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Call to Address Issues Hindering Osteoporosis Market Growth

Vast improvements in awareness, diagnosis and the treatment of osteoporosis have seen market revenues jump but the upward swing won't continue unless further improvements are made, warns Frost & Sullivan.

Latest research from the international marketing consulting company –– valued the market at $1.04 billion in 2000: a positive growth rate of 22 percent since 1997. Frost & Sullivan estimates the market growth will slow, reaching $1.86 billion in 2007.

The study focuses on two main areas within the market. The European hormone replacement therapy market was worth approximately $744.8 million in 2000, however, the majority of prescriptions were for the alleviation of menopausal symptoms with only a very small percentage of this revenue being attributed to prescriptions for osteoporosis prophylaxis. The European bisphosphonates market for use in osteoporosis generated $298.8 million 2000, with the majority of prescriptions being for the treatment rather than prevention of the disease.

Healthcare research analyst Jennifer Cassels says the total market is hindered by a lack of awareness of the silent disease. "The target population – women over the age of 45 years – show limited awareness of their personal risk of developing the disease and many still believe that osteoporosis is a consequence of growing old. Although the medical profession have a greater knowledge, they do not regard osteoporosis as a high priority disease and as a result of this many physicians do not educate or advise their patients about osteoporosis."

The study found women who were aware of the disease were often hindered by the restricted availability of diagnostic equipment. Limited funding means the number of bone densitometers, used to measure bone mass, the prime indicator of osteoporosis, varies dramatically throughout Europe. For example, in the UK there are only 4 units per million population. Sparse diagnostic resources have resulted in a very limited percentage of the female population being tested for osteoporosis, with this figure ranging from as little as 5 percent of women over 40 being tested in the UK, to 28 percent in Italy, the highest diagnosis rate in Europe.

Reimbursement issues also drive physicians to prescribe cheaper options. "In a number of countries, bisphosphonates are only reimbursed after either a fracture has occurred or if established osteoporosis has been diagnosed. For example, in France reimbursement of these drugs is limited to those patients who have already experienced a vertebral fracture," Ms Cassels explains.

"In Italy, the government granted reimbursement for bisphosphonates in 1998, however established osteoporosis must be diagnosed by radiograph and loss of vertebral height in order for treatments to be reimbursed. Gaining reimbursement may depend on clearly proving, by cost benefit analysis, that treating those suffering from osteoporosis before a fracture occurs, or by slowing the rate of bone loss in those at high risk of developing the disease is far more cost effective than waiting until a fracture occurs and incurring high hospital costs."

Many women taking HRT cease treatment or are adverse to beginning it in the first place due to the increased risk of developing endometrial and breast cancer, with the latter being the primary reason for stopping treatment. Additionally, after menopausal symptoms subside, women do not feel that it is necessary to continue treatment.

"Throughout Europe, the average time women take HRT is between one and two years, therefore they will not benefit from the positive effects that HRT has on bone. Patients taking bisphosphonates also suffer side effects such as oesophageal and gastrointestinal irritation and this often results in treatment cessation. Additionally, the strict administration regimen of bisphosphonates deters patients from continuing with this treatment form, hence revenue growth is restricted," Ms Cassels explains.

At the opposite end of the scale, changing demographics throughout Europe have increased the potential market for osteoporosis therapies. As health improves and life expectancy increases, there is a parallel increase in the incidence of osteoporosis. The number of hospital beds required to treat those with hip or spine fractures is predicted to continually rise over the next 50 years, reaching an estimated 56,000 in 2050.

Continual research and development of hormone replacement therapies has resulted in a substantial range of products, with varying dosages being marketed, allowing greater choice for the patient. The development of new bisphosphonates, such as Actonel, as well as the new once weekly formulation of Fosamax could raise compliance rates. Additionally, the recent discovery of a novel therapy, the selective oestrogen receptor modulators have been shown to have beneficial effects on bone, without stimulating endometrial or breast tissue. Frost & Sullivan predicts they will capture a large portion of the European osteoporosis market in the future.

Frost & Sullivan is an international marketing consulting company that monitors a comprehensive spectrum of healthcare markets for trends, market measurements and strategies. This ongoing research is utilised to complement a series of research publications to support industry participants with customised consulting needs.

Source: Frost & Sullivan