ago are now routinely performed at genomic
  testing labs all over the world.

56
Genetic Testing

• The use of genetic tests to measure a persons
  predisposition to blood clots, for example, is
  increasing at a rate of 150 per year.
  Gynecologists are expected to recommend that many
  couples planning to have a child be tested for
  the cystic fibrosis gene. While the
  prenatal-screening area is projected to increase
  at an annual rate of 8, the cancer and
  predisposition testing markets are expected to
  grow at rates of 30 and 29.8, respectively.
  Analysts attribute such high growth rates in the
  cancer and predisposition testing segments to
  continuing developments in genetic research.

57
Health Tecnical Machines

• The market for pre-hospital emergency and trauma
  equipment is really healthy, and is expected to
  remain that way well through century.
  Nevertheless the hospital market for emergency
  equipment is in a downturn. That segment of the
  market is considered saturated, with revenues
  derived primarily from replacement sales.
  Understandably, manufacturers have targeted
  pre-hospital prospects. As pre-hospital emergency
  and trauma equipment becomes increasingly
  automated, accurate and user-friendly, it is
  being put into the hands of an expanding end-user
  base of pre-hospital lay persons and minimally
  trained practitioners. That expanded user base,
  plus the rapid development and deployment of new,
  cost-effective equipment, gives the pre-hospital
  emergency market tremendous growth potential.
  Manufacturers and marketers are scrambling for
  position in the cost-conscious, highly
  competitive industry. As prices fall, products
  become more accessible, leading to increasing
  end-user demand creating a new hot prospects
  market.

58
Fitness Machines

• The culture of the body is increasing, as people
  get more conscious that their body is a machine
  that requires maintenance to work properly. They
  also care more about their looks and fitness and
  the way how other people see them. This new
  concept has driven people to the gym and to buy
  devices that enable them to pursue these two
  goals, Looking good and being good.
• Of course this option has opened a new branch of
  the health industry thats the production of such
  devices that can help people exercising. This
  already significant and growing market presents a
  great opportunity for high margins goods.

59
Childhood Obesity

• The rising obesity epidemic reflects the profound
  changes in society and in the behavioral patterns
  of communities over the last 20 - 30 years.
  Individuals may become obese, partly because they
  have a genetic predisposition to gain weight
  readily when they are exposed to unhealthy diets
  and lifestyles. Nevertheless, the fundamental
  cause of the obesity epidemic is the change in
  behaviors and lifestyles, especially with regard
  to diet and physical activity patterns.
  Furthermore, for childhood obesity, there is
  increasing evidence from a range of studies
  indicating the important role of early life
  environment in the later risk of obesity.
  Intrauterine life, infancy, and the pre-school
  period, have all been considered as possible
  critical periods during which the regulation of
  energy balance may be programmed for the long
  term. Obesity is a complex, multi-factorial
  disorder and coherent and comprehensive
  strategies are needed for its effective and
  sustainable prevention and management.
• Obesity is now well recognized as a disease in
  its own right, one, which is largely preventable
  through changes in lifestyle, especially diet and
  physical activity. Obesity is a major risk factor
  associated with increased morbidity and mortality
  from chronic noncommunicable diseases. In many
  parts of the world, obesity rates are doubling
  every 5 to 10 years and increasing the financial
  burden of providing medical care due to resulting
  health problems. World Health Statistics 2005
  published last month indicate