Of the world’s 371 million people diagnosed with diabetes, nearly 200 million live in Asia. According to the International Diabetes Federation (IDF), those numbers are set to climb dramatically. By 2030, it is estimated that 522 million people worldwide will have diabetes, with 300 million of them living in Asia. Already, China, India, Indonesia and Japan rank among the top ten countries with the greatest numbers of diabetics.
Recent studies suggest that Asians — especially Southeast Asians — have a higher genetic predisposition to developing Type II diabetes. This is the most common form of diabetes, previously known as “adult-onset” diabetes. Asian diabetics are typically younger and thinner than other people suffering from the disease. As Asians have gotten wealthier, they have started adopting Western lifestyle habits — such as little exercise and overeating — that put them at higher risk for diabetes.
Left untreated, diabetes is a killer. It causes levels of blood glucose to spike, putting diabetics at risk for cardiovascular disease, kidney disease, blindness, dementia and a host of other problems. Care for these conditions is expensive. The World Health Organization (WHO) estimates that diabetes linked chronic diseases will cost China alone $558 billion in lost productivity and healthcare costs over the next decade.
DISEASE MANAGEMENT EQUIPMENT
To manage their diseases, diabetics need a whole host of devices, from monitoring equipment to insulin pumps. Continuous glucose monitoring systems, insulin needles and syringes, insulin pens, infusion sets and injection ports are all products that are growing in demand among Asian consumers. Also growing in demand are devices tailored to younger diabetics. As in the rest of the world, the number of teens and pre-teens suffering from Type II diabetes is steadily increasing in Asia.
Along with a need for monitoring and treatment equipment is a need for diagnostics devices. Many of Asia’s diabetics remain undiagnosed, and others have pre-diabetic conditions that put them at risk for developing diabetes later. Companies that provide equipment for oral glucose tolerance tests, among other tests, should look to sell their product lines into the Asian markets.
Finally, medical equipment and drug manufacturers are also starting programs to educate patients and physicians. Eli Lilly, BD and Roche have partnered with the Chinese Ministry of Health to launch a long-term program (Project HOPE) to train healthcare workers in the diagnosis and treatment of diabetes. The program also includes public awareness programs at training centers throughout the country. To date, the program has reached more than 40,000 health care providers and 223,000 patients and their families.
WESTERN DEVICE MANUFACTURERS
Many US and European medical device companies have strong portfolios of diabetes products, and more and more are entering the Asian market.
Sanofi, Novo Nordisk, Abbot Laboratories, Medtronic, Bayer, Roche and Lifescan are among the biggest diabetes medical device companies active in Asia. Novo Nordisk’s insulin delivery systems are widely used, as are blood glucose monitoring systems like Abbott’s Optium, Roche’s Accucheck and Lifescan’s OneTouch. Especially popular are devices tailored to the Asian market. In October 2012, Sanofi launched a low-cost, reusable insulin pen called AllStar in India. Since then, Indian doctors say that the product has “changed the rules of the game.”
The device has a replaceable cartridge and it is much cheaper than imported alternatives. It is locally manufactured, which cuts down significantly on production and logistics costs. In addition to its AllStar pen, Sanofi is developing another product aimed at Asian diabetics: a “diabetes pack” that will combine different therapies for disease management. It plans to sell the pack in India and throughout other emerging markets in Asia.
Due to the trends of rapid economic development and urbanization across Asia, the next several generations of Asians are especially at risk for developing diabetes. Recent studies show that India, Indonesia, China, Vietnam, Malaysia and the Philippines will have the highest levels of new diabetes diagnoses over the next 20 years.
India was home to more than 63 million diabetics in 2012. According to the International Diabetes Federation (IDF), that number will rise by more than 75 percent by 2030. Only 15 million — less than a quarter — of Indian patients are currently treated for diabetes.
Most Indian patients suffer from Type II diabetes, accompanied by health complications like high blood pressure and obesity. Type II diabetes typically starts after the age of 40. In India, it is seen in children and adolescents, and it is often linked to obesity.
The IDF found that the average Indian patient with diabetes spent close to $68 on health maintenance in 2012. This number includes lab tests, drugs, medical devices and inpatient and outpatient care. While the Indian market presents unique challenges in terms of device affordability, successful foreign device manufacturers will be those who quickly adapt their products to local needs.
China has the world’s largest population of diagnosed diabetics: 93 million in 2012. More than 160 million Chinese are pre-diabetic, and many are unaware that they are even at risk. Those who are currently being treated for diabetes spent $194 on health maintenance related to diabetes in 2012.
Like India, China has vast regional markets with differing dynamics and affordability issues. But as Chinese consumers get richer, and their understanding of diabetes expands through programs like Project HOPE, they will be more likely to invest in diabetes-related devices and treatments.
Together, the countries of Southeast Asia have some of the highest rates of diabetes prevalence in the world. However, many of these cases remain undiagnosed. Of the 7.5 million people with diabetes in Indonesia, for example, 4.4 million do not even realize that they have it. Further, when international groups like the IDF conduct surveys in these countries, people found to have high levels of glucose do not always act upon the information. It will take a concerted combination of education and device affordability to make a difference in these emerging markets.
Foreign medical device manufacturers who want to expand their diabetes portfolios to Asia would do well to understand the dynamics of the market. Companies that combine their products with educational components, for example, will stand a greater chance of success.