Contrast Agents

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CHAPTER ONE: EXECUTIVE SUMMARY ..........................................................1

Image Enhancament Overview .......................................................................................... 1
X-Ray and CT ................................................................................................................... 2
Ultrasound ......................................................................................................................... 3
MRI ................................................................................................................................... 3
Radiopharmaceuticals ....................................................................................................... 4
World Market Summary .................................................................................................... 4
Volume Growth ................................................................................................................... 5
New Diagnostics ...............................................................................................................6
Toxicity Issues .................................................................................................................. 6
Generic Competition ......................................................................................................... 7
World Market Growth Analysis ........................................................................................ 8
Methodology....................................................................................................................... 10

CHAPTER TWO: INTRODUCTION .....................................................................13

Agents for the Early Detection of Disease ....................................................................... 13
Two Functions.................................................................................................................... 14
Adding Value ..................................................................................................................... 15
Key Clinical Markets ........................................................................................................ 16
X-Ray and CT ................................................................................................................. 17
Ultrasound ....................................................................................................................... 17
Updated Warning on Microbubbles ................................................................................ 18
Microbubble Composition ................................................................................................ 19
Targeted and Untargeted ................................................................................................. 20
MRI ................................................................................................................................. 21
Novel Agents ................................................................................................................... 22
Nuclear Medicine ............................................................................................................ 23
Diagnosing Functionality ................................................................................................ 23
Sourcing Issues Updated ................................................................................................. 25
PET.................................................................................................................................. 26
New Applications ............................................................................................................... 27
SPECT ............................................................................................................................. 28
Gamma Cameras ............................................................................................................. 31
Risks .................................................................................................................................... 31
Ionic and Non-Ionic Contrast .......................................................................................... 32
Issues ................................................................................................................................... 35
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Table of Contents
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Utilization Rate ............................................................................................................... 35

Technical Challenges ........................................................................................................ 36
Tracking Contrast Media ................................................................................................. 39
Contrast Modality Combinations .................................................................................... 40
Emerging Applications ..................................................................................................... 41
Atherosclerosis ............................................................................................................... 41
Nanotechnology .............................................................................................................. 41

CHAPTER THREE: MARKET DEVELOPMENTS ............................................43

FDA Approves Amyvid .................................................................................................... 43
Bayer HealthCare Business Integration ......................................................................... 44
Bayer Receives Gadavist Approval ................................................................................ 44
Agfas Generic Push ......................................................................................................... 45
Agfas Generic Push ....................................................................................................... 45
Improving Magnetic Resonance Visualization ............................................................... 46
Nanoparticle Contrast ...................................................................................................... 47
Tracking Stem Cells .......................................................................................................... 48

CHAPTER FOUR: MARKETS ...............................................................................51

Market Drivers .................................................................................................................. 51
Withstanding the Recession ............................................................................................. 53
Combination Imaging and Disease Management........................................................... 56
Opportunities from Increasing Specificity...................................................................... 58
Aging Population ............................................................................................................... 59
Utilization ....................................................................................................................... 60
Procedures....................................................................................................................... 61
Outlook for Contrast Media............................................................................................. 68
Market Forecast ................................................................................................................ 70
X-Ray and CT ................................................................................................................. 71
Ultrasound ...................................................................................................................... 74
MRI ................................................................................................................................. 77
Outlook for Molecular Imaging Agents .......................................................................... 79
Market Forecast ................................................................................................................ 82

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in whole or in any part, is strictly prohibited.

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CHAPTER FIVE:CORPORATE PROFILES........................................................89

Acusphere Inc.. .................................................................................................................. 89
Alseres Pharmaceuticals, Inc. ........................................................................................... 91
Amag Pharmaceuticals Inc ............................................................................................... 92
Aposense Ltd ...................................................................................................................... 93
ART Advanced Research Technologies Inc. ................................................................... 95
Avid Radiopharmaceuticals Inc ....................................................................................... 96
Bayer HealthCare. ............................................................................................................. 97
Bracco SpA ......................................................................................................................... 99
Cardinal Health ............................................................................................................... 101
Cell>Point ......................................................................................................................... 102
Covidien plc...................................................................................................................... 104
Daiichi Pharmaceutucal Co. Ltd .................................................................................... 106
Draximage ........................................................................................................................ 107
Endocyte Inc .................................................................................................................... 109
Eusa Pharma .................................................................................................................... 111
FluoroPharma Medical Inc ............................................................................................ 112
GE Healthcare ................................................................................................................. 114
Guerbet Group ................................................................................................................ 116
Hovione Farmaciencia SA .............................................................................................. 119
Immunomedics Inc .......................................................................................................... 120
Insight Agents .................................................................................................................. 121
Kereos Inc ........................................................................................................................ 122
King Pharmaceuticals ..................................................................................................... 123
Lantheus Medical Imaging ............................................................................................. 124
Luna Nanoworks ............................................................................................................. 126
Macrocyclics..................................................................................................................... 128
MDS Nordion ................................................................................................................... 130
Molecular Insight Pharmaceuticals, Inc ........................................................................ 131
Nanoscan Imaginf LLC ................................................................................................... 134
Palatin Technologies Inc ................................................................................................. 136
Pharmacyclics .................................................................................................................. 137
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Spago Imaging AB .......................................................................................................... 139

Targeson Inc .................................................................................................................... 140
Taejoon Pharmaceutical Co. Ltd ................................................................................... 142
VisEn Medical ................................................................................................................. 143
Zim Laboratories India Ltd ........................................................................................... 145

CHAPTER ONE: EXECUTIVE SUMMARY

Exhibit 1
World Market for X-Ray Medical Contrast Media, 2011-2015 ....................................... 9
Exhibit 2
World Market for CT Medical Contrast Media, 2011-2015 ............................................. 9
Exhibit 3
World Market for Ultrasound Medical Contrast Media, 2011-2015 ................................ 9
Exhibit 4
World Market for MRI Medical Contrast Media, 2011-2015 ....................................... 10
Exhibit 5
World Market for PET Radiopharmaceuticals, 2011-2015 ............................................ 10
Exhibit 6
World Market for SPECT Radiopharmaceuticals, 2011-2015 ....................................... 10

CHAPTER TWO: INTRODUCTION

Exhibit 7
Key Medical Contrast Agents by Type........................................................................... 16
Exhibit 8
Advantages of Non-Ionic Contrast Media ...................................................................... 34

CHAPTER FOUR: MARKETS

Exhibit 9
Patent Status of Selected Medical Imaging Agents ........................................................ 53
Exhibit 10
World Market for Medical Contrast Media and Radiopharmaceuticals, 2011-2015 ...... 55
Exhibit 11
World Market Share for Medical Contrast Media and Radiopharmaceuticals, 2011 ..... 55
Exhibit 12
World Market for Medical Contrast Media and Radiopharmaceuticals, 2015 ............... 56

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Table of Contents
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Exhibit 13
Key Players Percentage Share Worldwide Medical Contrast Media Market, 2012 ... 59
Exhibit 14
World Market Geographic Segmentation for Medical X-Ray Procedures, 2012............ 62
Exhibit 15
World Market Geographic Segmentation for Medical X-Ray Procedures, 2012............ 63
Exhibit 16
Worldwide Medical MRI Procedures, 2012 ................................................................... 63
Exhibit 17
World Market Geographic Segmentation for Medical MRI Procedures, 2012............... 64
Exhibit 18
Worldwide Medical CT Procedures, 2012 ...................................................................... 64
Exhibit 19
World Market Geographic Segmentation for Medical CT Procedures, 2012 ................. 65
Exhibit 20
Worldwide Medical Ultrasound Procedures, 2012 ......................................................... 65
Exhibit 21
World Market Geographic Segmentation for Medical Ultrasound Procedures, 2012 .... 66
Exhibit 22
Worldwide Medical PET Procedures, 2012 .................................................................... 66
Exhibit 23
World Market Geographic Segmentation for Medical PET Procedures, 2012 ............... 67
Exhibit 24
Worldwide Medical SPECT Procedures, 2012 ............................................................... 67
Exhibit 25
World Market Geographic Segmentation for Medical SPECT Procedures, 2012 .......... 68
Exhibit 26
Status of Selected Medical Imaging Agents.................................................................... 69
Exhibit 27
World Markets for X-Ray Contrast Media, 2011-2015 .................................................. 71
Exhibit 28
World Market for Medical X-Ray Contrast Media by Geographic Segment, 2011-2015 ....72
Exhibit 29
World Market for Medical X-Ray Contrast Media by Geographic Segment, 2012 ............. 72
Exhibit 30
World Market for CT Contrast Media, 2011-2015 ......................................................... 73
Exhibit 31
World Market for Medical CT Contrast Media by Geographic Segment, 2011-2015 .... 73
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in whole or in any part, is strictly prohibited.

Table of Contents
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Exhibit 32
World Market for Medical CT Contrast Media by Geographic Segment, 2012............. 74
Exhibit 33
World Market for Ultrasound Contrast Media, 2011-2015 ............................................ 75
Exhibit 34
World Market for Medical Ultrasound Contrast Media by Geographic Segment,
2011-2015 ....................................................................................................................... 76
Exhibit 35
World Market for Medical Ultrasound Contrast Media by Geographic Segment, 2012 .......... 76
Exhibit 36
World Market for MRI Contrast Media by Geographic Segment, 2011-2015 ............... 77
Exhibit 37
World Market for Medical MRI Contrast Media by Geographic Segment, 2011-2015 ......... 78
Exhibit 38
World Market for Medical MRI Contrast Media by Geographic Segment, 2012 .......... 78
Exhibit 39
Selected Molecular Imaging Products ............................................................................ 83
Exhibit 40
World Market for Medical PET Radiopharmaceuticals, 2011-2015 .............................. 85
Exhibit 41
World Market for Medical PET Radiopharmaceuticals by Geographic Segment,
2011-2015 ....................................................................................................................... 85
Exhibit 42
World Market for Medical PET Radiopharmaceuticals by Geographic Segment, 2012 ........ 86
Exhibit 43
World Market for Medical SPECT Radiopharmaceuticals, 2011-2015 ......................... 86
Exhibit 44
World Market for Medical SPECT Radiopharmaceuticals by Geographic Segment,
2011-2015 ....................................................................................................................... 87
Exhibit 45
World Market for Medical SPECT Radiopharmaceuticals by Geographic Segment, 2012 .... 87

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in whole or in any part, is strictly prohibited.

Introduction
21

The markets and indications for targeted CEUS include inflammation. Cancer
cells also express a specific set of receptors, mainly receptors that encourage
angiogenesis, or the growth of new blood vessels. If microbubbles are targeted with
ligands that bind receptors, such as the vascular endothelial growth factor (VEGF),
they can non-invasively and specifically identify areas of cancers. When used in
conjunction with Doppler ultrasound, microbubbles can help to measure the
myocardial flow rate that will help a doctor to diagnose valve problems. The relative
intensity of the microbubble echoes can also provide a quantitative estimate on blood
volume.
MRI
Contrast agents play a significant role in improving the quality of MRI
diagnostic images by increasing the contrast between different internal structures or
types of tissues in various disease states. Most contrast agents that have been
approved for human use are extracellular, gadolinium (Gd)-based agents that have a
relatively short residence time in the vascular system. In addition, intracellular agents
have been introduced that have longer residence times and which allow make possible
extended imaging procedures without the need for repeated injections of the agent.
Many MRI contrast agents that are on the market are applied, for the most part, to
image the central nervous system, but they also are used to check for cancer,
inflammation or to evaluate blood vessels.
These agents improve the resolution of MRI images by increasing the brightness
in various parts of the body where the agent resides.
The types of imaging media often used are chelated Gd or manganese, and
super-small coated iron oxide particles. The superparamagnetic iron oxide (SPIO)
particles have sizes ranging from 0.05 micron to 0.40 micron. The particles are coated
with such materials as dextran or starch. Several superparamagnetic iron oxide
contrast agents are available in the market. MRI contrast agents lead to better patient
diagnosis and staging. They could be cost effective when assessing medical
treatments and optimizing patient outcomes.

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Markets
63

Exhibit 15

World Market Geographic Segmentation for Medical X-Ray

Procedures
2012

%
%

Source: Kalorama Information

Exhibit 16

Worldwide Medical MRI Procedures, 2012

REGION

PROCEDURES
(MILLIONS)

Source: Kalorama Information

Copyright 2012 Kalorama Information

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in whole or in any part, is strictly prohibited.

Markets
73

Exhibit 30

World Market for CT Contrast Media, 2011-2015

Revenues (in billions)
2013
2012

2011

2014

2015

Source: Kalorama Information

Exhibit 31

World Market for Medical CT Contrast Media by Geographic

Segment 2011-2015
Revenues (in billions)
REGION

2011

2012

2013

2014

Source: Kalorama Information

Copyright 2012 Kalorama Information

Reproduction without prior written permission, in any media now in existence or hereafter developed,
in whole or in any part, is strictly prohibited.

2015