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Australia Healthcare Outlook 2010

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  • Australian healthcare market overview... there are some APAC & Korean market information as well
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  • Global: Pharmaceuticals/biotech comprises 70% of market with lowest growth rate Life Sciences & Health IT with highest growth rate (2010) APAC Medical Imaging at 36% of global market Pharma at 25% of global market. LS/HIT only 8% of global market 2009- apac is 23% 2010- 24% 2012 2010- pharma – 25% of global market 2012- 29% Devices- 24% of global market 26% Imaging- 32% 36% LS/HT is 8% of global market 9.4% Diagnostics 18% 19%
  • Australian healthcare market split in 2010 Pharma & biotech – 65% Med devices – 18% Clinical diagnostics – 6% Life sciences & health IT – 8% Medical imaging - 3%
  • Drivers API- Outsourcing from US$, Europe Global R&D- Next battle ground will be China- Novartis, Pfizer is expanding china operations Pharma is fastest growing market. China ~CAGR 16-17%. India CAGR~ 12-13: S.Korea~ 9-10% More than 500 biotechnology-derived medicines are in development. Non small cell lung cancer : APAC no. of patients : 500,000. Breast cancer : 250,000, Colorectal : 200,000 RESTRAINTS: • Unresolved political and changing regulations reduces confidence in the market, and could mean a reduction in focUS$ in these countries for MNCs • Concerns on quality of generics, parallel imports and counterfeits • Integration of MNC Pharma as result of large acquisitions last year (Pfizer-Wyeth, MSD-Schering, GSK-Stiefel, etc). Dedicated BUS$iness Units rather than Globally controlled BUS$ Biotech 150 Billion at CAGR 7-8%.. Majority of sales come from Vaccines
  • Source of revenue data: Datamonitor Industry Profile report Dec 2009 Drivers Growing demand for lifestyle disease drugs: “ Costs from diabetes alone are projected to increase 436 per cent (from 2003 to 2033), from $1.6 billion to $8.6 billion. These trends are largely caused by the increasing numbers of overweight and obese people (for diabetes) and the ageing population” Australian Treasury Intergenerational Report 2010 Uptake of new drugs e.g. PBS Section 100 highly specialised drugs: e.g. Herceptin (TRASTUZUMAB) Cost to PBS ($) 2005: $0; 2006 $6,8m; 2007 $62.3m; 2008 64.1m; 2009 74.7m Govt support for generics e.g. Gereric Medicines Awareness campaign. The DoHA commissioned the National Prescribing Service (NPS) to develop and deliver a campaign which ran in 2008 & 2009 e.g. “On the PBS the proportional share of PBS cost to Government of medicines manufactured by generic manufacturers has trended downwards, while the proportional share of PBS prescriptions has increased... In general, the data suggests that the PBS is buying more generics at a cheaper price while maintaining access to new innovative medicines” DoHA Impact of PBS Reform Report Restraints Saturated market – e.g. PBS & Medicare allow access to medicines & healthcare for the whole population Government attempts to restrain PBS expenditure e.g. PBS Reform – Announced Nov 2006 by DoHA to ensure long term sustainability of the PBS. PBS reform was originally forecast to save $580 million over the five years 2006–07 to 2010–11. The forecasts were reduced to $103 million ($110 million including the Repatriation Pharmaceutical Benefits Scheme (RPBS)) as a result of subsequent policy changes and other factors. Impact of BPS Reform Report p.8 PBS reform was originally estimated to produce savings to Government of $3 billion over 10 years. PwC modelling puts the figure in the range of $3.6 billion to $5.8 billion Impact of BPS Reform Report p.14
  • Data based on AIHW Projection of Health Expenditure 2003-2033 (Dec 2008) . 2010 figures calculated based on the numbers in the report. Antineoplastic & immunomodulating agents market data based on IMS data MAT Q2 2009 Generics  ” Australia's generics market is expected to undergo significant growth, boosted by improved substitution rates, government enthusiasm and products currently worth some AUD1.9bn (US$1.4bn) coming off patent over the next five years. In 2008, generic drugs accounted for 12% of the total pharmaceuticals market, and are forecast to increase market share to 14.5% by 2013, or some US$1.08bn at consumer prices. In terms of number of prescriptions written, Australia has one of the lowest generic penetrations in developed countries at around 30% of prescriptions, compared with 75% in the UK and approximately 50% in the US, although the government is looking to change this, in line with its cost-containment efforts.” Business Monitor International Pharmaceuticals & Healthcare Report Q2 2009 p.51-52
  • Drivers Convergence of the medical and drug indUS$try, eg. Drug eluting stents and glucose monitoring systems incorporated into insulin pumps, Cedasys Greater physician need for better and more precise medical devices in effort to reduce medical errors and improvement in patient safety Silver indUS$try devices - joint replacement, medical aids, number of beds, monitoring devices, etc. Challenges Regulatory hurdles-Longer patent review and approval times for new medical devices, Organ Transplantion Acts Distribution Networks- Geographic Expansion can be challenging due to inexperienced distributor staff. Training Issues- Making the US$e of products simple to US$e when the new products are targeted at Allied Staff, Nurses. Ex Cedasys (reducing time and cost, integration of patient monitoring and drug delivery devices) Key Take aways Global MNCs increase local manufacturing to reduce costs and improve accessibility of devices to secondary and primary care sector -Global MNCs- examples Hill Rom, GE Healthcare, Waters - J&J (AAA), Delphax ( spinal implants)
  • DRIVERS The government’s commitment to provide over $530 million over 4 years to reduce elective surgery waiting times. This will result in in over 40,000 additional elective surgery procedures annually. Around 70,000 Australians have a joint replacement surgery in a year. In Australia, private health insurance covers around 43% of the population. This encourages the demand for better medical care and increases expenditure on medical equipment. RESTRAINTS 1) As access to medical care, rising costs and device quality concerns become key issues, there will be changes that will impact the regulatory and reimbursement procedure of medical devices. 2) New technologies and materials that are being developed from stem cells and nanotechnology might replace the conventional technologies and devices used for treatment of orthopedic and cardiovascular conditions.
  • Drivers Total laboratory automation is favored by large hospital – Hub & Spoke Model, Faster response time Increased US$age of home care monitoring devices for blood pressure, and blood glucose monitoring as patient volume rises Early Detection- Increased pressure from reimbursement and government to move towards preventative healthcare- early cancer detection. Challenges Different cUS$tomer sets- R&D, Hospitals etc Allignment of payors, etc: Backend and front end integration of system is yet to be achieved Price Pressures_Increase competition with local Asian company that copied MNC products. Key Take Aways Sample Management- Collection, Storage will take back seat to other challenges like Volume Optimisation and Transport. IT-Data Management Tools (applications) need to be developed to transmit the information to newly developed web portal tools like EMR, PHR etc Incorporation of IT will be the new bUS$iness model
  • DRIVERS The National Cervical Screening Program aims to reduce morbidity and deaths from cervical cancer, in a cost-effective manner through an organised approach to cervical screening. The Program encourages women in the target population to have regular Pap smears. Bowel cancer is one of the most common forms of cancer in Australia, and around 80 Australians die each week from the disease. Chronic diseases presently make up more than 70 per cent of Australia’s overall disease burden and this is expected to increase to 80 per cent by 2020. Around 900,000 cases of diagnosed diabetes in Australia. Over 100,000 new cases of cancer diagnosed in Australia every year. Prevalence of cardiovascular disease in Australia is around 4 million. Factors such as ageing of population, lifestyle changes due to economic growth will increase the demand for medical products.
  • Drivers V alue based medical imaging products will be required to deal with this Phenomenon Ability to integrate Medical Imaging equipments with a hospital‘s information system is becoming increasingly important to hospitals. Case in Example: S.Korea, where diagnostic tests done on imaging devices which are unable to transmit reports to HIS, have lower re-imbursement rates Turnkey Project Contracts on Rise- OEMs will need to acquire non-traditional skills like consulting, design and planning etc. Examples of US$ $ 10 Million contracts on the rise for these projects. Challenges New CUS$tomer Sets- From corporate centers to stand alone diagnostic. Example in ASEAN countries like Malaysia there is a rise in these centres Price Erosion- Costs of High end ultrasound machines, C-arms and DR equipment has fallen by over 15-20% in the last 3 years. DRGs- Implementation of this system directly impacts margins Key Takeaways Leveraging existing installed base- US$e of Retrofit systems, Third party service contracts
  • DRIVERS Around 15 million diagnostic imaging procedures performed in Australia (around 3 million procedures performed in the public hospitals) Australia Diagnostic Imaging Association estimates that about 70% of diagnostic imaging services delivered in Australia are now funded through Medicare and this is growing . Presence of private diagnostic imaging groups such as I-Med, Primary Health care and Sonic Healthcare. Government is increasing competition and improving patient choice in Australia’s diagnostic imaging sector through deregulation and encouraging providers to compete for patients on price and convenience. BreastScreen is a national breast cancer screening program for women which operates in over 500 locations nationwide. Over 1.6 million women screened across Australia every year. RESTRAINTS Australia has 51 CT scanners (2 nd highest in the world after Japan) and 5 MRI machines per million population. Australia’s healthcare sector has invested heavily in high-cost equipment in recent years and there is current reluctance to invest in additional I infrastructure. 2) Mergers/acquisitions leads to formation of large private diagnostic imaging groups. I-Med (220 clinics), Primary Health care (161 clinics). Leads to price erosion as less number of customers and increasing bargaining power. Also, less demand for medical imaging modalities fuels price competition between suppliers.
  • Drivers 1) Operational Efficiency, Reducing Costs- Widespread adoption of Clinical Applications, EMR. Leading markets include Singapore, Australia, Taiwan, S.korea 2) Consumer Demand- Are more savvy, increased internet penetration- china largest users Strong demand for healthcare services- IT has come into the core role of “essential” services and maximise Challenges Interoperability- Most of cUS$tomers have disparate IT platforms. Integration- Connectivity issues between departments especially the pathology dept to obtain real time results Skilled Resources- CME programs need to being designed especially for allied staff who may not be IT savvy Take-Aways Hong Kong has US$$ 400 Mil budget for EMR implementation and Malaysia has launched..XX The human factor, is a key impediment in HIT adoption- Change Management Programs are extremely essential Hongkong and Malaysia are the two countries to watch out in terms of the new health initiatives during 2010-2012
  • Market split in 2009: Health IT market - $525 million / Life sciences IT market - $422 million DRIVERS South Australia is d eveloping Australia’s first fully integrated state wide electronic health record system through the $315 million Careconnect.sa program. Western Australia is investing in a $300 million ehealthWA program to invest in pharmacy information systems, clinical information systems and patient administration systems. NeHTA’s strategic plan includes two major tasks - Developing healthcare identifiers and coordinating the progression of the priority e-health solutions. There is a $196 million national fund allocation to NEHTA over three years to June 2012 . E-Health can benefit individual through better management and coordination of their care, increasing quality and safety and significantly decreasing costs and benefit clinicians through improved collaboration in care, using decision support tools to reduce potential adverse effects. Reducing medication error which is a leading cause of adverse events in Australia. RESTRAINTS Higher ICT investment in industries such as banking and finance as compared to healthcare in Australia. Traditionally, state governments have allocated higher ICT budgets for other departments such as transport, judiciary as compared to helathcare. Healthcare facilities have implemented obsolete, unsupported core applications that lacked industry standards in the past that pose a big challenge in the integration with new modules . They are now replacing these systems with capable, industry-standard products.
  • Departmental solutions – Radiology information systems, cardiology information systems, pharmacy information systems, etc. Patient & revenue cycle management – Patient administration systems,

Transcript

  • 1. Asia Pacific Healthcare Outlook Focus : Australia Analysis of Best Opportunities 24 th February 2010
  • 2.
    • Overview of Healthcare Market: Key Takeaways
    • In-depth Sectoral Analysis, APAC and Australia
    • Summary: Best Opportunity Analysis, Australia
    Agenda
  • 3. Global Healthcare Market: 2009
    • US and Europe were impacted in a major way by global crisis
    • Asia also slowed down but not as much as the West
    • Valuations were low and M&A was high, many smaller Biotech companies struggled
    • Major organizational restructuring occurred, along with portfolios being reassessed
    • Recovery of the markets to a large extent with strong growth in Asia
    • Start of major patent expiries
    • M&A activity down in the West but could be important in Asia, restructuring will continue
    • Asia becoming increasingly important as a market and outsourcing hub
    • 5Ps to drive market: Preventive, Preemptive, Personalized, Predictive, Personal Responsibility
    Global Healthcare Market: 2010-12 Setting the Scene Outlook for Healthcare Industry from 2010-12 Source: Frost & Sullivan
  • 4. 23.9% 27.2% 23.2% 26.4% CAGR 12.2% CAGR 6.5%
    • By 2015 APAC could represent ~40% of global market!
    Source: Frost & Sullivan Rest of the World APAC Global vs. Apac: The New Frontier By 2012 APAC expected to be close to 27% of global market Global & APAC Healthcare Revenues US$ Bn, 2009-2012
  • 5. Asia Pacific Market : 2009
    • Slowing down of GDP in mature markets – Japan took a big hit
    • Global consolidation left a difficult mess for integration on a local level – job losses and portfolio realignment
    • Price cutting and playing the margins game
    • The bubble burst for Medical Tourism
    • Asia started to set up infrastructure for offshoring and outsourcing for US/EU companies
    Asia Pacific Market : 2012
    • A shift in the center of the world economically and strategically to Asia
    • Asia to move from export led development to consumption led growth
    • APAC the fastest growing pharma market and API production hub
    • Increased government attention to primary and community based healthcare .
    • Increased use of mobile technology in healthcare service delivery
    Asia is However Transitionaing Moving toward a Multi–Polar World Order Source: Frost & Sullivan
  • 6. Australian Healthcare Market By 2012, Australia is estimated to be almost 5% of the APAC market Australian Healthcare Revenues, US$ Bn, 2009-2012 Source: Frost & Sullivan
  • 7.
    • Overview of Healthcare Market: Key Takeaways
    • In-depth Sectoral Analysis, APAC and Australia
    • Summary: Best Opportunity Analysis, Australia
    Agenda
  • 8. APAC Pharmaceuticals Market Earlier diagnosis improves disease management and length of therapy
    • Unresolved political and regulations issues
    • Quality concern of generics & counterfeits
    • Government tenders favour local manufacturers
    Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan Market Drivers Market Restraints
    • Long term use of multiple and specialized drugs for the ageing population
    • Government support for generics and biosimilars
    • Enhanced diagnosis and management in oncology, cardiovascular, pain etc
    CAGR 6.6 % CAGR 12.9 % APAC Share 750 825 866 909 24.6 % 28.5% Pharma Revenues, US$ Bn, 2009-2012
  • 9. Australia Pharmaceuticals Market Mature market driven by lifestyle diseases
    • Saturated market with low unmet needs
    • Government attempts to restrain PBS expenditure & BPS reforms
    • Growing demand for lifestyle diseases drugs in an aging population e.g. cancer, cardiovascular, diabetes
    • Uptake of new, expensive drugs
    • Strong government support for generics
    Pharmaceuticals Revenues, US$ Bn, 2009-2012 Market Drivers Market Restraints Source: Frost & Sullivan
  • 10.
    • Australia Cardiovascular market 2010 :~ US$ 3.15 Bn, with expenditure on pharmaceuticals for cardiovascular conditions growing at an average of 2.9% pa. Largest growth in dollar terms
    • Australia diabetes market 2010 : ~US$ 935mn. Expected to be one of the fastest growing markets, with expenditure on pharmaceuticals for diabetes growing at an average of 13.9% pa
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    Source: Frost & Sullivan. Generics Cardiovascular and metabolic diseases Neurological Conditions Oncology
    • Australia Neurological Conditions market 2010: ~ US$644mn
    • Expected to be one of the fastest growing markets, with expenditure on pharmaceuticals for neurological conditions growing at an average of 13.4% pa
    Top Growth Opportunities : Australia Pharmaceuticals Market
    • Australia generics market 2010 : ~ US$ 830 mn; Expected growth of ~ 7% pa
    • Government focus on increasing use of generic s as a means of cost reduction , opportunities from drugs coming off patient
    • Australia a ntineoplastic & immunomodulating agents market 2010: ~US$ 1.10Bn, with expenditure on pharmaceuticals for oncology growing at an average of 8.1% pa
    • Strong government support for cancer research, diagnosis and treatment
    Biologics
    • Heavy research & development activity into biologics and ability to afford high cost treatments is expected to lead to strong growth in the biologics market.
  • 11. APAC Medical Devices Market Transition to a mindset of monitoring
    • Regulatory and reimbursement hurdles
    • Lack of sufficient distribution networks
    • Inadequate training/certification for allied staff
    Market Drivers Market Restraints
    • Safety, accuracy, efficiency, cost
    • Silver industry devices
    • Convergence of devices and pharma products
    APAC Share CAGR 5.8% CAGR 10.2% Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan 23.8 % 25.8% Medical Devices Revenues, US$ Bn, 2009-2012
  • 12. Medical Devices Revenues, US$ Bn, 2009-2012
    • Government’s commitment to reduce elective surgery waiting time
    • Increasing number of joint replacement procedures due to ageing population
    • Expansion of private health insurance results in demand for better medical care
    Market Drivers
    • Increased medical device safety concerns could slow device approval cycle
    • Development of new technologies will replace conventional treatment methods.
    Market Restraints Australian Medical Devices Market Demand for better quality of healthcare driving growth Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan
  • 13. APAC Clinical Diagnostics Market Shift in business model from instrumentation to service revenues
    • High cost of genomics and proteomics tests
    • Mutually exclusive target customers
    • Reimbursement issues
    Market Drivers Market Restraints
    • Lab automation
    • Home care monitoring
    • Emphasis on early detection
    APAC Share CAGR 7.3% CAGR 6% Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan 17.8% 18.5% Clinical Diagnostics Revenues, US$ Bn, 2009-2012
  • 14. Clinical Diagnostics Revenues, US$ Bn, 2009-2012
    • Government programs for National Cervical and Bowel Cancer screening
    • Increasing incidence of chronic diseases and significant demographic trends
    • Increasing public awareness leads to early detection and monitoring of chronic diseases
    Market Drivers
    • Market maturity will lead to price erosion hindering market profitability
    • High healthcare costs discourages d evelopment of new tests/systems
    Market Restraints Australian Clinical Diagnostics Market Demand for better quality of healthcare driving growth Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan
  • 15. APAC Medical Imaging Market Turnkey projects drive double digit growth in Asia Market Drivers Market Restraints
    • Rise in turnkey projects
    • Increasing corporate wellness programs
    • Integration of Imaging with information systems
    • New customer sets to be addressed
    • Price erosion
    CAGR 6% CAGR 12.7% Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan APAC Share 30.3% 30.3% Medical Imaging Market Revenues, US$ Bn, 2009-2012
  • 16. Medical Imaging Revenues, US$ Bn, 2009-2012
    • Increase in patient demand
    • Increase in the number of Medicare funded diagnostic imaging services
    • Increasing competition in the diagnostic imaging services sector
    • Government initiatives such as BreastScreen
    Market Drivers
    • Market saturation due to high penetration of medical imaging modalities
    • Increasing pricing pressure
    Market Restraints Australian Medical Imaging Market Digital imaging to drive growth Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan
  • 17. PACS
          • Australian PACS market in 2010: ~US$ 49 million; CAGR: 9.0%
          • Focus by healthcare providers to integrate imaging with IT and integrate PACS with the hospital information system to improve efficiency and quality of healthcare
          • Increasing demand for cardiology PACS and orthopedics PACS solutions outside the radiology department
    Top Growth Opportunities CR/DR
          • Australian CR/DR market in 2010: ~US$ 66 million ; CAGR: 10.0%
          • Teleradiology - Shortages of radiologists require better information sharing and the need to share and transfer reports and images
          • Increase in the number of diagnostic imaging procedures. Around 15 million diagnostic imaging procedures performed in Australia. Around 3 million procedures performed in the public hospitals.
    Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan
  • 18. Top Growth Opportunities Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan SMBG
          • Australian self monitoring of blood glucose (SMBG) devices market in 2010: ~US$ 150 million; CAGR: 6.0
          • Increasing public awareness about diabetes and the need for glucose monitoring
          • Strong government support in form of initiatives such as National Diabetes Services Scheme
          • The total number of diabetic patients registered with NDSS has increased to 897, 867 at a CAGR of 9.8% in the period 2002-2008
    Minimally Invasive Surgery
          • Increase in day surgery procedures - In 2009, around 57% of total patient separations in hospitals were same day separations.
          • Number of day procedures in 2009: ~4.8 million; CAGR: 4.5%
          • Gastrointestinal endoscopy (around 0.64 million), Arthroscopy (0.14 million) are among the top 5 high volume procedures in Australia
          • Technological advancement, benefits to hospitals (economic savings) and patient benefits (shorter stay in hospital, reduction in risk of acquiring hospital infections)
  • 19.
    • Interoperability
    • Integration
    • Lack of skilled resources
    *Life Sciences & Healthcare IT includes: Software, Hardware, IT services Asia Pacific Lifesciences and Health IT Market Interoperability challenges hinder adoption Market Drivers Market Restraints
    • Operational efficiency
    • Strong and sustained demand for healthcare services
    • Consumer demand for quality and access to information
    CAGR 7% CAGR 11.3% APAC Share 50.6 54.6 58.4 62.5 Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan 14.5% 15.7% Lifesciences & Healthcare IT, US$ Bn, 2009-2012
  • 20. Australian Life Sciences and Health IT Market Government’s continued commitment to e-Health Life Sciences & Health IT Revenues, US$ Bn, 2009-2012
    • ICT initiatives by state health departments
      • NeHTA’s role in accelerating the adoption and awareness of e-health initiatives.
      • Patient demand to improve the efficiency and quality of healthcare
    Market Drivers
    • Chronic under-investment in healthcare IT
    • IT still not being recognized as the key enabler for successful change to healthcare delivery
    • Implementation of high-risk legacy systems in the past
    Market Restraints Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan
  • 21. Top Opportunities – Australian Life Sciences and Health IT Market Clinical IT Systems
          • Spending on departmental systems (radiology, cardiology, pharmacy, acute care, etc,) 2010: ~US$ 160 mn; CAGR: 15.3%
          • Modernization of the healthcare system, implementation of more accurate and reliable systems and shift from lengthy to short and more clinically intense hospital stays is driving investment in departmental systems.
          • Spending on infrastructure, interoperability and EHR solutions: ~US$ 45mn; CAGR: ~17.3%
          • State eHealth programs such as Healthelink (NSW Health) and government’s commitment to development of the right technology necessary to deliver the best e-health system is accelerating the growth in this segment.
    Solutions for Patient and Revenue Cycle Management
          • Spending on patient and revenue cycle management solutions 2010: ~US$ 104 mn; CAGR: 6.1%
          • T he steps taken by healthcare facilities to improve the quality and outcome of healthcare, reduce the administrative burden, and adopt a more standardized approach towards application of information systems is the key driver for this market segment.
          • Patient administration solutions being adopted in public hospitals in South Australia (careconnect.sa), Western Australia (eHealthWA) and Victoria (HealthSMART).
    Note: All figures are rounded; the base year is 2009. Source: Frost and Sullivan
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  • 22.
    • Overview of Healthcare Market : Key Takeaways
    • In-depth Sectoral Analysis, APAC and Australia
    • Summary: Best Opportunity Analysis, Australia
    Agenda
  • 23. Time Growth Home-based care Personalized medicine POCT/Self Monitoring Clinical IT Endoscopy Administrative IT EMR/EHR Source: Frost & Sullivan. Where to place your bets in 2010- 2012 : Australia Biologics Joint replacement Oncology, Diabetes Cardiovascular INNOVATION TRIGGER SUPER GROWTH NORMALISATION LEADERSHIP
  • 24. Thank You