REFERENCE CODE GDHCER081-15 PUBLICAT ION DATE M AY 2015 GLAUCOMA
Executive Summary Glaucoma is a common, asymptomatic group of eye diseases that causes damage to the eye s optic nerve, resulting in progressive, irreversible vision loss. Glaucoma is one of the leading causes of blindness worldwide, especially in elderly people (NEI, 2014a). Glaucoma is generally categorized as open-angle glaucoma (OAG), angle-closure glaucoma (ACG), secondary glaucoma, and congenital glaucoma. Other less common types of glaucoma include normal-tension glaucoma (NTG), pseudoexfoliation glaucoma, and pigmentary glaucoma (NEI, 2014b). Although there are many types of glaucoma, the two most important types are OAG and ACG, with OAG accounting for about 80 90% of all glaucoma cases (Mayo Clinic, 2014). OAG and ACG can be primary (primary open-angle glaucoma [POAG] and primary angle-closure glaucoma [PACG], respectively) or secondary, depending on the cause. The epidemiology of glaucoma is not well investigated to date, and the available epidemiological data on glaucoma are only limited to POAG (Quigley and Broman, 2006). According to a meta-analysis by Quigley and Broman in 2006, the prevalence of glaucoma varied widely across the globe, with a prevalence of 1.47% in Middle East, 2.23% in Europe, 3.35% in Latin America, 3.70% in Japan, and 4.32% in Africa (Quigley and Broman, 2006). This report provides an overview of the risk factors, comorbidities, and the global and historical trends for glaucoma in the seven major markets (7MM) (US, France, Germany, Italy, Spain, UK, and Japan). It includes a 10-year epidemiological forecast for the total prevalent cases of glaucoma segmented by sex and age (40 54 years, 55 69 years, 70 84 years, and 85 years) in these markets. In addition, this report provides a 10-year epidemiological forecast for: the total prevalent cases of glaucoma segmented by clinical type (POAG, PACG, secondary glaucoma, and congenital glaucoma); the total prevalent cases of NTG, which is a sub-type of OAG; and the diagnosed prevalent cases of POAG and PACG in these markets. Glaucoma is often associated with significant social and economic impact as most people with glaucoma have no early symptoms or pain from the increased intraocular pressure (IOP) and therefore, do not notice vision loss until much of the optic nerve damage has occurred (Mayo Clinic, 2014; NEI, 2014a). As shown in below mentioned figure GlobalData epidemiologists forecast that the total prevalent cases of glaucoma in the 7MM will grow by 14.60% over the next decade, from 13,748,430 total prevalent cases in 2013 to 15,761,674 total prevalent cases in 2023, with almost 60% of the total prevalent cases occurring in the US and Japan together. 2
Executive Summary 7MM, Total Prevalent Cases of Glaucoma, Ages 40 Years, Both Sexes, N, 2013 and 2023 Market 7MM 5EU US Japan Germany Italy France UK Spain 5,331,787 4,788,552 5,640,454 4,636,317 4,789,433 4,323,561 1,412,184 1,327,664 1,088,998 987,187 1,063,434 938,710 969,714 864,055 797,457 670,936 15,761,674 13,748,430 2023 2013 0 5,000,000 10,000,000 15,000,000 20,000,000 Total Prevalent Cases of Glaucoma (N) Source: GlobalData; Bonomi et al., 2000; Cedrone et al., 1997; Friedman et al., 2004; Friedman et al., 2006; Hollows and Graham, 1966; Iwase et al., 2004; Yamamoto et al., 2005 5EU = France, Germany, Italy, Spain, and UK; 7MM = US, 5EU, and Japan The increase in the number of total prevalent cases of glaucoma in the 7MM can be attributed to changing population demographics in the respective markets. However, further epidemiological research is warranted given that there is a paucity of national and international data evaluating the prevalence and trends of glaucoma worldwide. There is also a need to clearly demarcate the glaucoma population in each clinical type, as currently available epidemiological literature fails to clearly demarcate different glaucoma populations. 3
Table of Contents 1 Table of Contents 1 Table of Contents... 4 1.1 List of Tables... 5 1.2 List of Figures... 6 2 Introduction... 7 2.1 Catalyst... 7 2.2 Related Reports... 8 2.3 Upcoming Reports... 8 3 Epidemiology... 9 3.1 Disease Background... 9 3.2 Risk Factors and Comorbidities... 11 3.3 Global Trends... 13 3.3.1 US... 13 3.3.2 5EU... 14 3.3.3 Japan... 15 3.4 Forecast Methodology... 16 3.4.1 Sources Used... 18 3.4.2 Forecast Assumptions and Methods... 22 3.4.3 Sources Not Used... 28 3.5 Epidemiological Forecast for Glaucoma (2013 2023)... 29 3.5.1 Total Prevalent Cases of Glaucoma... 29 3.5.2 Age-Specific Total Prevalent Cases of Glaucoma... 30 3.5.3 Sex-Specific Total Prevalent Cases of Glaucoma... 32 3.5.4 Age-Standardized Total Prevalence of Glaucoma... 34 3.5.5 Total Prevalent Cases of Glaucoma, by Clinical Type... 35 3.5.6 Total Prevalent Cases of NTG... 37 3.5.7 Diagnosed Prevalent Cases of POAG and PACG... 39 4
Table of Contents 3.6 Discussion... 42 3.6.1 Epidemiological Forecast Insight... 42 3.6.2 Limitations of the Analysis... 42 3.6.3 Strengths of the Analysis... 43 4 Appendix... 45 4.1 Bibliography... 45 4.2 About the Authors... 48 4.2.1 Epidemiologists... 48 4.2.2 Reviewers... 48 4.2.3 Global Director of Therapy Analysis and Epidemiology... 49 4.2.4 Global Head of Healthcare... 50 4.3 About GlobalData... 51 4.4 About EpiCast... 51 4.5 Disclaimer... 52 1.1 List of Tables Table 1: Types of Glaucoma... 10 Table 2: Risk Factors and Comorbidities for Glaucoma... 12 Table 3: 7MM, Sources of Glaucoma Total Prevalence Data Used in the Epidemiology Forecast... 17 Table 4: 7MM, Sources of Epidemiological Data Used to Forecast the Total Prevalent Cases of Glaucoma Segmented by Clinical Types... 18 Table 5: 7MM, Sources Not Used in the Epidemiological Analysis of Glaucoma... 28 Table 6: 7MM, Total Prevalent Cases of Glaucoma, Ages 40 Years, Both Sexes, N, 2013 2023... 29 Table 7: 7MM, Total Prevalent Cases of Glaucoma, by Age, Both Sexes, N (Row %), 2013... 31 Table 8: 7MM, Total Prevalent Cases of Glaucoma, by Sex, Ages 40 Years, N (Row %), 2013... 33 Table 9: 7MM, Total Prevalent Cases of Glaucoma, by Clinical Type, Ages 40 Years, N (Row %), 2013. 36 5
Table of Contents Table 10: 7MM, Total Prevalent Cases of NTG, Ages 40 Years, Both Sexes, N, 2013 2023... 38 Table 11: 7MM, Diagnosed Prevalent Cases of POAG, Ages 40 Years, Both Sexes, N, 2013 2023... 39 Table 12: 7MM, Diagnosed Prevalent Cases of PACG, Ages 40 Years, Both Sexes, N, 2013 2023... 41 1.2 List of Figures Figure 1: 7MM, Total Prevalent Cases of Glaucoma, Ages 40 Years, Both Sexes, N, 2013 2023... 30 Figure 2: 7MM, Total Prevalent Cases of Glaucoma, by Age, Both Sexes, N, 2013 2023... 32 Figure 3: 7MM, Total Prevalent Cases of Glaucoma, by Sex, Ages 40 Years, N, 2013... 34 Figure 4: 7MM, Age-Standardized Total Prevalence of Glaucoma, by Sex, Ages 40 Years, %, 2013... 35 Figure 5: 7MM, Total Prevalent Cases of Glaucoma, by Clinical Type, Ages 40 Years, N, 2013... 37 Figure 6: 7MM, Total Prevalent Cases of NTG, Ages 40 Years, Both Sexes, N, 2013 2023... 38 Figure 7: 7MM, Diagnosed Prevalent Cases of POAG, Ages 40 Years, Both Sexes, N, 2013 2023... 40 Figure 8: 7MM, Diagnosed Prevalent Cases of PACG, Ages 40 Years, Both Sexes, N, 2013 2023... 41 6
Introduction 2 Introduction 2.1 Catalyst Glaucoma is a common, asymptomatic group of eye diseases that causes damage to the eye s optic nerve resulting in progressive, irreversible vision loss. Glaucoma is one of the leading causes of blindness worldwide, especially in elderly people (NEI, 2014a). Glaucoma is generally categorized as open-angle glaucoma (OAG), angle-closure glaucoma (ACG), secondary glaucoma, and congenital glaucoma (NEI, 2014b). Although there are many types of glaucoma, the two most important types are OAG and ACG, with OAG accounting for about 80 90% of all glaucoma cases (Mayo Clinic, 2014). OAG and ACG can be primary or secondary depending on the cause. They are called primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG) when the cause is unknown, and they are called secondary glaucoma when the cause can be traced to a known disease or condition. OAG is the most common type of glaucoma, accounting for about 80 90% of all glaucoma cases (Mayo Clinic, 2014). This report provides an overview of the risk factors, comorbidities, and the global and historical trends for glaucoma in the seven major markets (7MM) (US, France, Germany, Italy, Spain, UK, and Japan). It includes a 10-year epidemiological forecast for the total prevalent cases of glaucoma segmented by sex and age (40 54 years, 55 69 years, 70 84 years, and 85 years) in these markets. In addition, this report provides a 10-year epidemiological forecast for: the total prevalent cases of glaucoma segmented by clinical type (POAG, PACG, secondary glaucoma, and congenital glaucoma); the total prevalent cases of normal-tension glaucoma (NTG), which is a sub-type of OAG; and the diagnosed prevalent cases of POAG and PACG in these markets. GlobalData epidemiologists forecast that the total prevalent cases of glaucoma in the 7MM will grow by 14.60% over the next decade, from 13,748,430 total prevalent cases in 2013 to 15,761,674 total prevalent cases in 2023. GlobalData s epidemiological analysis is supported by the use of total prevalence data from epidemiological studies published in peer-reviewed journals. 7
Introduction GlobalData epidemiologists used uniform methodology across the markets to forecast the total prevalent cases of glaucoma, which allows for a meaningful comparison of the disease populations across the 7MM. 2.2 Related Reports GlobalData (2014). EpiCast Report: Allergic Conjunctivitis Epidemiology Forecast to 2023, October 2014, GDHCER037-14 GlobalData (2014). EpiCast Report: Age-Related Macular Degeneration Epidemiology Forecast to 2023, September 2014, GDHCER066-14 GlobalData (2015). EpiCast Report: Type 1 Diabetes Epidemiology Forecast to 2023, January 2015, GDHCER080-15 2.3 Upcoming Reports GlobalData (2015). EpiCast Report: Ankylosing Spondylitis Epidemiology Forecast to 2023, to be published 8
Appendix 4.3 About GlobalData GlobalData is a leading global provider of business intelligence in the healthcare industry. GlobalData provides its clients with up-to-date information and analysis on the latest developments in drug research, disease analysis, and clinical research and development. Our integrated business intelligence solutions include a range of interactive online databases, analytical tools, reports, and forecasts. Our analysis is supported by a 24/7 client support and analyst team. GlobalData has offices in New York, San Francisco, Boston, London, India, Korea, Japan, Singapore, and Australia. 4.4 About EpiCast EpiCast is a series of premier epidemiology reports written and developed by Master sand PhD-level epidemiologists. EpiCast Reports are in-depth, high quality, transparent, and market-driven, providing expert analysis of epidemiological trends and forecasting of patient populations for major markets. Specifically, the reports identify disease trends over a 10-year forecast period in six to seven major markets (US, France, Germany, Italy, Spain, UK, and Japan). Additional countries, such as Canada, Brazil, China, and India, are covered in these reports if their markets are highly relevant. 51
Appendix 4.5 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. 52