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Stakeholder Insight: COPD - Another Reason to QuitPublished by: Datamonitor Published: Dec. 21, 2005 - 205 Pages Table of ContentsTABLE OF CONTENTS About Datamonitor healthcare 2 About the Respiratory & Infectious Disease team 2 CHAPTER 1 EXECUTIVE SUMMARY 4 Scope 4 Datamonitor insight into the disease market 5 CHAPTER 2 DISEASE BACKGROUND 10 COPD is characterized by airflow limitation that is not fully reversible 10 Enigma of COPD pathogenesis 11 Smoking is the primary risk factor 14 Other risk factors 18 Disease severity is based on lung function and symptoms 19 COPD is a disease of the elderly 20 Prognosis is highly variable 22 Acute exacerbations are the most important complication 23 COPD patients have signifiant comorbidities 25 CHAPTER 3 EPIDEMIOLOGY 27 The difficulties in estimating COPD prevalence 27 28 million patients suffer from COPD 28 COPD population will grow by 14% by 2015 34 CHAPTER 4 DIAGNOSIS 38 Common symptoms may be dismissed as ‘just getting older’ 38 Gold-standard diagnostic tests are spirometry and reversibility test 40 Smokers do not recognize symptoms 44 Slow onset of COPD delays diagnosis 44 Lack of awareness among the general public 45 Lack of awareness among physicians 46 Patients may be initially diagnosed as asthmatics 46 Under-use of spirometry 47 Half of COPD patients may be undiagnosed 48 CHAPTER 5 TREATMENT OPTIONS 50 COPD market is valued at nearly $5 billion 50 Bronchodilators are mainstay symptomatic treatment 52 Beta2-agonists 53 Anticholinergics 55 Methyl xanthines 56 Combination short-acting anticholinergic/short-acting beta2-agonist products 57 Corticosteroids are the only effective anti-inflammatory 58 Fixed-dose combination inhaled corticosteroid/long-acting beta2-agonist products 61 Leukotriene antagonists 62 Exacerbations are still not preventable 62 Smoking cessation is key to decreasing decline in FEV1 65 Other pharmacological treatments combat infection 68 Non-pharmacological treatments 68 Pulmonary rehabilitation 68 Long-term oxygen therapy 70 Surgery 71 Treatment guidelines are comparable 72 Adherence to guidelines 75 CHAPTER 6 PRESCRIBING TRENDS 77 Current prescribing trends do not reflect best practice 77 Many patients with mild COPD prescribed long-acting bronchodilators 79 Inhaled corticosteroids are widely prescribed 82 Country prescribing trends are similar 85 Efficacy drives prescribing behaviour 87 Fixed-dose ICS/LABA combinations have the highest efficacy 87 Fixed-dose ICS/LABA combinations are most cost-effective to the payer 88 Patients are most compliant with fixed-dose ICS/LABA combination 90 CHAPTER 7 FUTURE TRENDS 92 Shortfalls with COPD therapies warrant new approaches 92 Alternatives to inhaled corticosteroids remain elusive 94 Novel combinations: same room, different color 97 Improved smoking cessation thearpies are critical 101 Improving nicotine replacement therapy 101 The high prevalence of COPD demands improved awareness and diagnosis 104 CHAPTER 8 OPINION LEADER TRANSCRIPTS 106 UK opinion leader 106 UK opinion leader 121 US opinion leader 136 Spanish opinion leader 150 Canadian opinion leader 166 APPENDIX A 180 References 180 Weblinks 188 APPENDIX B 190 Physician sample breakdown 190 The survey questionnaire 193 Disclaimer 204 AbstractIntroductionCOPD is a deadly disease of the elderly, with patients suffering years of progressive discomfort and disability with no pharmacological interventions able to slow the progressive decline in lung function. A large, increasing patient population demands the development of truly novel COPD-focused therapies which must be coupled with improved disease awareness and diagnosis. Scope Analysis of diagnosis, epidemiology, and treatment of COPD Assessment of the extent to which physicians treat COPD severities differently Examination of the use of drug classes and brands across the COPD sub-populations Evaluation of future prescribing trends and the potential of novel COPD therapies Highlights Current treatment practice will continue to diverge from international guidelines, with the most important change being the increased use of long-acting bronchodilators in mild COPD. The use of inhaled corticosteroids will continue to be reserved primarily for late stage disease, until alternative anti-inflammatory agents are available from 2010 onwards. With no revolutionary new drugs in the pipeline, and novel combinations of existing classes of drugs only offering gains patient compliance, improvements in smoking cessation and pulmonary rehabilitation offer the greatest hope to COPD patients. Reasons to Purchase Identify the most lucrative target niche populations for developmental products Understand how to position new COPD therapies Gain insight into prescribing patterns and physician opinion on current treatment paradigms Get Full Details About This Report >> |
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