By Ames Gross, President and Founder of Pacific Bridge Medical
This article was also published on MedTech Intelligence.
Neurological disorders are steadily increasing in Asia. Despite being home to 60% of the world’s population, Asia only has around 20% of the world’s neurologists and an even smaller portion of available treatments, according to a 2015 WHO study. This unmet demand for treatments provides opportunities for Western neurology companies to expand and grow in the region.
Among more than 600 neurological disorders in the world, cerebrovascular and neurodegenerative disorders are the most common in Asia.
Cerebrovascular diseases, such as ischemic strokes and transient ischemic attacks (TIA), are much more widespread in Asia, particularly South and parts of Southeast Asia, than in Europe or North America. Stroke is the leading cause of death in India and Indonesia, accounting for between one-third and one-fifth of all premature deaths in the countries respectively. According to a 2015 study from the Indian Academy of Neurology, there are more than 1.8 million people suffering from stroke in the country. This trend is largely attributed to risk factors including hypertension, high cholesterol, diabetes and tobacco consumption in the region. In high-income countries such as Japan, Korea, Taiwan and Singapore, cerebrovascular diseases have declined in the past decade as the population becomes increasingly health-conscious.
Neurodegenerative diseases have witnessed a steady rise in many Asian countries due to the rapidly aging population. Currently, over one-quarter of Japan’s population is over 65, while other countries such as Korea, China, Taiwan and Singapore are all expected to undergo rapid aging. According to a 2016 study in the Journal of Internal Medicine, Alzheimer’s Disease (AD) is the most common neurodegenerative disorder in Asia and comprises of over 60% of all cases. There are an estimated 7 million Alzheimer’s patients in China, 4 million in India and 1.5 million in Japan. Parkinson’s Disease (PD) is the second most common neurodegenerative disease in Asia, although the prevalence in Asia is slightly lower than in Europe or North America.
Neuroinfectious diseases have declined rapidly in Asia, but diseases such as paragonimiasis and Japanese encephalitis still exist in rural and warmer regions. While the number of cases of brain and central nervous system tumors remain small in comparison to other cancers, they have been steadily increasing.
Western Neurology Companies In Asia
Western companies that manufacture CT, MRI and other diagnostic neuroimaging devices have established a strong presence in the Asian markets. According to a 2015 OECD report, Japan has the highest per capita number of MRI and CT scanners in the world and is one of the largest markets for these devices. Other markets such as China and Korea are also growing rapidly as an aging population has increased the number of neurological disorders in the population. GE, Siemens and Phillips are some of the biggest foreign neuroimaging players in the region.
In recent years, neuroimaging companies that utilize virtual reality (VR) have grown particularly quickly. VR neuroimaging offers medical practitioners an unprecedented opportunity to view the brain and helps with patient diagnosis, operations and education.
A number of VR neuroimaging startups are racing to obtain regulatory approval and enter the Asian markets. EchoPixel (Palo Alto, CA), a startup that develops VR software for brain and body imaging, has already obtained approval from the FDA and is seeking regulatory approval in Asia. Surgical Theater (Cleveland, OH), another startup producing VR neuroimaging software, has collaborated with Taiwanese electronics giant HTC to provide hardware for its product. In 2016, Surgical Theater launched a showcase of its products in China, and hopes to expand in the Asian markets.
Neurology startups utilizing VR technology also have applications that extend beyond imaging, such as stroke rehabilitation. MindMaze (Lausanne, Switzerland), developed the ‘MindMotion Pro’ software to help stroke patients relearn movement through VR guidance. The company has received over $100 million in funding, and has successfully marketed its products to a number of hospitals in Asia.
Foreign neuro-oncology firms are also increasing their presence in Asia. In December 2016, Novocure (Portsmouth, NH) received approval from Japan’s Ministry of Health, Labor and Welfare (MHLW) to market ‘Optune,’ a portable device that emits alternating electric fields to inhibit brain cancer cell growth. In March 2017, Novocure gained approval for a smaller version of its Optune device in Japan.
Neurological disorders, particularly cerebrovascular and neurodegenerative disorders, will grow in Asia in the foreseeable future. As the middle classes in Asia grow in the developing countries, cerebrovascular diseases such as stroke will replace infectious diseases as one of the leading causes of death. Neurodegenerative disorders will also increase as a result of the aging population, as well as increasing awareness and diagnosis among doctors and patients in Asia. Innovative Western device companies that target these neurological disorders will find many opportunities to grow and succeed in Asia.