personalized medicine-genetic-diagnostics-technologies
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US Genetics Diagnostics Markets
March 2006
SUPPLEMENTAL INDUSTRY RESEARCH
2006 MaRS Emerging Technologies Briefings
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 2
Genetic Diagnostic Applications
Genetic Diagnostic tests fall under 3 applications:
1. Pharmacogenomic testing
2. Prenatal Newborn testing
3. Predisposition and Diagnostic testing
This report defines the genetic testing market as the sales of test kits, reagent and home brew test revenues. Revenue numbers do not include the instrumentation used to perform the tests and reference laboratory testing revenues
Tests classified for infectious diseases are considered a separate segment of the vitro diagnostic market and are not discussed in this report.
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 3
Pharmacogenomic testing
Pharmocogenomic tests are preformed on human DNA to assess the efficacy, safety and therapeutic concentration of a therapeutic treatment. They are performed wto determine the clinical course of therapeutic treatment and clinical drug trials. Revenues do not include drugs or therapies prescribed because of testing results
Market Size - $95 million (US) Forecast (2011) - $468 million (US)
CAGR (2004-2011) - 26%
Barriers Rapidly evolving science hinders establishment of clear regulatory rules
Limiting potential drug’s market size discourages Pharma industry adoption
High cost and uncertainty about reimbursement
Drivers FDA encouraging incorporation of pharmacogenomic testing in clinical development
Adverse and ineffective drug reaction drives clinician acceptance
Pharma industry’s desire to gain FDA approval for rejected or dangerous drugs drives market adoption
Competition Major players : Abbot Diagnostics and Roche Diagnostics
Others: smaller companies involved through alliances such as Celera and Gentris
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 4
Prenatal and Newborn Testing
Inherited disease screening is the largest segment of the genetic testing market. Current serum protein tests to assess the risk of a disease are not as reliable or sensitive, often giving false positives or negatives. Early detection significantly improves the ability to effectively manage or treatment various genetic diseases
Market Value - $335 million (US) Forecast (2011) - $796 million (US)
CAGR (2004-2011) - 13%
Barriers High Cost and uncertain reimbursement deters patients and clinicians
Ethical concerns and Invasive nature of fetal tissue collection
Drivers CDC and American college of Obstetricians and Gynecologists recommends testing to all couples
planning pregnancy
Expiry of Roche’s patents on PCR will decrease cost and increase competition
Increasing superiority of genetic screening for accuracy and number of targets
Currently Cystic Fibrosis test is the strongest driver of applications total market growth
Competition Major Players: Abbot Diagnostics and Bayer Diagnostics
Others: medium companies with few key products such as TM Bioscience
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 5
Predisposition and Diagnostic
Genotyping assays have permitted the association of genetic variation with disease incidence. Various platforms are being developed to prognose and diagnose a variety of diseases. Early detection and profiling can significantly improve patient outcomes
Market Value - $100 million (US) Forecast (2011) - $268 million (US)
CAGR (2004-2011) - 15%, with cancer testing predominating
Barriers Uncertainty and privacy issues regarding insurance
Ethical issues pose significant restraint
Biomarker detection becomes difficult with more complex diseases
Drivers Early detection is a primary factor affecting cancer survival rates
Intellectual property patents allow companies to develop niches
Competition Major Players: Abbot Diagnostics, Roche Diagnostics and Johnson&Johnson
Others: medium companies with few key products like Myriad Genetics and Third Wave Technologies
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 6
Challenge 1-2 years
3-4 years 5-7 years
Lack of Healthcare providers education hinders test uptake
High High High
Healthcare conservatism impedes testing uptake
High Medium Low
Absence of precedent restrains pharmaceutical industry to use pharmacogenomics tests for drug development
Medium Medium Medium
Obtaining FDA approval for pharmacogenomic testing poses significant challenges for companies
Medium Medium Low
Large volumes of testing by home-brew techniques continue to limit the sales of kits
Medium Medium Low
Divers population mandates the need for ethnically comprehensive genetic panels
Medium Medium Low
Hospital Laboratories are reluctant to adopt new molecular procedures
Medium Medium Low
Top industry Challenges for US genetic markers market from 2005-2011
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 7
Strategic Solutions to Challenges
Implement Clinician education at all levels
Invest in direct to consumer advertising
Address the issue of cost
Develop Prenatal tests that allows to use of fetal DNA from maternal Circulation
Market Genetic tests as superior to protein prescreening
Meet end user needs by offering tests on automated platforms
Offer panels that provide high detection rates for all ethnic groups
Obtain FDA approval for genetic tests
Promote the passage of anti-discriminatory legislation.
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 8
Key End Users of Genetic testing
Over 1400 molecular pathology labs in the US, with bulk of genetic testing being provided by a few big labs. Creating partnership with any of these large labs secures significant market share
Large Labs: Quest Diagnostics
LabCorp
Genzyme
Medium Labs: Mayo
ARUP ( Associated Regional and University Laboratories Pathologist)
MD Anderson
Regional clinics and hospital Laboratories
Key End User product feature requirements: Clinical Practicality of test
Strong client portfolio and relationship with laboratories
Result turnaround time
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 9
Platform Comparisons
Important issue in genetic testing market is deciding which testing platform or technology will have highest adoption rates in Clinical labs
Technology issues are throughput, sample concentration, procedure sensitivity and specificity
Economic issues are costs of instrument and reagents, current platforms available in the lab, and ease of use of the procedures
Genetic testing looks for genetic marker such as Single Nucleotide Polymorphism (SNP) , Restriction Fragment length Polymorphism (RFLP) or short tandem repeat (STR)
Theoretically any marker can be identified through any of the platforms
Real- Time Polymerase Chain Reaction ( RTPC)
Capillary Electrophoresis
Micro-array
Multiplexing Instruments
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 10
Platform Comparisons: Capillary Electrophoresis
Electrophoresis Platform:
A method of detection for specific gene sequences using gel electrophoresis
Currently high availability of electrophoresis instrumentation in labs means that kits designed for this platform should have the most rapid uptake.
Least expensive- $15K US for state of the art equipment
Electrophoresis also offers low costs per tests - kit cost $80/patient
Versatile in number of different application
Important platform for low margin test like Cytochrome P450, where US labs do not expect high customer demand, so don’t want to invest in higher costing platforms
Major disadvantage is labor intensity
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 11
Platform Comparisons: RT-PCR
RT-PCR Platform:
A method for rapid and simultaneous amplification, detection and quantification of gene fragments or gene expression
Slower adoption than electrophoresis due to the cost of machinery - $30K
Expected to have significant uptake because of prevalence in SNP testing
Currently many specialty labs like Quest Diagnostics have high RT-PCR usage
Cost expected to drop as Roche loses patent protection on many of RT-PCR components, opening the field to competition
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 12
Platform Comparisons: Microarrays (Gene Chips)
Microarray Platform: A method for rapid detection of multiple simultaneous gene fragments or
gene expression. Probes that react to patient’s genetic material are arranged in grid pattern on glass or plastic platform. Resulting matches constitute a positive test, which are readily identifiable.
Most Expensive $150K-$180K + $500 per test
Reaction indicate particular genetic sequences, such as those related to diseases, or how people will respond to certain medications. Microarrays also can enable researchers to see which genes are being switched on and off under different medical conditions.
Currently does not have many clinical applications, so drawback for laboratories to invest in platform
Roche’s AmpliChip is only FDA approved microarray test for diagnostic use
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 13
Platform Comparisons: Multiplexing
Multiplexing Platform: A method for simultaneous detection of specific gene fragments, gene
expression, immune response proteins and enzymes. Multifunction beads are manipulated to bind and signal the specific presence of a a variety of substrates
More versatile than microarray
Allows more variation with regards to type of test - up to 100 assays to be preformed simultaneously on one sample.
Slower than competing technologies however
Multiplexing technology are expected to gain market share. Example is Luminex’ xAMP technology which is currently is partnership agreements with Abbot Laboratories, EreGen, TM Bioscience.
FDA awarded its first approval for a CF diagnostic test to TM Bioscience’s multi-plexing platform based test.
Extracted from Frost and Sullivan Market Engineering, October 2005
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 14
Regulatory Issues
FDA regulates reagents, kits and instruments sold to and performed by clinical labs.
Diagnostic tests can be sold as Analyte Specific Reagents (ASR) to highly sophisticated CLIA-certified labs. FDA exercised restrain in regulating home- brew tests performed by these labs. No specific clinical, validity or performance claims are allowed for unregulated ASRs. Potential liabilities if a lab chooses to provide an ASR rather than a 510(k)-cleared alternative.
Receiving a 510(k) FDA approval is a significant market barrier: Four FDA approved genetic diagnostic tests:
Roche AmpliChip, used to individualize dosage of antidepressants, antipsychotics, beta-blockers, and some chemotherapy drugs
TM Bioscience (Toronto, Canada) TAG-IT assay for detecting cystic fibrosis
Visual Genetics (Toronto, Canada acquired by Bayer in ‘02) TRUGENE HIV-1 Genotyping Kit, used to detect variations in the genome of the human immunodeficiency virus that make the virus resistant to some anti-retroviral drugs.
Third Wave’s Invader assay detects variations in a gene that produces the enzyme UDP-glucuronosyltransferase, and predicts adverse events. http://www.fda.gov/cdrh/oivd/index.htmlhttp://www.fda.gov/cder/genomics/default.htm
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 15
Regulatory Issues
March 2005 - Final Guidance for Industry Pharmacogenomic Data Submissions, facilitate the use of pharmacogenomic data in drug development
April 2005 - Drug-Diagnostic Co-Development — Preliminary Draft Concept Paper
Development of in-vitro diagnostics for mandatory use in decision making for drug selection for patients in clinical practice:
Identify patients most likely to respond to the drug or exhibit adverse events
Optional tests in drug development for understanding mechanism or selecting patients for clinical trials
February 9, 2006 - New Guidance draft document on Pharmacogenetic Tests and Genetic Tests for Heritable Markers to shorten development and review timelines, facilitate rapid transfer of new technology from the research bench to the clinical diagnostic laboratory, and encourage informed use of pharmacogenomic and genetic diagnostic devices. http://www.fda.gov/cdrh/oivd/index.htmlhttp://www.fda.gov/cder/genomics/default.htm
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 16
Addenum from OGI
Ontario Companies in Genetic Diagnostic field
Company Name Description Biomedical Photometrics Inc. & GeneFocus
Gene Focus has developed state-of-the-art readers for genetic and tissue arrays and biochips based on patented confocal laser imaging technology as well as imaging system for non-standard microarrays and liquid biochips.
Chondrogene Chondrogene uses functional genomics to enable early diagnosis and personalized therapeutic intervention based on disease-specific biomarkers. The applications of this technology is in the discovery and development of diagnostic and therapeutic products across 4 disease areas: Cancer, Central Nervous System Disorders, Cardiovascular Disease and Arthritis.
Genesis Genomics Genesis Genomics implements mitochondrial DNA (mtDNA) sequencing technology and bioinformatics to exploit specific mtDNA data for commercial applications in medical diagnostics.
Genetic Diagnostics Inc. GDI’s Genexus Analyzer platform and Triplex Assay are new platform technology for conducting DNA diagnostic tests. GDI's platform has an unprecedented ability to effectively and efficiently detect Single Nucleotide Polymorphisms (SNP's).
TM Biosciences Tm Bioscience is developing Genetic testing on a multi-plex platform for genetic mutations related to hematology, toxicology, and other debilitating genetic disorders. Companies CF test is the first such test to receive FDA approval and their technology has been adopted by leading reference laboratory such as Mayo Clinic and Specialty Labs.
Epocal Epocal biochips combine features lab-on-a-chip microfluidics and microarrays (DNA arrays, protein arrays, cell arrays) into a single technology.
HealthGene Health Gene offers an extensive menu of state-of-the-art molecular diagnostic tests.
Thanks to Rhonda Tannenbaum of the Ontario Genomics Institute (OGI) for information
MaRS Emerging Technologies Briefings - February 27th, 2006 Event (Supplemental Industry Research) Slide 17
Addenum from OGI
OGI award recipient in Genetic Diagnostic
Researcher Description
Dr. Brent Zanke OGI Applied Health Award – assessment for risk of colorectal tumours in Canada
Dr.s Peter Liu/Andrew Emilli
OGI Applied Health Award – Protein expression profiling platform for Heart Disease Biomarker Discovery
Dr.John Dick OGI Applied Health Award – Development and Application of Functional Genomics Technologies
Drs. Ulli Krull/Alex MacKenzie/Paul Piunno
OGI Competition II Award - Nucleic acid diagnostic systems
Dr. Kevin Kain OGI Competition III Award – Quantum Dot Diagnostics: simultaneous genomic and proteomic profiling of multiple pathogens at point-of-care
Thanks to Rhonda Tannenbaum of the Ontario Genomics Institute (OGI) for information