MEDICAL DEVICES & DIAGNOSTICS PULSE SURVEY

MEDICAL DEVICES & DIAGNOSTICS PULSE SURVEY DIABETESApril 2020

New Pharmaceuticals

Flash Glucose Monitors (Abbott FreeStyle Libre)

Continuous Blood Glucose Monitor

(CGM)

Automated Insulin Delivery Systems (Artificial

Pancreas, Closed Loop)Insulin Pump

% patients in 2020% patients in 2018

17% 18% 18% 12% 8%

26% 32%21% 17% 10%

29% 25% 25% 26% 14%

33%23% 22%

10% 5%

48%

22%18% 10% 8%

30%

11% 14% 11%4%

15%9% 11%

4% 1%

To what extent are patients requesting information on specific treatments/technologies?

398 (2020)/347 (2018) practicing Endocrinologists from 10-12 selected markets were invited at random to take part in a 5-minute survey consisting of 10-11 structured questions (fielded in local languages). All data were collected via an online survey over a 5-day period in January 2018 and March 2020.

Base 2020: Endocrinologists: USA: n=51, Europe n= 203 (UK n=40, FR n=41, DE n=38, ES n=41, IT n=43), China n=41, India n=20*, Brazil n=26*, Russia n=33 (1new), Japan n=24* (1new)

Base 2018: (Endocrinologists): USA n=71, Europe n=176 (UK n=36, FR n=30, DE n=37, ES n=35, IT n=38), China n=35, India n=31, Brazil n=34

Ipsos MD&D Pulse Survey DIABETES

USA RUSSIAEUROPE JAPANINDIA BRAZILCHINA

New pharmaceuticals are still the most asked about topic from diabetes patients in all markets apart from Europe. Flash Glucose Monitors are also widely asked about especially in Europe (especially so in France and Italy), much less so in Russia and Japan.

Damage caused by Diabetes

0%

Biggest concern 20% 40% 60% 80% 100%

High blood glucose

Fear of getting worse

Fear of needles/blood

Public insulin injections/glucose test

Illness/pain

Managing diet

Losing weight

Stigma of having diabetes

Managing exercise

What are patients’ biggest concerns?






Showing % of endocrinologists who rated concerns as top 3

Damage caused by diabetes is the highest patient concern in most countries followed by high blood glucose, then fear of getting worse – all especially so in Japan. India has the highest reported fear of needles (higher than the fear of getting worse or damage caused by diabetes) and USA the highest concern about losing weight.





Most important

Most important

Which tasks are most important for the diabetes nurse?

How Important are attributes when evaluating BGM brand?


Delivering education on device use, disease and complications as well as lifestyle advice are seen as the most crucial roles of the nurse. In China and Russia, they are also relied on for admin duties and in India for logistical organisation. They are not expected to make treatment recommendations.

Accuracy measured by proximity to lab results is the most important feature, followed by cost of strips, especially in India and Russia. False positive rates are important in all markets, except Japan, and reuse of strips is most important in India. Look and feel of the device is the least important attribute.

Accuracy: proximity to lab results

Cost of test strips

Usability: ease of patient use

Accuracy: false positive rates

Features: reuse same strip if not enough blood

Quality: reputation of manuf.

Features: visual indicators high/low/OK

Digital apps: sync with device to track data

Look & feel: unique/sleek design

Quality: country of manufacture

0% 20% 40% 60% 80% 100%

Education: how to use devices

Education: diabetes disease

Lifestyle advice (diet/exercise)

Education: complications & damage

Admin duties: patient records

Logistical organization

Making clinical workflow efficient

Recommendations on model of BGM

Recommendations on treatment

0% 20% 40% 60% 80% 100%

Showing % of endocrinologists rating 6 or 7 out of 7






Which are the most recommended blood glucose meter brands?


Overall, the most recommended brand is Accu-Check from Roche, particularly in Brazil and India, and this has dropped significantly in Europe in favor of increasing recommendations of Freestyle Libre, which is also the most highly recommended brand in Japan. OneTouch by J&J is most highly recommended in USA and Russia. USA has the lowest rate of specific brand recommendation from endocrinologists.

Among respondents who recommend a brand

*% of respondents who recommend a brand of blood glucose meter at all

73% 88% 100% 85% 96% 94% 83%

Accu-Chek (Roche)

OneTouch (Lifescan/J&J)

Freestyle (Abbott)

Other Brands

Contour (Ascensia)

5%15%

70%

10%

35%55%

6% 3%

47% 35%

12% 6%

32% 29% 27%7% 5%

28%

20%33%

14%5%

16%38%

22%16%

8%

68%

4%

28%






Which are the most common triggers to prescribe CGM?

Most highly ranked triggers Least highly ranked triggers


Positive impact on patient motivation/ compliance

Treatment change that better suits CGM

63% 33%40%

66%60%

58%79%

53%40%

22%20%

38%36%38%

27%27%

20%15%

8%39%

46%

42%

71%54%

70%77%

61%71%

59%67%

71%75%

65%45%46%

65%55%

68%60%

69%61%

21%

Clinical evidence of superior patient outcomes

CGM becomes reimbursed

Quality of data and insights of the CGM

Patient request for CGM

Positive impact on compliance is most compelling to prescribe CGM, followed by clinical evidence of superior outcomes, then quality of data and insights. However, in Japan and China, a treatment change that better suits CGM is also a common trigger. Patient request is relatively rare, except in Russia and Japan.

Showing % of endocrinologists who rated concerns as top 3





Who is the most innovative manufacturer in Diabetes? (Blood Glucose Meters)


Roche is increasingly being viewed as the most innovative in the BGM sector along side Abbott then J&J. Abbott leads the way for CGM with some competition from Medtronic in Russia & Japan and Dexcom in USA and EU.

BLOOD GLUCOSE METERS

CONTINUOUS BLOOD GLUCOSE METERS

20%

24% 41% 59% 55% 58% 15% 38%

50%

4%

4%

42%

9%

6%

59%

15%24%

4%3%

19%

20%45%

15%6%

10%

29%

12%14%

3%

17%

36%

11%22%

30%12%

3%9% 37%

20%

8%18%

59%54%

1%

31% 41% 60% 46% 30% 21%

46%

13%

3%

55%

44%

50%

47%

6%

42%

15%

16%

15%

32%

14%

24%

37%

32%

46%

30%

33%

37%

10%

13%

10%

29%

38%

24%

25%

% endocrinologists in 2020% endocrinologists in 2018





Who is the most innovative manufacturer in Diabetes? (Insulin Delivery)


Medtronic still dominates the field in insulin pump and automated insulin delivery systems.

% endocrinologists in 2020% endocrinologists in 2018

INSULIN PUMPS

AUTOMATED INSULIN DELIVERY SYSTEMS

57% 64% 68% 80% 80% 52% 58%

17%

24%

3%

12%

82%

12%3%

8%3%

6%

61%

10%13%

5%3%

6%

34%

10%14%

15%11%

7%26%

55%

8%18%

9%6%

2%7%

76%

4%

2%6%

1%

53% 53% 44% 40% 54% 24% 50%

4%

21%

9%

12%

15%

74%

4%

4%

3%

3%

3%

48%

5%

20%10%

5%3%

34%

12%29%

27%17%

46%

3%10%

6%11%

7% 7%10% 11%

69%

4%

4%

4%4%

How many patients do endocrinologists recommend to use an app vs. how many actually use an app?

China still has the highest proportion of patients getting app recommendations and also using apps to manage diabetes. Despite high recommendation levels, the uptake in India is amongst the lowest – alongside Russia and Japan. Recommendation and use has grown slightly in Europe and Brazil but has decreased in USA and India.






% Patients app recommended to 2018 Data % patients actually using an app

60%

50%

40%

30%

20%

10%

0%2018-2020 2018-2020

• It is an established fact that diabetes is a complex disease to manage, as many factors impact outcomes. The growing use of CGMs and digital health solutions will continue to increase, particularly in diabetes, as the ability to provide insights on each of those factors will help determine most effective solutions, which leads to better disease management at both the individual and population health levels.

• Given the current COVID-19 situation, digital health is on the verge of a breakthrough. The use of digital health solutions, particularly telemedicine and remote patient monitoring, will necessitate healthcare providers to become more comfortable with available technologies. At present, this is especially true as they manage their high-risk patients, including those with diabetes. After the COVID-19 situation settles, the push to use digital health solutions can lead to a shorter adoption cycle of future technologies including those used for diabetes, assuming certain limitations (e.g. security, interoperability, etc.) are addressed.

• One thing to keep in mind is as more data become available, it is important to understand the needs of different end users. Those using diabetes data to analyse population health will need very granular data whereas healthcare professionals treating patients will need trends and insights that they can easily share with their patients on an individual level.

2018-2020 2018-2020 2018-2020 2020 2020

Additional insights





How many patients are using remote monitoring systems past, present and future?


The proportion of patients who are using remote monitoring systems are rapidly increasing and are expected to continue to do so especially in China, Europe and India. Lowest previous, current and expected future uptake is in Japan.

% of patients using remote monitoring system in 2018

% of patients expected to use in 10 years

% of patients using remote monitoring system in 2020

% of patients expected to use in 5 years

17%18%32%43%

13%21%37%55%

28%28%46%67%

13%13%36%60%

13%17%34%50%

12%27%46%

5%13%26%

Most important

How impactful are digital applications for diabetes?


Data tracking and pattern detection and medication compliance are the most impactful benefits more so in Russia, India and China and least so in Japan. Exercise and nutrition advice have the lowest relative impact, perhaps as other apps are also used for these purposes.

Data tracking & pattern detection

Compliance to medication

Multi-data analysis

Patient engagement

Compliance to BGM use

Communication with Doctors

Medication reminders

Disease education

Exercise advice

Nutrition advice

0% 20% 40% 60% 80% 100%





What additional support should diabetes device manufacturers provide to physicians?


Key findings: Training/education for HCPs is still the most important support, especially in Russia and Brazil. New technology development is widely welcomed, especially in India.

Training/education for HCPs:• Educational resources for

professionals – on software, data, device

Financial assistance/funding:• Lower cost of test strips/device

or make it free• Rebates, coupons, financial

support

New technology development:• Improve accuracy of results• Extra features, i.e. recommend

insulin dosage

Make data management secure, easier and comprehensive:• Integration of data from

different devices into one platform

• More complete/quality data

Better system integration:• System compatibility with other

programs i.e. phone apps


Training/ education for healthcare professionals

20%34%

32%

54%70%

38%

27%

4%7%

25%23%

18%13%

10%11%

15%

35%4%

15%17%

12%17%

15%

15%19%

3%8%

8%

13%5%

30%

3%4%

12%

12%6%

8%

10%10%

10%

Financial assistance/funding

New technology development

Make data management secure, easier and comprehensive

Better system integration

24/7 assistance and support

Expertise plus execution to deliver results

From strategic research & consulting through commercial execution

Assess portfolio & asset opportunities

Demonstrate value & create market access

Bring products to market faster & more successfully

Gain insight to drive better commercial performance

Leverage commercial infrastructure

Better communicate with & understand customers

Or visit our microsite:www.ipsos-medtech.com

For more information on MD&D market research and data from this survey, please contact us at:

[email protected]

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Ipsos’ healthcare team partners with pharmaceutical, biotech, medical device and technology organisations to inspire better healthcare

Market mapping/landscaping• Assessment of unmet

needs

• Regulatory environment

• Competitor landscape

• Current practice

• Patient pathways

Opportunity assessment & Identification• Market sizing &

forecasting

• Market segmentation

New product design & development• Innovation workshops

with R&D, marketing & customers to generate new ideas

• Fine-tuning existing concepts

Concept testing• Pricing & value

assessment

• Human factors/usability testing

• Conjoint analysis of best features/value per feature

Launch strategy• Message/positioning

testing

• Price optimisation

• Value proposition/story refinement

• Engagement strategies

• Preferred marketing channels

• Target identification

Brand health tracking• Advertising and

messaging effectiveness

• Brand equity

• Sales force effectiveness

• Awareness & usage

Customer experience/satisfaction• Customer loyalty

• Value optimisation strategies

Next-gen/upgrade strategies• Assessment of unmet

needs

• Identification of gaps in a portfolio

Portfolio (merger) management• Optimisation of existing

portfolio

• Risk of cannibalisation of new product design or merging of two company portfolios

• Rebranding effect in case of company mergers

Early Development

Late development

Launch Post-launch Portfolio management

Expertise across the product lifestyle


Operating in over 50 countries, our 1000+ healthcare experts support key business decisions for our clients throughout the commercial lifecycle – from early-stage strategy, through to product launch and performance optimisation. We do this through a uniquely integrated combination of therapeutic, market, analytical and commercial expertise, as well as gold standard, proprietary real-world evidence.

How can SERMO RealTime benefit my business?


• SERMO RealTime (a digital HCP-only rapid research tool) provides a valuable add-on to traditional research methods to gather almost instant and affordable insights in today’s fast-paced environment

• SERMO RealTime can be used for multiple purposes, including:

– refining an upcoming study design

– supporting ongoing business decisions

– checking on brand messaging and/or visuals

– tracking market trends

– analysing general sentiment pre-and post-campaign

– supporting a workshop discussion

• Questionnaires can be scripted & launched in 24-48 hrs (upper band for translations)

• Depending on the target sample respondent & size, surveys can be in field for 1-5 days 76% of all pulse surveys complete in under 5 hours

• Questions are fielded online to a global panel of 1.8 million HCPs, covering 40+ specialities from 30 countries, including: US, Europe (15 markets), Mexico, Brazil, Argentina, Turkey, Russia and APAC (seven markets)

• Target lists can also be uploaded and panel matched

• Raw data is provided instantly in Excel, and in one to three days in PowerPoint

• Surveys can have up to 10 questions with two optional screener questions

SERMO – A leading global social network for physicians, where close to 800,000 fully-verified and licensed physicians from more than 150 countries talk real-world medicine, review what peers think of different treatment options-including ratings and comments on prescription drugs-collectively solve cases, respond to healthcare polls and earn honorarium from surveys. In 17 years, SERMO has become the world’s largest healthcare professional (HCP) polling company. The SERMO research network is comprised of 1.8 million HCPs and includes 40 percent of the US physician population.Most of the 700,000 surveys SERMO conducts annually are among specialist physicians – over 70 percent of physician members are specialists.

How does it work?

Contact the authorsDrew Norris Global Head, MD&D Centre of [email protected]

Hannah Osborn Research Director, MD&D Centre of [email protected]

About the Ipsos Healthcare Service LineIpsos’ Healthcare Service Line partners with pharmaceutical, biotech and medical device manufacturers to inspire better healthcare. Operating in 50+ markets, our 1,000+ experts support key business decisions for our clients throughout the commercial lifecycle, from early-stage strategy, to launch, to performance optimization. We do this through a uniquely integrated combination of therapeutic and market expertise, gold standard real-world evidence and market-leading custom research approaches—all underpinned by a global footprint and unprecedented access to today’s healthcare stakeholders.

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