Gastroparesis Market

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


The Gastroparesis market report provides current treatment practices, emerging drugs, and market share of the individual therapies, current and forecasted 7MM Gastroparesis market size from 2017 to 2030.The report also covers current Gastroparesis 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

Gastroparesis Disease Understanding and Treatment Algorithm

Gastroparesis Overview

Gastroparesis, which is a translated meaning of “stomach paralysis”, is a digestive disorder characterized by delayed gastric emptying of solid food in the absence of mechanical obstruction of the stomach, resulting in the cardinal symptoms of early satiety, postprandial fullness, nausea, vomiting, belching and bloating. It is now recognized as part of a broader spectrum of gastric neuromuscular dysfunction that includes impaired gastric accommodation. The overlap between the symptoms, of Gastroparesis and other disorders such as functional dyspepsia makes the diagnosis of Gastroparesis.


Gastroparesis may be idiopathic or associated with diabetes mellitus, may occur after a medical intervention (iatrogenic or post-surgical), or with neurological disorders, it can also occur after a viral or bacterial infection, such as Salmonella gastroenteritis. Interestingly, Helicobacter pylori infection of the stomach does not seem to influence gastric emptying or accommodation but may be associated with heightened sensitivity in patients with functional dyspepsia.


According to the American Diabetes Association, Gastroparesis is a disorder affecting people with both type 1 and type 2 diabetes, in which the stomach takes too long to empty its contents (delayed gastric emptying). The vagus nerve controls the movement of food through the digestive tract. If this nerve is damaged or stops working, the muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped. Just as with other types of neuropathy, diabetes can damage the vagus nerve if blood glucose levels remain high over a long period. High blood glucose causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves.

Gastroparesis Diagnosis

Patients with postprandial upper abdominal symptoms such as nausea, vomiting, postprandial fullness, bloating, and epigastric pain are candidates for gastric motility tests. Patients must first undergo an upper GI endoscopy; if this test does not reveal a cause for the symptoms, patients can begin motility and functional investigations. Furthermore, the most relevant functional test is a measurement of gastric emptying, which is best assessed with scintigraphy conducted over at least 3 h; however, only the regulatory agencies approve the stable isotope breath test. These tests are well-validated, and data from healthy control individuals are available. When results from tests of gastric emptying are inconclusive, particularly in patients with prominent postprandial fullness or early satiety, measurements of gastric accommodation are also indicated. Impaired gastric accommodation is diagnosed with validated methods that are available, such as SPECT and MRI, or with screening tests such as the proximal stomach size on the gastric scintiscan (taken immediately after radiolabelled meal ingestion) or by a water load or nutrient drink test.

Gastroparesis Treatment

Management of Gastroparesis involves correcting fluid, electrolyte and nutritional deficiencies, identifying and treating the cause of delayed gastric emptying (for example, diabetes mellitus), and suppressing or eliminating symptoms.Therapeutic strategies rely on dietary modification, medications that stimulate gastric motor activity, antiemetic drug therapy and nonpharmacological measures such as endoscopic or surgical intervention or gastric electrical stimulation. Dietary modifications represent the first line of treatment for gastroparesis and are generally used for all patients, regardless of disease severity. Oral intake is preferable for nutrition and hydration in patients with gastroparesis. If a gastroparesis-suitable diet fails to manage symptoms, patients may be treated medically with pharmacological agents, including prokinetic and antiemetic medications. Gastric prokinetic medications increase the rate or amplitude of stomach contractions and, thus, increase the rate of gastric emptying. Medications currently approved (although not in all countries) include metoclopramide, domperidone, and erythromycin.


DelveInsight’s Gastroparesis market report gives a thorough understanding of Gastroparesis by including details such as disease definition, causes, mechanism, and diagnosis.

Gastroparesis Epidemiology

The disease epidemiology covered in the report provides historical as well as forecasted epidemiology include Total Prevalence of Gastroparesis, Gender-specific Prevalence of Gastroparesis, Severity-specific Prevalence of Gastroparesis, Type-specific Prevalence of Gastroparesis and Total Diagnosed Prevalent Population of Gastroparesis scenario in the 7MM covering the United States, EU5 countries (Germany, Spain, Italy, France and the United Kingdom) and Japan from 2017 to 2030.

Key Findings

This section provides glimpses of the Gastroparesis epidemiology in the 7MM.

  • The total prevalent population of gastroparesis in the 7MM is expected to rise from 33,690,400 in 2017.
  • As per estimates, the highest prevalence of gastroparesis was observed in the United States with 13,019,321 cases in 2017, which is likely to rise by 2030.
  • As per DelveInsight’s analysis, a higher percentage of prevalence was observed for females, in comparison to males, in all the 7MM countries.
  • According to DelveInsight’s analysis, it has been observed that mild cases are more prominent in comparison to moderate-to-severe. In the United States, 7,811,592 mild cases were observed in 2017, i.e., 60% of the gastroparesis patient pool. Additionally, moderate-to-severe accounted for 40% of the gastroparesis patient pool.
  • Among the major types of gastroparesis, i.e., idiopathic, diabetic and post-surgical gastroparesis, idiopathic gastroparesis accounts for a higher number of gastroparesis cases.
  • Among the EU5 countries, in 2017, Germany had the highest prevalent population of gastroparesis followed by Spain and Italy. On the other hand, the United Kingdom had the lowest prevalent population of Gastroparesis

Country wise- Gastroparesis Epidemiology

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

Gastroparesis Drug Chapters

This segment of the Gastroparesis report encloses the detailed analysis of the mid- and late-stage (Phase-III and Phase-II) pipeline drugs. It also helps to understand the clinical trial details, expressive pharmacological action, agreements and collaborations, approval and patent details of each included drug and the latest news and press releases.

Gastroparesis Marketed Drugs

Gimoti (metoclopramide) Nasal Spray: Evoke Pharma

To mitigate symptoms associated with acute and recurrent diabetic gastroparesis in women with diabetes mellitus, Gimoti—a metoclopramide nasal spray—is used. Metoclopramide is a benzamide derivative that is structurally similar to procainamide. It is one of the most commonly used agents in the management of DGP. It is both a central and a peripheral dopamine-2 (D2)-receptor antagonist with antiemetic and prokinetic actions that increase the antral contractions and coordinates antral duodenal motility. Metoclopramide can be administered, parenterally, when symptoms are severe. Since 1979, metoclopramide tablets and metoclopramide for injection have been the only products approved in the United States to treat gastroparesis. Gimoti is a novel formulation of metoclopramide providing systemic delivery via nasal administration. In June 2020, US FDA approved Gimoti (metoclopramide) nasal spray, the first and only nasally-administered product indicated for the relief of symptoms in adults with acute and recurrent diabetic gastroparesis

Reglan: ANI Pharmaceuticals

Reglan is a drug that increases the motility (movements and contractions) of the stomach and upper intestine. It is used to treat certain stomach problems and nausea and vomiting caused by chemotherapy. It is a type of antiemetic and motility agent, also called metoclopramide. It is one of the most commonly used agents in the management of diabetic gastroparesis. It is both a central and a peripheral dopamine-2 (D2)-receptor antagonist with antiemetic and prokinetic actions that increases the antral contractions and coordinates antral duodenal motility. The company had initially filed a New Drug Administration (NDA) to the FDA on June 2018, and however, it was declined by the US FDA.

Motilium (Domperidone): Janssen

Domperidone is a dopamine receptor antagonist, which exhibits gastric prokinetic as well as antiemetic properties via action on the area postrema, which is the vomiting center present in the brainstem. It works by blocking the receptors for the neurotransmitter dopamine in the gut and in the part of the brain linked to vomiting. Specifically, it works on peripheral dopamine receptors in the GI wall and chemoreceptor trigger zone (CTZ) center of the brainstem.


Domperidone is legal in Europe and Canada for Gastroparesis. This product is not legal in the US. In June 2004, the FDA issued a public warning that distributing any domperidone-containing products is illegal.

Products detail in the report…

Gastroparesis Emerging Drugs

Relamorelin: Allergan

Relamorelin, by Allergan, is a potent ghrelin agonist in development for the treatment of Diabetic Gastroparesis. Derived from the natural ghrelin sequence, Relamorelinhas been optimized to stimulate gastrointestinal (GI) motility, with greater potency and enhanced stability and pharmacokinetics. The US Food and Drug Administration (FDA) have granted Fast Track review status to Relamorelin for the treatment of diabetic gastroparesis.

Tradipitant: Vanda Pharmaceuticals

Tradipitant is a neurokinin-1 receptor (NK-1R) antagonist, and currently in phase III clinical development for Gastroparesis.This product is a new chemical entity (NCE) and is being developed by the Vanda pharmaceuticals. This company licensed this product from Eli Lilly in 2012.Tradipitant is an investigational drug that is not currently approved for use in any indication.

Velusetrag: Theravance Biopharma

Velusetrag is an oral, investigational medicine developed for gastrointestinal motility disorders. It is a highly selective agonist with high intrinsic activity at the human 5-HT4 receptor and is being developed in collaboration with Alfa Wassermann in a Phase II program to test its efficacy, safety, and tolerability in the treatment of patients with Gastroparesis. The US FDA has granted Fast Track designation to velusetrag (TD-5108) for the treatment of symptoms associated with idiopathic and diabetic gastroparesis.

CIN-102: CinDome Pharma

CinDome Pharma, a subsidiary of CinRx Pharma is developing deuterated domperidone (CIN-102) to provide patients suffering from Gastroparesis with an improved treatment option. CIN-102 is a D2/3 antagonist developed through deuteration and novel formulation processes. Non-deuterated domperidone is a well-known D2/D3 receptor antagonist used in many parts of the world for the treatment of nausea and vomiting and Gastroparesis. The company has completed two phase I studies and is now initiating its phase II programs. 

Nimacimab: Bird Rock Bio

Besides the abovementioned key players, another pharma company named Bird Rock Bio has initiated the phase II clinical trial for their drug candidate Nimacimab for the management of Diabetic Gastroparesis. It is a peripheral antagonist antibody to cannabinoid receptor 1 (CB1). The company has initiated a phase II clinical study for Diabetic Gastroparesis. The company is also investigating this product in nonalcoholic steatohepatitis (NASH) and diabetic kidney disease (DKD).

TAK-906: Takeda

Takeda is evaluating TAK-906 in Phase II clinical trial in adult participants with gastroparesis compared with placebo during 12 weeks of treatment. It was previously named as ATC 1906.

Metopimazine (NG101): Neurogastrx

NG101 is a potent, selective and peripherally restricted dopamine D2 receptor antagonist under development for the treatment of gastroparesis.


Neurogastrx has generated preclinical data indicating that in addition to its potent antiemetic properties, NG101 is also expected to significantly increase gastric motility, conferring NG101 an ideal pharmacological profile for the treatment of gastroparesis.

Products detail in the report…

Gastroparesis Market Outlook

Gastroparesis is a complex, debilitating dysmotility disorder with challenging symptom management. Given the limited efficacy of treatment options and serious side effects, significant research continues for therapeutic options for gastroparesis.


The usual treatments for gastroparesis include nutritional assessment, dietary modifications, and pharmacological therapies. The treatment landscape of gastroparesis comprises of very few pharmacological therapies such as prokinetic agents, antiemetic agents (off-label), and antianxiety benzodiazepine agents (off-label). Furthermore, electrical stimulation therapies, endoscopic therapies, and surgical therapies are used for the treatment management of gastroparesis. The primary aim of existing therapies is to improve the efficiency of the gastric pump and to relieve symptoms of nausea, bloating, vomiting, and pain; the selection of recommended drugs is based on the severity of the symptoms (grades). Prokinetic agents—metoclopramide, domperidone, and erythromycin—are mainly used to increase the rate of gastric emptying and decrease symptoms in patients with gastroparesis.


The Gastroparesis market outlook of the report helps to build a detailed comprehension of the historic, current and forecasted Gastroparesis market trends by analyzing the impact of current therapies on the market, unmet needs, drivers and barriers, and demand of better technology.


This segment gives a thorough detail of Gastroparesis market trend of each marketed drug and late-stage pipeline therapy by evaluating their impact based on the annual cost of therapy, inclusion and exclusion criteria’s, mechanism of action, compliance rate, growing need of the market, increasing patient pool, covered patient segment, expected launch year, competition with other therapies, brand value, their impact on the market and view of the key opinion leaders. The calculated market data are presented with relevant tables and graphs to give a clear view of the market at first sight.


According to DelveInsight, Gastroparesis 7MM market is expected to change in the study period 2017–2030.

Key Findings

This section includes a glimpse of the Gastroparesis 7MM market.

  • The market size of gastroparesis the seven major markets is USD 3,072.74 Million in 2017.
  • For gastroparesis, the current market for the treatment includes prokinetics comprising metoclopramide, domperidone, erythromycin, antiemetics and few others. Majority of the products in these classes were approved long back and hence, are available as generics.
  • Of the emerging therapies, the products which are anticipated to be launched in the 7MM include Gimoti (EVK-001, Evoke Pharma), Relamorelin (Allergan), Tradipitant (Vanda Pharmaceuticals), TAK-906 (Takeda), and CIN-102 (Deuterated Domperidone, CinRX Pharma). Some of these products have received Fast-track Designations and are expected to enter the treatment market, in different regions across the 7MM countries, during the forecast period [2020–2030].
  • Among the EU5 countries, Germany had the highest market size in 2017.
  • Among 7MM, Japan accounts for the third-highest market size during the forecast period 2017–2030, at a CAGR of 5.75 %.

Market Outlook for Seven Major Markets

This section provides the total Gastroparesis market size and market size by therapies in the United States, Germany, France, Italy, Spain, the United Kingdom and Japan.

Gastroparesis Drugs Uptake

This section focusses on the rate of uptake of the potential drugs that are expected to get launched in the market during the study period 2017–2030. The analysis covers Gastroparesis 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.

Gastroparesis 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 Gastroparesis emerging therapies.

Competitive Intelligence Analysis

We perform competitive and market intelligence analysis of the Gastroparesis 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 Gastroparesis, explaining its causes, signs and symptoms, pathogenesis and currently available therapies.
  • Comprehensive insight has been provided into the Gastroparesis epidemiology and treatment.
  • Additionally, an all-inclusive account of both the current and emerging therapies for Gastroparesis is provided, along with the assessment of new therapies, which will have an impact on the current treatment landscape.
  • A detailed review of Gastroparesis 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 Gastroparesis market.

Report Highlights

  • Gastroparesis market is anticipated to increase at a CAGR of 8.09% for the study period 2017–2030.
  • The United States accounted for 45.65% of the total market share in the 7MM.
  • Tradipitant is projected to lead the market with the highest market share in 2030.
  • In the coming years, Gastroparesis 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 Gastroparesis R&D. The therapies under development are focused on novel approaches to treat/improve the disease condition.
  • Major players are involved in developing therapies for Gastroparesis. Launch of emerging therapies will significantly impact the Gastroparesis market.
  • Our in-depth analysis of the pipeline assets across different stages of development (phase III and phase II), different emerging trends and comparative analysis of pipeline products with detailed clinical profiles, key competitors, launch date along with product development activities will support the clients in the decision-making process regarding their therapeutic portfolio by identifying the overall scenario of the research and development activities.

Gastroparesis Report Insights

  • Patient Population
  • Therapeutic Approaches
  • Gastroparesis Pipeline Analysis
  • Gastroparesis Market Size and Trends
  • Market Opportunities
  • Impact of upcoming Therapies

Gastroparesis Report Key Strengths

  • Eleven Years Forecast
  • 7MM Coverage
  • Gastroparesis Epidemiology Segmentation
  • Key Cross Competition
  • Highly Analyzed Market
  • Drugs Uptake

Gastroparesis Report Assessment

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

Companies:

  • Relamorelin: Allergan
  • Tradipitant: Vanda Pharmaceuticals
  • Velusetrag: Theravance Biopharma
  • CNSA-001: Censa Pharmaceuticals/PTC Therapeutics
  • CIN-102: CinDome Pharma
  • Nimacimab: Bird Rock Bio
  • TAK-906: Takeda
  • Metopimazine (NG101): Neurogastrx
  • Moventig (Naloxegol): AstraZeneca

Key Questions

Market Insights:

  • What was the Gastroparesis market share (%) distribution in 2017 and how it would look like in 2030?
  • What would be the Gastroparesis total market size as well as market size by therapies across the 7MMduring the forecast period (2020–2030)?
  • What are the key findings pertaining to the market across the 7MM and which country will have the largest Gastroparesis market size during the forecast period (2020–2030)?
  • At what CAGR, the Gastroparesis market is expected to grow at the 7MM level during the forecast period (2020–2030)?
  • What would be the Gastroparesis market outlook across the 7MM during the forecast period (2020–2030)?
  • What would be the Gastroparesis market growth until 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 Gastroparesis?
  • What is the historical Gastroparesis patient pool in the United States, EU5 (Germany, France, Italy, Spain, and the UK) and Japan?
  • What would be the forecasted patient pool of Gastroparesis at the 7MM level?
  • What will be the growth opportunities across the 7MM with respect to the patient population pertaining to Gastroparesis?
  • Out of the countries mentioned above, which country would have the highest prevalent population of Gastroparesis 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 Gastroparesis along with the approved therapy?
  • What are the current treatment guidelines for the treatment of Gastroparesis in the US and Europe?
  • What are the Gastroparesis 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 Gastroparesis?
  • How many therapies are developed by each company for the treatment of Gastroparesis?
  • How many emerging therapies are in the mid-stage and late stage of development for the treatment of Gastroparesis?
  • What are the key collaborations (Industry–Industry, Industry–Academia), Mergers and acquisitions, licensing activities related to the Gastroparesis 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 Gastroparesis and their status?
  • What are the key designations that have been granted for the emerging therapies for Gastroparesis?
  • What are the 7MM historical and forecasted market of Gastroparesis?

Reasons to buy

  • The report will help in developing business strategies by understanding trends shaping and driving the Gastroparesis.
  • To understand the future market competition in the Gastroparesis market and Insightful review of the key market drivers and barriers.
  • Organize sales and marketing efforts by identifying the best opportunities for Gastroparesis 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 Gastroparesis market.
  • To understand the future market competition in the Gastroparesis market.

 

1 Key Insights

2 Glioblastoma Multiforme Market Overview at a Glance

2.1 Market Share (%) Distribution of GBM in 2017

2.2 Market Share (%) Distribution of GBM in 2030

3 Executive Summary of Glioblastoma Multiforme (GBM)

4 Disease Background and Overview: Glioblastoma Multiforme (GBM)

4.1 Introduction

4.2 Classification of Glioblastoma Multiforme

4.3 Glioblastoma Types

4.3.1 Astrocytomas

4.3.2 Ependymomas

4.3.3 Oligodendrogliomas

4.3.4 Mixed gliomas

4.3.5 Optic pathway gliomas

4.4 Symptoms

4.5 Pathophysiology

4.5.1 Macroscopic and Histological Features of GBM

4.5.2 Genetic and Molecular Pathogenesis

4.6 Inheritance of Glioblastoma Multiforme

4.6.1 Genetic Variations of Glioblastoma Multiforme

4.7 Molecular Classification

4.7.1 Specific Molecular Biomarkers

4.8 Diagnosis of Glioblastoma Multiforme

4.8.1 Neurological Exams

4.8.2 Angiograms

4.8.3 Magnetic resonance imaging (MRI) and computerized Tomography (CT)

4.8.4 Perfusion MRI

4.8.5 MR spectroscopy

4.8.6 Histological Diagnosis

4.8.7 Surgical Biopsy

4.9 Glioblastoma in Nut Shell

5 Epidemiology and Patient Population

5.1 Key Findings

5.2 7MM Total Diagnosed Incident Patient Population of Glioblastoma Multiforme

6 Country Wise-Epidemiology of Glioblastoma Multiforme

6.1 United States

6.1.1 Assumptions and Rationale

6.1.2 Total Diagnosed Incident Population of Glioblastoma Multiforme in the United States

6.1.3 Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in the United States

6.1.4 Type-specific Diagnosed Incidence of Glioblastoma Multiforme in the United States

6.1.5 Age-specific Diagnosed Incidence of Glioblastoma Multiforme in the United States

6.1.6 Diagnosed Incident Population based on Primary Site of GBM in the United States

6.1.7 Diagnosed Incident Population based on Histologic Classification of GBM Tumor in the United States

6.2 EU5 Countries

6.2.1 Assumptions and Rationale

6.3 Germany

6.3.1 Total Diagnosed Incident Population of Glioblastoma Multiforme in Germany

6.3.2 Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Germany

6.3.3 Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Germany

6.3.4 Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Germany

6.3.5 Diagnosed Incident Population based on Primary Site of GBM in Germany

6.3.6 Diagnosed Incident Population based on Histologic Classification of GBM in Germany

6.4 France

6.4.1 Total Diagnosed Incident Population of Glioblastoma Multiforme in France

6.4.2 Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in France

6.4.3 Type-specific Diagnosed Incidence of Glioblastoma Multiforme in France

6.4.4 Age-specific Diagnosed Incidence of Glioblastoma Multiforme in France

6.4.5 Diagnosed Incident Population based on Primary Site of GBM in France

6.4.6 Diagnosed Incident Population based on Histologic Classification of GBM in France

6.5 Italy

6.5.1 Total Diagnosed Incident Population of Glioblastoma Multiforme in Italy

6.5.2 Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Italy

6.5.3 Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Italy

6.5.4 Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Italy

6.5.5 Diagnosed Incident Population based on Primary Site of GBM in Italy

6.5.6 Diagnosed Incident Population based on Histologic Classification of GBM in Italy

6.6 Spain

6.6.1 Total Diagnosed Incident Population of Glioblastoma Multiforme in Spain

6.6.2 Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Spain

6.6.3 Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Spain

6.6.4 Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Spain

6.6.5 Diagnosed Incident Population based on Primary Site of GBM in Spain

6.6.6 Diagnosed Incident Population based on Histologic Classification of GBM in Spain

6.7 United Kingdom

6.7.1 Total Diagnosed Incident Population of Glioblastoma Multiforme in the United Kingdom

6.7.2 Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in the United Kingdom

6.7.3 Type-specific Diagnosed Incidence of Glioblastoma Multiforme in the United Kingdom

6.7.4 Age-specific Diagnosed Incidence of Glioblastoma Multiforme in the United Kingdom

6.7.5 Diagnosed Incident Population based on Primary Site of GBM in the United Kingdom

6.7.6 Diagnosed Incident Population based on Histologic Classification of GBM in the United Kingdom

6.8 Japan

6.8.1 Assumptions and Rationale

6.8.2 Total Diagnosed Incident Population of Glioblastoma Multiforme in Japan

6.8.3 Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Japan

6.8.4 Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Japan

6.8.5 Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Japan

6.8.6 Diagnosed Incident Population based on Primary Site of GBM in Japan

6.8.7 Diagnosed Incident Population based on Histologic Classification of GBM in Japan

7 Treatment

7.1 Surgery

7.2 Chemotherapy

7.3 Radiation

7.4 Others

7.4.1 Targeted therapy

7.4.2 Tumor treatment fields (TTF)

7.4.3 Immunotherapy

7.5 Management of Symptoms with Medication

8 Treatment Algorithm

9 The American Society of Clinical Oncology (ASCO) Endorsed American Society for Radiation Oncology (ASTRO) Guideline on Radiation Therapy for Glioblastoma

10 The National Comprehensive Cancer Network (NCCN) Guidelines for Glioblastoma

11 Glioblastoma in Adults: A Society for Neuro-Oncology (SNO) and European Society of Neuro-Oncology (EANO) Consensus Review on Current Management and Future Directions

11.1 Medical Management and Supportive Care

11.2 Standard Therapy

11.3 Surgical Management

11.4 Radiotherapy Considerations

11.5 Recurrent Glioblastoma Scenario

12 SEOM (Medical Oncology Spanish Society) Clinical Guidelines for Diagnosis and Treatment of Glioblastoma

13 Recognized Establishments

14 Unmet Needs

15 Marketed Drugs

15.1 Avastin: Genentech

15.1.1 Drug Description

15.1.2 Regulatory Milestones

15.1.3 Other Development Activities

15.1.4 Safety and Efficacy

15.1.5 Product Profile

15.2 Temodar/Temodal: Merck

15.2.1 Drug Description

15.2.2 Regulatory Milestones

15.2.3 Other Development Activities

15.2.4 Safety and Efficacy

15.2.5 Product Profile

16 Emerging Drugs

16.1 Key Cross Competition

16.2 Other emerging therapies in development

16.3 Ofranergene obadenovec (VB-111): VBL Therapeutics

16.3.1 Product Description

16.3.2 Clinical Development

16.3.3 Safety and Efficacy

16.4 Trans Sodium Crocetinate: Diffusion Pharmaceuticals

16.4.1 Product Description

16.4.2 Clinical Development

16.4.3 Safety and Efficacy

16.5 Regorafenib: Bayer

16.5.1 Product Description

16.5.2 Clinical Development

16.5.3 Safety and Efficacy

16.6 Durvalumab (MEDI4736): MedImmune

16.6.1 Product Description

16.6.2 Clinical Development

16.6.3 Safety and Efficacy

16.7 Tasadenoturev (DNX-2401): DNAtrix

16.7.1 Product Description

16.7.2 Clinical Development

16.7.3 Safety and Efficacy

16.8 ONC201: Oncoceutics

16.8.1 Product Description

16.8.2 Clinical Development

16.8.3 Safety and Efficacy

16.9 Selinexor (KPT-330): Karyopharm Therapeutics

16.9.1 Product Description

16.9.2 Clinical Development

16.9.3 Safety and Efficacy

16.1 VBI-1901: VBI Vaccines

16.10.1 Product Description

16.10.2 Clinical Development

16.10.3 Safety and Efficacy

16.11 Paxalisib (GDC-0084): Kazia Therapeutics

16.11.1 Product Description

16.11.2 Clinical Development

16.11.3 Safety and Efficacy

16.12 AV-GBM-1: Aivita Biomedical

16.12.1 Product Description

16.12.2 Clinical Development

16.12.3 Safety and Efficacy

16.13 MDNA55: Medicenna Therapeutics

16.13.1 Product Description

16.13.2 Clinical Development

16.13.3 Safety and Efficacy

16.14 VAL-083 (Dianhydrogalactitol): DelMar Pharmaceuticals

16.14.1 Product Description

16.14.2 Clinical Development

16.14.3 Safety and Efficacy

16.15 ITI-1000 (pp65 DC Vaccine): Immunomic Therapeutics

16.15.1 Product Description

16.15.2 Clinical Development

16.15.3 Safety and Efficacy

16.16 INO-5401+ INO-9012+ Cemiplimab (REGN2810): Inovio Pharmaceuticals

16.16.1 Product Description

16.16.2 Clinical Development

16.16.3 Safety and Efficacy

17 Glioblastoma Multiforme: 7 Major Market Analysis

17.1 Key Findings

17.2 Total Market Size of Glioblastoma Multiforme in the 7 MM

17.3 The United States Market Outlook

17.4 United States Market Size

17.4.1 Total Market size of Glioblastoma Multiforme in the United States

17.4.2 Market Size of Glioblastoma Multiforme by Current Therapies

17.4.3 Market Size of Glioblastoma Multiforme by Emerging Therapies

17.5 EU-5 Countries: Market Outlook

17.6 Germany

17.6.1 Total Market size of Glioblastoma Multiforme in Germany

17.6.2 Market Size of Glioblastoma Multiforme by Current Therapies

17.6.3 Market Size of Glioblastoma Multiforme by Emerging Therapies

17.7 France

17.7.1 Total Market Size of Glioblastoma Multiforme in France

17.7.2 Market Size of Glioblastoma Multiforme by Current Therapies

17.7.3 Market Size of Glioblastoma Multiforme by Emerging Therapies

17.8 Italy

17.8.1 Total Market Size of Glioblastoma Multiforme in Italy

17.8.2 Market Size of Glioblastoma Multiforme by Current Therapies

17.8.3 Market Size of Glioblastoma Multiforme by Emerging Therapies

17.9 Spain

17.9.1 Total Market Size of Glioblastoma Multiforme in Spain

17.9.2 Market Size of Glioblastoma Multiforme by Current Therapies

17.9.3 Market Size of Glioblastoma Multiforme by Emerging Therapies

17.1 United Kingdom

17.10.1 Total Market Size of Glioblastoma Multiforme in the United Kingdom

17.10.2 Market Size of Glioblastoma Multiforme by Current Therapies

17.10.3 Market Size of Glioblastoma Multiforme by Emerging Therapies

17.11 Japan: Market Outlook

17.11.1 Total Market Size of Glioblastoma Multiforme in Japan

17.11.2 Market Size of Glioblastoma Multiforme by Current Therapies

17.11.3 Market Size of Glioblastoma Multiforme by Emerging Therapies

18 Market Access and Reimbursement

18.1 United States

18.2 Europe

18.3 Japan

19 Case Reports

19.1 Glioblastoma and intracranial aneurysms: Case report and review of the literature (United States)

19.2 A New Method for Ethical and Efficient Evidence Generation for Off-label Medication Use in Oncology (A Case Study in Glioblastoma) (United Kingdom)

19.3 Diagnosis and treatment of early-stage glioblastoma (Japan)

20 KOL Reviews

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 Glioblastoma Multiforme, Market, Epidemiology and Key Events (2017–2030)

Table 2: Total Diagnosed Incident Patient Population of Glioblastoma Multiforme in the 7MM (2017–2030)

Table 3: Total Diagnosed Incident Population of Glioblastoma Multiforme in the United States (2017–2030)

Table 4: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in the United States (2017–2030)

Table 5: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in the United States (2017–2030)

Table 6: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in the United States (2017–2030)

Table 7: Diagnosed Incident Population based on Primary Site of GBM Tumor in the United States (2017–2030)

Table 8: Diagnosed Incident Population based on Histologic Classification of GBM Tumor in the United States (2017–2030)

Table 9: Total Diagnosed Incident Population of Glioblastoma Multiforme in Germany (2017–2030)

Table 10: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Germany (2017–2030)

Table 11: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Germany (2017–2030)

Table 12: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Germany (2017–2030)

Table 13: Diagnosed Incident Population based on Primary Site of Glioblastoma Multiforme Tumor in Germany (2017–2030)

Table 14: Diagnosed Incident Population based on Histologic Classification of GBM Tumor in Germany (2017–2030)

Table 15: Total Diagnosed Incident Population of Glioblastoma Multiforme in France (2017–2030)

Table 16: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in France (2017–2030)

Table 17: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in France (2017–2030)

Table 18: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in France (2017–2030)

Table 19: Diagnosed Incident Population based on Primary Site of Glioblastoma Multiforme Tumor in France (2017–2030)

Table 20: Diagnosed Incident Population based on Histologic Classification of GBM Tumor in France (2017–2030)

Table 21: Total Diagnosed Incident Population of Glioblastoma Multiforme in Italy (2017–2030)

Table 22: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Italy (2017–2030)

Table 23: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Italy (2017–2030)

Table 24: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Italy (2017–2030)

Table 25: Diagnosed Incident Population based on Primary Site of Glioblastoma Multiforme Tumor in Italy (2017–2030)

Table 26: Diagnosed Incident Population based on Histologic Classification of GBM Tumor in Italy (2017–2030)

Table 27: Total Diagnosed Incident Population of Glioblastoma Multiforme in Spain (2017–2030)

Table 28: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Spain (2017–2030)

Table 29: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Spain (2017–2030)

Table 30: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Spain (2017–2030)

Table 31: Diagnosed Incident Population based on Primary Site of Glioblastoma Multiforme Tumor in Spain (2017–2030)

Table 32: Diagnosed Incident Population based on Histologic Classification of GBM Tumor in Spain (2017–2030)

Table 33: Total Diagnosed Incident Population of Glioblastoma Multiforme in the United Kingdom (2017–2030)

Table 34: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in the United Kingdom (2017–2030)

Table 35: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in the United Kingdom (2017–2030)

Table 36: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in the United Kingdom (2017–2030)

Table 37:Diagnosed Incident Population based on Primary Site of Glioblastoma Multiforme Tumor in the UK (2017–2030)

Table 38: Diagnosed Incident Population based on Histologic Classification of GBM Tumor in the United Kingdom (2017–2030)

Table 39: Total Diagnosed Incident Population of Glioblastoma Multiforme in Japan (2017–2030)

Table 40: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Japan (2017–2030)

Table 41: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Japan (2017–2030)

Table 42: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Japan (2017–2030)

Table 43: Diagnosed Incident Population based on Primary Site of GBM Tumor in Japan (2017–2030)

Table 44: Diagnosed Incident Population based on Histologic Classification of GBM Tumor in Japan (2017–2030)

Table 45: Adjuvant Treatment of Glioblastoma based on Age and Karnofsky Performance Status

Table 46: Summary of recommendations

Table 47: Comparison of emerging drugs under development

Table 48: Comparison of emerging drugs under development

Table 49: VB-111, Clinical Trial Description, 2020

Table 50: Trans Sodium Crocetinate, Clinical Trial Description, 2020

Table 51: Regorafenib, Clinical Trial Description, 2020

Table 52: Durvalumab, Clinical Trial Description, 2020

Table 53: Tasadenoturev (DNX-2401), Clinical Trial Description, 2020

Table 54: ONC201, Clinical Trial Description, 2020

Table 55: Selinexor (KPT-330), Clinical Trial Description, 2020

Table 56: VBI-1901, Clinical Trial Description, 2020

Table 57: Paxalisib (GDC-0084), Clinical Trial Description, 2020

Table 58: AV-GBM-1, Clinical Trial Description, 2020

Table 59: MDNA55, Clinical Trial Description, 2020

Table 60: VAL-083 (Dianhydrogalactitol), Clinical Trial Description, 2020

Table 61: pp65 DC Vaccine, Clinical Trial Description, 2020

Table 62: INO-5401+ INO-9012+ Cemiplimab (REGN2810), Clinical Trial Description, 2020

Table 63: Total 7 Major Market Size of Glioblastoma Multiforme in USD Million (2017–2030)

Table 64: Total Market Size of Glioblastoma Multiforme in the United States, in USD Million (2017–2030)

Table 65: Market size of Glioblastoma Multiforme by Current Therapies in the United States, in USD Million (2017–2030)

Table 66: Market size of Glioblastoma Multiforme by Emerging Therapies in the United States, in USD Million (2017–2030)

Table 67: Total Market Size of Glioblastoma Multiforme in Germany, in USD Million (2017–2030)

Table 68: Market size of Glioblastoma Multiforme by Current Therapies in Germany, in USD Million (2017–2030)

Table 69: Market size of Glioblastoma Multiforme by Emerging Therapies in Germany, in USD Million (2017–2030)

Table 70: Total Market Size of Glioblastoma Multiforme in France, in USD Million (2017–2030)

Table 71: Market size of Glioblastoma Multiforme by Current Therapies in France, in USD Million (2017–2030)

Table 72: Market size of Glioblastoma Multiforme by Emerging Therapies in France, in USD Million (2017–2030)

Table 73: Total Market Size of Glioblastoma Multiforme in Italy, in USD Million (2017–2030)

Table 74: Market size of Glioblastoma Multiforme by Current Therapies in Italy, in USD Million (2017–2030)

Table 75: Market size of Glioblastoma Multiforme by Emerging Therapies in Italy, in USD Million (2017–2030)

Table 76: Total Market Size of Glioblastoma Multiforme in Spain, in USD Million (2017–2030)

Table 77: Market size of Glioblastoma Multiforme by Current Therapies in Spain, in USD Million (2017–2030)

Table 78: Market size of Glioblastoma Multiforme by Emerging Therapies in Spain, in USD Million (2017–2030)

Table 79: Total Market Size of Glioblastoma Multiforme in the United Kingdom, in USD Million (2017–2030)

Table 80: Market size of Glioblastoma Multiforme by Current Therapies in the United Kingdom, in USD Million (2017–2030)

Table 81: Market size of Glioblastoma Multiforme by Emerging Therapies in the UK, in USD Million (2017–2030)

Table 82: Total Market Size of Glioblastoma Multiforme in Japan, in USD Million (2017–2030)

Table 83: Market size of Glioblastoma Multiforme by Current Therapies in Japan, in USD Million (2017–2030)

Table 84:Market size of Glioblastoma Multiforme by Emerging Therapies in Japan, in USD Million (2017–2030)

List of Figures

Figure 1: Classification of Glioblastoma

Figure 2: Different types of Glioblastoma

Figure 3: Generalized transcription pathways related to Glioblastoma disease

Figure 4: Up-regulated Genetic Pathways in Glioblastoma

Figure 5: Overall pathways of IDH mutations

Figure 6: Chemistry of O6-Methylguanine-DNA Methyltransferase (MGMT)

Figure 7: Functioning of MicroRNA as a biomarker in Glioblastoma

Figure 8: Total Diagnosed Incident Patient Population of GBM in the 7MM (2017–2030)

Figure 9: Total Diagnosed Incident Population of Glioblastoma Multiforme in the US (2017–2030)

Figure 10: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in the US (2017–2030)

Figure 11: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in the US (2017–2030)

Figure 12: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in the US (2017–2030)

Figure 13: Diagnosed Incident Population based on Primary Site of GBM Tumor in the US (2017–2030)

Figure 14: Diagnosed Incidence based on Histologic Classification of GBM Tumor in the US (2017–2030)

Figure 15: Total Diagnosed Incident Population of Glioblastoma Multiforme in Germany (2017–2030)

Figure 16: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Germany (2017–2030)

Figure 17: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Germany (2017–2030)

Figure 18: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Germany (2017–2030)

Figure 19: Diagnosed Incident Population based on Primary Site of GBM Tumor in Germany (2017–2030)

Figure 20: Diagnosed Incidence based on Histologic Classification of GBM Tumor in Germany (2017–2030)

Figure 21: Total Diagnosed Incident Population of Glioblastoma Multiforme in France (2017–2030)

Figure 22: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in France (2017–2030)

Figure 23: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in France (2017–2030)

Figure 24: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in France (2017–2030)

Figure 25: Diagnosed Incident Population based on Primary Site of GBM Tumor in France (2017–2030)

Figure 26: Diagnosed Incidence based on Histologic Classification of GBM Tumor in France (2017–2030)

Figure 27: Total Diagnosed Incident Population of Glioblastoma Multiforme in Italy (2017–2030)

Figure 28: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Italy (2017–2030)

Figure 29: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Italy (2017–2030)

Figure 30: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Italy (2017–2030)

Figure 31: Diagnosed Incident Population based on Primary Site of GBM Tumor in Italy (2017–2030)

Figure 32: Diagnosed Incidence based on Histologic Classification of GBM Tumor in Italy (2017–2030)

Figure 33: Total Diagnosed Incident Population of Glioblastoma Multiforme in Spain (2017–2030)

Figure 34: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Spain (2017–2030)

Figure 35: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Spain (2017–2030)

Figure 36: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Spain (2017–2030)

Figure 37: Diagnosed Incident Population based on Primary Site of GBM Tumor in Spain (2017–2030)

Figure 38: Diagnosed Incidence based on Histologic Classification of GBM Tumor in Spain (2017–2030)

Figure 39: Total Diagnosed Incident Population of Glioblastoma Multiforme in the UK (2017–2030)

Figure 40: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in the UK (2017–2030)

Figure 41: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in the UK (2017–2030)

Figure 42: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in the UK (2017–2030)

Figure 43: Diagnosed Incident Population based on Primary Site of GBM Tumor in the UK (2017–2030)

Figure 44: Diagnosed Incidence based on Histologic Classification of GBM Tumor in the UK (2017–2030)

Figure 45: Total Diagnosed Incident Population of Glioblastoma Multiforme in Japan (2017–2030)

Figure 46: Gender-specific Diagnosed Incidence of Glioblastoma Multiforme in Japan (2017–2030)

Figure 47: Type-specific Diagnosed Incidence of Glioblastoma Multiforme in Japan (2017–2030)

Figure 48: Age-specific Diagnosed Incidence of Glioblastoma Multiforme in Japan (2017–2030)

Figure 49: Diagnosed Incident Population based on Primary Site of GBM Tumor in Japan (2017–2030)

Figure 50: Diagnosed Incidence based on Histologic Classification of GBM Tumor in Japan (2017–2030)

Figure 51: NCCN Guidelines for treatment of Anaplastic Gliomas/Glioblastoma

Figure 52: NCCN Guidelines for Treatment of Recurrent Anaplastic Gliomas/Glioblastoma

Figure 53: Unmet Needs of Glioblastoma

Figure 54: Total 7 Major Market Size of Glioblastoma Multiforme in USD Million (2017–2030)

Figure 55: Total Market Size of GBM in the United States, USD Millions (2017–2030)

Figure 56: Market size of GBM by Current Therapies in the US, in USD Million (2017–2030)

Figure 57: Market size of GBM by Emerging Therapies in the US, in USD Million (2017–2030)

Figure 58: Total Market Size of Glioblastoma Multiforme in Germany, USD Million (2017–2030)

Figure 59: Market size of GBM by Current Therapies in Germany, in USD Million (2017–2030)

Figure 60: Market size of GBM by Emerging Therapies in Germany, in USD Million (2017–2030)

Figure 61: Total Market Size of Glioblastoma Multiforme in France, USD Million (2017–2030)

Figure 62: Market size of GBM by Current Therapies in France, in USD Million (2017–2030)

Figure 63: Market size of GBM by Emerging Therapies in France, in USD Million (2017–2030)

Figure 64: Total Market Size of Glioblastoma Multiforme in Italy, USD Million (2017–2030)

Figure 65: Market size of Glioblastoma Multiforme by Current Therapies in Italy, in USD Million (2017–2030)

Figure 66: Market size of GBM by Emerging Therapies in Italy, in USD Million (2017–2030)

Figure 67: Total Market Size of Glioblastoma Multiforme in Spain, USD Million (2017–2030)

Figure 68: Market size of Glioblastoma Multiforme by Current Therapies in Spain, in USD Million (2017–2030)

Figure 69: Market size of GBM by Emerging Therapies in Spain, in USD Million (2017–2030)

Figure 70: Total Market Size of GBM in the United Kingdom, USD Million (2017–2030)

Figure 71: Market size of GBM by Current Therapies in the UK, in USD Million (2017–2030)

Figure 72: Market size of GBM by Emerging Therapies in the UK, in USD Million (2017–2030)

Figure 73: Total Market Size of Glioblastoma Multiforme in Japan, USD Million (2017–2030)

Figure 74: Market size of Glioblastoma Multiforme by Current Therapies in Japan, in USD Million (2017–2030)

Figure 75: Market size of GBM by Emerging Therapies in Japan, in USD Million (2017–2030)

Figure 76: Market Drivers

Figure 77: Market Barriers

Figure 78: SWOT Analysis

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