Out of the 410 million people worldwide who have been diagnosed with diabetes as of 2014, more than 60% of the cases were from Asia, according to the International Diabetes Federation (IDF). Last year China alone recorded 100 million diabetics and 1.5 million deaths from the condition, the highest number of diabetes cases and mortalities of any country. By 2030, China is predicted to have 150 million diabetics. India is close behind, with roughly 67 million cases last year, and will have an estimated 100 million diabetics by 2030, as reported by the IDF. Across Asia, the number of diabetes cases is projected to increase to more than 320 million over the next 10 years.
Many studies indicate that Asians genetically have a higher chance of developing diabetes, and nowadays, their adoption of a more sedentary lifestyle combined with increased consumption of processed foods and carbohydrates is driving the rise in diabetes incidence. Left untreated or improperly managed, diabetes increases the risk for other illnesses, such as cardiovascular disease, kidney disease and blindness, and can eventually lead to death.
Governments in China, Malaysia, Singapore, Japan and India have identified diabetes as a significant disease threat and strain on their public health systems. For instance, a recent joint study by the IDF and the Chinese Diabetes Society (CDS) indicated that expenses related to diabetes account for approximately 13% of total medical expenditure in China.
Awareness and Demand for Diabetes Treatment in Asia
Many multinational companies have joined in a public sector effort to help educate Asian populations about diabetes. AstraZeneca recently announced a three-year partnership to develop a diabetes education and care program in China. In November 2014, Johnson & Johnson partnered with Mitsubishi Tanabe to promote glucose control in Japan. Both companies have designed and distributed pamphlets to educate patients about diabetes, along with promoting Mitsubishi’s two diabetes medications and Johnson & Johnson’s glucose monitoring device. Novo Nordisk’s Foundation is funding the non-profit Steno Diabetes Center, a hospital, research and teaching center in Malaysia—Malaysia has the highest prevalence of diabetes in Southeast Asia.
Despite growing awareness of the disease, the Asian market for basic diabetes treatments remains underserved. Demand is particularly strong for products such as insulin needles and syringes, infusion sets, injection ports, and most significantly, continuous glucose monitors. According to various sources, Asia’s market for diabetes care-related devices is predicted to grow at a compound annual rate upwards of 9% over the next five years, with China and India leading the way. Even in Japan, where population and economic growth are relatively stagnant, the market for diabetes intervention is strong.
Opportunities for Multi-national Companies in the Asian Diabetes Market
Large multi-national companies, such as Medtronic, Lifescan, Bayer and Abbott, are already capitalizing on the growing demand for diabetes products in this region. Medtronic’s Vice President, Hooman Hakami, has stated that he expects future sales in China will represent 20% of the company’s global diabetes revenues.
There are plenty of opportunities for small-to-medium size businesses to make inroads in Asia as well. For example, Echo Therapeutics, based in New Jersey, recently partnered with Medical Technologies Innovation Asia (MTIA), a Hong Kong-based medical device company, to license and transfer its glucose monitoring technology to MTIA to gain access to the market in China. In 2014, the Canadian medical device company Miraculins, Inc. signed an agreement with Hong Kong’s Catalyn Medical Technologies to sell Miraculin’s diabetes screening device, Scout Ds, in China.
There are also additional opportunities to market more advanced treatment technologies in Asia. According to GBI Research, demand for novel treatment products such as Glucagon-Like Peptide-1 (GLP-1) agonists, Dipeptidyl Peptidase-4 (DPP-4) inhibitors, and Sodium Glucose Transporter-2 (SGLT-2) is rising in Asia alongside an increase in the number of patients with the means to pay for more expensive treatments.
Take Japan, for example, where healthcare-related expenditure per capita is already several dozen times higher than China. Japanese consumers enjoy relatively high incomes and have an appetite for advanced healthcare technologies. Merck (known as MSD outside the United States and Canada) recently submitted a new application in Japan for Omarigliptin, a once-weekly treatment for Type 2 diabetes that works by inhibiting the enzyme DPP-4. DPP-4 destroys the hormone incretin, which helps the body produce insulin. Eli Lilly and Japan’s Takeda Pharmaceutical have also announced plans to sell similar once-weekly, Type-2 diabetes treatments in Japan.
Medical device manufacturers are likely to encounter some bumps as they expand their networks in Asia. For example, many countries’ healthcare systems have instituted price reduction programs for diabetes care products, resulting in lower revenues for companies. Reimbursement policies are also in transition. For example, newer classes of drugs, such as DPP-4 inhibitors, are not reimbursed by China’s universal health system. And in China and India, especially, Western manufacturers face increasing competition—and potential IP infringement—by a growing number of local firms.
These hurdles should not hinder companies interested in expanding their Asian footprint. The growing incidence of diabetes and rising numbers of middle- and upper-middle class patients will fuel demand for both basic and innovative treatment options. Meanwhile, governments and public health organizations are searching for ways to help educate Asian populations on how to manage diabetes, creating opportunities for Western companies with the expertise to help.