Scrip's Complete Guide to Women's Healthcare
Therapeutic

Women's healthcare is already a multi-billion dollar industry and it continues to grow steadily year on year, fuelled by both greater consumer demand and better treatment options. More effective ways of managing breast cancer, osteoporosis, the menopause and infertility are expected to have a considerable impact on women's health worldwide. New treatment regimens under investigation and new products in development will also change the market.

This report provides invaluable information on the current and future market for women's healthcare products, covering reproductive disorders, contraceptives, the menopause, hormone replacement therapy, osteoporosis and women's cancers. The report presents detailed information on current strategies for managing women's health and an analysis of predicted future trends. Important competitor information is provided in the report with details of companies' research activities.

PUBLICATION: April 2000
REF: BS1039E
PAGES: 150+
PRICE: £495/$1,040/¥119,000

CONTENTS
LIST OF TABLES
LIST OF FIGURES
EXECUTIVE SUMMARY
ABBREVIATIONS


CHAPTER 1 INTRODUCTION
1.1 Trends in women's healthcare
1.2 Unmet needs and predicted developments
1.2.1 Cancer
1.2.1.1 Breast cancer
1.2.1.2 Cervical cancer
1.2.1.3 Ovarian cancer
1.2.1.4 Endometrial cancer
1.2.2 The menopause
1.2.3 Osteoporosis
1.2.4 Contraception
1.2.5 Infertility
1.2.6 Gynaecology
1.2.7 Female sexual dysfunction
1.3 The women's healthcare industry
1.3.1 Cancer
1.3.2 The menopause, osteoporosis and HRT
1.3.3 Contraception
1.3.4 Infertility
1.3.5 Female sexual dysfunction

CHAPTER 2 WOMEN'S CANCERS
2.1 Breast cancer
2.1.1 Risk factors
2.1.2 Detection and diagnosis
2.1.3 Staging
2.1.4 Prognosis
2.1.5 Treatment
2.1.6 Endocrine therapy
2.1.6.1 Anti-oestrogens
2.1.6.2 Selective oestrogen receptor modulators
2.1.6.3 Aromatase inhibitors
2.1.6.4 Progestogens
2.1.7 Chemotherapy
2.1.7.1 New developments
2.1.7.2 Sequential therapy
2.1.7.3 High-dose chemotherapy
2.1.8 Prevention strategies
2.1.8.1 Tamoxifen trials
2.1.8.2 Raloxifene trials
2.1.8.3 Prophylactic mastectomy
2.1.8.4 Removal of ovaries
2.1.9 Emerging therapies for breast cancer
2.1.9.1 Herceptin
2.1.9.2 Zoladex
2.1.10 Breast cancer biotherapies in development
2.1.11 Proteomics
2.1.12 Microwaves
2.2 Cervical cancer
2.2.1 Risk factors
2.2.1.1 Genetic link to cervical cancer
2.2.2 Screening and early detection
2.2.3 Diagnosis and staging
2.2.4 Prognosis
2.2.5 Prevention
2.2.6 Treatment options
2.2.6.1 Surgery
2.2.6.2 Radiotherapy
2.2.6.3 Chemotherapy plus radiotherapy
2.2.6.4 Clinical trials with concurrent chemotherapy
2.2.7 Vaccine development
2.3 Ovarian cancer
2.3.1 Risk factors
2.3.2 Pathology
2.3.3 Diagnosis and detection
2.3.4 Staging
2.3.5 Prognosis
2.3.6 Prevention
2.3.7 Treatment
2.3.7.1 Surgery and radiotherapy
2.3.7.2 Chemotherapy
2.3.8 Drugs in development
2.3.9 Gene therapy for ovarian cancer
2.4 Endometrial cancer
2.4.1 Risk factors
2.4.2 Pathology
2.4.3 Early symptoms and diagnosis
2.4.4 Tumour grading and staging
2.4.5 Treatment
2.4.5.1 Surgical treatment
2.4.5.2 Radiotherapy
2.4.5.3 Medical treatment
2.4.6 Prognosis
2.4.7 Preventive measures
2.4.8 New drug developments
2.5 The women's cancer market
2.5.1 Incidence of women's cancers
2.5.2 Market value of drugs used to treat women's cancers

CHAPTER 3 THE MENOPAUSE, HRT AND OSTEOPOROSIS
3.1 The menopause
3.2 Hormone replacement therapy
3.2.1 Types of therapy available
3.2.1.1 Oral preparations
3.2.1.2 Transdermal delivery systems
3.2.1.3 Oestradiol implants
3.2.1.4 Topical oestrogens
3.2.2 Contra-indications for HRT
3.2.3 Side effects of HRT
3.2.4 Benefits of HRT
3.2.4.1 Relief of vasomotor and psychological symptoms
3.2.4.2 Protection against osteoporosis
3.2.4.3 Cardiovascular disease
3.2.4.4 Oestrogens and Alzheimer's disease
3.2.4.5 Protection against colorectal cancer
3.2.4.6 Macular degeneration
3.2.4.7 Short-term memory
3.2.5 Risks associated with HRT
3.2.5.1 Endometrial cancer
3.2.5.2 Breast cancer
3.2.5.3 Venous thromboembolism
3.2.6 Recent developments in HRT products
3.2.6.1 Low-dose continuous combined preparations
3.2.6.2 Transdermal products
3.2.6.3 Intranasal oestrogens
3.2.6.4 Alternatives to HRT
3.3 Osteoporosis
3.3.1 Pathogenesis of osteoporosis
3.3.2 Risk factors
3.3.3 Diagnosis and screening
3.3.4 Prevention
3.3.5 Established and emerging treatments
3.3.5.1 HRT
3.3.5.2 Selective oestrogen receptor modulators
3.3.5.3 Calcitonins
3.3.5.4 Bisphosphonates
3.3.6 New opportunities in drug development
3.3.6.1 Parathyroid hormone
3.3.6.2 PTH-related protein
3.3.6.3 Activators of non-genomic oestrogen-like signalling
3.3.6.4 Osteoprotegrin
3.3.6.5 OSA and OSB
3.3.6.6 Bone density protein
3.3.6.7 Statins
3.3.7 The market for HRT and osteoporosis
3.3.7.1 The target population
3.3.7.2 The value of the market

CHAPTER 4 CONTRACEPTION
4.1 Background
4.2 The combined oral contraceptive pill
4.2.1 Side effects of combined oral contraceptives
4.2.2 Benefits of combined oral contraceptives
4.2.2.1 Ovarian and endometrial cancers
4.2.2.2 Reduced risk of hip fracture
4.2.3 Risks associated with combined oral contraceptives
4.2.3.1 Breast cancer
4.2.3.2 Cervical cancer
4.2.3.3 Third-generation oral contraceptives and cardiovascular disease
4.2.3.4 Myocardial infarction
4.2.3.5 Stroke
4.2.3.6 Gum disease
4.2.4 Long-term risks of combined oral contraceptives
4.3 The progestogen-only pill
4.4 Parenteral contraceptives
4.4.1 Depot injections
4.4.1.1 Depo-Provera
4.4.1.2 Lunelle
4.4.1.3 Mesigyna
4.4.2 Implants
4.4.2.1 Norplant
4.4.2.2 Implanon
4.4.2.3 Jadelle
4.4.3 Progestogen-only intrauterine devices
4.4.3.1 Levonova
4.4.4 Vaginal rings
4.4.5 Contraceptive patches
4.4.5.1 Evra Contraceptive Patch
4.4.5.2 Levotech's contraceptive transdermal patch
4.5 Emergency contraception
4.5.1 Regimens available for emergency contraception
4.5.1.1 The Yuzpe regimen
4.5.1.2 Levonorgestrel
4.5.1.3 Mifepristone
4.5.2 The Lothian project
4.5.3 Opinion concerning emergency contraception
4.6 Japan - a new market
4.7 The world market for contraceptive products
4.8 Future developments

CHAPTER 5 FEMALE INFERTILITY
5.1 Background to reproductive health
5.1.1 Menstrual phase
5.1.2 Pre-ovulatory phase
5.1.3 Ovulation
5.1.4 Postovulatory phase
5.1.5 Fertilisation
5.2 Why are couples infertile?
5.3 Identifying the causes of infertility
5.4 Drugs to treat infertility
5.4.1 Drugs which suppress the menstrual cycle
5.4.2 Drugs which stimulate the ovaries
5.4.2.1 Anti-oestrogens
5.4.2.2 Human menopausal gonadotropin
5.4.2.3 Follicle-stimulating hormone
5.4.3 Drugs which trigger ovulation
5.4.3.1 Human chorionic gonadotropin
5.4.4 Drugs used to support pregnancy after assisted reproductive technique
5.5 Assisted reproductive technique procedures
5.5.1 In vitro fertilisation
5.5.2 Gamete intrafallopian transfer
5.5.3 Zygote intrafallopian transfer or tubal embryo transfer
5.5.4 Donated eggs or sperm and frozen embryos
5.6 Risks of infertility therapy
5.6.1 Multiple births
5.6.2 Cancer
5.6.3 Ovarian hyperstimulation
5.6.4 Ectopic pregnancy
5.7 Products in development
5.7.1 Drugs which suppress the menstrual cycle
5.7.2 Drugs which stimulate the ovaries
5.7.3 Drugs which trigger ovulation
5.7.4 Preclinical projects
5.7.4.1 ALZA
5.7.4.2 Ares-Serono
5.7.4.3 ASTA Medica
5.7.4.4 Inhale Therapeutics Systems
5.7.4.5 Novo Nordisk
5.8 Predicted future trends in management
5.8.1 Recombinant products
5.8.2 Patient convenience
5.8.3 Procedures and techniques
5.8.3.1 Blastocyst transfer
5.8.3.2 Pre-embryo culture and selection
5.8.3.3 Implantation
5.8.4 Access to treatment
5.9 Incidence of fertility problems
5.9.1 Driving factors
5.10 Market data
5.10.1 Size and predicted growth
5.10.2 Country-specific data
5.10.3 Market shares
5.10.4 Breakdown for specific products/product types
5.10.4.1 Gonal-F versus Puregon (Follistim)
5.11 Conclusions

CHAPTER 6 GYNAECOLOGICAL DISORDERS AND OBSTETRICS
6.1 Background to menstrual disorders
6.1.1 Dysmenorrhea (menstrual pain/cramps)
6.1.2 Menorrhagia
6.1.3 Endometriosis
6.1.4 Premenstrual syndrome
6.1.5 Amenorrhoea
6.1.6 Uterine fibroids (fibroid tumours)
6.1.7 Endometrial hyperplasia
6.1.8 Polycystic ovarian syndrome
6.1.9 Toxic shock syndrome
6.1.10 Pelvic inflammatory disease
6.2 Current management of menstrual disorders
6.2.1 Non-steroidal anti-inflammatory drugs
6.2.2 Non-NSAID pain control
6.2.3 Combined oral contraceptives
6.2.4 Progesterone
6.2.5 Gonadotropin-releasing hormone analogues
6.2.6 Gonadotropin release inhibitors
6.2.7 Antifibrinolytics
6.2.8 Anticholinergics
6.2.9 Antibiotics
6.2.10 Antidiabetic agents
6.2.11 Surgical options
6.3 Products in clinical development for menstrual disorders
6.3.1 SR-49059
6.3.2 Abarelix
6.3.3 Avorelin
6.3.4 Dienogest
6.3.5 Fulvestrant
6.3.6 Teverelix
6.3.7 FP-1096
6.3.8 PH-80
6.3.9 Cetrorelix
6.3.10 INS-1
6.4 Introduction to pregnancy- and birth-related problems
6.4.1 Gestation
6.4.1.1 Pre-eclampsia, eclampsia and pregnancy-induced hypertension
6.4.1.2 Gestational diabetes
6.4.2 Labour
6.5 Current management of pregnancy- and birth-related problems
6.5.1 Gestation
6.5.1.1 Pre-eclampsia and pregnancy-induced hypertension
6.5.1.2 Gestational diabetes
6.5.1.3 Progesterone deficiency
6.5.2 Labour
6.5.2.1 Labour inhibition
6.5.2.2 Cervical ripening
6.5.2.3 Labour induction
6.6 Products in development for pregnancy- and birth-related problems
6.6.1 Atosiban
6.6.2 SR-49059
6.6.3 TT-235
6.6.4 KUR-2146
6.6.5 Antiprogestins
6.7 Incidence data
6.7.1 Menstrual disorders
6.7.2 Endometriosis
6.7.3 Infectious diseases
6.7.4 Obstetrics
6.8 Conclusions

CHAPTER 7 FEMALE SEXUAL DYSFUNCTION
7.1 Background
7.1.1 Symptoms, diagnosis and pathology
7.1.2 Mediators of female sexual responses
7.1.2.1 Hormonal mediators
7.1.2.2 Neuromodulatory mediators
7.1.3 Causes of female sexual dysfunction
7.1.3.1 Physiological causes
7.1.3.2 Psychological causes
7.2 Current management of female sexual dysfunction
7.3 New treatments for female sexual dysfunction
7.3.1 Hormonal therapy for female sexual dysfunction
7.3.1.1 Watson
7.3.1.2 Cellegy
7.3.2 Vasodilators
7.3.2.1 Vivus
7.3.2.2 NexMed
????? (-Adrenoceptor antagonists
7.3.3.1 Zonagen
7.3.4 Phosphodiesterase 5 inhibitors
7.3.4.1 IC351
7.3.4.2 Viagra (sildenafil)
7.3.5 Earlier-stage developments
7.4 Predicted future trends in management
7.5 Incidence data
7.6 Predicted market size
7.7 Conclusions

CHAPTER 8 COMPANY PROFILES
8.1 Introduction
8.2 Akzo Nobel (Organon)
8.2.1 Summary
8.2.2 Financial data
8.2.3 Women's health products
8.2.4 Women's health pipeline
8.3 American Home Products
8.3.1 Summary
8.3.2 Financial data
8.3.3 Women's health products
8.3.4 Women's health pipeline
8.4 Ares-Serono
8.4.1 Summary
8.4.2 Financial data
8.4.3 Women's health products
8.4.4 Women's health pipeline
8.5 AstraZeneca
8.5.1 Summary
8.5.2 Financial data
8.5.3 Women's health products
8.5.4 Women's health pipeline
8.6 Johnson & Johnson
8.6.1 Summary
8.6.2 Financial data
8.6.3 Women's health products
8.6.4 Women's health pipeline
8.7 Eli Lilly
8.7.1 Summary
8.7.2 Financial data
8.7.3 Women's health products
8.7.4 Women's health pipeline
8.8 Merck & Co
8.8.1 Summary
8.8.2 Financial data
8.8.3 Women's health products
8.8.4 Women's health pipeline
8.9 Novartis
8.9.1 Summary
8.9.2 Financial data
8.9.3 Women's health products
8.9.4 Women's health pipeline
8.10 Novo Nordisk
8.10.1 Summary
8.10.2 Financial data
8.10.3 Women's health products
8.10.4 Women's health pipeline
8.11 Pfizer
8.11.1 Summary
8.11.2 Financial data
8.11.3 Women's health products
8.11.4 Women's health pipeline
8.12 Pharmacia & Upjohn
8.12.1 Summary
8.12.2 Financial data
8.12.3 Women's health products
8.12.4 Women's health pipeline
8.13 Schering AG
8.13.1 Summary
8.13.2 Financial data
8.13.3 Women's health products
8.13.4 Women's health pipeline
8.14 Solvay
8.14.1 Summary
8.14.2 Financial data
8.14.3 Women's health products
8.14.4 Women's health pipeline
8.15 Warner-Lambert
8.15.1 Summary
8.15.2 Financial data
8.15.3 Women's health products
8.15.4 Women's health pipeline
REFERENCES
APPENDIX A EXCHANGE RATES


LIST OF TABLES
Table 1.1 Forecasts of the age distribution of women worldwide
Table 1.2 Forecasts of the age distribution of women in more developed countries
Table 1.3 Forecasts of the age distribution of women in less developed countries

Table 2.1 Breast cancer staging
Table 2.2 Hormonal therapies recently launched or in development for the treatment of breast cancer
Table 2.3 Non-endocrine drugs launched or in development for the treatment of breast cancer
Table 2.4 Biotherapies in development for the treatment of breast cancer
Table 2.5 Cervical cancer staging
Table 2.6 Clinical trials evaluating concurrent chemo-radiotherapy for women with high-risk cervical cancer
Table 2.7 Vaccines in development for the treatment and prevention of cervical cancer
Table 2.8 Ovarian cancer staging
Table 2.9 Drugs in development for the treatment of ovarian cancer
Table 2.10 Endometrial cancer staging
Table 2.11 Incidence of women's cancers in major markets
Table 2.12 Incidence and 1- and 5-year prevalence of women's cancers in the major EU markets (age range 15-75+ years)
Table 2.13 Cytotoxic drugs marketed or to be marketed mainly (but not exclusively) for women's cancers (sales/projected sales $ million)
Table 2.14 Sales and projected sales of hormonal drugs for the treatment of breast cancer ($ million)

Table 3.1 Oral preparations launched for HRT
Table 3.2 Transdermal products launched for HRT
Table 3.3 Transdermal products in development for HRT
Table 3.4 HRT products in development other than transdermal products
Table 3.5 Drugs launched for the prevention and treatment of osteoporosis
Table 3.6 Drugs in development for the prevention and treatment of osteoporosis
Table 3.7 Projected female population aged 50 years and above, 1995-2010
Table 3.8 Women aged 50 and over with osteoporosis, 1995-2010 (million)
Table 3.9 HRT/osteoporosis: sales and forecast sales, 1998-2002 ($ million)
Table 3.10 Sales of osteoporosis drugs in 1998 ($ million) and as % total market
Table 3.11 Sales of osteoporosis drugs in 2002 ($ million) and as % total market
Table 3.12 Sales and forecast sales of HRT/osteoporosis drugs, 1998-2002 ($ million)
Table 3.13 Sales of the major drug categories for HRT/osteoporosis, 1998-2002 ($ million)

Table 4.1 Combined oral contraceptive preparations launched and in development
Table 4.2 Low-dose oral contraceptive products approved for Japan
Table 4.3 Sales of contraceptive products by the market leaders in 1998
Table 4.4 Market dominance projections for 2002
Table 4.5 Sales and projected sales of oral contraceptives by company 1997-2002 ($ million)
Table 4.6 Sales and projected sales of oral contraceptives by product 1997-2002 ($ million)

Table 5.1 Causes of infertility in men and women
Table 5.2 Marketed GnRH analogues for treatment of infertility
Table 5.3 Marketed antio-estrogens for treatment of infertility
Table 5.4 Progesterones available for post-ART pregnancy support
Table 5.5 Products in development for the treatment of infertility
Table 5.6 FSH in IVF - recombinant versus urinary
Table 5.7 Sales and projected sales for key reproductive health products, 1998-2006 ($ million)
Table 5.8 Sales of Ares-Serono's reproductive health products, 1997-1999 ($ million)
Table 5.9 Sales of Organon's reproductive health products, 1998-1999 ($ million)

Table 6.1 Marketed progestogens for gynaecological disorders
Table 6.2 Marketed GnRH analogues for gynaecological disorders
Table 6.3 Drugs recently launched or in development for gynaecological disorders

Table 7.1 AFUD Consensus Panel classification and definitions of FSD
Table 7.2 Products in development to treat FSD
Table 7.3 FSD market - predicted size, growth and major products 2002-2006 ($ million)

Table 8.1 Selected financial data for Akzo Nobel, 1996-1999 ($ million)
Table 8.2 Some of Akzo Nobel's leading women's health products
Table 8.3 Akzo Nobel's women's health R&D pipeline
Table 8.4 Selected financial data for American Home Products, 1996-1999 ($ million)
Table 8.5 Sales of American Home Products' leading women's health products, 1997-1999 ($ million)
Table 8.6 American Home Products' women's health R&D pipeline
Table 8.7 Selected financial data for Ares-Serono, 1996-1999 ($ million)
Table 8.8 Sales of Ares-Serono's reproductive health products, 1997-1999 ($ million)
Table 8.9 Ares-Serono's women's health R&D pipeline
Table 8.10 Selected financial data for AstraZeneca, 1996-1999 ($ million)
Table 8.11 Sales of AstraZeneca's leading women's health products, 1998-1999 ($ million)
Table 8.12 AstraZeneca's women's health R&D pipeline
Table 8.13 Selected financial data for Johnson & Johnson, 1996-1999 ($ million)
Table 8.14 Johnson & Johnson's leading women's health products
Table 8.15 Johnson & Johnson's women's R&D health pipeline
Table 8.16 Selected financial data for Eli Lilly, 1996-1999 ($ million)
Table 8.17 Sales for raloxifene, 1998-1999 ($ million)
Table 8.18 Eli Lilly's women's health R&D pipeline
Table 8.19 Selected financial data for Merck & Co, 1996-1999 ($ million)
Table 8.20 Merck & Co's women's health R&D pipeline
Table 8.21 Selected financial data for Novartis, 1996-1999 ($ million)
Table 8.22 Novartis' women's health R&D pipeline
Table 8.23 Selected financial data for Novo Nordisk, 1996-1999 ($ million)
Table 8.24 Sales of Novo Nordisk's HRT products, 1998-1999 ($ million)
Table 8.25 Novo Nordisk's women's health R&D pipeline
Table 8.26 Selected financial data for Pfizer, 1996-1999 ($ million)
Table 8.27 Pfizer's women's health R&D pipeline
Table 8.28 Selected financial data for Pharmacia & Upjohn, 1996-1999 ($ million)
Table 8.29 Pharmacia & Upjohn's women's health R&D pipeline
Table 8.30 Selected financial data for Schering AG, 1996-1999 ($ million)
Table 8.31 Schering AG's leading women's health products, 1998-2002 (sales in $ million)
Table 8.32 Schering AG's women's health R&D pipeline
Table 8.33 Selected financial data for Solvay, 1996-1999 (ECU million)
Table 8.34 Summary of Solvay's leading women's health products
Table 8.35 Solvay's women's health R&D pipeline
Table 8.36 Selected financial data for Warner-Lambert, 1996-1999 ($ million)
Table 8.37 Warner-Lambert's women's health R&D pipeline

Table A:1 Exchange rates versus the US$


LIST OF FIGURES
Figure 2.1 AstraZeneca's sales and projected sales of hormonal therapies for women's cancers, 1998-2002
Figure 2.2 Sales and projected sales for Herceptin, 1998-2002

Figure 5.1 Sales of Ares-Serono's reproductive health products by market, first half 1999 ($ million)
Figure 5.2 Gonadotropin consumption in 1998 (ampoules/1,000 inhabitants)
Figure 5.3 Estimated share of worldwide reproductive health market, 1998-1999
Figure 5.4 Half-year sales figures for Gonal-F and Ares-Serono's urinary-derived products in the US, 1998-1999 ($ million)

Figure 7.1 Incidence of female sexual dysfunction


EXECUTIVE SUMMARY
Women's healthcare is big business. Women are far bigger consumers of healthcare resources than men, accounting for an estimated 2 of every 3 dollars spent on healthcare in the US. The pharmaceutical industry already provides a wealth of treatment options specifically for women, from hormone replacement therapies to breast cancer treatments. Profits from women's healthcare are set to continue rising over the next 10-20 years as healthcare demands increase and more new, innovative products become available.


Two main factors are stimulating the increasing healthcare demands of women. Firstly, women are generally becoming more knowledgeable about their own health and more proactive in seeking the best healthcare options. A recent study by Beta Research Corporation (New York, US) examined the attitudes to health of 4,100 adult women of all ages. The survey found that 55% believe women's healthcare has generally improved over the last 5 years and 65% said they were more involved in their own healthcare compared with 5 years ago. Some 62% of the women said that they now research ailments or treatments that affect them or their family and 78% are now questioning their doctors' choice of treatment. The survey also found that 59% of women 'would pay just about anything' when it comes to their health.


Secondly, demographic changes mean that there are now increasing numbers of women living after the menopause, when they often become particularly heavy consumers of pharmaceuticals such as hormone replacement therapy products, anti-osteoporotics and breast cancer treatments. The numbers of older women will continue to increase over the next 10-30 years, leading to an increased burden on healthcare resources. At present, women live for on average 6 or 7 years longer than men and have a greater susceptibility than men to chronic illnesses such as obesity, diabetes, depression and arthritis. On average, women are more likely to experience illness and disability at some point in their lives than men.


Also driving the women's healthcare industry is the pharmaceutical industry, which continues to plough significant R&D funding into research for products to treat women's health disorders. The Pharmaceutical Research and Manufacturers of America estimates that research on women's health by the pharmaceutical industry has increased by around 75% over the 10 years from 1989-1999. Several factors have been involved in this increase:


This report discusses disorders that are specific to women. Each chapter explains the pathology of the disorder, strategies currently available for its management, gaps that represent unmet medical needs and products that are in development. The global incidence of the disorders is discussed and the market for existing and new products is presented, looking at the major companies that are involved. In addition, each chapter looks at the emerging trends in the treatment of the disorders.

© PJB Publications Ltd. 2000
All rights reserved.