Point of Care Testing: Evaluating the return to evidence based medicine, novel technologies and the competitive landscape

Published: January 2010
No. of Pages: 283
  

Diagnostic practice is undergoing a quiet revolution, with IVD tests moving out of the centralized hospital laboratory to point of care testing (POCT) locations. POC tests are more expensive than lab-based tests, but promise to reduce the overall cost of healthcare while improving the quality of outcomes. They are thus attractive to manufacturers and increasingly in demand by physicians, patients, and healthcare providers.

This report explores the opportunities for POC testing provided by recent technology improvements, disease trends, and new marketing channels. It examines established and emerging health-related applications of POC diagnostics based on immunoassays, clinical chemistry, and nucleic acid testing. Within each POCT market sector, leading companies and their strategies and products are examined.

Key features of this report

  • Examines different types of POC testing technologies and information they provide in clinical situations.
  • Assesses current market satisfaction, areas of need and competition for POC testing in the areas of: diabetes; fertility; hemostasis; cardiology; infectious disease; drugs of abuse; automated urine/blood analysis; and cancer screening.
  • Surveys analytes/biomarkers incorporated in commercial POCT products on the market and in commercial development in all the major application areas.


Scope of this report

  • Understand the role of POC tests in diagnosis and monitoring in different clinical situations.
  • Gain an insight into how the market for POC tests is shaping up in each of the major application areas.
  • Identify competitors or potential collaborators developing improved or novel POC technologies and products.
  • Assess established and emerging marketing channels for POC tests.


Key Market Issues

  • In most countries, the average spending on IVDs is a very low percentage of the healthcare budget, but spending on POC IVDs which offer speed, convenience, and improved outcomes is set to grow at an increased rate.
  • Since 2006, wider adoption of POC testing in the US has been driven by the issuance of testing guidelines by the National Academy of Clinical Biochemistry; the US market now represents more than half of the global POC testing market.
  • Expanding medical and non-medical POC testing locations, which include fast-growing retail health clinics in the US, provide new marketing opportunities for manufacturers of POC tests.


Key findings from this report

  • The POC testing market is forecast to grow from $13.4 billion in 2008 to $22.5 billion in 2013. The POCT market currently represents 25% of the total IVD market.
  • There are many players in the POCT market and many diverse products. Examples of leading companies include Abbott Laboratories (glucose monitoring and blood analysis products), Inverness Medical Innovations (various consumer and professional products), Quidel (pregnancy and infectious disease products), and Cepheid (first POC molecular tests on the market).
  • 130 companies have had their POC products CLIA waived by the FDA in the 3 year period prior to November 2009. Amongst these companies were 53 companies with glucose monitoring products and 39 companies with pregnancy testing products.
  • Sales of glucose monitoring products accounted for 76% of the POCT market in 2008 and this sector is expected to remain the leading sector in 2013. However, POC testing for HbA1c is assuming increasing importance in diabetes.


Key questions answered

  • What are the applications for POCT technologies in healthcare?
  • Which are the prominent companies and products within each POCT market sector?
  • How are the key players making an impact on the POCT market?
  • Which POC tests have been CLIA waived in the last 3 years?

Point of Care Testing: Evaluating the return to evidence based medicine, novel technologies and the competitive landscape

Table of Contents:

Point of Care Testing

Executive summary

Market overview

POC testing in diabetes

Fertility-related tests

Hemostasis testing

Cardiology tests

Infectious disease tests

Drugs of abuse testing

Clinical chemistry and other rapid tests

Company profiles

Market analysis and forecasts

Chapter 1 Market overview

Summary

The shift to POC diagnostic testing

Locations for POC testing

Background on IVD technologies

Clinical chemistry

Immunoassays

Nucleic acid testing

Technologies for POC testing

Lateral-flow tests

Next-generation lateral-flow devices

Electrochemical enzymatic tests

Advances in microfluidics

Data management and connectivity

Market drivers

Market restraints

Regulation of in vitro diagnostic tests (US)

CLIA

Chapter 2 POC testing in diabetes

Summary

Diabetes diagnostics and monitoring

Meter systems for blood glucose monitoring

Increasing performance requirements

Examples of POC device manufacturers

Roche Diagnostics

Arkray

Home Diagnostics

Abbott Diabetes Care

Nova Biomedical

Epocal

Diagnostic Devices

HemoCue

Luminous Medical

Health-Chem Diagnostics

Continuous glucose monitoring systems

Examples of POC device manufacturers

DexCom

Medtronic MiniMed

Abbott Diabetes Care

HbA1c testing

Examples of POC device manufacturers

Diazyme Laboratories

HemoCue

Bio-Rad Laboratories

Siemens

Trinity Biotech

Chapter 3 Fertility-related tests

Summary

Introduction

Pregnancy (hCG) tests

Detection of hCG variants

Ovulation tests

OTC pregnancy test kits

Examples of manufacturers of pregnancy tests

Inverness Medical Innovations

Swiss Precision Diagnostics

Church & Dwight

Siemens Healthcare Diagnostics

Applied DNA Technologies

Quidel

BTNX

Germaine Laboratories

Other fertility-related tests

Chapter 4 Hemostasis testing

Summary

Introduction

Hemostasis modulation

Use of anticoagulants

Use of antiplatelets

Hemostasis testing

Coagulation testing

Prothrombin time

Activated partial thromboplastin time

Activated coagulation time

Guidelines on POC coagulation testing (US)

Examples of manufacturers of POC tests

Abbott Laboratories

Axis-Shield

Siemens

Instrumentation Laboratory

Haemoscope

Helena Point of Care

Inverness Medical Innovations

International Technidyne

Roche Diagnostics

Akers Biosciences

Platelet function tests

POC testing

Examples of manufacturers of POC tests

Helena Point of Care

Siemens Healthcare Diagnostics

Accumetrics

Chapter 5 Cardiology tests

Summary

Overview of cardiovascular disease

Lipids associated with atherosclerosis

Lipid management guidelines (US)

Laboratory lipid profiling

Mail-in fingerstick tests

Point-of-care lipid tests

Routine assay methods

Examples of manufacturers of CLIA waived tests

AccuTech

Inverness Medical Innovations

Polymer Technology Systems

Abaxis

Cardiac protein biomarker diagnostics

Biomarkers of necrosis

Biomarkers of hemodynamic stress

Biomarker panels for risk stratification

The need for POC testing

Examples of manufacturers of POC tests

Siemens

Inverness Medical Innovations

ELITech Group

Roche Diagnostics

Response Biomedical

Abbott Point of Care

Chapter 6 Infectious disease tests

Summary

Introduction

POC testing

Rapid immunoassays

Nucleic acid testing

Sexually-transmitted diseases

HIV

Chlamydia

HPV

HSV-2

Trichomonas vaginalis

Gonorrhea

Respiratory infections

Influenza A and B

Influenza A swine flu

RSV

Strep A

Legionella

M. tuberculosis

Gastrointestinal infections

H. pylori

C. difficile

Parasites

Other infections/conditions

Enteroviral meningitis

Infectious mononucleosis

Hepatitis C

Strep B

MRSA

Sepsis

Malaria

Acute conjunctivitis

Platelet-associated bacteria

Periodontal disease

Urine infection

Chapter 7 Drugs of abuse testing

Summary

Introduction

Point-of-care urine-based testing

Commonly abused prescription drugs

Opioids

Central nervous system depressants

Stimulants

Psychoactive drugs

Methadone

Illicit drugs

Methamphetamine

Cocaine

Heroin

Phencyclidine

Cannabinoids

POC testing sites

CLIA waived DOA rapid tests

Examples of POC DOA test manufacturers

Inverness Medical Innovations

Nanogen

Bio-Rad Laboratories

Siemens Healthcare Diagnostics

Instant Technologies

NOVX Systems

Detection of DOA in oral fluids

Chapter 8 Clinical chemistry and other rapid tests

Summary

Introduction

Urinalysis reagent strips

Automated urinalysis

POC clinical chemistry analyzers

Examples of manufacturers

Abaxis

Abbott Laboratories

Arkray

Cancer POC testing

Colon cancer screening

Bladder cancer screening

Other products

Chapter 9 Company profiles

Summary

Abaxis Inc

Company description

POC technology/products

Abbott Laboratories

Company description

POC technology/products

Accumetrics

Company description

POC technology/products

AccuTech LLC

Company description

POC technology/products

Akers Biosciences Inc

Company description

POC technology/products

American Bio Medica Corporation

Company description

POC technology/products

AmniSure International LLC

Company description

POC technology/products

Arkray USA Inc

Company description

POC technology/products

Banyan Biomarkers Inc

Company description

POC technology/products

BioHelix Corporation

Company description

POC technology/products

Bio-Rad Laboratories Inc

Company description

POC technology/products

BiOracle Ltd

Company description

POC technology/products

Calypte Biomedical Corporation

Company description

POC technology/products

Cepheid

Company description

POC technology/products

Diazyme Laboratories

Company description

POC technology/products

ELITech Group

Company description

POC technology/products

Enigma Diagnostics Ltd

Company description

POC technology/products

GeneEx Inc

Company description

POC technology/products

Health-Chem Diagnostics LLC

Company description

POC technology/products

Helena Laboratories Corporation

Company description

POC technology/products

Home Diagnostics Inc.

Company description

POC technology/products

International Technidyne Corporation

Company description

POC technology/products

Inverness Medical Innovations Inc

Company description

POC technology/products

Meso Scale Diagnostics LLC

Company description

POC technology/products

Micronics

Company description

POC technology/products

Molecular Vision Ltd

Company description

POC technology/products

NOVX Systems Inc

Company description

POC technology/products

OraSure Technologies Inc

Company description

POC technology/products

Phadia AB

Company description

POC technology/products

PointCare Technologies Inc

Company description

POC technology/products

Polymer Technology Systems Inc

Company description

POC technology/products

Princeton BioMeditech Corporation

Company description

POC technology/products

Qualigen Inc

Company description

POC technology/products

Quidel Corporation

Company description

POC technology/products

Rapid Pathogen Screening Inc

Company description

POC technology/products

Response Biomedical Corporation

Company description

POC technology/products

Roche Diagnostics Corporation

Company description

POC technology/products

Siemens Healthcare Diagnostics Inc

Company description

POC technology/products

Trinity Biotech Plc

Company description

POC technology/products

Verax Biomedical Inc

Company description

POC technology/products

Chapter 10 Market analysis and forecasts

Summary

Outlook for the POCT market

Forecasts for individual POCT market sectors

Glucose monitoring

HbA1c testing

Pregnancy/fertility testing

Infectious disease testing

Lipid profiling

Cardiac marker testing

Coagulation testing

Drugs of abuse testing

Automated urine/blood analysis

Cancer screening

Penetrating the healthcare system

POCT in retail health clinics

POCT in physicians office labs

Future POCT technologies

Appendix

Research methodology

Glossary

 

List of Figures

Figure 1.1: Approaches to overcoming limitations of traditional PCR-based assays

Figure 1.2: A representative basic lateral flow immunoassay (LFI) device

Figure 1.3: Schematic of an electrochemical glucose biosensor with meter display

Figure 1.4: Schematic of a lab-on-a-chip device

Figure 1.5: Drivers & restraints for the POCT market

Figure 2.6: Patient potential for type 2 diabetes

Figure 2.7: Causes of inaccurate glucose test results

Figure 6.8: Infectious disease tests CLIA waived (%), Nov 2006 - Oct 2009

Figure 6.9: GeneXpert system for PCR-based DNA testing

 

List of Tables

Table 2.1: Glucose monitoring products 2006-09

Table 2.2: Glucose monitoring products 2006-09 (ctd 1)

Table 2.3: Glucose monitoring products 2006-09 (ctd 2)

Table 2.4: Glucose monitoring products 2006-09 (ctd 3)

Table 2.5: Glucose monitoring products 2006-09 (ctd 4)

Table 2.6: Glucose monitoring products 2006-09 (ctd 5)

Table 2.7: HbA1c testing products

Table 3.8: Pregnancy and ovulation tests

Table 3.9: Pregnancy and ovulation tests (ctd 1)

Table 3.10: Pregnancy and ovulation tests (ctd 2)

Table 3.11: Pregnancy and ovulation tests (ctd 3)

Table 5.12: Lipid profiling tests

Table 6.13: Infectious disease tests - Strep A infection

Table 6.14: Infectious disease tests - H. pylori infection

Table 6.15: Infectious disease tests - Infectious mononucleosis

Table 6.16: Infectious disease tests - HIV infection

Table 6.17: Infectious disease tests - influenza A/B infection

Table 6.18: Infectious disease tests - urinary infection

Table 7.19: Drugs of abuse (DOA) test systems and analytes

Table 7.20: Drugs of abuse (DOA) test systems and analytes (ctd 1)

Table 7.21: Drugs of abuse (DOA) test systems and analytes (ctd 1)

Table 8.22: Automated urine analyzers/reagents

Table 8.23: Automated urine analyzers/reagents (ctd 1)

Table 8.24: Automated urine analyzers/reagents (ctd 2)

Table 8.25: Blood chemistry analyzers/reagents

Table 8.26: Blood chemistry analyzers/reagents (ctd 1)

Table 8.27: Immunological Fecal Occult Blood (FOB) tests

Table 9.28: Abbott Laboratories sales to external customers ($m), 2006-08

Table 9.29: Cepheid product sales by market ($ thousands), 2007-08

Table 9.30: Inverness Medical Innovations sales ($ thousands), 2007-08

Table 9.31: Quidel POC diagnostic revenues ($ thousands), 2007-08

Table 10.32: POCT market forecast by application, 2008-13

Table 10.33: POCT market forecast by region, 2008-13

Published By: Business Insights
Product Code: Business Insights1132


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