Mumbai : Mar 29 : Avascular Nnecrosis (AVN) and Osteoarthritis (OA) are probably are two most devastating conditions affecting our quality of life and thereby higher impact on disability adjusted life year (DALY). The burden of disability arising due to AVN and OA are likely to have significant influence over the economy as increasingly more of younger population are now found to be suffering contrary to the belief that the problem prevail only in elderly population.
When we take introspection in to these two causes of disability; we find some of the following facts which are high statistically significant.
“Avascular necrosis (AVN, also known as osteonecrosis) of the femoral head occurs when the cells of the trabecular bone spontaneously die, leading to fracture. Depending on the amount of femoral head involved, collapse of the articular surface will occur as the disease advances. In the USA, this occurs in 10,000–20,000 adults every year, typically between the ages of 20 and 60 years. Once collapse of the femoral head occurs in these patients, severe pain ensues, and the disease course rarely regresses. The primary therapeutic strategy by which these patients experience pain relief is total hip arthroplasty (THA), but at a younger age than in patients undergoing THA for degenerative arthritis.” ¹
“It is estimated that 20000 to 30000 new patients are diagnosed with osteonecrosis annually accounting for approximately 10% of the 250000 total hip arthroplasties done annually in the United States.” “It typically affects relatively young, active people between 20 and 40 years and regularly follows an unrelenting course resulting in substantial loss of function.” “The estimated frequency of the most frequent risk factors for ONFH in the United States is: alcohol (20%-40%), corticosteroid therapy (35%-40%), and idiopathic (20%-40%).” ²
“Every year 50,000 people in the US are afflicted with the silent disease avascular necrosis.” “As of 2010, over 50,000 people a year were afflicted with AVN in the US at a cost of over 1 billion dollars in hip replacements, – AVN accounting for almost 25% of the hip replacement market.” ³
Treatment Option for Avascular Nnecrosis (AVN): ⁴
Secondly, “Osteoarthritis (OA) is the most common degenerative joint disease, affecting more than 25% of the population over 18 years-old.” “OA is the most prevalent joint disease associated with pain and disability. It has been forecast that 25% of the adult population, or more than 50 million people in the US, will be affected by this disease by the year 2020 and that OA will be a major cause of morbidity and physical limitation among individuals over the age of 40.” ⁵
“About 6% of adults age 30 have frequent knee pain and radiographic osteoarthritis.” ⁶
Treatment Option for Osteoarthritis (OA):
These findings from the above imply that these devastating conditions are silent at the beginning; then there is a level of negligence, procrastination and incidental managing at the intermediate stage; finally when the condition advances grossly restricting the range of movements, there is no scope for regress and the patients have to live a compromised life adversely affected by disability adjusted life year (DALY).
Regenerative medicines will be intended to cure these conditions as compared to just managing; and hence, patients will be able to live a normal life as good as before getting affected by the disease, an uncompromised living!
Market Scenario reveals the following indicators: ⁸
osteoarthritis (OA) market was valued at $1.6 billion in the 7MM in 2016, and is expected to increase to $3.5 billion in 2026, at a compound annual growth rate (CAGR) of 8.1%. The US contributed 68% of the market share in 2016, which is linked to the large OA population and high drug prices in this market. Multiple biologic drug launches are expected during the forecast period and will lead to rapid market growth in the US and Japan, posting CAGRs of 9.2% and 6.1%, respectively.” ⁹
“The total knee replacement market in North America, which covers Canada, Mexico, and the United States, is set to rise from $3.63 billion in 2016 to around $4.2 billion by 2023, representing a compound annual growth rate of 2.2 percent, according to research and consulting firm GlobalData.” ¹⁰
“The AJRR continued to expand in 2015, increasing enrollment to 612 hospitals from 417 in 2014, with data collection from 416 of those institutions. Due to a 102% increase in joint arthroplasty procedures compared to 2014, this report reflects over 427,000 cumulative procedures between 2012 and the end of 2015.” ¹¹
“Around 7 million Americans are living with a hip or knee replacement” ¹²
“Global market for hip and knee orthopedic surgical implants was valued at USD 17 billion in 2015. It is projected to grow to USD 33 billion by 2022.” “Over 324,000 people underwent total hip replacement surgery in 2015, in the U.S. itself.” ¹³
This gives us an idea that there is a vast potential to improve one’s individual economy by getting cured through regeneration, while at the same time taping this potential of regenerative medicines will lead to a robust market economy.
Ref 8: GlobalData Healthcare, Report Code: GDHC073POA, Page 10, Published: September’2017
Ref 9: GlobalData Healthcare, Report Code: GDHC073POA, Page 11, Published: September’2017
Ref 10: GlobalData 05.24.17 https://www.odtmag.com/contents/view_breaking-news/2017-05-24/north-amer...
Ref 11: American Joint Replacement Registry 2016 Annual Report
Ref 12: J Bone Joint Surg Am. 2015;97:1386-97 d http://dx.doi.org/10.2106/JBJS.N.01141