Brachytherapy Devices - Global Opportunity Assessment, Competitive Reference Code: GDME0161MAR Publication Date: August 2012 The Global Brachytherapy Devices Market is Expected to Grow During the Forecast Period The global brachytherapy devices market is forecast to grow from $XXm in 2011 to $XXm by 2018 at a Compound Annual Growth Rate (CAGR) of XX%, as shown in the following figure. Brachytherapy Devices Market, Global, Revenue ($m), 2011 2018 CAGR (2011 2018): XX% Brachytherapy Devices Market, The US, Revenue ($m), 2011 2018 Revenue ($m) CAGR (2011 2018): XX% Revenue ($m) 2011 2018 Source: GlobalData analysis based on 20 primary research interviews with marketing managers, product development managers, marketing vice presidents, distributors and physicians in Asia, Europe and North America 2011 2018 Source: GlobalData analysis based on 20 primary research interviews with marketing managers, product development managers, vice presidents, distributors and physicians in Asia, Europe and North America The market is expected to be driven by the increasing incidence of cancer. Brachytherapy is an effective outpatient procedure that can be easily customized to the individual patient s needs. As a lifetime treatment option, brachytherapy costs are substantially lower than for radical prostatectomy and Intensitymodulated Radiation Therapy (IMRT). Furthermore, higher adoption of brachytherapy for the treatment of cancers such as brain tumor, liver cancer and macular degeneration will continue to drive demand for brachytherapy devices in the future. The US is the Biggest Market for Brachytherapy Devices The US is the biggest market for brachytherapy devices, accounting for XX% of the global brachytherapy market in 2011. It was valued at $XXm in the same year and is forecast to grow at a CAGR of XX% to $XXm by 2018, as shown in the following figure: Demand for brachytherapy devices products in the US is mainly driven by the increasing incidence of cancer and the adoption of brachytherapy devices for treatment. Technological advancements such as three-dimensional (XXD) treatment planning solutions allow physicians to administer more accurate and precise doses, resulting in a dramatic decrease in treatment and recovery times. In addition, the positive outcome associated with temporary High Dose Rate (HDR) brachytherapy for gynecological cancers have made brachytherapy standard treatment protocol. A similar trend of acceptance for the treatment of other types of cancer is expected to drive the future growth of the US brachytherapy devices market. Increasing Global Incidence of Cancer to Drive the Brachytherapy Devices Market According to a Globocan report from 2008, the number of new cases of cancer diagnosed worldwide increases annually. It is becoming a global pandemic with rising incidence and death rates in low and middle-income countries. Each year, XX million people are diagnosed with cancer globally, of which men accounted for nearly XX million cases in 2008. Page 1
1 Table of Contents 1 Table of Contents... 3 1.1 List of Tables... 5 1.2 List of Figures... 6 2 Introduction... 7 2.1 GlobalData Report Guidance... 7 3 Disease Overview... 8 3.1 Breast Cancer... 8 3.2 Signs and Symptoms... 8 3.3 Epidemiology... 8 3.4 Prostate Cancer... 10 3.5 Signs and Symptoms... 10 3.6 Epidemiology... 11 4 Brachytherapy - Device Overview... 13 4.1 Brachytherapy, Market Segmentation... 14 4.1.1 Temporary Brachytherapy... 14 4.1.2 Permanent Brachytherapy... 15 5 Brachytherapy Devices - Global Market Characterization... 16 5.1 Brachytherapy Devices Market, Global, Revenue ($m), Historic, 2004 2011... 16 5.2 Brachytherapy Devices Market, Global, Revenue ($m), Forecast, 2011 2018... 17 5.3 Brachytherapy Devices Market, Key Trends... 18 5.3.1 Multiple Imaging Techniques and High-precision Targeted Brachytherapy Play a Major Role in Deciding Brachytherapy Treatment Planning... 18 5.3.2 New Radioisotopes for Increased Effectiveness Constantly Explored for Delivering Brachytherapy... 19 5.4 Brachytherapy Devices, Market Dynamics... 20 5.4.1 Market Drivers... 21 5.4.2 Market Restraints... 25 6 Brachytherapy Devices Market, Global, Segment Analysis, Revenue ($m), 2004 2018... 27 6.1 Temporary Brachytherapy Devices Market, Global, Revenue ($m), Historic, 2004 2011... 27 6.2 Temporary Brachytherapy Devices Market, Global, Revenue ($m), Forecast, 2011 2018... 28 6.3 Permanent Brachytherapy Devices Market, Global, Revenue ($m), Historic, 2004 2011... 29 6.4 Permanent Brachytherapy Devices Market, Global, Revenue ($m), Forecast, 2011 2018... 30 7 Brachytherapy Devices Market, by Country, Revenue ($m), 2004 2018... 31 7.1 Brachytherapy Devices Market, The US, Revenue ($m), Historic, 2004 2011... 31 7.2 Brachytherapy Devices Market, The US, Revenue ($m), Forecast, 2011 2018... 32 7.3 Brachytherapy Devices Market, The UK, Revenue ($m), Historic, 2004 2011... 33 7.4 Brachytherapy Devices Market, The UK, Revenue ($m), Forecast, 2011 2018... 34 7.5 Brachytherapy Devices Market, Germany, Revenue ($m), Historic, 2004 2011... 35 7.6 Brachytherapy Devices Market, Germany, Revenue ($m), Forecast, 2011 2018... 36 7.7 Brachytherapy Devices Market, France, Revenue ($m), Historic, 2004 2011... 37 7.8 Brachytherapy Devices Market, France, Revenue ($m), Forecast, 2011 2018... 38 7.9 Brachytherapy Devices Market, Italy, Revenue ($m), Historic, 2004 2011... 39 7.10 Brachytherapy Devices Market, Italy, Revenue ($m), Forecast, 2011 2018... 40 7.11 Brachytherapy Devices Market, Spain, Revenue ($m), Historic, 2004 2011... 41 7.12 Brachytherapy Devices Market, Spain, Revenue ($m), Forecast, 2011 2018... 42 7.13 Brachytherapy Devices Market, Japan, Revenue ($m), Historic, 2004 2011... 43 7.14 Brachytherapy Devices Market, Japan, Revenue ($m), Forecast, 2011 2018... 44 8 Brachytherapy Devices Market: Company Shares (%), 2011... 45 8.1 Brachytherapy Devices Market, Global, Company Share (%), 2011... 45 8.2 Temporary Brachytherapy Devices Market, Global, Company Share (%), 2011... 47 8.3 Permanent Brachytherapy Devices Market, Global, Company Share (%), 2011... 48 8.4 Brachytherapy Devices Market, Global, Competitive Assessment, 2011... 50 8.5 Brachytherapy Devices Market, Key Market Participants... 51 8.5.1 Oncura... 51 8.5.2 C.R. Bard... 53 8.5.3 Nucletron (an Elekta Company)... 55 8.5.4 Theragenics... 58 8.5.5 IBt Bebig... 60 8.5.6 Varian Medical Systems, Inc.... 62 Page 3
9 Brachytherapy Devices Market, Deals Landscape... 66 9.1 Brachytherapy Devices Market, Key Acquisitions, 2008 2012... 67 9.1.1 Elekta Completes Acquisition of Nucletron for $523m... 67 9.1.2 Eckert & Ziegler Subsidiary IBt Bebig Acquires SonoTECH GmbH... 67 9.1.3 C. R. Bard Completes Acquisition of SenoRx for $213m... 68 9.1.4 Huiheng Medical Completes Acquisition of Portola Medical... 68 9.1.5 icad Completes Acquisition of Xoft... 68 9.2 Brachytherapy Devices Market: Partnerships... 69 9.3 Brachytherapy Devices Market: Key Partnerships, 2008 2012... 70 9.3.1 Integrated Oncology Network Announced Partnership and has Acquired Equity Interests in Prologics and Northern Ohio Regional Cancer Center... 70 9.3.2 IBA Dosimetry Enters into Distribution Agreement with Axios Oncology... 71 9.3.3 Theragenics Signs Distribution Agreement with Oncura... 71 9.3.4 Nucletron Enters into Licensing Agreement with MedCom and Pi-Medical... 71 9.3.5 IsoRay Enters into Exclusive Licensing Agreement with Hologic... 71 9.3.6 Theragenics Signs an Agreement with Core Oncology... 72 10 Appendix... 73 10.1 Market Definitions... 73 10.1.1 Brachytherapy Devices... 73 10.1.2 Permanent Brachytherapy Devices... 73 10.1.3 Temporary Brachytherapy Devices... 74 10.2 Acronyms... 74 10.3 Sources... 76 10.4 Research Methodology... 77 10.4.1 Secondary Research... 77 10.4.2 Primary Research... 77 10.4.3 Models... 78 10.4.4 Forecasts... 78 10.4.5 Expert Panels... 78 10.4.6 GlobalData Consulting... 78 10.5 Contact Us... 79 10.6 Disclaimer... 79 Page 4
1.1 List of Tables Table 1: Breast Cancer, Disease Population by Country, 2006 2011... 9 Table 2: Prostate Cancer, Disease Population by Country, 2006 2011... 11 Table 3: Brachytherapy Classification, 2012... 14 Table 4: Brachytherapy Devices Market, Global, Revenue ($m), 2004 2011... 16 Table 5: Brachytherapy Devices Market, Global, Revenue ($m), 2011 2018... 17 Table 6: Physical Properties of New Brachytherapy Sources under Investigation... 19 Table 7: Estimated Number of New Cancer Patients per 100,000 Population (All Ages), 2008 2020.. 21 Table 8: Cumulative Mean Prostate Cancer Treatment Costs over Five and Half Years, by Primary Treatment and Risk Factor... 22 Table 9: Temporary Brachytherapy Devices Market, Global, Revenue ($m), 2004 2011... 27 Table 10: Temporary Brachytherapy Devices Market, Global, Revenue ($m), 2011 2018... 28 Table 11: Permanent Brachytherapy Devices Market, Global, Revenue ($m), 2004 2011... 29 Table 12: Permanent Brachytherapy Devices Market, Global, Revenue ($m), 2011 2018... 30 Table 13: Brachytherapy Devices Market, The US, Revenue ($m), 2004 2011... 31 Table 14: Brachytherapy Devices Market, The US, Revenue ($m), 2011 2018... 32 Table 15: Brachytherapy Devices Market, The UK, Revenue ($m), 2004 2011... 33 Table 16: Brachytherapy Devices Market, The UK, Revenue ($m), 2011 2018... 34 Table 17: Brachytherapy Devices Market, Germany, Revenue ($m), 2004 2011... 35 Table 18: Brachytherapy Devices Market, Germany, Revenue ($m), 2011 2018... 36 Table 19: Brachytherapy Devices Market, France, Revenue ($m), 2004 2011... 37 Table 20: Brachytherapy Devices Market, France, Revenue ($m), 2011 2018... 38 Table 21: Brachytherapy Devices Market, Italy, Revenue ($m), 2004 2011... 39 Table 22: Brachytherapy Devices Market, Italy, Revenue ($m), 2011 2018... 40 Table 23: Brachytherapy Devices Market, Spain, Revenue ($m), 2004 2011... 41 Table 24: Brachytherapy Devices Market, Spain, Revenue ($m), 2011 2018... 42 Table 25: Brachytherapy Devices Market, Japan, Revenue ($m), 2004 2011... 43 Table 26: Brachytherapy Devices Market, Japan, Revenue ($m), 2011 2018... 44 Table 27: Brachytherapy Devices Market, Global, Company Revenue ($m), 2011... 45 Table 28: Temporary Brachytherapy Devices Market, Global, Company Revenue ($m), 2011... 47 Table 29: Permanent Brachytherapy Devices Market, Global, Company Revenue ($m), 2011... 48 Table 30: Oncura, Key Marketed Products, 2011... 51 Table 31: C. R. Bard Inc., Key Marketed Products, 2011... 53 Table 32: Nucletron, Brachytherapy, Key Marketed Products, 2011... 56 Table 33: Theragenics Corporation, Brachytherapy, Key Marketed Products, 2011... 58 Table 34: IBt Bebig, Key Marketed Products, 2011... 60 Table 35: Varian Medical Systems, Inc, Key Marketed Products, 2011... 62 Table 36: Brachytherapy Devices Market, Mergers and Acquisitions, Global, 2008 2012*... 66 Table 37: Brachytherapy Devices Market, Partnerships, Global, 2008 2012*... 69 Page 5
1.2 List of Figures Figure 1: Breast Cancer, Disease Population by Country, 2006 2011... 9 Figure 2: Prostate Cancer, Disease Population by Country, 2006 2011... 11 Figure 3: Brachytherapy Devices Market, Segmentation, 2012... 14 Figure 4: Brachytherapy Devices Market, Global, Revenue ($m), 2004 2011... 16 Figure 5: Brachytherapy Devices Market, Global, Revenue ($m), 2011 2018... 17 Figure 6: Brachytherapy Devices, Market Dynamics... 20 Figure 7: Estimated Number of New Cancer Patients per 100,000 Population (All Ages), 2008 2020.. 21 Figure 8: Use of Brachytherapy in Cancer Treatment, 2010... 23 Figure 9: Temporary Brachytherapy Devices Market, Global, Revenue ($m), 2004 2011... 27 Figure 10: Temporary Brachytherapy Devices Market, Global, Revenue ($m), 2011 2018... 28 Figure 11: Permanent Brachytherapy Devices Market, Global, Revenue ($m), 2004 2011... 29 Figure 12: Permanent Brachytherapy Devices Market, Global, Revenue ($m), 2011 2018... 30 Figure 13: Brachytherapy Devices Market, The US, Revenue ($m), 2004 2011... 31 Figure 14: Brachytherapy Devices Market, The US, Revenue ($m), 2011 2018... 32 Figure 15: Brachytherapy Devices Market, The UK, Revenue ($m), 2004 2011... 33 Figure 16: Brachytherapy Devices Market, The UK, Revenue ($m), 2011 2018... 34 Figure 17: Brachytherapy Devices Market, Germany, Revenue ($m), 2004 2011... 35 Figure 18: Brachytherapy Devices Market, Germany, Revenue ($m), 2011 2018... 36 Figure 19: Brachytherapy Devices Market, France, Revenue ($m), 2004 2011... 37 Figure 20: Brachytherapy Devices Market, France, Revenue ($m), 2011 2018... 38 Figure 21: Brachytherapy Devices Market, Italy, Revenue ($m), 2004 2011... 39 Figure 22: Brachytherapy Devices Market, Italy, Revenue ($m), 2011 2018... 40 Figure 23: Brachytherapy Devices Market, Spain, Revenue ($m), 2004 2011... 41 Figure 24: Brachytherapy Devices Market, Spain, Revenue ($m), 2011 2018... 42 Figure 25: Brachytherapy Devices Market, Japan, Revenue ($m), 2004 2011... 43 Figure 26: Brachytherapy Devices Market, Japan, Revenue ($m), 2011 2018... 44 Figure 27: Brachytherapy Devices Market, Global, Company Share (%), 2011... 45 Figure 28: Temporary Brachytherapy Devices Market, Global, Company Share (%), 2011... 47 Figure 29: Permanent Brachytherapy Devices Market, Global, Company Share (%), 2011... 48 Figure 30: Brachytherapy Devices Market, Global, Competitive Assessment, 2011... 50 Figure 31: Oncura, SWOT Analysis, 2012... 51 Figure 32: C.R. Bard, SWOT Analysis, 2012... 54 Figure 33: Nucletron, SWOT Analysis, 2012... 56 Figure 34: Nucletron, Product Launches, 2007 2012... 57 Figure 35: Theragenics, SWOT Analysis, 2012... 59 Figure 36: IBt Bebig, SWOT Analysis, 2012... 61 Figure 37: Varian Medical Systems, Inc, SWOT Analysis, 2012... 63 Figure 38: Varian, Product Launches, 2007 2012... 64 Page 6
2 Introduction Brachytherapy is a type of radiation therapy used for the treatment of cancer. It involves placing a radioactive material inside or near the tumor, and is also known as internal radiation therapy. It allows the physician to treat a small area with a higher overall dose of radiation in a shorter time than for EBRT. Brachytherapy is used to treat cancers such as prostate, cervix, head and neck, skin and breast cancers. In this report, the brachytherapy devices market is divided into two categories: permanent brachytherapy devices and temporary brachytherapy devices. Permanent brachytherapy involves the insertion of radioactive seeds or pellets inside or near the tumor which are then left inside the body. This segment includes devices such as Iodine-XX (XX-XX) seeds and Palladium-XX (Pd-XX) seeds. Temporary brachytherapy involves placing a highly radioactive material inside a catheter or slender tube for a specific amount of time. Temporary brachytherapy can be administered at a Low-dose Rate (LDR) or HDR, and devices comprise afterloaders and HDR accessories. 2.1 GlobalData Report Guidance The chapter begins with an executive summary capturing the key points driving and restraining growth in the global brachytherapy market. Chapter two is the introduction to the report and contains the report guidance. Chapter three provides an overview of breast cancer and prostate cancer, including epidemiology and signs and symptoms. Chapter four provides an overview of the permanent and temporary brachytherapy device markets. Chapter five provides information on the global brachytherapy market in terms of size from 2004 to 2018. Chapter six contains information related to the brachytherapy market s key drivers, restraints and trends. Chapter seven comprises a cross-country analysis of the top seven markets in the sector: the US, the UK, Germany, France, Italy, Spain and Japan. It discusses each country separately and provides figures, drivers and restraints for each country. Chapter eight discusses the competitive landscape of the global brachytherapy market, and includes profiles of key players. Chapter nine covers M&A activity in the brachytherapy market between 2008 and 2012, with some of the deals that took place in 2010 and 2011 discussed in detail. Chapter 10 is the appendix to the report. Page 7
5.4.1 Market Drivers 5.4.1.1 Increasing Incidence of Cancer Cases Globally to Drive Brachytherapy Devices Market According to the 2008 Globocan report, every year the number of new cancer cases diagnosed each year increases significantly. Cancer is becoming a global pandemic with rising incidence and death rates in low and middle-income countries. Each year, XX million people are diagnosed with cancer worldwide, of which men account for nearly 6.6 million cases. The most common cancers among men were lung cancer (XX million cases), prostate cancer (XX million) and stomach cancer (XX million). Breast cancer (XX million), cervical/uterus cancer (XX million) and colorectal cancer (XX million) were responsible for the most new cancer cases in women. The following figure and table depict the estimated number of new cancer patients per XX population between 2008 and 2020: Figure 7: Estimated Number of New Cancer Patients per 100,000 Population (All Ages), 2008 2020 New Cancer Patients per 100,000 Population Asia Europe North America Africa South America and Caribbean 2008 2020 Source: International Agency for Research on Cancer Table 7: Estimated Number of New Cancer Patients per 100,000 Population (All Ages), 2008-2020 Region 2008 2020 Growth 2008 2020 Asia Europe North America Africa South America and Caribbean Source: International Agency for Research on Cancer Page 21
6 Brachytherapy Devices Market, Global, Segment Analysis, Revenue ($m), 2004 2018 6.1 Temporary Brachytherapy Devices Market, Global, Revenue ($m), Historic, 2004 2011 The global market for temporary brachytherapy devices was valued at $XXm in 2004 and grew at a CAGR of XX% to reach $XXm in 2011, as shown in the following figure and table: Figure 9: Temporary Brachytherapy Devices Market, Global, Revenue ($m), 2004 2011 Revenue ($m) 2004 2005 2006 2007 2008 2009 2010 2011 Afterloaders HDR Accessories Source: GlobalData analysis based on 20 primary research interviews with marketing managers, product development managers, marketing vice presidents, distributors and physicians in Asia, Europe and North America Table 9: Temporary Brachytherapy Devices Market, Global, Revenue ($m), 2004-2011 Afterloaders HDR accessories Total 2004 2005 2006 2007 2008 2009 2010 2011 CAGR 2004 2011 Source: GlobalData analysis based on 20 primary research interviews with marketing managers, product development managers, marketing vice presidents, distributors and physicians in Asia, Europe and North America Afterloaders was the largest segment within the temporary brachytherapy devices market, valued $XXm in 2011 having grown at a CAGR of XX% during the 2004 2011 period. The market was driven by increased adoption rates due to shorter procedure times and increased comfort in comparison with permanent brachytherapy. Page 27
6.2 Temporary Brachytherapy Devices Market, Global, Revenue ($m), Forecast, 2011 2018 The global market for temporary brachytherapy devices is expected to grow at a CAGR of XX% during the 2011 2018 period to reach $XXm in 2018, as shown in the following figure and table: Figure 10: Temporary Brachytherapy Devices Market, Global, Revenue ($m), 2011 2018 Revenue ($m) 2011 2012 2013 2014 2015 2016 2017 2018 Afterloaders HDR Accessories Source: GlobalData analysis based on 20 primary research interviews with marketing managers, product development managers, marketing vice presidents, distributors and physicians in Asia, Europe and North America Table 10: Temporary Brachytherapy Devices Market, Global, Revenue ($m), 2011-2018 Afterloaders HDR accessories Total 2011 2012 2013 2014 2015 2016 2017 2018 CAGR 2011 2018 Source: GlobalData analysis based on 20 primary research interviews with marketing managers, product development managers, marketing vice presidents, distributors and physicians in Asia, Europe and North America Afterloaders will remain the largest segment, growing at a CAGR of XX% during the 2011 2018 period to reach $XXm in 2018. The HDR accessories market is expected to grow at a CAGR of XX% in the same period to reach $XXm by 2018. The market will be driven by the adoption of HDR brachytherapy for the treatment of new cancers and tremendous advancements in treatment planning software in terms of reduced treatment planning time. Page 28
8 Brachytherapy Devices Market: Company Shares (%), 2011 8.1 Brachytherapy Devices Market, Global, Company Share (%), 2011 The following figure depicts the global brachytherapy devices market in terms of company share in 2011, and the following table outlines company revenue for the same year: Figure 27: Brachytherapy Devices Market, Global, Company Share (%), 2011 Others Core Oncology Theragenics Nucletron IBt Bebig CR Bard Oncura Varian Source: GlobalData analysis based on 20 primary research interviews with marketing managers, product development managers, marketing vice presidents, distributors and physicians in Asia, Europe and North America Table 27: Brachytherapy Devices Market, Global, Company Revenue ($m), 2011 Company Nucletron Oncura Varian CR Bard IBt Bebig Theragenics Core Oncology Others Revenue ($m) Source: GlobalData analysis based on 20 primary research interviews with marketing managers, product development managers, marketing vice presidents, distributors and physicians in Asia, Europe and North America Page 45
10 Appendix The data and analysis within this report is driven by Medical etrack Medical etrack gives you the key information to drive sales, investment and deal making activity in your business. It includes the following information: 15,000+ Market size data tables across 740 medical equipment segments and 39 countries with historic data from 2004 forecast to 2018 6,000+ Primary expert interviews conducted per annum for ensuring data and report quality 1,100+ Conferences on medical equipment covered 1,000+ Industry leading reports per annum covering growing sectors, market trends, investment opportunities and competitive landscape 600+ Analysis reports covering market and pipeline product analysis reports by indication, medical equipment trends and issue reports and investment and M&A trend reports worth over $3m 43,000+ Medical equipment companies profiled 1,500+ Private, emerging and technology start-up company profiles 1,500+ Medical equipment manufacturers in China and India 1,500+ Medical equipment companies in Japan 700+ Companies with revenue splits and market shares by category 1,500+ Quarterly and annual medical equipment company financials 700+ Medical equipment company SWOTs 9,000+ Pipeline product profiles 8,000+ Marketed product profiles 14,000+ Clinical trials 15,000+ Trial investigators 13,000+ New product patents 3,300+ Companies with products in development 17,000+ Deals in the medical equipment industry 1,100+ Surgical and diagnostic procedures by therapy area 40+ Key healthcare indicators by country For more information or to receive a free demo of the service visit http://www.medicaletrack.com/contactus.aspx?rd=demo 10.1 Market Definitions 10.1.1 Brachytherapy Devices Brachytherapy devices are those which are used to deliver a specific dose of radiation to a tumor using a radiation source placed inside the body. The radiation source can either be placed inside the tumor, next to it, or in a hollow space of an organ of which the lining has tumor cells. 10.1.2 Permanent Brachytherapy Devices Permanent brachytherapy devices are those which are placed inside the patient to deliver radiation but are not removed at the end of the procedure. The radioisotopes contained within the devices stop emitting radiation after a certain length of time and become harmless. Permanent brachytherapy devices include I- 125 seeds and Pd-103 seeds. 10.1.2.1 Iodine Seeds Iodine seeds comprise I-125 seeds which are used to deliver LDR brachytherapy to cancer patients. Page 73
10.1.2.2 Palladium Seeds Palladium seeds comprise Pd-103 seeds which are used to deliver LDR brachytherapy to cancer patients. 10.1.2.3 Cesium Seeds Cesium seeds comprise Cs-131 seeds which are used to deliver LDR brachytherapy to cancer patients. 10.1.3 Temporary Brachytherapy Devices Temporary brachytherapy devices are those which allow the radiation source to be placed inside the patient to deliver radiation and then be removed after each treatment session. Temporary brachytherapy devices include afterloaders and HDR accessories. 10.1.3.1 Afterloaders An afterloader is a device which is used to deliver a source of radiation, such as Ir-192. It is annealed at the tip of a wire into the tumor site for a predefined period and distance. By varying the period and the distance it is possible to modulate the size of the radiation dose delivered to the tumor. The report covers only remote afterloaders used in temporary brachytherapy. 10.1.3.2 HDR Accessories HDR accessories are used in the delivery of HDR brachytherapy treatment with an afterloader. The HDR accessories segment includes catheters, applicators and template grids which are designed to conform to different anatomies of the patient. The sales revenue of HDR accessories excludes specialized catheters such as Mammosite used for alternative HDR brachytherapy treatments. 10.2 Acronyms 2D: Two Dimensional 3D: Three Dimensional 3DCRT: 3D Conformal Radiotherapy ABS: ACA: ACS: American Brachytherapy Society Affordable Care Act American Cancer Society AJCC: American Joint Committee on Cancer BPH: Benign Prostatic Hyperplasia CAGR: Compound Annual Growth Rate CMS: Centers for Medicare and Medicaid Services CSAW: Cervical Screening Awareness Week CT: Computer Tomography DICOM RT: Digital Imaging and Communications in Medicine Radiotherapy EBRT: External-beam Radiation Therapy ECCA: European Cervical Cancer Association EPA: Environmental Protection Agency ESTRO: European Society for Therapeutic Radiology and Oncology FDA: Food and Drug Administration FIRST: Fully Integrated Real Time Seed Treatment GPO: HDR: Group Purchasing Organizations High Dose Rate Page 74
HPV: IAEA: IBU: Human Papilloma Virus International Atomic Energy Agency Integrated Brachytherapy Unit ICARO: International Conference on Advances in Radiation Oncology ICER: Institute for Clinical and Economic Review IGABT: Image-guided Adaptive Brachytherapy IGRT: IHME: IMRT: LDR: Image-guided Radiation Therapy Institute for Health Metrics and Evaluation Intensity-modulated Radiation Therapy Low Dose Rate MHLW: Ministry of Health, Labor and Welfare MHT: Menopausal Hormone Therapy MPFS: Medicare Physician Fee Schedule MRI: NGO: Magnetic Resonance Imaging Non-governmental Organization NPEP: National Partnership for Environmental Priorities NSCLC: Non-small-cell Lung Cancer PET: PICC: PSID: Positron Emission Tomography Peripherally Inserted Central Catheters Permanent Seed Implant Dosimetry QALY: Quality-adjusted Life Year SBRT: Stereotactic Body Radiotherapy SIRT: Selective Internal Radiation Therapy TNM: Tumor, Nodes, Metastasis VCMC: Vaginal CT/MR Multi Channel Applicator VMAT: Volumetric Modulated Arc Therapy WHO: World Health Organization Page 75
10.3 Sources Eckert & Ziegler Bebig (2011). 3rd Quarter 2011. Available from: http://www.bebig.eu/fileadmin/ir/annual_reports/3q2011_report_en_final.pdf. Eckert & Ziegler Bebig (2011). 3rd Quarter 2011. Available from: http://www.bebig.eu/fileadmin/ir/annual_reports/3q2011_report_en_final.pdf. Elekta, AB. (2011). Acquisition of Nucletron: Building a Strong Position in the Cancer Care Market. Investor presentation. Available from: http://www.elekta.com/dms/elekta/elekta- assets/investors/pdf/presentations/investor-presentation-elekta-nucletronjune- 21_final/Investor%20Presentation%20Elekta%20NucletronJune%2021_final.pdf. Elekta, AB. (2011). Closing of Nucletron acquisition. Investor presentation. Available from: http://www.elekta.com/dms/elekta/elekta-assets/investors/pdf/presentations/investor-presentation-elekta- Nucletron-closing-110915/Investor%20Presentation%20Elekta%20Nucletron%20closing%20110915.pdf. Elekta, AB. (2011). Elekta growth through innovation ASTRO. Investor presentation. Available from: http://www.elekta.com/dms/elekta/elekta-assets/investors/pdf/presentations/astro-2011.pdf. Globocan (2008). Estimates of worldwide burden of cancer in 2008: Globocan 2008. International Journal of Cancer; 127(12): 2893-2917. Institute for Clinical and Economic Review (2010). Management options for low-risk prostate cancer: a report on comparative effectiveness and value. Available from: http://www.icer- review.org/index.php/download-document/99-management-options-for-low-risk-prostate-cancer- A-Report-on-Comparative-Effectiveness-and-Value.html. [Accessed May 9, 2012]. International Agency for Research on Cancer (2012). Cancer Mondial. Available from: http://globocan.iarc.fr/ [Accessed May 2, 2012]. Institute for Health Metrics and Evaluation (IHME) (2011). University of Washington. Available from: http://www.healthmetricsandevaluation.org/news-events/news-release/more-women-dying-breast-and-cervicalcancer-younger-age-developing-countrie. [Accessed May 2, 2012]. Medicare Physician Fee Schedule (MPFS) (2012). Centers for Medicare & Medicaid Services. Available from: http://www.cms.gov/medicare/medicare-fee-for-service- Payment/PhysicianFeeSched/index.html?redirect=/PhysicianFeeSched/. [Accessed April 4, 2012]. National Cancer Institute at the National Institutes of Health, Breast Cancer Treatment. Health professional version. Available from: http://www.cancer.gov/cancertopics/pdq/treatment/breast/healthprofessional. [Accessed April 27, 2012]. Smith GL, et al (2012). Association between treatment with brachytherapy vs whole-breast irradiation and subsequent mastectomy, complications, and survival among older women with invasive breast cancer. Journal of the American Medical Association; 307(17):1827 1837. Venselaar JLM and Rivard MJ (2009). International Atomic Energy Agency - International Conference on Advances in Radiation Oncology (IAEA - ICARO) meeting 2009. Current issues and trends in brachytherapy; a medical physics perspective. Available from: http://videoserver1.iaea.org/media/hhw/radiotherapy/icaro%20proceedings/presentation%20slides/tuesday/1 %20UNIDO/1%20morning/s8a/s8a-vanselaar.pdf. Wilson LS, et al (2006). Cumulative cost pattern comparison of prostate cancer treatments. Cancer; 109(3): 518 527. World Health Organization, International agency for research on cancer, Globocan 2008 project. Available from: http://globocan.iarc.fr/ [Accessed May 2, 2012]. Page 76
10.4 Research Methodology GlobalData s dedicated research and analysis teams consist of qualified professionals with experience in marketing, market research, consulting background in the medical devices industry and advanced statistical expertise. GlobalData adheres to the codes of practice of the Market Research Society (www.mrs.org.uk) and the Strategic and Competitive Intelligence Professionals (www.scip.org). All GlobalData databases are continuously updated and revised. The following research methodology is followed for all databases and reports. 10.4.1 Secondary Research The research process begins with exhaustive secondary research on internal and external sources being carried out to source qualitative and quantitative information relating to each market. The secondary research sources that are typically referred to include, but are not limited to: Company websites, annual reports, financial reports, broker reports, investor presentations and SEC Filings; Company websites, annual reports, financial reports, broker reports, investor presentations and SEC Filings; Industry trade journals, scientific journals and other technical literature; Internal and external proprietary databases; Relevant patent and regulatory databases; National government documents, statistical databases and market reports; Procedure registries; and News articles, press releases and web-casts specific to the companies operating in the market. The research process begins with exhaustive secondary research on internal and external sources being carried out to source qualitative and quantitative information relating to each market. The secondary research sources that are typically referred to include, but are not limited to: Company websites, annual reports, financial reports, broker reports, investor presentations and SEC filings; In trade journals, scientific journals and other technical literature; Internal and external proprietary databases; Relevant patent and regulatory databases; National government documents, statistical databases and market reports; Procedure registries; and News articles, press releases and web-casts specific to the companies operating in the market 10.4.2 Primary Research GlobalData conducts thousands of interviews a year with industry participants and commentators in order to validate its data and analysis. A typical research interview fulfills the following functions: It provides first-hand information on market size, market trends, growth trends, competitive landscape and future outlook; Helps in validating and strengthening the secondary research findings; and Further develops the analysis team s expertise and market understanding. Primary research involves e-mail interactions and telephonic interviews for each market, category, segment and sub-segment across geographies. The participants who typically take part in such a process include, but are not limited to: Page 77
Industry participants: CEOs, VPs, marketing/product managers, market intelligence managers and national sales managers; Hospital stores, laboratories, pharmacies, distributors and paramedics; Outside experts: investment bankers, valuation experts, research analysts specializing in specific medical equipment markets; and Key opinion leaders: physicians and surgeons specializing in different therapeutic areas corresponding to different kinds of medical equipment. 10.4.3 Models Where no hard data is available, GlobalData uses modeling and estimates in order to produce comprehensive data sets. The following rigorous methodology is adopted: Available hard data is cross-referenced with the following data types to produce estimates: Demographic data on population segments; Macro-economic indicators such as GDP, inflation rate; Healthcare indicators such as health expenditure, physician base, healthcare infrastructure and facilities; and Selected epidemiological and procedure statistics 10.4.4 Forecasts GlobalData uses proprietary forecast models. The following four factors are utilized in the forecast models: Historic growth rates; Macro indicators such as population trends and healthcare spending; Forecast epidemiological data; and Qualitative trend information and assumptions. The data is then cross checked by the expert panel. 10.4.5 Expert Panels GlobalData uses a panel of experts to cross-verify its databases and forecasts. GlobalData s expert panel comprises marketing managers, product specialists, international sales managers from medical device companies; academics from research universities, KOLs from hospitals, consultants from venture capital funds and distributors/suppliers of medical equipment and supplies. Historic data and forecasts are relayed to GlobalData s expert panel for feedback and adjusted in accordance with their feedback 10.4.6 GlobalData Consulting We hope that the data and analysis in this brief will help you make informed and imaginative business decisions. If you have further requirements, GlobalData s consulting team may be able to help you. GlobalData offers tailor-made analytical and advisory services to drive your key strategic decisions. For more information about GlobalData s consulting capabilities, please contact us directly at info@globaldata.com Page 78
10.6 Disclaimer All Rights Reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form by any means, electronic, mechanical, photocopying, recording or otherwise without the prior permission of the publisher, GlobalData. Page 79