Epidemiology Based Market Forecast

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Epidemiology Based Market Forecast

Introduction

Disease OverviewEpidemiology Overview

Forecasting Process

Points To RememberData SourcesQ&A

GlobalData uses epidemiology-based treatment flow model to forecast the market size. Theforecasting model used at GlobalData makes use of epidemiology data gathered from research

publications and primary interviews with physicians to represent the treatment flow patterns for

individual diseases and therapies.

The epidemiology-based forecasting model for a medical device is helpful in:

Deriving the type of patient segment which is actually going for the proceduresFrequency of usage of the device depending on the patient type which further helps to arrive at

the absolute unit sale of a device in a yearThe market for any medical device is directly proportional to the volume of units sold and the

price per unit.

Market Size = Volumes of units sold X Average Selling Price

Epidemiology Based Market Forecast

Introduction

Disease OverviewEpidemiology OverviewForecasting Process

Points To Remember

Data SourcesQ&A

Disease overview plays most important role in your forecasting model. This section provides a

context of the most important scientific and epidemiological aspects of the disease.Furthermore, in-depth understanding of the disease/indication will help you to narrow down and

isolate the actual patient pool/procedure you need to consider for your concerned device/implant.

Be well-versed with this section and study your disease strongly, as entire flow of the forecastmodel depends on the basic understanding of the disease.

Clearly define the type of disease and patient segmentation while studying disease overview

Type of disease (Chronic/Acute): This will be helpful in deciding whether you have to doprevalence based forecasting or incidence based forecasting. For Eg: As diabetes is a chronic

disease we will follow prevalence based forecasting. For traumatic cases (Eg: traumatic arthritis)


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we will follow incidence based forecasting.

Type of patients (Male, female, infants, elderly): This will help you to understand among which

patient population your indication is more common and will ultimately help you to select themajor patient pool for the market model. For Eg: Rheumatoid arthritis (RA) is more common in

women than in men. In fact, 70% of the patients with RA are women. So here your major patient

pool will comprised of female population.Age Group: Thorough study of the disease will help in understanding among which age groupthe disease is more prevalent. In certain cases, the population of a specific age group is

considered. Indications such as Osteoarthritis (Above 40 years of age), Myocardial infarction

(Above 20 years of age) are examples of indications in which age specific population pool isconsidered.

Epidemiology Overview

The epidemiology-based forecasting model considers the data on prevalence, incidence, diseased

population, diagnosed and treated population.

This epidemiology data is gathered from association websites and population based studies andresearch articles published in journals or available on Pubmed and Medscape. This information isvalidated from interviews with physicians/ KOLs.

The prevalence of a disease is the percentage of the total population who suffer from a

disease/condition. Prevalence based forecasting is mostly done for chronic diseases.Incidence is the number of new cases of a condition, symptom, death, or injury that develop

during a specific time period, such as a year. The incidence based forecasting is mostly done for

acute conditions such as trauma, infections.The diagnosed population is the population diagnosed with a disease expressed as a percentageof the prevalent population.

The treated population is calculated as a percentage of the population diagnosed with a disease.

Forecasting Process

The market forecast begins with the general population. This may vary depending upon theindication.In certain cases, the population of a specific age group is considered. Indications such as

Osteoarthritis (Above 45 years of age), Myocardial infarction (Above 20 years of age) are

examples of indications in which age specific population pool is considered.Depending upon the severity of the disease prevalence or incidence rate is applied to this

population base to identify the prevalent/incident pool. This number needs to be validated

through primary and secondary sources. The secondary sources used for applying these rates


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should not be older than four to five years for the base year. For historic data you can anytime go

to old sources for that year for which you are looking for historic data.

Prevalence: Be careful while applying a prevalence rate on general population. Use at least twoto three sources to finalize your prevalence rate.

Prevalence of a disease is expressed either as a percentage or as a ratio. For example, if the

prevalence of the disease is expressed as 1.2/10000, then the disease population can be calculatedby cross-multiplication of the data with the total population in the geography.In some cases, the prevalence is expressed as a percentage of a particular age group/ Gender.

For Eg: If the prevalence is expressed as a percentage of all men above 30 years of age, then the

calculation would involve ONLY the male population above 30 years of age.

Forecasting Process (Contd)

For Eg: If your indication is prevalent in 45 years and above patient group then you have toapply that prevalence rate only in the 45 years and above age group of general population.

For Eg: If you are getting a prevalence rate of diabetes as 0.26% in age group under 20 years of

age, then you cannot apply this prevalence rate to overall population. You will have to bespecific in applying this to age-wise population group with reference to mentioned prevalence.Prevalence of diseases might vary across geographies.

Incidence data - Incidence rate is the number of new cases of a particular disease that occur in a

year. Incidence data is expressed as a ratio or as real numbers. In case of genetic disorders,incidence data might be expressed as a ratio or percentage of the birth rate in the country. Use at

least two to three sources to finalize your incidence rate.

For Eg: If, over the course of one year, five women are diagnosed with breast cancer, out of atotal female study population of 200 (who do not have breast cancer at the beginning of the studyperiod), then we would say the incidence of breast cancer in this population was 0.025. (or 2,500

per 100,000 women-years of study)

Diagnosis Rate - People who get diagnosed for the disease. Diagnosis rate/diagnosed populationneeds to be searched through secondary sources and then has to be validated with KOL

interviews. Proper rationale or assumption should be used while applying diagnosis rate on to

your diseased population.

Increase or decrease of the diagnosis rate may depend on the following factors:

Accessibility to Primary Care Physicians (PCPs)/ specialized doctors

Availability of diagnostic centers (Advancements in the technology)Availability of better health care services

Awareness about the disease

Severity of the symptomsGovernment initiatives

The treated patient pool is derived by applying the treatment rate to the diagnosed patient pool.


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Treatment rate is sourced from secondary sources and verified through primary interviews.

Remember not all the treated population will go for the procedures. The treated population going

for the device usage depends upon the severity of the disease, access to health care andaffordability.

For E.g.: Patients with Vertebral Compression Fractures (VCF) who undergoes treatment is

around 20% of the diagnosed pool. But out of this treated patient pool nearly 18% goes fortreatment with VCF repair devices, whereas remaining patients goes for alternative treatmentssuch as drugs and braces.

Another E.g.: Patients with Renal Artery Stenosis (RAS) who undergoes treatment, not all the

treated patient pool goes for renal artery stenting. Some patients also goes for alternativetreatments such as drugs and life style modification.

The device uptake percentage is allocated based on the primary responses and the information

available in secondary sources (Such as user site).

Increase or decrease of the treatment rate may depend on the following factors:Affordability/Willingness

Technological advancesAccessibility to specialized doctors

Average selling price (ASP) of the device is mostly gathered from primary and secondary

source. ASP is the price at which a device is available in a target country to an end user (End

user is defined in different ways for different nodes. Eg: Typically for capital equipment andimplantable consumables, end user is considered to be the healthcare setting. For consumables

purchased by patient, the end user is a patient).

Factors such as company share, reimbursement, company type (local/domestic or multinational)are taken into consideration during analysis of average selling prices.

Following sources are used for ASP analysis:

Company websites

Annual reports/industry reportsPress releases

Product monologue

Following factors may influence the price dynamics :

Government regulations

CompetitionDisease burden/Unmet need

For countries wherein adequate data is not available, analogue/benchmarking based forecasting

technique is used.

For E.g.: If you are getting specific data point (prevalence, incidence, diagnosis rate, treatmentrate or similar index) for a particular country, then with the help of supporting sources you can

consider this as benchmark and can apply it on other countries as well depending upon the

similarity in the demographics of both the countries (Kindly note that you can benchmark the


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data only on the basis of similar demographics).

Classic E.g.: Brazil and Mexico, Chile and Argentina.

The model considers the impact of price inflation of the devices.

Following factors may influence the price dynamics :

Government regulationsCompetition

Disease burden/Unmet need

For countries wherein adequate data is not available, analogue/benchmarking based forecastingtechnique is used.For E.g.: If you are getting specific data point (prevalence, incidence, diagnosis rate, treatment

rate or similar index) for a particular country, then with the help of supporting sources you can

consider this as benchmark and can apply it on other countries as well depending upon thesimilarity in the demographics of both the countries (Kindly note that you can benchmark the

data only on the basis of similar demographics).

Classic E.g.: Brazil and Mexico, Chile and Argentina.


Following factors may influence the price dynamics :Government regulations

Competition

Disease burden/Unmet need

For countries wherein adequate data is not available, analogue/benchmarking based forecastingtechnique is used.

For E.g.: If you are getting specific data point (prevalence, incidence, diagnosis rate, treatment

rate or similar index) for a particular country, then with the help of supporting sources you canconsider this as benchmark and can apply it on other countries as well depending upon the

similarity in the demographics of both the countries (Kindly note that you can benchmark the

data only on the basis of similar demographics).Classic E.g.: Brazil and Mexico, Chile and Argentina.


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Points To Remember :

Understand your disease thoroughly

Understand your patient pool

Do proper patient segmentationAdd the inclusion and exclusion of taxonomy

Prevalence/ Incidence data should be taken from major Government websites and associations.

Validate this data point from at least four to five sources

The sources used for prevalence and incidence data for the base year should not be older thanfour to five years

Take expert insights on the diagnosis, treatment and usage of the device from the respective

Country participant supported by secondary sources.Give the other name for the device if at all it was referredDo the primaries from the user end

Benchmarking/Analogue based forecasting can be done only if the countries have similar

demographicsMaintain source sheet

It should contain the last access date

Screen shots of the dataWeb source of the data

Key Data Sources :

World Health Organization

Harrisons Principles of Internal Medicine (For complete understanding of the disease)

Annual reports


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Federal Institute for Drugs and Medical Devices

Pharmaceuticals and Medical Devices Agency

National Institute for Health and Clinical Excellence, the UKCountry Specific Medical Agencies such as Italian Medical Agency

The New England Journal of Medicine

Healthcare Cost and Utilization Project (HCUP)European Hospital and Healthcare Federation (HOPE)Medicines and Health Products Agency

National Institutes of Health, the US

Centers for Disease Control and Prevention, the USMedscape

Pubmed

Documents

Epidemiology Based Market Forecast