Horngren’s Cost Accounting A Managerial Emphasis, Canadian 9th edition soluti...
Therapeutics and biomaterials for musculoskeletal disease global markets
1. Therapeutics and Biomaterials for Musculoskeletal Disease: Global Markets
Report Summary
The global market for musculoskeletal disease is currently approaching $45 billion.
The overall 5-year compound annual growth rate (CAGR) is forecasted to be about
5%, bringing the total market to more than $57 billion by 2014.
Rheumatoid arthritis and osteoarthritis currently represent 53% of the total market.
The RA market was worth an estimated $9.5 billion in 2009 and should reach nearly
$12.5 billion by 2015, while the osteoarthritis segment was valued at $14.5 billion
in 2009 and should reach an estimated $19 billion by 2014. For both sectors this
represents a compound annual growth rate (CAGR) of 5.6%.
Lupus is an emerging area for development, as outcome measures and
understanding of the disease pathology become more refined. This segment was
valued at $1.5 billion in 2009 and is projected to reach $2 billion by 2014, a
compound annual growth rate (CAGR) of 5.2%.
INTRODUCTION
STUDY GOALS AND OBJECTIVES
BCC’s goal in conducting this study was to determine the current status of the
musculoskeletal disease (MSD) treatments and assess the growth potential of this
area over a 5-year period from 2009 to 2014.
Our key objective was to present a comprehensive analysis of the current pipeline
of therapeutics and biomaterials utilized in the treatment of MSDs, analyze the
forecast for Musculoskeletal Disease Therapeutics Market and treatments, and
outline the key factors that will influence this therapeutic area in the next few
years.
Diseases of the musculoskeletal system have plagued a significant portion of the
population, and the number of incidence increases as the population ages. There
have been many successful therapeutics marketed to date, but there is still room
for more effective therapies. Advances in biomaterials are being translated into
viable products in the orthobiologics area as well, thus changing the way a number
of related disease states are treated. More is being elucidated about these diseases,
and this promises to translate into more therapies and market opportunities for a
variety of players.
Browse All Pharmaceuticals Market Research
2. REASONS FOR DOING THIS STUDY
Musculoskeletal disease affects roughly 20% of the population and is a significant
factor in overall healthcare expenditure. Diseases such as rheumatoid arthritis,
osteoporosis, and osteoarthritis are treated with various drug types, and a large
development pipeline of potential new therapies is currently being tested. Clinical
success has proven elusive, however, as there are now numerous companies
developing novel treatments. This report reviews the programs in development and
quantifies the market opportunities in MSDs. This study aims to quantify the
direction in which this market is heading and the areas in which opportunities may
lie.
SCOPE OF REPORT
The scope of this report focuses on the ethical pharmaceutical segment and
biomaterials areas, usually categorized with medical devices. We have compiled a
study of the market, as well as current and emerging modes of treatment. We
present the segment economic environment, technological descriptions and issues,
applications, market factors and potential, and forecasts for the time period from
2009 to 2014. We also project usage in the major primary and secondary disease
application areas. This study will be of interest to the drug industry, patients, and
the medical community. It will also be of interest also to suppliers of products and
services to this market area.
INTENDED AUDIENCE
The intended audience for this report is the pharmaceutical and biotechnology
diagnostics industries, as well as the medical industry that treats patients in these
areas.
METHODOLOGY
BCC presents an analysis by each disease area and the number of current patients.
Based on our surveys, we then analyze the potential applications for
pharmaceuticals and forecast markets for 2009 and 2014.
Table of Contents
CHAPTER ONE: INTRODUCTION
STUDY GOALS AND OBJECTIVES
REASONS FOR DOING THIS STUDY
SCOPE OF REPORT
INTENDED AUDIENCE
METHODOLOGY
3. INFORMATION SOURCES
ANALYST CREDENTIALS
RELATED BCC REPORTS
BCC ONLINE SERVICES
DISCLAIMER
CHAPTER TWO: SUMMARY
SUMMARY
SUMMARY TABLE GLOBAL POTENTIAL MARKET FOR MUSCULOSKELETAL
DISEASE, THROUGH 2014 ($ MILLIONS)
FIGURE 2 GLOBAL POTENTIAL MARKET FOR MUSCULOSKELETAL DISEASE,
2009 AND 2014 ($ MILLIONS)
CHAPTER THREE: OVERVIEW
TABLE 1 PROPORTION OF U.S. POPULATION REPORTING CHRONIC MEDICAL
CONDITIONS (%)
FIGURE 1 PROPORTION OF U.S. POPULATION REPORTING CHRONIC MEDICAL
CONDITIONS (%)
DEFINITION AND MARKET STRUCTURE
TABLE 2 GLOBAL POTENTIAL MARKET FOR MUSCULOSKELETAL DISEASE,
THROUGH 2014 ($ MILLIONS)
FIGURE 2 GLOBAL POTENTIAL MARKET FOR MUSCULOSKELETAL DISEASE, 2009
AND 2014 ($ MILLIONS)
DISEASES OF THE BONE
OSTEOPOROSIS
PAGET’S DISEASE
OSTEOMALACIA
RICKETS
OSTEOMYELITIS
AVASCULAR NECROSIS (OSTEONECROSIS)
4. DISEASES OF THE SKELETAL MUSCLE
MYOPATHY
CHRONIC FATIGUE SYNDROME
FIBROMYALGIA
MUSCULAR DYSTROPHY
DERMATOMYOSITIS
POLYMYOSITIS
RHABDOMYOLYSIS
COMPARTMENT SYNDROME
DISEASES OF THE JOINTS
RHEUMATOID ARTHRITIS (RA)
Epidemiology
Symptoms and Diagnosis
Standard of Treatment
New Developments
New Treatments
Recent Clinical Trials
Outlook for Disease Area
LUPUS
Causes
Epidemiology
Symptoms and Diagnosis
Standard of Treatment
5. New Developments
New Treatments
Recent Clinical Trials
Outlook for Disease Area
GOUT
Epidemiology
Symptoms and Diagnosis
Standard of Treatment
New Treatments
Recent Clinical Trials
Outlook for Disease Area
JUVENILE IDIOPATHIC ARTHRITIS
Epidemiology
Symptoms and Diagnosis
Standard of Treatment
New Treatments
Recent Clinical Trials
Outlook for Disease Area
OSTEOARTHRITIS
Epidemiology
Symptoms and Diagnosis
Standard of Treatment
New Treatments
6. Recent Clinical Trials
Outlook for Disease Area
PSORIATIC ARTHRITIS
Epidemiology
Symptoms and Diagnosis
Standard of Treatment
New Treatments
Recent Clinical Trials
Outlook for Disease Area
ANKYLOSING SPONDYLITIS
Epidemiology
Symptoms and Diagnosis
Standard of Treatment
Recent Clinical Trials
Outlook for Disease Area
OSTEOPOROSIS
Epidemiology
Symptoms and Diagnosis
Standard of Treatment
New Treatments
Recent Clinical Trials
Outlook for Disease Area
7. CHAPTER FOUR: THERAPEUTICS
TABLE 3 GLOBAL REVENUE OF THERAPEUTICS FOR MSD, 2009 (%/$
MILLIONS)
FIGURE 3 GLOBAL REVENUE OF THERAPEUTICS FOR MSD, 2009 ($
MILLIONS)
DMARDS
TABLE 4 GLOBAL REVENUE OF DMARDS FOR MSD, INCLUDING BIOLOGICAL
RESPONSE MODIFIERS, BY DRUG, 2009 ($ MILLIONS)
FIGURE 4 GLOBAL REVENUE OF DMARDS FOR MSD, INCLUDING BIOLOGICAL
RESPONSE MODIFIERS, BY DRUG, 2009 ($ MILLIONS
BIOLOGICS
NSAIDS
TABLE 5 GLOBAL REVENUE OF NSAIDS FOR MSD, 2009 ($ MILLIONS)
FIGURE 5 GLOBAL REVENUE OF NSAIDS FOR MSD BY DRUG, 2009 ($
MILLIONS)
CORTICOSTEROIDS
TABLE 6 GLOBAL REVENUES OF CORTICOSTEROIDS FOR MSD, 2009 ($
MILLIONS)
FIGURE 6 GLOBAL REVENUES OF CORTICOSTEROIDS FOR MSD, 2009 ($
MILLIONS)
BISPHOSPHONATES
TABLE 7 GLOBAL BISPHOSPHONATES MARKET FOR MSD, 2009 ($ MILLIONS)
FIGURE 7 GLOBAL BISPHOSPHONATES MARKET FOR MSD, 2009 ($
MILLIONS)
8. CALCITONINS
TABLE 8 GLOBAL CALCITONINS MARKET FOR MSD, 2009 ($ MILLIONS)
FIGURE 8 GLOBAL CALCITONINS MARKET FOR MSD, 2009 ($ MILLIONS)
ESTROGEN REPLACEMENT THERAPY
SELECTIVE ESTROGEN RECEPTOR MODULATORS
TABLE 9 GLOBAL SERM MARKET FOR MSD, 2009 ($ MILLIONS)
PARATHYROID HORMONE
TABLE 10 GLOBAL PTH MARKET FOR MSD ($ MILLIONS)
ORTHOBIOLOGICS
BMPS
TABLE 11 GLOBAL BMP MARKET FOR MSD, 2009 ($ MILLIONS)
FIGURE 9 GLOBAL BMP MARKET FOR MSD BY COMPANY, 2009 ($ MILLIONS)
PROTEIN THERAPY
GENE THERAPY
CELLULAR THERAPY
SYNTHETIC BONE GRAFT
POLYMERS
COMPOSITE GRAFTS
DEMINERALIZED BONE MATRIX
9. VISCOSUPPLEMENTATION
TABLE 12 VISCOSUPPLEMENTATION MARKET SHARE BY PRODUCT, 2009 (%)
FIGURE 12 VISCOSUPPLEMENTATION MARKET SHARE BY PRODUCT, 2009
(%)
MARKET SIZE AND KEY PLAYERS
TABLE 13 TOP 10 COMPANIES IN MSD MARKET, REVENUE AND ASSOCIATED
GLOBAL MARKET SHARE, 2009 ($ MILLIONS/%)
FIGURE 13 TOP 10 COMPANIES IN MSD MARKET BY GLOBAL MARKET
SHARE, 2009 (%)
MARKET SIZE
KEY PLAYERS
Pfizer
Abbott
J&J
Merck
Amgen
Roche
UCB
BMS
Medtronic
GLOBAL INDUSTRY STRUCTURE
TABLE 14 SWOT ANALYSIS OF MSD MARKET: NSAIDS
TABLE 15 SWOT ANALYSIS OF MSD MARKET: BIOLOGICALS
GROWTH DRIVERS
10. GROWTH OBSTACLES
APPLICATIONS
TABLE 16 GLOBAL PROJECTED MARKET FOR MSD, BY APPLICATION,
THROUGH 2014 ($ MILLIONS)
FIGURE 12 GLOBAL PROJECTED MARKET FOR MSD, BY APPLICATION, 2006-
2014 ($ MILLIONS)
ORTHOBIOLOGICS
TABLE 17 GLOBAL ORTHOBIOLOGICS MARKET SHARE, BY COMPANY, 2009
(%)
FIGURE 15 GLOBAL ORTHOBIOLOGICS MARKET SHARE, BY COMPANY, 2009
(%)
AUTOGENOUS BONE GRAFT AND THE BONE GRAFT SUBSTITUTE MARKET
FUSION RATES: ALWAYS ROOM FOR IMPROVEMENT
DRIVERS OF GROWTH IN THE MARKET
SEGMENTS IN THE BONE AND BONE SUBSTITUTE MARKET
FUTURE DISPLACEMENT IN A DYNAMIC SPINE MARKET?
TABLE 18 GLOBAL MARKET FORECAST FOR ORTHOBIOLOGICS, BY MATERIAL
TYPE, THROUGH 2014 ($ MILLIONS)
FIGURE 16 GLOBAL MARKET FORECAST FOR ORTHOBIOLOGICS, BY
MATERIAL TYPE, 2008-2014 ($ MILLIONS)
MARKET CHALLENGES
HIGH COST OF BMPS
PATENT PROTECTION
11. BIOCOMPATIBILITY ISSUES
EXISTING MARKET
MEDTRONIC INFUSE
STRYKER OP-1
DEPUY MP52
AVERAGE SELLING PRICE
FUTURE OF THE MARKET
THERAPEUTICS
TABLE 19 PROJECTED MARKET FOR KEY MSD PRODUCTS, THROUGH 2014 ($
MILLIONS)
FIGURE 15 PROJECTED MARKET FOR KEY MSD PRODUCTS, 2008-2014
($MILLIONS)
TABLE 20 TREATMENTS AND MOA
SUMMARY OF COMMON MEDICATIONS
TABLE 21 SIDE EFFECTS
TABLE 22 PREVALENCE OF MAJOR MSDS IN MAJOR GLOBAL MARKETS, 2009
(%)
TABLE 23 GLOBAL POTENTIAL MARKET FOR TOTAL MSD, THROUGH 2014 ($
MILLIONS)
TABLE 24 KEY OTC TREATMENTS AND NATURAL PRODUCTS
TABLE 25 DRUGS USED TO TREAT MSD
TABLE 26 LEADING MSD THERAPIES AND COST PER DAY (U.S. DOLLARS)
CHAPTER FIVE: LEGISLATION AND REGULATORY ENVIRONMENT
HEALTHCARE REFORM
COST-BENEFIT ANALYSIS
REIMBURSEMENT AND PRICING
12. REGULATORY CHALLENGES
BIOSIMILARS
CHAPTER SIX: RELATED DEALS AND PARTNERSHIPS
TABLE 27 VENTURE INVESTMENT IN MSD COMPANIES
RELATED DEALS AND …
TABLE 28 RELATED DEALS AND PARTNERSHIPS
CHAPTER SEVEN: PIPELINE
TABLE 29 CLINICAL DEVELOPMENT PIPELINE
CHAPTER EIGHT: PATENT ANALYSIS
PATENT EXPIRATIONS
ACTEMRA
SIMPONI
KINERET
CIMZIA
NEW PATENTS FILED
TABLE 30 PATENT ANALYSIS
TABLE 31 KEY PATENT HOLDERS IN BONE/JOINT DISEASE AREA
(NUMBER/%)
FIGURE 19 KEY PATENT HOLDERS IN BONE/JOINT DISEASE MARKET (%)
13. CHAPTER NINE: COMPANY PROFILES
AB SCIENCE
ABBOTT
ABLYNX, NV
ACCELERON PHARMA
ACTIVE BIOTECH RESEARCH AB
ALDER BIOPHARMACEUTICALS, INC.
ALETHIA BIOTHERAPEUTICS, INC.
AMGEN
ARANA THERAPEUTICS
ARRAY BIOPHARMA
ASTELLAS
ASTION PHARMA A/S
ASTRAZENECA
BAYER SCHERING PHARMA AG
BIOGENIDEC
BIOIBERICA
BIOMET
BIOTIE THERAPIES
BMS
BOEHRINGER INGELHEIM
14. BONE MEDICAL, LTD.
CAPSITONIN ORAL CALCITONIN
ORAL PARATHYROID HORMONE BN003
TNF REGULATORS BN006
BONE CELL REGULATOR: BN005 AND BN008
BTG INTERNATIONAL LTD.
CAN-FITE BIOPHARMA
CARTICEPT MEDICAL, INC.
CELGENE CORPORATION
CENTOCOR ORTHO BIOTECH
CEPHALON, INC.
CHELSEA THERAPEUTICS, INC.
CHEMOCENTRYX, INC.
CHUGAI
TABLE 32 CHUGAI H’S PROGRAMS IN DEVELOPMENT FOR BONE AND JOINT
DISEASES
COMBINATORX, INC.
CRYSTAL GENOMICS
CYTOKINETICS
DELENEX THERAPEUTICS AG
ELAN
ELI LILLY
16. BONE VOID FILLING
CRANIOMAXILLOFACIAL SURGERY
ORAL AND PERIODONTAL REPAIR
ITALFARMACO S.P.A.
JOHNSON & JOHNSON
KENSEY NASH
LEXICON PHARMACEUTICALS
MEDAREX
MEDIGENE AG
MEDIMMUNE, LLC
MEDIPOST CO., LTD.
MEDIVIR AB
MIV 710/711 (CATH-K)
MEDTRONIC SOFAMOR DANEK
MERCK
MERRIMACK PHARMACEUTICALS
MERRION PHARMACEUTICALS, LTD.
MITSUBISHI TANABE
MORPHOSYS AG
NEOVACS SA
NICOX SA
NIPPON KAYAKU
NORDIC BIOSCIENCE A/S
17. NOVARTIS
NOVO NORDISK A/S
NOXXON PHARMA AG
NPS PHARMACEUTICALS
NUON THERAPEUTICS, INC.
NUVO RESEARCH, INC.
NYCOMED
ONO PHARMA
ORTHOVITA
OSTEOLOGIX, INC.
OSTEOTECH
PALAU PHARMA
PANGENETICS BV
PG102-PROTOTYPE
PG102
PASCOE PHARMA
PDL BIOPHARMA, INC.
PFIZER
PHYTOHEALTH CORPORATION
PHN031(PH3)
Description
Development Status
POZEN, INC.
18. RADIUS HEALTH
REGENERON
RIGEL PHARMA, INC.
RIVEX PHARMA, INC.
ROCHE
SANOFI-AVENTIS
SERVIER
SMITH & NEPHEW PLC
SPINAL RESTORATION, INC.
STRYKER BIOTECH
SUCAMPO PHARMACEUTICALS, INC.
SYNTHES, INC.
TAKEDA
TEVA
TRUBION PHARMACEUTICALS INC.
TRUBION PHARMACEUTICALS INC. (CONTINUED)
UCB
UNIGENE LABS
VERTO MEDICAL, LTD.
WRIGHT MEDICAL TECHNOLOGY INC.
XOMA
ZELOS THERAPEUTICS, INC.
ZELOS THERAPEUTICS, INC. (CONTINUED)
19. ZIMMER
ZOSANO PHARMA
ZYMOGENETICS, INC.
ATACICEPT (FORMERLY TACI-IG)
AUGMENT BONE GRAFT (FORMERLY GEMOS1TM)/AUGMENT INJECTABLE BONE
GRAFT (FORMERLY GEM-OS2TM)
CHAPTER TEN: OUTLOOK—TRENDS AND CHALLENGES
MSDS ARE A LARGE BURDEN ON THE HEALTHCARE SYSTEM
OUTLOOK FOR ORTHOBIOLOGICS IS BRIGHT
OSTEOPOROSIS: PAYER ACCEPTANCE IS KEY ISSUE
COMPETITION FOR THE RA PATIENT POPULATION FAILING ANTI-TNF THERAPIES
LUPUS IS A CHALLENGING INDICATION
DIAGNOSIS RATES FOR PSORIATIC ARTHRITIS AND AS
LIST OF TABLES
SUMMARY TABLE GLOBAL POTENTIAL MARKET FOR
MUSCULOSKELETAL DISEASE, THROUGH 2014 ($ MILLIONS)
TABLE 1 PROPORTION OF U.S. POPULATION REPORTING CHRONIC
MEDICAL CONDITIONS (%)
TABLE 2 GLOBAL POTENTIAL MARKET FOR MUSCULOSKELETAL
DISEASE, THROUGH 2014 ($ MILLIONS)
20. TABLE 3 GLOBAL REVENUE OF THERAPEUTICS FOR MSD, 2009 (%/$
MILLIONS)
TABLE 4 GLOBAL REVENUE OF DMARDS FOR MSD, INCLUDING
BIOLOGICAL RESPONSE MODIFIERS, BY DRUG, 2009 ($ MILLIONS)
TABLE 5 GLOBAL REVENUE OF NSAIDS FOR MSD, 2009 ($ MILLIONS)
TABLE 6 GLOBAL REVENUES OF CORTICOSTEROIDS FOR MSD, 2009
($ MILLIONS)
TABLE 7 GLOBAL BISPHOSPHONATES MARKET FOR MSD, 2009 ($
MILLIONS)
TABLE 8 GLOBAL CALCITONINS MARKET FOR MSD, 2009 ($
MILLIONS)
TABLE 9 GLOBAL SERM MARKET FOR MSD, 2009 ($ MILLIONS)
TABLE 10 GLOBAL PTH MARKET FOR MSD ($ MILLIONS)
TABLE 11 GLOBAL BMP MARKET FOR MSD, 2009 ($
MILLIONS)
TABLE 12 VISCOSUPPLEMENTATION MARKET SHARE BY
PRODUCT, 2009 (%)
TABLE 13 TOP 10 COMPANIES IN MSD MARKET, REVENUE AND
ASSOCIATED GLOBAL MARKET SHARE, 2009 ($ MILLIONS/%)
TABLE 14 SWOT ANALYSIS OF MSD MARKET: NSAIDS
TABLE 15 SWOT ANALYSIS OF MSD MARKET: BIOLOGICALS
TABLE 16 GLOBAL PROJECTED MARKET FOR MSD, BY
APPLICATION, THROUGH 2014 ($ MILLIONS)
21. TABLE 17 GLOBAL ORTHOBIOLOGICS MARKET SHARE, BY
COMPANY, 2009 (%)
TABLE 18 GLOBAL MARKET FORECAST FOR ORTHOBIOLOGICS, BY
MATERIAL TYPE, THROUGH 2014 ($ MILLIONS)
TABLE 19 PROJECTED MARKET FOR KEY MSD PRODUCTS,
THROUGH 2014 ($ MILLIONS)
TABLE 20 TREATMENTS AND MOA
TABLE 21 SIDE EFFECTS
TABLE 22 PREVALENCE OF MAJOR MSDS IN MAJOR GLOBAL
MARKETS, 2009 (%)
TABLE 23 GLOBAL POTENTIAL MARKET FOR TOTAL MSD, THROUGH
2014 ($ MILLIONS)
TABLE 24 KEY OTC TREATMENTS AND NATURAL PRODUCTS
TABLE 25 DRUGS USED TO TREAT MSD
TABLE 26 LEADING MSD THERAPIES AND COST PER DAY (U.S.
DOLLARS)
TABLE 27 VENTURE INVESTMENT IN MSD COMPANIES
TABLE 28 RELATED DEALS AND PARTNERSHIPS
TABLE 29 CLINICAL DEVELOPMENT PIPELINE
TABLE 30 PATENT ANALYSIS
TABLE 31 KEY PATENT HOLDERS IN BONE/JOINT DISEASE AREA
(NUMBER/%)
TABLE 32 CHUGAI H’S PROGRAMS IN DEVELOPMENT FOR BONE
AND JOINT DISEASES
22. LIST OF FIGURES
SUMMARY FIGURE GLOBAL POTENTIAL MARKET FOR
MUSCULOSKELETAL DISEASE, 2009 AND 2014 ($ MILLIONS)
FIGURE 1 PROPORTION OF U.S. POPULATION REPORTING CHRONIC
MEDICAL CONDITIONS (%)
FIGURE 2 GLOBAL POTENTIAL MARKET FOR MUSCULOSKELETAL
DISEASE, 2009 AND 2014 ($ MILLIONS)
FIGURE 3 GLOBAL REVENUE OF THERAPEUTICS FOR MSD, 2009 ($
MILLIONS)
FIGURE 4 GLOBAL REVENUE OF DMARDS FOR MSD, INCLUDING
BIOLOGICAL RESPONSE MODIFIERS, BY DRUG, 2009 ($ MILLIONS
FIGURE 5 GLOBAL REVENUE OF NSAIDS FOR MSD BY DRUG, 2009 ($
MILLIONS)
FIGURE 6 GLOBAL REVENUES OF CORTICOSTEROIDS FOR MSD, 2009
($ MILLIONS)
FIGURE 7 GLOBAL BISPHOSPHONATES MARKET FOR MSD, 2009 ($
MILLIONS)
FIGURE 8 GLOBAL CALCITONINS MARKET FOR MSD, 2009 ($
MILLIONS)
FIGURE 9 GLOBAL BMP MARKET FOR MSD BY COMPANY, 2009 ($
MILLIONS)
23. FIGURE 10 VISCOSUPPLEMENTATION MARKET SHARE BY
PRODUCT, 2009 (%)
FIGURE 11 TOP 10 COMPANIES IN MSD MARKET BY GLOBAL
MARKET SHARE, 2009 (%)
FIGURE 12 GLOBAL PROJECTED MARKET FOR MSD, BY
APPLICATION, 2006-2014 ($ MILLIONS)
FIGURE 13 GLOBAL ORTHOBIOLOGICS MARKET SHARE, BY
COMPANY, 2009 (%)
FIGURE 14 GLOBAL MARKET FORECAST FOR ORTHOBIOLOGICS, BY
MATERIAL TYPE, 2008-2014 ($ MILLIONS)
FIGURE 15 PROJECTED MARKET FOR KEY MSD PRODUCTS, 2008-
2014 ($MILLIONS)
FIGURE 16 KEY PATENT HOLDERS IN BONE/JOINT DISEASE
MARKET (%)
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