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									                                   Top 10 Healthcare Trends in 2011
 Reference Code: GBIME0020MR                                                                                          Publication Date: March 2011


                                    Pharmaceutical Companies Focus More on Oncology Market Owing to Increased utilization
                                    of high-cost targeted and long duration therapies

The global oncology                 Globally, cancer is one of the leading causes of death next only to cardiovascular diseases. The
therapeutics market is              global oncology therapeutics market was estimated at $24.9 billion in 2009 and is expected grow at
expected grow at a                  a Compound Annual Growth Rate (CAGR) of approximately 3.6% between 2009 and 2017 to
Compound Annual Growth              record a sales value of approximately $33 billion. The moderate CAGR of 3.6% can be attributed to
Rate (CAGR) of                      declining cancer incidence rates in the US and in the top five countries in the EU. Few other factors
approximately 3.6%                  such as restrictive pricing and reimbursement policies, off-label uses of anti-cancer therapies,
between 2009 and 2017               comparative effectiveness reforms and patent expiry of major blockbuster drugs are expected to
to reach $33 billion in             affect the growth of the market.
2017.                               However, the increased use of targeted/personalized therapies such as Herceptin, first-time
                                    innovations such as cancer vaccines and longer treatment periods for growing number of patients,
                                    have contributed positively to the growth of this market.
                                    With more than 80 molecules in the late-stage development findings of innovative treatment for
                                    niche segments and the evolution of new cancer segments, cancer therapeutics market continues
                                    to attract investments from pharmaceutical companies.

                                     Top 10 Trends, Oncology Therapeutics Market, Global, Market Revenues ($bn), 2002-2017

                                                            35
                                                                                             CAGR (2009-2016): 3.6%

                                                            30


                                                            25   CAGR (2002-2009): 8.4%
                                             Revenue (bn)




                                                            20


                                                            15


                                                            10


                                                            5


                                                            0
                                                                       2002                       2009                        2017


                                     Source: GBI Research




Top 10 Healthcare Trends in 2011                                                                                GBIME0020MR / Published MAR 2011
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                                   Outsourcing Will Remain the Key Strategy for Biopharmaceutical Companies: India and
                                   China are fast developing into lucrative business opportunities for outsourcing clinical
                                   research
                                   The global pharmaceutical industry is currently witnessing rapid expansion with advances in
                                   manufacturing processes, technology innovation and integration. The ever increasing financial
                                   woes of the pharmaceutical industry have provided a huge opportunity to contract outsourcing
                                   organizations to capitalize on the combined advantage of their expertise and economies of scale.
                                   Contract research organizations will emerge as strategic partners for biopharmaceutical
                                   companies. The service models of the contract research organizations are evolving to become
                                   more functional, where services are outsourced based on the analysis of their core competencies.
                                   The drug discovery markets in India and China are set to grow at double digit rates, with rapid
                                   developments in the market landscape and changing market dynamics in the global pharmaceutical
                                   industry. According to industry experts, India and China typically provide cost advantages of up to
                                   60–70% in drug discovery research. Other major benefits include availability of skilled manpower,
                                   the scale of available resources to conduct clinical trials and the improved state of intellectual
                                   property protection in the two countries.
                                   According to GBI Research, the combined drug discovery market in both countries was more than
                                   $2.3 billion in 2009, representing a compound annual growth (CAGR) rate of 36.2% from 2004 with
                                   the market expected to grow to reach $8.2 billion by 2016.

                                    Top 10 Trends, Drug Discovery Market, India and China, Market Size, $bn, 2004–2016

                                                                             9

                                                                             8

                                                                                                     CAGR (2009-2016) - 19.8%
                                           Drug Discovery Market Size, $bn




                                                                             7

                                                                             6

                                                                             5

                                                                             4
                                                                                 CAGR (2004-2009) - 36.2%
                                                                             3

                                                                             2

                                                                             1

                                                                             0
                                                                                    2004                        2009                         2016


                                    Source: GBI Research




Top 10 Healthcare Trends in 2011                                                                                                GBIME0020MR / Published MAR 2011
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                                   The Large Pharmaceutical Companies are Diversifying through Inorganic Growth
                                   The acquisitions that have occurred in the past few years show a growing trend for companies
                                   dominant in the pharmaceutical sphere, expanding beyond drugs and diversifying into medical
                                   devices in order to strengthen their product portfolios.
                                   The patent expiration of many drugs is the most important reason for the increasing acquisition of
                                   medical device companies by pharmaceutical giants. In addition to more than 40% loss of the
                                   selling price immediately after a branded drug‘s patent expiry, the entry of generics leads to a
                                   further price decline. Therefore, pharmaceutical companies are forced to look for options that
                                   provide them with financial stability.
                                   Pharmaceutical companies are also following the strategy of inorganic growth in order to gain
                                   immediate revenues by acquiring mid-sized medical device companies. The acquisitions will readily
                                   give them profits compared to investment in R&D activities that would delay any profits by several
                                   years. Diversification is another reasons why pharmaceutical companies are going beyond drugs to
                                   find innovative solutions to reduce the over dependence on the revenues from their drug portfolios.
                                   Most companies rely heavily on the performance of their blockbuster drugs, but by diversifying into
                                   medical devices they now have access to a wider range of revenue generation sources.




Top 10 Healthcare Trends in 2011                                                                     GBIME0020MR / Published MAR 2011
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                                   1         Table of Contents
                                   1   Table of Contents ........................................................................................................................ 4
                                       1.1    List of Tables..................................................................................................................... 8
                                       1.2    List of Figures ................................................................................................................. 10
                                   2   Top 10 Healthcare Trends in 2011 ............................................................................................ 13
                                       2.1    Introduction ..................................................................................................................... 13
                                       2.2    GBI Research Report Guidance ..................................................................................... 14
                                   3   Refurbished Systems: Soft Hospital Spending Drives Demand for Refurbished Medical Devices
                                       and Capital Equipment .............................................................................................................. 15
                                       3.1    Introduction ..................................................................................................................... 15
                                       3.2    Standardization and Regulations .................................................................................... 15
                                       3.3    Refurbishment Process ................................................................................................... 15
                                       3.4    Brand Factor ................................................................................................................... 16
                                       3.5    Clean Green Approach ................................................................................................... 16
                                       3.6    Value Chain Key Driver for Refurbished Systems........................................................... 16
                                       3.7    Conclusion ...................................................................................................................... 17
                                   4   Hospital Information Systems: Government Aid and Cost Savings Driving Development and
                                       Adoption .................................................................................................................................... 18
                                       4.1    Introduction ..................................................................................................................... 18
                                       4.2    Global Hospital Information Systems: Market Characterization ...................................... 19
                                       4.3    Global Hospital Information Systems: Market Dynamics ................................................ 20
                                          4.3.1    Key Drivers of Adoption ........................................................................................... 21
                                       4.4    Global Hospital Information Systems Market: Strategic Competitive Assessment .......... 23
                                   5   Big Medical Device Companies Turn to Life Sustaining Product Portfolio For Growth .............. 24
                                       5.1    Introduction ..................................................................................................................... 24
                                       5.2    Company Profiles............................................................................................................ 25
                                          5.2.1    Medtronic: ................................................................................................................ 25
                                          5.2.2    Boston Scientific: ..................................................................................................... 25
                                          5.2.3    St Jude Medical: ...................................................................................................... 25
                                          5.2.4    Roche ...................................................................................................................... 26
                                       5.3    Key Therapeutic Areas ................................................................................................... 27
                                          5.3.1    Cardiovascular......................................................................................................... 27
                                          5.3.2    Neurology ................................................................................................................ 34
                                          5.3.3    Diabetes Care Devices: ........................................................................................... 37
                                   6   The Regulatory Ecosystem: Changes in the US and Europe to impact industry ....................... 41
                                       6.1    United States: The 510 (k) Reform ................................................................................. 41
                                       6.2    European Union EU Medical Device Directive (MDD) Changes ..................................... 41
                                          6.2.1    Summary of Changes .............................................................................................. 41
                                          6.2.2    Impact on the Medical Device Market ...................................................................... 41
                                       6.3    Post Marketing Guidance: A Safety Net against Recalls and Safety Issues ................... 42
                                          6.3.1    Summary of Changes .............................................................................................. 42
                                          6.3.2    Impact on the Medical Device Market ...................................................................... 42
                                          6.3.3    Conclusions ............................................................................................................. 42
                                          6.3.4    Key Points: .............................................................................................................. 42
                                   7   The Large Pharmaceutical Companies are Diversifying through Inorganic Growth................... 43
                                       7.1    Novartis Acquires Alcon .................................................................................................. 43
                                          7.1.1    Overview ................................................................................................................. 43
                                          7.1.2    Deal Rationale ......................................................................................................... 44
                                          7.1.3    Deal Analysis ........................................................................................................... 44
                                          7.1.4    Company Profile ...................................................................................................... 46
                                       7.2    Abbott Acquires Advanced Medical Optics ..................................................................... 46
                                          7.2.1    Overview ................................................................................................................. 46
                                          7.2.2    Deal Rationale ......................................................................................................... 46
                                          7.2.3    Deal Analysis ........................................................................................................... 47


Top 10 Healthcare Trends in 2011                                                                                                  GBIME0020MR / Published MAR 2011
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                                        7.2.4     Company Profile ...................................................................................................... 48
                                     7.3    Johnson & Johnson Consolidates Medical Device Portfolio by Acquiring Mentor and
                                            Omrix .............................................................................................................................. 48
                                        7.3.1     Overview ................................................................................................................. 48
                                        7.3.2     Deal Rationale ......................................................................................................... 48
                                        7.3.3     Deal Analysis ........................................................................................................... 49
                                        7.3.4     Company Profile ...................................................................................................... 51
                                     7.4    Biopharmaceutical companies will continue to extend and expand their portfolio and
                                            geographic reach through Mergers, Acquisitions & Licensing Agreements .................... 52
                                        7.4.1     Mergers and Acquisitions ........................................................................................ 52
                                        7.4.2     Deals by Value ........................................................................................................ 53
                                        7.4.3     Top 10 Mergers and Acquisitions in 2010 ............................................................... 54
                                     7.5    Licensing Agreements .................................................................................................... 55
                                        7.5.1     Deals by Therapy Area ............................................................................................ 55
                                        7.5.2     Deals by Value ........................................................................................................ 56
                                        7.5.3     Deals by Value ........................................................................................................ 57
                                   8 Pharmaceutical Companies Focus More on Oncology Market Owing to Increased utilization of
                                     high-cost targeted and long duration therapies.......................................................................... 58
                                     8.1    Introduction ..................................................................................................................... 58
                                     8.2    Oncology Therapeutics: Market Overview ...................................................................... 58
                                     8.3    The Global Oncology Therapeutics Market Is Expected To Reach Revenues of $33
                                            Billion By 2016 ................................................................................................................ 59
                                        8.3.1     Sales Value ............................................................................................................. 59
                                        8.3.2     Avastin, Rituxan and Herceptin are the major selling brands and are expected to
                                                  lead the market through 2015 .................................................................................. 60
                                        8.3.3     Increased Interest of Pharmaceutical Companies in Targeted and Customized
                                                  Therapies ................................................................................................................ 61
                                     8.4    Oncology Therapeutics Market Is Backed By Strong R&D Activity ................................. 62
                                     8.5    R&D Trends .................................................................................................................... 65
                                        8.5.1     Discovery of Unknown Mutations that Play Key Role in Cancers ............................ 65
                                        8.5.2     Pairing Therapeutics and Diagnostics ..................................................................... 66
                                     8.6    Key Late Stage Pipeline Drugs ....................................................................................... 67
                                        8.6.1     Lung Cancer ............................................................................................................ 67
                                        8.6.2     Breast Cancer.......................................................................................................... 68
                                        8.6.3     Colorectal Cancer .................................................................................................... 70
                                        8.6.4     Non-Hodgkin’s Lymphoma ...................................................................................... 74
                                        8.6.5     Prostate Cancer....................................................................................................... 77
                                   9 Outsourcing Will Remain the Key Strategy for Biopharmaceutical Companies: CRO, CMO And
                                     Drug Discovery Outsourcing Will Continue to Grow at a greater pace ...................................... 81
                                     9.1    Introduction ..................................................................................................................... 81
                                     9.2    Contract Manufacturing Organizations will receive significant impetus from emerging
                                            economies....................................................................................................................... 82
                                     9.3    Contract Manufacturing Organizations (CMO) in Eastern Europe are set to Grow at a
                                            Faster Rate ..................................................................................................................... 83
                                     9.4    Market Forecasts ............................................................................................................ 85
                                     9.5    Comparative Analysis of Eastern European Countries ................................................... 86
                                        9.5.1     Infrastructural Facilities – Railways, Roadways, Airways, Power and Overall
                                                  Logistics Support ..................................................................................................... 87
                                        9.5.2     Labor - Availability of Skilled Labor at Affordable Rates and Labor Flexibility ......... 88
                                        9.5.3     Broad Economic Indicators – GDP, Availability of Credit, Taxation Policies ............ 89
                                        9.5.4     Ease of Doing Business – Overall Government and Regulatory Support ................ 90
                                     9.6    Contract Research Outsourcing Market will continue to Grow, Driven by the Demand by
                                            the Biopharmaceutical Industry ....................................................................................... 92
                                        9.6.1     Introduction .............................................................................................................. 92
                                        9.6.2     Market Characterization .......................................................................................... 93
                                     9.7    Contract Research Outsourcing Service Model .............................................................. 94


Top 10 Healthcare Trends in 2011                                                                                                GBIME0020MR / Published MAR 2011
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                                         9.7.1       Fully Integrated Service Model ................................................................................ 95
                                         9.7.2       Functional Service Model ........................................................................................ 96
                                      9.8    India and China are the fastest growing markets with regard to drug discovery research
                                              ........................................................................................................................................ 97
                                         9.8.1       Introduction .............................................................................................................. 97
                                         9.8.2       Drug Discovery in India and China – Market Characteristics ................................... 98
                                         9.8.3       Why India and China? ............................................................................................. 99
                                         9.8.4       Availability of Skilled Manpower .............................................................................. 99
                                         9.8.5       Scale of Available Resources for Clinical Development ........................................ 101
                                         9.8.6       Major Therapeutic Areas under Research ............................................................. 101
                                         9.8.7       Improved IP Protection in India and China ............................................................ 102
                                         9.8.8       Government Support for the Drug Discovery Development ................................... 103
                                         9.8.9       Risk Sharing Agreements: A Step Forward by Indian and Chinese Companies ... 105
                                         9.8.10 SWOT Analysis ..................................................................................................... 106
                                   10 Reduction Of Healthcare Costs And Drug Safety Issues Will Remain The Main Focus Of
                                      Regulatory Authorities And Biopharmaceutical Industries ....................................................... 108
                                      10.1 Risk Evaluation and Mitigation Strategy (REMS) .......................................................... 108
                                         10.1.1 What is REMS? ..................................................................................................... 108
                                         10.1.2 Risk Evaluation and Mitigation Strategies - Food and Drug Administration
                                                     Amendments Act (FDAAA) of 2007 ....................................................................... 109
                                         10.1.3 Components of REMS ........................................................................................... 109
                                         10.1.4 FDA Approved REMS (2008-2010) ....................................................................... 110
                                      10.2 Opioids and REMS ....................................................................................................... 117
                                      10.3 Erythropoiesis-Stimulating Agents (ESAs) .................................................................... 118
                                      10.4 Case Studies................................................................................................................. 119
                                         10.4.1 Accutane (Isotretinoin) ........................................................................................... 119
                                         10.4.2 Tysabri (Natalizumab) ........................................................................................... 120
                                      10.5 Major Players Are Becoming Increasingly Aligned around Personalized Medicine and
                                             Companion Diagnostics – Oncology Continues to be the Prime Focus ........................ 121
                                      10.6 Global Companion Diagnostics Market, Oncology, Revenue Forecasts ($m), 2009-2016
                                              ...................................................................................................................................... 124
                                      10.7 Biomarkers Facilitate Quick Turnover of Drugs and Significant Reduction in Drug
                                             Discovery and Development Costs ............................................................................... 127
                                      10.8 The Biomarkers Market Is Forecast To Reach $6.3 Billion By 2016 ............................. 128
                                         10.8.1 Breast cancer biomarkers contributed to a majority (24%) of the total market
                                                     revenue ................................................................................................................. 129
                                      10.9 Biomarkers in Cancer Research – Pipeline by Indication ............................................. 132
                                   11 Upcoming Sales & Marketing Models will offset the issues/pitfalls of traditional models ......... 134
                                      11.1 Introduction ................................................................................................................... 134
                                         11.1.1 Layoff in the Pharmaceutical Companies .............................................................. 134
                                      11.2 Key Account Management Will Be Implemented In All Large and Medium Sized
                                             Pharmaceutical Companies .......................................................................................... 135
                                         11.2.1 Introduction ............................................................................................................ 135
                                         11.2.2 Key Account Management Process ....................................................................... 135
                                         11.2.3 Types of Key Account Management ...................................................................... 142
                                         11.2.4 Case Studies ......................................................................................................... 143
                                      11.3 Contract Sales Outsourcing Will Increase Due to its Strategic Advantage to Improve
                                             Productivity ................................................................................................................... 149
                                         11.3.1 Contract Sales Representatives ............................................................................ 150
                                         11.3.2 Sales Team Recruitment and Training .................................................................. 150
                                         11.3.3 Sales Data Analytics and Management ................................................................. 151
                                         11.3.4 Shared Sales Teams and Telesales ...................................................................... 151
                                         11.3.5 Medical Science Liaisons ...................................................................................... 151
                                         11.3.6 The Evolving Model ............................................................................................... 152
                                         11.3.7 Case Study ............................................................................................................ 153
                                      11.4 Closed Loop Marketing Adoption Has Increased Over the Last Few Years ................. 154

Top 10 Healthcare Trends in 2011                                                                                                    GBIME0020MR / Published MAR 2011
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                                         11.4.1 Benefits for Sales & Physicians ............................................................................. 155
                                         11.4.2 Benefits for Analytics ............................................................................................. 155
                                         11.4.3 Benefits for Legal & Regulatory Departments ....................................................... 155
                                         11.4.4 Benefits for Marketing............................................................................................ 155
                                         11.4.5 Case Study ............................................................................................................ 155
                                   12 Biologics Price Competition and Innovation Act, 2009 Opens the Gates for Approval of
                                      Biosimilars in the US ............................................................................................................... 159
                                      12.1 Biosimilars Approval Pathways in the US and Europe – Market Characterization ........ 159
                                         12.1.1 Global Biosimilar Market Size and Forecast .......................................................... 160
                                         12.1.2 The US Biosimilar Market Size and Forecast ........................................................ 162
                                         12.1.3 Europe Biosimilar Market Size and Forecast ......................................................... 163
                                         12.1.4 Japan Biosimilars Size and Market Forecasts ....................................................... 164
                                      12.2 Biosimilars Approval Pathways in the US and Europe – Drivers and Restraints........... 165
                                         12.2.1 Drivers ................................................................................................................... 166
                                         12.2.2 Restraints .............................................................................................................. 171
                                      12.3 Market Forecasts for Biosimilars ................................................................................... 174
                                         12.3.1 Human Growth Hormone (hGH) Biosimilars Markets ............................................ 174
                                         12.3.2 Erythropoietin (EPO) Biosimilars Markets ............................................................. 176
                                         12.3.3 Granulocyte – Colony Stimulating Factor (G-CSF) Biosimilars Markets ................ 178
                                      12.4 Opportunity Analysis - Development and Approval of Biosimilar mABs May Face Tough
                                             Regulatory Environment ............................................................................................... 180
                                         12.4.1 Interferon alfa Biosimilars ...................................................................................... 180
                                         12.4.2 Interferon beta Biosimilars ..................................................................................... 182
                                         12.4.3 Insulin and Insulin Analogs Biosimilars .................................................................. 183
                                         12.4.4 TNF alfa Inhibitor Biosimilars ................................................................................. 185
                                         12.4.5 Biosimilars for Monoclonal Antibodies against Cancer .......................................... 186
                                   13 Appendix ................................................................................................................................. 189
                                      13.1 Abbreviations ................................................................................................................ 189
                                      13.2 Research Methodology ................................................................................................. 192
                                         13.2.1 Coverage ............................................................................................................... 192
                                         13.2.2 Secondary Research ............................................................................................. 192
                                         13.2.3 Primary Research .................................................................................................. 193
                                         13.2.4 Expert Panel Validation ......................................................................................... 193
                                      13.3 Contact Us .................................................................................................................... 193
                                      13.4 Disclaimer ..................................................................................................................... 193
                                      13.5 Sources ......................................................................................................................... 194




Top 10 Healthcare Trends in 2011                                                                                                 GBIME0020MR / Published MAR 2011
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                                   1.1       List of Tables
                                   Table 1:  Top 10 Trends, Cataract Surgery Devices Market, Global, Revenue ($m) 2009–2016 45
                                   Table 2:  Top 10 Trends, Refractive Surgery Devices Market, Global, Revenue ($m) 2009–2016
                                             ....................................................................................................................................... 47
                                   Table 3: Top 10 Trends, Breast Implants Market, Global, Revenue ($m), 2009–2016 ................ 49
                                   Table 4: Top 10 Trends, Breast Implants Market ,Global, Company Share (%),2009 ................... 50
                                   Table 5: Top 10 Trends, Global Top 10 Mergers and Acquisitions, 2010 .................................... 54
                                   Table 6: Top 10 Trends, Oncology Therapeutics Market, Global, Market Revenues ($bn), 2002-
                                             2009 ............................................................................................................................... 59
                                   Table 7: Top 10 Trends, Oncology Therapeutics Market, Global, Market Revenues ($bn), 2009-
                                             2017 ............................................................................................................................... 59
                                   Table 8: Top 10 Trends, Oncology Therapeutics Market, Top 10 Brands‘ Sales ($m), 2006-2009
                                             ....................................................................................................................................... 60
                                   Table 9: Top 10 Trends, Contract Manufacturing Organizations (CMO) in Eastern Europe, Market
                                             Characterization, Eastern Europe CMO Market Size, $bn, 2007-2016 .......................... 85
                                   Table 10: Top 10 Trends, Drug Development Outsourcing Models ............................................... 94
                                   Table 11: Top 10 Trends, Drug Discovery Market, India and China, Historic Market Size, $bn,
                                             2004–2009 ..................................................................................................................... 98
                                   Table 12: Top 10 Trends, Drug Discovery Market, India and China, Market Size Forecast, $bn,
                                             2009–2016 ..................................................................................................................... 98
                                   Table 13: Top 10 Trends, Major Therapeutic Areas of Drug Discovery Research in India and China
                                             ..................................................................................................................................... 102
                                   Table 14: Top 10 Trends, SWOT Analysis – Drug Discovery Market in India and China ............. 106
                                   Table 15: Top 10 Trends, Risk Evaluation and Mitigation Strategy, List of FDA Approved REMS,
                                             2008 ............................................................................................................................. 110
                                   Table 16: Top 10 Trends, Risk Evaluation and Mitigation Strategy, List of FDA Approved REMS,
                                             2009 ............................................................................................................................. 111
                                   Table 17: Top 10 Trends, Risk Evaluation and Mitigation Strategy, List of FDA Approved REMS,
                                             2010 ............................................................................................................................. 114
                                   Table 18: Top 10 Trends, Sales of Personalized Therapeutics ($m), 2007-2009 ........................ 121
                                   Table 19: Top 10 Trends, Personalized Medicine Market, List of Selected Personalized
                                             Diagnostics and Therapeutics, 2010*........................................................................... 123
                                   Table 20: Top 10 Trends, Companion Diagnostics Market, Oncology, Global, Revenues ($m),
                                             2009–2016 ................................................................................................................... 125
                                   Table 21: Top 10 Trends, Biomarkers in Cancer Research, Global, Cancer Biomarkers Market
                                             Revenues ($bn), 2007–2016 ........................................................................................ 128
                                   Table 22: Top 10 Trends, Biomarkers in Cancer Research, Global, Breast Cancer Biomarkers
                                             Market Revenues ($m), 2007–2016 ............................................................................. 130
                                   Table 23: Top 10 Trends, Biomarkers in Cancer Research, Global, Prostate Cancer Biomarkers
                                             Market Revenues ($m), 2007–2016 ............................................................................. 131
                                   Table 24: Top 10 Trends, Biomarkers in Cancer Research, Global, Pipeline by Indication and
                                             Stage of Development, 2010 ........................................................................................ 133
                                   Table 25: Top 10 Trends, Biosimilars Approval Pathways in the US and Europe, Global, Market
                                             Forecasts, ($m), 2009-2016 ......................................................................................... 160
                                   Table 26: Top 10 Trends, Biosimilars Approval Pathways in the US and Europe, the US, Market
                                             Forecasts, ($m), 2009–2016 ........................................................................................ 162
                                   Table 27: Top 10 Trends, Biosimilars Approval Pathways in the US and Europe, Europe, Market
                                             Forecasts, ($m), 2009–2016 ........................................................................................ 163
                                   Table 28: Top 10 Trends, Biosimilars Approval Pathways in the US and Europe, Japan, Market
                                             Forecasts, ($m), 2009–2016 ........................................................................................ 164
                                   Table 29: Top 10 Trends, Biosimilars Approval Pathways in the US and Europe, Comparison for a
                                             Biosimilar, 2010............................................................................................................ 169
                                   Table 30: Top 10 Trends, Biosimilars Approval Pathways in the US and Europe, Patent Expiry for
                                             Major Biologic Drugs, 2010–2016 ................................................................................ 170
                                   Table 31: Top 10 Trends, Biosimilars Approval Pathways in the US and Europe, Costs of
                                             Development, Manufacturing and Approval of Biosimilars By Cell Culture Type, ($m),
                                             2010 ............................................................................................................................. 172
                                   Table 32: Top 10 Trends, Biosimilars Approval Pathways in the US and Europe, Global, hGH
                                             Biosimilars Market Forecasts, ($m), 2009–2016 .......................................................... 174
                                   Table 33: Top 10 Trends, Biosimilars Approval Pathways in the US and Europe, Global, EPO
                                             Biosimilars Market Forecasts, ($m), 2009–2016 .......................................................... 176


Top 10 Healthcare Trends in 2011                                                                                                   GBIME0020MR / Published MAR 2011
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