市場調查報告書

先天性高胰島素血症:至2030年的市場考察,流行病學,預測

Congenital Hyperinsulinism - Market Insights, Epidemiology and Market Forecast- 2030

出版商 DelveInsight Business Research LLP 商品編碼 968233
出版日期 內容資訊 英文 166 Pages
商品交期: 最快1-2個工作天內
價格
先天性高胰島素血症:至2030年的市場考察,流行病學,預測 Congenital Hyperinsulinism - Market Insights, Epidemiology and Market Forecast- 2030
出版日期: 2020年11月03日內容資訊: 英文 166 Pages
簡介

先天性高胰島素血症(CHI),是指與胰島素分泌失調相關的臨床,遺傳和形態學異質性疾病組。這種情況會導致個體異常高水平的胰島素,胰島素是一種有助於控制血糖水平的激素。患有這種疾病的人經常發生低血糖症。這些情況會導致嬰兒和幼兒精力不足(嗜睡),易怒或餵養困難。低血糖的反復發作增加了嚴重併發症的風險,例如呼吸困難,癲癇發作,智力殘疾,視力喪失,腦損傷和昏迷。 CHI影響約50,000個新生兒中之一,在某些人群中更常見,影響2500個新生兒中之一。

本報告提供美國、德國、法國、義大利、西班牙、英國、日本主要7個國家的先天性高胰島素血症的流行病學相關市場調查,市場概要,疾病的背景和概要,流行病學與患者數,治療方法,各國家指南,未滿足需求,上市的治療藥,新的治療藥,各國分析與展望等資訊。

目錄

第1章 主要調查結果

第2章 市場概要

第3章 摘要整理

第4章 疾病的背景和概要

  • 簡介
  • 胰臟B細胞的生理學,葡萄糖代謝,胰島素分泌
  • 組織學為基礎CHI的類型
    • 局部性
    • 擴散性
  • CHI的原因
    • 一時性高胰島素症
    • 持續性高胰島素症
  • 分子基礎
    • 遺傳形式
  • 臨床表現與症狀
    • 新生兒期
    • 嬰兒期和兒童期
    • 症狀性CHI通常對二氮嗪有反應
  • 病理學
  • 高胰島素血症性低血糖的遺傳學
    • 胰腺B細胞KATP通道缺陷
    • 麩胺酸去氫酶(GDH)和高胰島素-高血氨症(HI/HA)
    • Mutations in Mitochondrial L-3-Hydroxyacyl-CoA Dehydrogenase(HADH)和CHI的突變
    • GCK的活性化突然變異和CHI
    • Mutations in Solute Carrier Family 16 Member 1 (SLC16A1) and Exercise-induced CHI
    • Hepatocyte Nuclear Factor (HNF) 1Aα&4α (HNF1α&4α) and CHI
    • Mutations in the Mitochondrial Uncoupling Protein 2(UCP2)的變異和CHI
    • Somatic overexpression of Hexokinase 1(HK1)和CHI
    • Phosphoglucomutase 1 and 2(PGM1及2)遺傳基因變異和CHI
  • 診斷
  • 鑑別診斷

第5章 流行病學和患者數

  • 主要調查結果
  • 在主要7個國家的診斷患者數

第6章 各國流行病學

  • 美國
    • 前提和根據
    • 診斷患者數
    • 各類型的診斷患者數
    • 各變異的診斷患者數
  • 歐洲5個國家
    • 德國
    • 法國
    • 義大利
    • 西班牙
    • 英國
  • 日本

第7章 治療

  • 緊急/迅速的管理
  • 標準的治療(長期管理)
    • 手術
    • Diazoxide
    • Octreotide
    • 鈣離子阻斷劑
    • 升糖素
  • 新的有潛力的治療方法

第8章 美國家指南

  • 新生兒,嬰兒,兒童的管理

第9章 歐洲的指南

  • 低血糖的管理

第10章 日本的指南

  • 1次治療
  • 2次治療
  • 外科治療
  • 治療結束

第11章 治療流程

第12章 公認團體

第13章 未滿足需求

第14章 上市的治療藥

  • Proglycem:Teva Pharmaceuticals
    • 概要
    • 其他開發活動
    • 產品簡介

第15章 新藥

  • 主要的競爭產品
  • Dasiglucagon: Zealand Pharma
    • 概要
    • 其他開發活動
    • 臨床開發
    • 產品簡介
  • XOMA 358/RZ358:XOMA/Rezolute
  • CSI-Glucagon(連續皮下升糖素注射):Xeris Pharmaceuticals
  • Avexitide:Eiger BioPharmaceuticals

第16章 屬性分析

第17章 主要7個國家的市場分析

  • 主要調查結果
  • 市場規模

第18章 主要7個國家市場展望

  • 美國
  • 德國
  • 法國
  • 義大利
  • 西班牙
  • 英國
  • 日本

第19章 主要專家的見解

第20章 病例報告

第21章 促進市場成長的要素

第22章 市場障礙

第23章 SWOT分析

第24章 附錄

第25章 DelveInsight的服務

第26章 免責聲明

第27章 關於DelveInsight

目錄
Product Code: DIMI0522

DelveInsight's 'Congenital Hyperinsulinism (CHI) - Market Insights, Epidemiology and Market Forecast- 2030' report delivers an in-depth understanding of the Congenital Hyperinsulinism (CHI), historical and forecasted epidemiology as well as the Congenital Hyperinsulinism (CHI) market trends in the United States, EU5 (Germany, Spain, Italy, France, and United Kingdom) and Japan.

The Congenital Hyperinsulinism (CHI) market report provides current treatment practices, emerging drugs, and market share of the individual therapies, current and forecasted 7MM Congenital Hyperinsulinism (CHI) market size from 2017 to 2030. The report also covers current Congenital Hyperinsulinism (CHI) treatment practice/algorithm, market drivers, market barriers and unmet medical needs to curate the best of the opportunities and assesses the underlying potential of the market.

Geography Covered:

  • The United States
  • EU5 (Germany, France, Italy, Spain, and the United Kingdom)
  • Japan

Study Period: 2017-2030

Congenital Hyperinsulinism (CHI) Disease Understanding and Treatment Algorithm

Congenital Hyperinsulinism (CHI) Overview

Congenital hyperinsulinism (CHI) refers to a clinically, genetically, and morphologically heterogeneous group of disorders associated with dysregulated insulin secretion. This condition causes individuals to have abnormally high levels of insulin, which is a hormone that helps control blood sugar levels. People with this condition have frequent occurrences of low blood sugar (hypoglycemia). These occurrences can lead to a lack of energy (lethargy), irritability, or difficulty feeding in infants and young children. Repeated episodes of low blood sugar increase the risk of severe complications such as breathing difficulties, seizures, intellectual disability, vision loss, brain damage, and coma. CHI affects approximately 1 in 50,000 newborns, and is more common in certain populations, affecting up to 1 in 2,500 newborns.

Genetic forms of CHI are due to mutation in the genes involved in the regulation of insulin secretion. CHI typically presents with fasting hypoglycemia but can present with postprandial hypoglycemia or, in some cases, hypoglycemia can be provoked by protein/leucine loading or even exercise. Patients with CHI can vary in their presentation from having no symptoms to having severe, medically unresponsive disease, which might require a near-total pancreatectomy.

Mutations in the ABCC8 and KCNJ11 genes are the most common causes of CHI and account for 40-45% of all cases (82% of diazoxide-unresponsive patients), whereas mutations have been identified on six other genes in approximately 5-10% of the cases. The genetic etiology for the remaining 45-55% of patients is still unknown. 55-60% of diazoxide-unresponsive CHI are focal forms, whereas 40-45% are diffuse forms, in western countries.

Histologically, CHI has been classified into two major subgroups: diffuse (affecting the whole pancreas) and focal (being localized to a single region of the pancreas) disease. Advances in molecular genetics, radiological imaging techniques (such as fluorine-18 L-3, 4-dihydroxyphenylalanine-PET-CT (18FDOPA-PET-CT scanning), and surgical techniques have completely changed the clinical approach to infants with severe congenital forms of hyperinsulinemic hypoglycemia.

Congenital Hyperinsulinism (CHI) Diagnosis

The main criterion of CHI is inadequate insulin secretion, which may be diagnostic if insulin levels are increased, normal or detectable in the presence of hypoglycemia (<2.5 mmol/L). There is no correlation between the severity of hypoglycemia and serum insulin levels. One of the other criteria is intravenous glucose requirement higher than 8-10 mg/kg/min to maintain normoglycemia. A good glycemic response to glucagon injection is also indicative of CHI. A 4-6 h fasting test can help diagnose CHI if insulin concentration is not abnormal in the presence of hypoglycemia. Some forms of CHI may portray elevated serum lactate levels may also be found. Increased serum ammonia concentration during hypoglycemia may be associated with hyperinsulinism/ hyperammonemia syndrome. The molecular genetic analysis for SUR1 and KIR6.2 genes mutations may confirm the diagnosis of CHI. Another indicator of excess insulin is a glucagon stimulation test. Glucagon is a hormone that opposes insulin action and stimulates the release of glucose from liver glycogen stores. A rise in blood glucose after glucagon administration at the time of hypoglycemia is a sensitive marker for hyperinsulinism.

The diagnostic criteria for CHI include:

  • Fasting and/or post-prandial hypoketotic hypoglycemia (<2.5-3 mmol/L)
  • Inappropriate plasma insulin levels (plasma insulin concentration detectable) and c-peptide concomitant to hypoglycemia: Indeed, insulin levels should be undetectable at the time of hypoglycemia. In CHI patients, plasma insulin levels are not frequently high during hypoglycemia, and they remain within the normal range of the laboratory. However, normal ranges of insulin levels were set with normal blood glucose.
  • When an increase in blood glucose is greater than 1.7 mmol/L (30 mg/dL) within 30-40 min after IM or IV administration of 1 mg glucagon: Indeed insulin promotes glycogen storage and inhibits its use. Conversely, glucagon stimulates glycogenolysis. When glucagon increases blood glucose, it proves the paradoxical hepatic glycogen content despite hypoglycemia, and it rules out the differential diagnosis of glycogen storage disease.
  • Inappropriately low ketone bodies in plasma and urines and low free fatty acids in plasma even for fasting hypoglycemia (Insulin inhibits lipolysis).

A major specific but inconstant diagnostic criterion is the glucose infusion rate required to maintain blood glucose above 3 mmol/L. A glucose infusion rate higher than 10 mg/kg.min in a neonate proves insulin-related hypoglycemia.

Congenital Hyperinsulinism (CHI) Treatment

Prompt treatment of hypoglycemia due to HI is crucial to avoid brain damage. Other alternative fuels, such as ketones or lactate, may be available for the brain during periods of hypoglycemia. In contrast, HI prevents the production of these fuels and leaves the brain without a source of energy. Hypoglycemia can be treated by giving a carbohydrate-containing drink by mouth or, if severe, by giving glucose through the vein or by injecting glucagon.

Medications used to treat HI include diazoxide, octreotide, and glucagon. Emergency management includes parenteral glucose infusion, glucagon administration and frequent feeding. An individualized long-term management plan for each patient aims to normalize plasma glucose levels, provide an age-adjusted fasting tolerance, and avoid neurological symptoms associated with hypoglycemia. The introduction of pharmacological therapy should be one at a time to gauge the response and to monitor their side effects carefully.

Approximately 95-99% of children with diffuse KATP-HI require pancreatectomies. The surgeries are not mandatorily curative, and the patients may continue to require frequent feeds and medications to prevent hypoglycemia post-surgery. The hope with such surgery is to minimize the intense medical regimen that otherwise would be needed to protect the child from recurrent, severe hypoglycemia.

Currently, the first-line treatment of CHI involves the use of KATP channel agonist (diazoxide) alone or in combination with glucagon. The second-line treatment option for diazoxide unresponsive patients includes somatostatin analogs (octreotide), glucagon, calcium channel antagonists (nifedipine), and others (glucocorticosteroids and alpha-glucosidase).

Congenital Hyperinsulinism (CHI) Epidemiology

The disease epidemiology covered in the report provides historical as well as forecasted epidemiology segmented by Total Diagnosed Prevalent Population of Congenital Hyperinsulinism (CHI), Type-specific Diagnosed Prevalence based on Cause of Congenital Hyperinsulinism (CHI), Type-specific Diagnosed Prevalence based on Histological Presentation of Congenital Hyperinsulinism (CHI) and Mutation-specific Diagnosed Prevalence of Congenital Hyperinsulinism (CHI) in the 7MM market covering the United States, EU5 countries (Germany, France, Italy, Spain, and United Kingdom) and Japan from 2017 to 2030.

Key Findings

This section provides glimpse of the Congenital Hyperinsulinism (CHI) epidemiology in the 7MM.

  • The total diagnosed prevalent population of CHI in the seven major markets was found to be 20,008 in 2017.
  • The diagnosed prevalent cases of CHI, in the United States, were found to be 8,557 in 2017.
  • In 2017, the cases of transient, persistent, and unknown type of CHI in the United States, were found to be 5,134, 2,995 and 428, respectively.
  • It was found that in the United States, the focal, diffuse, and atypical cases of CHI were 3,594, 4,603 and 359, respectively, in 2017.
  • In 2017, it was found that in the United States, mutations in ABCC8 and KCNJ11 genes were found in 4,706 cases, while other gene mutations accounted for 3,850 cases.
  • In the EU5 countries, the diagnosed prevalence of CHI was found to be maximum in the United Kingdom with 2,281 cases, followed by Germany with 1,966 cases in 2017. While, the least number of cases were found in Spain, with 1,224 cases in 2017.
  • In Japan, the diagnosed prevalence of CHI was found to be 2,581 in 2017.

Country Wise- Congenital Hyperinsulinism (CHI) Epidemiology

The epidemiology segment also provides the Congenital Hyperinsulinism (CHI) epidemiology data and findings across the United States, EU5 (Germany, France, Italy, Spain, and the United Kingdom) and Japan.

Congenital Hyperinsulinism (CHI) Drug Chapters

The drug chapter segment of the Congenital Hyperinsulinism (CHI) report encloses the detailed analysis of Congenital Hyperinsulinism (CHI) marketed drugs and mid and late stage pipeline drugs. It also helps to understand the Congenital Hyperinsulinism (CHI) clinical trial details, expressive pharmacological action, agreements and collaborations, approval and patent details of each included drug and the latest news and press releases.

Congenital Hyperinsulinism (CHI) Marketed Drugs

Proglycem: Teva Pharmaceuticals

Proglycem (diazoxide) is a nondiuretic benzothiadiazine derivative taken orally for the management of symptomatic hypoglycemia, which is used to treat low blood sugar levels due to certain medical conditions that cause the release of too much insulin from the pancreas. It works mainly by blocking the pancreas from releasing insulin; this action helps to increase blood sugar. As per the information available from the FDA, the oral capsules of Proglycem have been discontinued. In contrast, the oral suspension is clinically prescribed and currently underuse.

Product details in the report…

Congenital Hyperinsulinism (CHI) Emerging Drugs

Dasiglucagon: Zealand Pharma

Zealand Pharma is developing dasiglucagon (ZP4207), a potential first-in-class glucagon analog with a unique stability profile in a liquid formulation; glucagon is the physiological counter regulator of insulin, causing a rise in blood glucose. The drug is stable in an aqueous formulation, suitable for pump use, and, therefore, for treatment of CHI. Dasiglucagon (ZP4207) is being evaluated in phase III for congenital hyperinsulinism. The company also intends to evaluate the potential of chronic dasiglucagon infusions delivered through a pump to prevent hypoglycemia in children diagnosed with CHI in the phase III clinical trial. Moreover, researchers hope to reduce morbidities associated with hypoglycemia, neurodevelopmental defects, and the need for pancreatectomy.

Product details in the report…

XOMA 358/RZ358: XOMA/Rezolute

RZ358 is an intravenously administered human monoclonal antibody that binds with high potency and selectivity to an allosteric site on the insulin receptor. It counteracts the effects of elevated insulin at its target tissues by diminishing the binding and downstream signaling of insulin at its receptor. This unique mechanism of action gives properties of reversibility and graded activity, which are dependent on the extent of insulin elevation. Therefore, RZ358 is ideally suited as a potential therapy for hyperinsulinism, and it is being developed to treat the hypoglycemia associated with diseases such as CHI. The drug is a first-in-class fully human antibody that inhibits the effects of elevated insulin (hyperinsulinemia) via allosteric modulation of the insulin receptor. XOMA 358's novel mechanism of action makes it well-suited as a therapy for severe, persistent hypoglycemia caused by hyperinsulinemic conditions, such as CHI. Previously, XOMA completed a phase II developmental trial of the drug in patients with CHI and patients with hypoglycemia post-bariatric surgery (PBS). In December 2017, Rezolute, formerly known as AntriaBio, acquired an exclusive global license to develop and commercialize XOMA 358 (now RZ358) for all indications. In July 2020, the company announced Resumption and US-Expansion of its phase IIb RIZE study (RZ358-606) in CHI.

Product details in the report…

CSI-Glucagon (Continuous Subcutaneous Glucagon Infusion): Xeris Pharmaceuticals

Xeris Pharmaceuticals is developing CSI-Glucagon (continuous subcutaneous glucagon infusion) for the prevention of hypoglycemia in patients with congenital hyperinsulinism. Xeris proprietary glucagon formulation has the potential to provide the first soluble, room temperature stable, pump-delivered glucagon product for continuous infusion to combat high insulin levels and thus prevent severe hypoglycemia. The company utilizes proprietary XeriSol and XeriJect non-aqueous formulation technology platforms designed to address the challenges presented by aqueous formulations of certain drugs. The drug has already completed phase II trial for the prevention of hypoglycemia in patients with CHI in October 2018.

Product details in the report…

Avexitide: Eiger BioPharmaceuticals

Avexitide (formerly known as Exendin 9-39) is a 31 amino acid peptide fragment of exenatide under development by Eiger BioPharmaceuticals for the treatment of CHI. It is a well-characterized, competitive GLP-1 antagonist that blocks GLP-1 from binding to the GLP-1 receptor, reduces insulin secretion, and prevents steep falls in glucose levels (EigerBio). In November 2015, Eiger BioPharmaceuticals acquired an exclusive license to avexitide from Stanford University for the treatment of post-bariatric surgical hypoglycemia. The drug is currently in phase II of clinical trials for CHI, and the company is assessing strategic options to advance the drug in PBH and CHI.

Product details in the report…

Congenital Hyperinsulinism (CHI) Market Outlook

As per the Congenital Hyperinsulinism International, congenital hyperinsulinism (HI) is the most frequent cause of severe, persistent hypoglycemia in newborn babies and children. In most of the countries, it is estimated to occur in approximately 1/25,000-1/50,000 births. Out of which, about 60% of babies with HI develop hypoglycemia during the first month of life, while 30% might be diagnosed in a later stage of their life. Thus, initiation of early treatment is essential for aggressive prevention of hypoglycemia and resulting brain damage.

There is only one approved therapy for CHI in the market, namely, Proglycem (diazoxide)-a non-diuretic benzothiadiazine derivative used for the management of symptomatic hypoglycemia. Proglycem capsules and suspension are manufactured by IVAX Pharmaceuticals and Teva Pharmaceuticals, respectively; the suspension was manufactured for Gate Pharmaceuticals, a division of Teva Pharmaceuticals. As per the FDA, the oral capsules have been discontinued; however, the oral suspension is clinically prescribed and currently underuse. Additionally, several generic versions of this drug is also available in the market now.

Parenteral glucose infusion is administered intravenously as a bolus as it is a potent trigger for insulin secretion. Glucagon administration is used as first-line therapy for managing CHI patients, particularly in emergencies where patients are unable to take oral feed and/or intravenous access is difficult to obtain. Frequent feeding with high-calorie carbohydrates can reduce the frequency and severity of hypoglycemic episodes; hence, frequent feeding is another advised protocol. Long-term management or standard therapy is individualized, wherein the usual goal is to normalize plasma glucose levels, provide an age-adjusted fasting tolerance, and avoid neurological symptoms associated with hypoglycemia. Surgery is performed to either remove a section or complete the pancreas in case of focal and diffuse congenital hyperinsulinism, respectively. The surgeries are not mandatorily curative, and the patients may continue to require frequent feeds and medications to prevent hypoglycemia post-surgery.

The first-line therapy is a potassium channel (KATP) channel opener for the treatment of the patients with CHI; Diazoxide and chlorothiazide belong to this class of drugs. Somatostatin analog such as octreotide is used as second-line therapy. Nifedipine or amlodipine belongs to calcium channel antagonists are merely used as a third-Line therapy, e.g., as an add-on treatment, in partial diazoxide/octreotide resistance, and/or following partial pancreatectomy.

The current emerging market of CHI possesses few potential drugs in late and mid-stage developments to be launched soon. Dasiglucagon is currently in the phase III stage of development followed by RZ358, CSI-Glucagon (Continuous Subcutaneous Glucagon Infusion), and Avexitide that are in phase II clinical developmental stage. Out of these therapies, RZ358 and CSI-Glucagon have already completed their phase II clinical developmental trial.

Key Findings

This section includes a glimpse of the Congenital Hyperinsulinism (CHI) 7MM market.

  • The market size of CHI in the seven major markets was estimated to be USD 186.7 Million in 2017.
  • The United States accounts for the largest market size of CHI in comparison to EU5 (the United Kingdom, Germany, France, Italy, and Spain) and Japan.
  • In 2017, among the EU5 countries, the UK had the largest market size with USD 12.8 Million, while Spain had the smallest market size of CHI with USD 6.9 Million.
  • The Japan CHI market accounted for USD 14.8 million in 2017.

The United States Market Outlook

This section provides the total Congenital Hyperinsulinism (CHI) market size and market size by therapies in the United States.

EU-5 Market Outlook

The total Congenital Hyperinsulinism (CHI) market size and market size by therapies in Germany, France, Italy, Spain, and the United Kingdom are provided in this section.

Japan Market Outlook

The total Congenital Hyperinsulinism (CHI) market size and market size by therapies in Japan are provided.

Congenital Hyperinsulinism (CHI) Drugs Uptake

This section focusses on the rate of uptake of the potential drugs recently launched in the Congenital Hyperinsulinism (CHI) market or expected to get launched in the market during the study period 2017-2030. The analysis covers Congenital Hyperinsulinism (CHI) market uptake by drugs; patient uptake by therapies; and sales of each drug.

This helps in understanding the drugs with the most rapid uptake, reasons behind the maximal use of new drugs and allow the comparison of the drugs on the basis of market share and size which again will be useful in investigating factors important in market uptake and in making financial and regulatory decisions.

Congenital Hyperinsulinism (CHI) Development Activities

The report provides insights into different therapeutic candidates in phase II, and phase III stage. It also analyzes key players involved in developing targeted therapeutics.

Pipeline Development Activities

The report covers the detailed information of collaborations, acquisition and merger, licensing and patent details for Congenital Hyperinsulinism (CHI) emerging therapies.

Competitive Intelligence Analysis

We perform competitive and market Intelligence analysis of the Congenital Hyperinsulinism (CHI) market by using various competitive intelligence tools that include-SWOT analysis, PESTLE analysis, Porter's five forces, BCG Matrix, Market entry strategies, etc. The inclusion of the analysis entirely depends upon the data availability.

Scope of the Report:

  • The report covers the descriptive overview of Congenital Hyperinsulinism (CHI), explaining its causes, signs and symptoms, pathogenesis and currently available therapies.
  • Comprehensive insight has been provided into the Congenital Hyperinsulinism (CHI) epidemiology and treatment.
  • Additionally, an all-inclusive account of both the current and emerging therapies for Congenital Hyperinsulinism (CHI) are provided, along with the assessment of new therapies, which will have an impact on the current treatment landscape.
  • A detailed review of Congenital Hyperinsulinism (CHI) market; historical and forecasted is included in the report, covering the 7MM drug outreach.
  • The report provides an edge while developing business strategies, by understanding trends shaping and driving the 7MM Congenital Hyperinsulinism (CHI) market.

Report Highlights:

  • In the coming years, Congenital Hyperinsulinism (CHI) market is set to change due to the rising awareness of the disease, and incremental healthcare spending across the world; which would expand the size of the market to enable the drug manufacturers to penetrate more into the market.
  • The companies and academics are working to assess challenges and seek opportunities that could influence Congenital Hyperinsulinism (CHI) R&D. The therapies under development are focused on novel approaches to treat/improve the disease condition.
  • Delvelnsight has also analysed mutation-specific data of CHI, which suggests that mutations in the ABCC8 and KCNJ11 genes are the most common causes of CHI while mutation in several other genes (GLUD1, GCK, HADH, SLC16A1, HNF4A, and HNF1A) are also involved in the development of CHI.
  • As per DelveInsight's analysis, CHI, based on cause, can be categorized into three types, namely, Transient, Persistent and Unknown.
  • Type-specific data of CHI on the basis of histological presentation suggests that CHI can be divided into three sub-types, namely, Focal, Diffuse, and Atypical CHI.
  • Currently, the first-line treatment of CHI involves the use of KATP channel agonist (diazoxide) alone or in combination with glucagon. The second-line treatment option for diazoxide unresponsive patients includes somatostatin analogs (octreotide), glucagon, calcium channel antagonists (nifedipine), and others (glucocorticosteroids and alpha-glucosidase inhibitors).
  • Expected Launch of potential therapies, Dasiglucagon (Zealand Pharma), RZ3584/XOMA 358 (XOMA Pharmaceuticals/Rezolute), CSI-Glucagon (Xeris Pharmaceuticals), and Avexitide (Eiger BioPharmaceuticals) will increase the market size in the coming years, assisted by an increase in diagnosed prevalent population of CHI.

Congenital Hyperinsulinism (CHI) Report Insights

  • Patient Population
  • Therapeutic Approaches
  • Congenital Hyperinsulinism (CHI) Pipeline Analysis
  • Congenital Hyperinsulinism (CHI) Market Size and Trends
  • Market Opportunities
  • Impact of upcoming Therapies

Congenital Hyperinsulinism (CHI) Report Key Strengths

  • Eleven Years Forecast
  • 7MM Coverage
  • Congenital Hyperinsulinism (CHI) Epidemiology Segmentation
  • Key Cross Competition
  • Highly Analyzed Market
  • Drugs Uptake

Congenital Hyperinsulinism (CHI) Report Assessment

  • Current Treatment Practices
  • Unmet Needs
  • Pipeline Product Profiles
  • Market Attractiveness
  • Market Drivers and Barriers

Key Questions:

Market Insights:

  • What was the Congenital Hyperinsulinism (CHI) market share (%) distribution in 2017 and how it would look like in 2030?
  • What would be the Congenital Hyperinsulinism (CHI) total market size as well as market size by therapies across the 7MM during the forecast period (2020-2030)?
  • What are the key findings pertaining to the market across the 7MM and which country will have the largest Congenital Hyperinsulinism (CHI) market size during the forecast period (2020-2030)?
  • At what CAGR, the Congenital Hyperinsulinism (CHI) market is expected to grow at the 7MM level during the forecast period (2020-2030)?
  • What would be the Congenital Hyperinsulinism (CHI) market outlook across the 7MM during the forecast period (2020-2030)?
  • What would be the Congenital Hyperinsulinism (CHI) market growth till 2030 and what will be the resultant market size in the year 2030?
  • How would the market drivers, barriers and future opportunities affect the market dynamics and subsequent analysis of the associated trends?

Epidemiology Insights:

  • What is the disease risk, burden and unmet needs of Congenital Hyperinsulinism (CHI)?
  • What is the historical Congenital Hyperinsulinism (CHI) patient pool in the United States, EU5 (Germany, France, Italy, Spain, and the UK) and Japan?
  • What would be the forecasted patient pool of Congenital Hyperinsulinism (CHI) at the 7MM level?
  • What will be the growth opportunities across the 7MM with respect to the patient population pertaining to Congenital Hyperinsulinism (CHI)?
  • Out of the above-mentioned countries, which country would have the highest prevalent population of Congenital Hyperinsulinism (CHI) during the forecast period (2020-2030)?
  • At what CAGR the population is expected to grow across the 7MM during the forecast period (2020-2030)?

Current Treatment Scenario, Marketed Drugs and Emerging Therapies:

  • What are the current options for the treatment of Congenital Hyperinsulinism (CHI) along with the approved therapy?
  • What are the current treatment guidelines for the treatment of Congenital Hyperinsulinism (CHI) in the US and Europe?
  • What are the Congenital Hyperinsulinism (CHI) marketed drugs and their MOA, regulatory milestones, product development activities, advantages, disadvantages, safety and efficacy, etc.?
  • How many companies are developing therapies for the treatment of Congenital Hyperinsulinism (CHI)?
  • How many therapies are developed by each company for the treatment of Congenital Hyperinsulinism (CHI)?
  • How many emerging therapies are in the mid-stage and late stage of development for the treatment of Congenital Hyperinsulinism (CHI)?
  • What are the key collaborations (Industry-Industry, Industry-Academia), Mergers and acquisitions, licensing activities related to the Congenital Hyperinsulinism (CHI) therapies?
  • What are the recent novel therapies, targets, mechanisms of action and technologies developed to overcome the limitation of existing therapies?
  • What are the clinical studies going on for Congenital Hyperinsulinism (CHI) and their status?
  • What are the key designations that have been granted for the emerging therapies for Congenital Hyperinsulinism (CHI)?
  • What are the 7MM historical and forecasted market of Congenital Hyperinsulinism (CHI)?

Reasons to buy:

  • The report will help in developing business strategies by understanding trends shaping and driving the Congenital Hyperinsulinism (CHI).
  • To understand the future market competition in the Congenital Hyperinsulinism (CHI) market and Insightful review of the key market drivers and barriers.
  • Organize sales and marketing efforts by identifying the best opportunities for Congenital Hyperinsulinism (CHI) in the US, Europe (Germany, Spain, Italy, France, and the United Kingdom) and Japan.
  • Identification of strong upcoming players in the market will help in devising strategies that will help in getting ahead of competitors.
  • Organize sales and marketing efforts by identifying the best opportunities for Congenital Hyperinsulinism (CHI) market.
  • To understand the future market competition in the Congenital Hyperinsulinism (CHI) market.

Table of Contents

1 Key Insights

2 Congenital Hyperinsulinism (CHI) Market Overview at a Glance

  • 2.1 Market Share (%) Distribution of CHI in 2017
  • 2.2 Market Share (%) Distribution of CHI in 2030

3 Executive Summary of Congenital Hyperinsulinism (CHI)

4 Disease Background and Overview: Congenital Hyperinsulinism (CHI)

  • 4.1 Introduction
  • 4.2 Pancreatic B Cell Physiology, Glucose Metabolism and Insulin Secretion
  • 4.3 Types of CHI based on histology
    • 4.3.1 Focal CHI
    • 4.3.2 Diffuse CHI
  • 4.4 Causes of CHI
    • 4.4.1 Transient Hyperinsulinism
    • 4.4.2 Persistent Hyperinsulinism
  • 4.5 Molecular Basis
    • 4.5.1 Modes of Inheritance
  • 4.6 Clinical Presentation and Symptoms
    • 4.6.1 During the neonatal period
    • 4.6.2 During infancy and childhood
    • 4.6.3 Syndromic CHI are usually diazoxide-responsive
  • 4.7 Pathophysiology
  • 4.8 Genetics of hyperinsulinaemic hypoglycemia
    • 4.8.1 Pancreatic B-cell KATP Channel Defects
    • 4.8.2 Glutamate Dehydrogenase (GDH) and Hyperinsulinaemia-hyperammonaemia Syndrome (HI/HA)
    • 4.8.3 Mutations in Mitochondrial L-3-Hydroxyacyl-CoA Dehydrogenase (HADH) and CHI
    • 4.8.4 Activating Mutations in GCK and CHI
    • 4.8.5 Mutations in Solute Carrier Family 16 Member 1 (SLC16A1) and Exercise-induced CHI
    • 4.8.6 Hepatocyte Nuclear Factor (HNF) 1Aα&4α (HNF1α&4α) and CHI
    • 4.8.7 Mutations in the Mitochondrial Uncoupling Protein 2 (UCP2) and CHI
    • 4.8.8 Somatic overexpression of Hexokinase 1 (HK1) and CHI
    • 4.8.9 Phosphoglucomutase 1 and 2 (PGM1 and 2) Gene Mutations and CHI
  • 4.9 Diagnosis
  • 4.1 Differential Diagnosis

5 Epidemiology and Patient Population

  • 5.1 Key Findings
  • 5.2 Total Diagnosed Prevalent Population of Congenital Hyperinsulinism in the 7MM

6 Country Wise-Epidemiology of Congenital Hyperinsulinism

  • 6.1 United States
    • 6.1.1 Assumptions and Rationale
    • 6.1.2 Total Diagnosed Prevalent Population of Congenital Hyperinsulinism in the United States
    • 6.1.3 Type-specific Diagnosed Prevalence Based on Disease Persistance in the United States
    • 6.1.4 Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in the United States
    • 6.1.5 Mutation-specific Diagnosed Prevalence of CHI in the United States
  • 6.2 EU5 Countries
    • 6.2.1 Assumptions and Rationale
  • 6.3 Germany
    • 6.3.1 Total Diagnosed Prevalent Population of CHI in Germany
    • 6.3.2 Type-specific Diagnosed Prevalence Based on Disease Persistance in Germany
    • 6.3.3 Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Germany
    • 6.3.4 Mutation-specific Diagnosed Prevalence of CHI in Germany
  • 6.4 France
    • 6.4.1 Total Diagnosed Prevalent Population of Congenital Hyperinsulinism in France
    • 6.4.2 Type-specific Diagnosed Prevalence Based on Disease Persistance in France
    • 6.4.3 Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in France
    • 6.4.4 Mutation-specific Diagnosed Prevalence of CHI in France
  • 6.5 Italy
    • 6.5.1 Total Diagnosed Prevalent Population of Congenital Hyperinsulinism in Italy
    • 6.5.2 Type-specific Diagnosed Prevalence Based on Disease Persistance in Italy
    • 6.5.3 Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Italy
    • 6.5.4 Mutation-specific Diagnosed Prevalence of CHI in Italy
  • 6.6 Spain
    • 6.6.1 Total Diagnosed Prevalent Population of Congenital Hyperinsulinism in Spain
    • 6.6.2 Type-specific Diagnosed Prevalence Based on Disease Persistance in Spain
    • 6.6.3 Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Spain
    • 6.6.4 Mutation-specific Diagnosed Prevalence of CHI in Spain
  • 6.7 United Kingdom
    • 6.7.1 Total Diagnosed Prevalent Population of Congenital Hyperinsulinism in the United Kingdom
    • 6.7.2 Type-specific Diagnosed Prevalence Based on Disease Persistance in the United Kingdom
    • 6.7.3 Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in the United Kingdom
    • 6.7.4 Mutation-specific Diagnosed Prevalence of CHI in the United Kingdom
  • 6.8 Japan
    • 6.8.1 Assumptions and Rationale
    • 6.8.2 Total Diagnosed Prevalent Population of Congenital Hyperinsulinism in Japan
    • 6.8.3 Type-specific Diagnosed Prevalence Based on Disease Persistance in Japan
    • 6.8.4 Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Japan
    • 6.8.5 Mutation-specific Diagnosed Prevalence of CHI in Japan

7 Treatment

  • 7.1 Emergency/Prompt Management
  • 7.2 Standard Therapies (Long Term Management)
    • 7.2.1 Surgery
    • 7.2.2 Diazoxide
    • 7.2.3 Octreotide
    • 7.2.4 Calcium Channel Antagonists
    • 7.2.5 Glucagon
  • 7.3 Potential Novel Therapies

8 The United States Guidelines for CHI

  • 8.1 Management of Neonates, Infants, and Children with a Persistent Hypoglycemia Disorder
    • 8.1.1 Neonates, Infants, and Children with Hypoglycemia Disorders

9 European Guidelines for CHI

  • 9.1 Management of hypoglycemia
    • 9.1.1 Hypoglycemia Pathway I
    • 9.1.2 Pathway II for Hypoglycemia

10 Japanese Guidelines for CHI

  • 10.1 First-Line Treatment
  • 10.2 Second-Line Treatment
  • 10.3 Surgical Treatment
  • 10.4 End of Treatment

11 Treatment Algorithm for CHI

12 Recognized Establishments

13 Unmet Needs

14 Marketed Drug

  • 14.1 Proglycem: Teva Pharmaceuticals
    • 14.1.1 Drug Description
    • 14.1.2 Other Development Activities
    • 14.1.3 Product Profile

15 Emerging Drugs

  • 15.1 Key Cross Competition
  • 15.2 Dasiglucagon: Zealand Pharma
    • 15.2.1 Product Description
    • 15.2.2 Other Development Activities
    • 15.2.3 Clinical Development
    • 15.2.4 Product Profile
  • 15.3 XOMA 358/RZ358: XOMA/Rezolute
    • 15.3.1 Product Description
    • 15.3.2 Other Development Activities
    • 15.3.3 Clinical Development
    • 15.3.4 Product Profile
  • 15.4 CSI-Glucagon (Continuous Subcutaneous Glucagon Infusion): Xeris Pharmaceuticals
    • 15.4.1 Product Description
    • 15.4.2 Other Development Activities
    • 15.4.3 Clinical Development
    • 15.4.4 Product Profile
  • 15.5 Avexitide: Eiger BioPharmaceuticals
    • 15.5.1 Product Description
    • 15.5.2 Other Development Activities
    • 15.5.3 Product Profile

16 Attribute Analysis

  • 16.1 Key Points

17 Congenital Hyperinsulinism (CHI): Seven Major Market Analysis

  • 17.1 Key Findings
  • 17.2 Market Size of Congenital Hyperinsulinism (CHI) in the 7MM

18 Market Outlook: 7MM

  • 18.1 United States Market Size
    • 18.1.1 The total market size of Congenital Hyperinsulinism (CHI)
    • 18.1.2 Market Size by Therapies
  • 18.2 EU5 Market Size
  • 18.3 Germany
    • 18.3.1 The total market size of Congenital Hyperinsulinism (CHI)
    • 18.3.2 Market Size by Therapies
  • 18.4 France
    • 18.4.1 The total market size of Congenital Hyperinsulinism (CHI)
    • 18.4.2 Market Size by Therapies
  • 18.5 Italy
    • 18.5.1 The total market size of Congenital Hyperinsulinism (CHI)
    • 18.5.2 Market Size by Therapies
  • 18.6 Spain
    • 18.6.1 The total market size of Congenital Hyperinsulinism (CHI)
    • 18.6.2 Market Size by Therapies
  • 18.7 United Kingdom
    • 18.7.1 The total market size of Congenital Hyperinsulinism (CHI)
    • 18.7.2 Market Size by Therapies
  • 18.8 Japan Market Size
    • 18.8.1 The total market size of Congenital Hyperinsulinism (CHI)
    • 18.8.2 Market Size by Therapies

19 KOL Reviews

20 Case Reports

21 Market Drivers

22 Market Barriers

23 SWOT Analysis

24 Appendix

  • 24.1 Bibliography
  • 24.2 Report Methodology

25 DelveInsight Capabilities

26 Disclaimer

27 About DelveInsight

List of Tables

  • Table 1: Summary of CHI, Market, Epidemiology and Key Events (2017-2030)
  • Table 2: Genetic mechanisms of CHI
  • Table 3: Total Diagnosed Prevalent Population of CHI in the 7MM (2017-2030)
  • Table 4: Total Diagnosed Prevalent Population of CHI in the United States (2017-2030)
  • Table 5: Type-specific Diagnosed Prevalence Based on Disease Persistance in the United States (2017-2030)
  • Table 6: Type-specific Prevalence Based on Histological Presentation of CHI in the United States (2017-2030)
  • Table 7: Mutation-specific Diagnosed Prevalence of Congenital Hyperinsulinism in the United States (2017-2030)
  • Table 8: Total Diagnosed Prevalent Population of CHI in Germany (2017-2030)
  • Table 9: Type-specific Diagnosed Prevalence Based on Cause of CHI in Germany (2017-2030)
  • Table 10: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Germany (2017-2030)
  • Table 11: Mutation-specific Diagnosed Prevalence of Congenital Hyperinsulinism in Germany (2017-2030)
  • Table 12: Total Diagnosed Prevalent Population of CHI in France (2017-2030)
  • Table 13: Type-specific Diagnosed Prevalence Based on Disease Persistance in France (2017-2030)
  • Table 14: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in France (2017-2030)
  • Table 15: Mutation-specific Diagnosed Prevalence of Congenital Hyperinsulinism in France (2017-2030)
  • Table 16: Total Diagnosed Prevalent Population of CHI in Italy (2017-2030)
  • Table 17: Type-specific Diagnosed Prevalence Based on Disease Persistance of CHI in Italy (2017-2030)
  • Table 18: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Italy (2017-2030)
  • Table 19: Mutation-specific Diagnosed Prevalence of Congenital Hyperinsulinism in Italy (2017-2030)
  • Table 20: Total Diagnosed Prevalent Population of CHI in Spain (2017-2030)
  • Table 21: Type-specific Diagnosed Prevalence Based on Cause of CHI in Spain (2017-2030)
  • Table 22: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Spain (2017-2030)
  • Table 23: Mutation-specific Diagnosed Prevalence of Congenital Hyperinsulinism in Spain (2017-2030)
  • Table 24: Total Diagnosed Prevalent Population of CHI in the United Kingdom (2017-2030)
  • Table 25: Type-specific Diagnosed Prevalence Based on Cause of CHI in the United Kingdom (2017-2030)
  • Table 26: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in the UK (2017-2030)
  • Table 27: Mutation-specific Diagnosed Prevalence of Congenital Hyperinsulinism in the UK (2017-2030)
  • Table 28: Total Diagnosed Prevalent Population of CHI in Japan (2017-2030)
  • Table 29: Type-specific Diagnosed Prevalence Based on Disease Persistance in Japan (2017-2030)
  • Table 30: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Japan (2017-2030)
  • Table 31: Mutation-specific Diagnosed Prevalence of Congenital Hyperinsulinism in Japan (2017-2030)
  • Table 32: Drugs for medical therapy of Hyperinsulinaemic Hypoglycemia
  • Table 33: Management of Neonates, Infants, and Children with a Persistent Hypoglycemia Disorder
  • Table 34: Clinical Questions pertaining to treatment goals and the first-line treatment
  • Table 35: Clinical Questions pertaining to second-line treatment
  • Table 36: Clinical Questions pertaining to surgical treatment
  • Table 37: Clinical Questions pertaining to the end of treatment
  • Table 38: Comparison of emerging drugs under development
  • Table 39: Dasiglucagon, Clinical Trial Description, 2020
  • Table 40: XOMA 35, Clinical Trial Description, 2020
  • Table 41: CSI-Glucagon, Clinical Trial Description, 2020
  • Table 42: Glucose Infusion Rate Response in Study XSGO-CH01
  • Table 43: Seven Major Market Size of Congenital Hyperinsulinism (CHI) in USD Million (2017-2030)
  • Table 44: Total Market Size of Congenital Hyperinsulinism (CHI) in the United States, in USD Million (2017-2030)
  • Table 45: Market size of Congenital Hyperinsulinism (CHI) by therapies in the US, in USD Million (2017-2030)
  • Table 46: Total Market Size of Congenital Hyperinsulinism (CHI) in Germany, in USD Million (2017-2030)
  • Table 47: Market size of Congenital Hyperinsulinism (CHI) by therapies in Germany, in USD Million (2017-2030)
  • Table 48: Total Market Size of Congenital Hyperinsulinism (CHI) in France, in USD Million (2017-2030)
  • Table 49: Market size of Congenital Hyperinsulinism (CHI) by therapies in France, in USD Million (2017-2030)
  • Table 50: Total Market Size of Congenital Hyperinsulinism (CHI) in Italy, in USD Million (2017-2030)
  • Table 51: Market size of Congenital Hyperinsulinism (CHI) by therapies in Italy, in USD Million (2017-2030)
  • Table 52: Total Market Size of Congenital Hyperinsulinism (CHI) in Spain, in USD Million (2017-2030)
  • Table 53: Market size of Congenital Hyperinsulinism (CHI) by therapies in Spain, in USD Million (2017-2030)
  • Table 54: Total Market Size of Congenital Hyperinsulinism (CHI) in the United Kingdom, in USD Million (2017-2030)
  • Table 55: Market size of Congenital Hyperinsulinism (CHI) by therapies in the UK, in USD Million (2017-2030)
  • Table 56: Total Market Size of Congenital Hyperinsulinism (CHI) in Japan, in USD Million (2017-2030)
  • Table 57:Market size of Congenital Hyperinsulinism (CHI) by therapies in Japan, in USD Million (2017-2030)

List of Figures

  • Figure 1: Regulation of insulin release from pancreatic B-cell
  • Figure 2: Histological Types of CHI (Focal and Diffuse)
  • Figure 3: Persistent CHI
  • Figure 4: Mutations Occurred Throughout SUR1 and Kir6.2
  • Figure 5: Glucose Induced Insulin Secretion Pathway
  • Figure 6: KATP channel-dependent pathways of insulin secretion
  • Figure 7: Diagnostic Tree for CHI
  • Figure 8: Total Diagnosed Prevalent Population of CHI in the 7MM (2017-2030)
  • Figure 9: Total Diagnosed Prevalent Population of CHI in the United States (2017-2030)
  • Figure 10: Type-specific Diagnosed Prevalence Based on disease persistance in the US (2017-2030)
  • Figure 11: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in the US (2017-2030)
  • Figure 12: Mutation-specific Diagnosed Prevalence of CHI in the United States (2017-2030)
  • Figure 13: Total Diagnosed Prevalent Population of CHI in Germany (2017-2030)
  • Figure 14: Type-specific Diagnosed Prevalence Based on Disease Persistance in Germany (2017-2030)
  • Figure 15: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Germany (2017-2030)
  • Figure 16: Mutation-specific Diagnosed Prevalence of CHI in Germany (2017-2030)
  • Figure 17: Total Diagnosed Prevalent Population of CHI in France (2017-2030)
  • Figure 18: Type-specific Diagnosed Prevalence Based on Disease Persistance in France (2017-2030)
  • Figure 19: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in France (2017-2030)
  • Figure 20: Mutation-specific Diagnosed Prevalence of CHI in France (2017-2030)
  • Figure 21: Total Diagnosed Prevalent Population of CHI in Italy (2017-2030)
  • Figure 22: Type-specific Diagnosed Prevalence Based on Disease Persistance in Italy (2017-2030)
  • Figure 23: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Italy (2017-2030)
  • Figure 24: Mutation-specific Diagnosed Prevalence of CHI in Italy (2017-2030)
  • Figure 25: Total Diagnosed Prevalent Population of CHI in Spain (2017-2030)
  • Figure 26: Type-specific Diagnosed Prevalence Based on Based on Disease Persistance in Spain (2017-2030)
  • Figure 27: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Spain (2017-2030)
  • Figure 28: Mutation-specific Diagnosed Prevalence of CHI in Spain (2017-2030)
  • Figure 29: Total Diagnosed Prevalent Population of CHI in the United Kingdom (2017-2030)
  • Figure 30: Type-specific Diagnosed Prevalence Based on Disease Persistance in the UK (2017-2030)
  • Figure 31: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in the UK (2017-2030)
  • Figure 32: Mutation-specific Diagnosed Prevalence of CHI in the United Kingdom (2017-2030)
  • Figure 33: Total Diagnosed Prevalent Population of CHI in Japan (2017-2030)
  • Figure 34: Type-specific Diagnosed Prevalence Based on Disease Persistance in Japan (2017-2030)
  • Figure 35: Type-specific Diagnosed Prevalence Based on Histological Presentation of CHI in Japan (2017-2030)
  • Figure 36: Mutation-specific Diagnosed Prevalence of CHI in Japan (2017-2030)
  • Figure 37: Algorithm for the treatment of hyperinsulinism
  • Figure 38: Care related recommendations for neonatal CHI patients
  • Figure 39: Unmet Needs of Congenital Hyperinsulinism
  • Figure 40: Seven Major Market Size of Congenital Hyperinsulinism (CHI) in USD Million (2017-2030)
  • Figure 41: Total Market Size of CHI in the United States, USD Millions (2017-2030)
  • Figure 42: Market size of CHI by therapies in the United States, in USD Million (2017-2030)
  • Figure 43: Total Market Size of CHI in Germany, USD Millions (2017-2030)
  • Figure 44: Market size of CHI by therapies in Germany, in USD Million (2017-2030)
  • Figure 45: Total Market Size of CHI in France, USD Millions (2017-2030)
  • Figure 46: Market size of CHI by therapies in France, in USD Million (2017-2030)
  • Figure 47: Total Market Size of CHI in Italy, USD Millions (2017-2030)
  • Figure 48: Market size of CHI by therapies in Italy, in USD Million (2017-2030)
  • Figure 49: Total Market Size of CHI in Spain, USD Millions (2017-2030)
  • Figure 50: Market size of CHI by therapies in Spain, in USD Million (2017-2030)
  • Figure 51: Total Market Size of CHI in the United Kingdom, USD Millions (2017-2030)
  • Figure 52: Market size of CHI by therapies in the United Kingdom, in USD Million (2017-2030)
  • Figure 53: Total Market Size of CHI in Japan, USD Millions (2017-2030)
  • Figure 54: Market size of CHI by therapies in Japan, in USD Million (2017-2030)
  • Figure 55: Market Drivers
  • Figure 56: Market Barriers
  • Figure 57: SWOT Analysis