Diabetes is a disorder of carbohydrate metabolism which is characterised by abnormally high blood glucose concentrations. It is a devastating disease, particularly because of the long term complications associated with it, and it imposes an enormous burden on healthcare funding.

In 1985 there were an estimated 30 million cases of diabetes worldwide. In 1994, the World Health Organization (WHO) estimated the number of diagnosed cases worldwide to be 110 million and declared that diabetes had reached epidemic proportions. During the last three years the number has risen to 130 million and by 2025 it is expected to be as great as 300 million. The reason for this escalation in diabetes prevalence is explained in part by the fact that the world population is ageing. People are living longer and thus more likely to fall prey to age related diseases. Further to this, in both the developed and developing world, an industrialised life-style with its characteristics of a high fat diet and physical inactivity is the major contributor to onset of the disease. Most of the increase is occurring in the developing world, where urbanisation is progressing rapidly.

The aims of the report are: to inform the reader of the characteristics, aetiology, management and prevalence of diabetes; to provide a comprehensive review of the current status of the diabetes treatment market; and to take a look at the potential treatments of the future.

Chapter One sets the scene with a review of the background to diabetes. It highlights some of the problems which need to be overcome and suggests ways in which they might be tackled.

Chapter Two provides a general overview of the characteristics and causes of disease. It describes the essential features of diabetes mellitus and distinguishes between the two existing types, Type 1 (also known as juvenile onset diabetes, or insulin dependent diabetes mellitus, IDDM) and Type 2 diabetes (also known as non-insulin dependent diabetes, NIDDM). Two other types of glucose intolerance, impaired glucose tolerance (IGT) and gestational diabetes, are also discussed. These two conditions frequently develop into overt Type 2 disease later in life.

Type 1 diabetes is predominantly, but not entirely, a disease of youth. It is caused by the autoimmune destruction of the insulin secreting pancreatic ß-cells. This leads to an absolute deficiency in endogenous insulin and a lifelong dependence on insulin. Genetic and environmental factors (such as early exposure to cow's milk, nitrate intake and viral infections) have been attributed to the development of the disease and the likelihood is that both play a part. There is also considered to be a geographical influence because the disease is more prevalent in northern populations (eg Finland). These associations are discussed in Chapter Two.

Type 2 diabetes is also caused by a combination of genetic and environmental factors but has a different aetiology. There are two main pathological defects in the disease. These are insulin resistance (a decreased ability of the peripheral tissues to respond to insulin) and ß-cell dysfunction (an inability of the pancreas to provide sufficient insulin to compensate for insulin resistance). Type 2 disease occurs mainly, but again not entirely, in those over the age of 40. The associated risk factors are obesity (particularly central obesity), physical inactivity and the consumption of a high fat diet. It is prevalent among populations adopting a lifestyle incorporating these features and consequently it is common in the industrialised nations. However, the concern is that in rapidly industrialising regions, eg urban areas in large parts of Asia, there is an alarming escalation in the prevalence of Type 2 disease, which parallels the rate of industrialisation.

The major causes of diabetes morbidity and mortality are due to the long term complications of the disease. High concentrations of glucose in the blood precipitate a cascade of structural and functional vascular changes that eventually cause progressive damage to eyes (retinopathy), kidneys (nephropathy), nerves (neuropathy), blood vessels and the heart. The risk of coronary heart disease is two to three times higher in diabetics and in the industrialised world it is the cause of death of 30-50% of patients over the age of 40. Diabetic complications are of enormous personal, social and economic importance and consume a significant proportion of healthcare resources. These issues are discussed in Chapter Two.

The global situation concerning diabetes is the focus of Chapter Three. This chapter provides detailed epidemiological information on the prevalence of the disease throughout the world. The data reveal the regions where the disease (both Type 1 and Type 2 diabetes) is most common and where the highest increases in prevalence rates are expected to occur in the near future. Type 2 diabetes constitutes approximately 90% of all cases of diabetes in the developed world and almost all cases in the developing world. It is predicted that Asia will represent the core of the Type 2 diabetes epidemic as the countries in this region continue to modernise.

Issues affecting the market are discussed in Chapter Three on a regional basis. Important factors influencing the market include: diabetes prevalence; the political situation; the priority given to diabetes as a disease; social and cultural attitudes; public awareness and legislative issues. The major markets are to be found in the developed regions of the world, namely Europe, the US and Japan. However, the Pacific rim is a growing market where the economy is flourishing, and the incidence of diabetes is accelerating rapidly in conjunction with the rush to industrialise. In contrast, South American and African countries do not have a strong economy and the needs of the diabetic population are not satisfied even regarding a basic supply of insulin.

The way in which healthcare is organised and funded understandably has a significant impact on the market. Chapter Three discusses the cost of treating diabetes in the US and the UK.

The world market for insulin was estimated to be approximately $1.8 million in 1996. Chapter Three explains how this was distributed among the major world markets and the way in which it was apportioned between the leading companies in the field. Predictions are made concerning future sales of insulin and insulin analogues as the millennium approaches.

Chapter Three also provides data for the world oral hypoglycaemic drug market which is currently estimated to be approaching $2 million. Market values are given for both the major world markets and for the market share of the major players in the field. Predicted sales are given for both established products and for new drugs entering the market.

The diagnosis and management of diabetes are discussed in Chapter Four. This chapter is concerned with the clinical presentation of the disease and its diagnosis and management. It discusses the role of the professional care team, the need for education, the importance of self management including diet, exercise and the self monitoring of blood glucose concentrations. It also outlines the protocols for treatment, the classes of drugs used and the input of the major drug companies into managed care. The treatment of diabetes complications is also discussed.

A wide range of pharmaceutical products is currently on the market and many more are being developed for the treatment of diabetes and its complications. Chapter Five provides in-depth coverage of the drugs available, describes their mechanism of action and for drugs in development, their therapeutic potential. Among the drugs discussed are the insulins, insulin substitutes, oral hypoglycaemics, alpha-glucosidase inhibitors, antihypertensives and aldose reductase inhibitors. These are the most established drugs on the market. Sulphonylureas and the biguanide metformin have been the mainstay of the oral hypoglycaemic market for more than 30 years. Metformin is enjoying a new lease of life following its launch in the US market in 1995 and has recorded substantial sales, also in the European markets, since its launch.

The alpha-glucosidase inhibitors delay the digestion of carbohydrates, which results in a lowering of postprandial hyperglycaemia and a smoothing effect on the fluctuations in daily blood glucose profile. Problems with gastric disturbance have limited the widespread use of these compounds. The lead company in this market is Bayer with acarbose (Glucobay).

There has been significant progress in the development of insulin analogues, as exemplified by Eli Lilly & Company's Humalog. Others are in development and this is an area which promises to make a valuable contribution to the insulin market in the future. The idea of designer insulins to mimic the natural insulin profile closely is an attractive one.

The thiazolidinediones are a new class of drugs that enhance insulin action without directly stimulating insulin secretion. Unlike the biguanides and the sulphonylureas, they are not insulin secretagogues but insulin sensitisers that act primarily by improving insulin resistance. The first drug of this class to be launched onto the market was troglitazone. Its lauch was hailed as probably the most significant event in the progress of the oral hypoglycaemic market in the last three years. However, troglitazone is now the centre of a furore following evidence of liver damage and fatalities among patients in the US and Japan. As a result, Glaxo Wellcome has withdrawn the drug from the market, but it is still available in the US and in Japan through Warner-Lambert and Sankyo respectively.

Other types of drug in development include some novel insulin secretagogues, such as repaglinide (licensed to Novo Nordisk) and A4166 (in development by Ajinomoto). Both are in Phase III clinical trials.

The amylin analogue, pramlintide, is being developed by Amylin Pharmaceuticals in collaboration with Johnson & Johnson, as a regulator of blood glucose concentrations. The drug has progressed in development over the last three years and is now in Phase III trials.

The Diabetes Control and Complications Trial (DCCT) demonstrated that intensive insulin therapy delayed, reversed or prevented the onset of long term end organ complications in Type 1 diabetics. The outcome of the trial provided a breakthrough in standard thinking regarding treatment of the disease. However, problems with weight gain and an increased frequency of hypoglycaemic attacks have made intensive insulin therapy less satisfactory than was hoped. It is also costly and labour intensive to administer and requires total commitment from the patient. Consequently, pharmaceutical companies are now focusing on developing new drugs and methods to achieve rigorous blood glucose control.

Chapter Six provides information on companies involved in the diabetes market. These include: those with a major interest in insulin (eg Novo Nordisk, Eli Lilly & Company); companies marketing and developing oral hypoglycaemic agents (eg Pfizer, Bayer, Warner-Lambert); and new companies (eg Alizyme, Alteon, Ergo Science, Shaman Pharmaceuticals) set up to focus on novel areas of diabetes research which may lead to valuable treatments in the future.

Diabetes: Therapeutic advances and market opportunities

Diabetes currently claims an estimated 130 million victims worldwide, and this figure is on the rise as the population ages. Scrip's report will inform you of the characteristics, aetiology, management and prevalence of this devastating disease. A comprehensive review of the diabetes treatment market is provided, and potential treatments for the future are assessed.

The report describes Type 1 and Type 2 diabetes, impaired glucose intolerance and gestational diabetes, and discusses fully the associated complications. Detailed epidemiological information is also provided. The in-depth consideration of the diabetes market includes information on market share and predicted sales for current and emerging drugs and cost of treatment.

Scrip's highly readable report gives you valuable information about diabetes drugs, including the insulins, insulin substitutes, oral hypoglycaemics, a-glucosidase inhibitors, antihypertensives and aldose reductase inhibitors. Drugs in development, such as repaglinise and pramlintide, are discussed in detail.

Key companies profiled include: Alizyme; Alteon; Bayer; Eli Lilly; Ergo Science; Novo Nordisk; Pfizer; Shaman and Warner-Lambert.

PUBLISHED: JANUARY 1998
REF: BS905E
PAGES: 150+ PRICE: £495/$1,040/¥119,000

TABLE OF CONTENTS
LIST OF TABLES
EXECUTIVE SUMMARY
GLOSSARY OF ABBREVIATIONS

CHAPTER 1 INTRODUCTION
1.1 Background
1.2 Objectives of the report
1.3 Methodology
1.4 Report structure
1.5 Boundaries of the report
1.6 Exchange rates

CHAPTER 2 DIABETES MELLITUS: THE DISEASE
2.1 Characteristic features of diabetes
2.2 Types of diabetes
2.2.1 Type 1 diabetes
2.2.2 Type 2 diabetes
2.2.3 IGT
2.2.4 Gestational diabetes
2.3 Classification of Type 1 and Type 2 diabetes
2.4 Glucose homeostasis and the physiological effects of insulin
2.5 Aetiology of Type 1 diabetes
2.5.1 Genetic susceptibility
2.5.2 Environmental determinants
2.5.2.1 Dietary factors
2.5.2.2 Viral infection
2.5.3 Islet cell antigens
2.6 Aetiology of Type 2 diabetes
2.6.1 Genetic determinants
2.6.2 Environmental determinants
2.6.2.1 Obesity
2.6.2.2 Physical inactivity
2.6.2.3 Dietary factors
2.6.2.4 Age
2.6.3 Type 2 diabetes and breast feeding
2.6.4 Islet pathology of Type 2 diabetes
2.7 IGT
2.8 Gestational diabetes
2.9 Diabetes complications
2.9.1 Microvascular disease
2.9.1.1 Diabetic nephropathy
2.9.1.2 Diabetic retinopathy
2.9.1.3 Diabetic neuropathy
2.9.2 Macrovascular disease
2.9.2.1 Hyperinsulinaemia and atherosclerosis
2.9.2.2 Dyslipidaemia in Type 2 diabetes
2.9.3 Conclusions

CHAPTER 3 THE GLOBAL ISSUES
3.1 Worldwide prevalence of diabetes
3.1.1 Prevalence of Type 1 diabetes
3.1.2 Prevalence of Type 2 diabetes
3.1.3 IGT
3.1.4 Diabetes in the US
3.1.5 Diabetes in the UK
3.2 The ageing population
3.3 Deaths due to diabetes in developed countries
3.4 World organisations
3.4.1 The International Diabetes Federation (IDF)
3.4.2 WHO
3.5 The cost of treating diabetes
3.6 Diabetes and the world markets
3.6.1 Western Europe
3.6.2 North America
3.6.3 Latin America
3.6.4 Africa
3.6.5 Indian subcontinent
3.6.5.1 Pakistan
3.6.6 Middle East and North Africa
3.6.7 Asia and Oceania
3.7 Availability and cost of insulin
3.7.1 Insulin strength
3.8 Estimated size of the insulin market
3.9 The diabetes pharmaceutical market
3.9.1 The insulin market
3.9.1.1 Expansion of the Russian antidiabetics market
3.9.2 The oral hypoglycaemic market

CHAPTER 4 DIAGNOSIS AND MANAGEMENT OF DIABETES
4.1 Clinical presentation
4.1.1 Type 1 diabetes
4.1.2 Type 2 diabetes
4.2 Diagnosis
4.2.1 Updated US guidelines for diabetes diagnosis
4.2.2 New Canadian guidelines for diabetes care
4.3 Management of diabetes
4.4 Self management
4.4.1 Diet
4.4.2 Exercise
4.4.3 Smoking
4.4.4 Self monitoring
4.4.4.1 Monitoring blood glucose concentrations
4.4.4.2 Testing urine glucose
4.4.4.3 Targets for management of glucose control
4.4.5 Hypoglycaemia
4.4.6 Management during illness
4.4.7 Pregnancy
4.5 Pharmacological treatment of hyperglycaemia in Type 2 diabetics
4.5.1 Sulphonylureas
4.5.2 Biguanides
4.5.3 alpha-glucosidase inhibitors
4.5.4 Thiazolidinediones
4.5.5 Insulin
4.6 Diagnosis and treatment of chronic complications
4.6.1 Retinopathy
4.6.2 Nephropathy
4.6.3 Neuropathy
4.6.4 Macrovascular disease
4.6.4.1 Dyslipoproteinaemias
4.6.4.2 Hypertension
4.7 Education
4.8 The role of major drug companies in disease management
4.8.1 Novo Nordisk
4.8.1.1 Education services
4.8.1.2 Literature services
4.8.1.3 Patient materials
4.8.1.4 Research services
4.8.1.5 Sponsorships
4.8.1.6 Agreements with other companies
4.8.2 Eli Lilly & Company

CHAPTER 5 ANTIDIABETIC AGENTS
5.1 Introduction
5.2 Insulin
5.2.1 Insulins available
5.2.1.1 Short acting insulins
5.2.1.2 Intermediate and long acting insulins
5.2.2 Some recommended insulin regimens
5.2.3 Insulin analogues
5.2.3.1 Short acting analogues
5.2.3.2 Long acting insulin analogues
5.2.3.3 Adverse effects
5.3 Oral antidiabetic drugs
5.3.1 Sulphonylureas
5.3.1.1 First generation sulphonylureas
5.3.1.2 Second generation sulphonylureas
5.3.1.3 Third generation sulphonylureas
5.3.1.4 Cardiovascular side effects of sulphonylureas
5.3.2 Other insulin secretagogues
5.3.3 Biguanides
5.3.3.1 Mechanism of action of metformin
5.3.3.2 Effect on the lipid profile
5.3.3.3 Therapeutic application of metformin
5.3.4 Thiazolidinediones
5.3.4.1 Troglitazone
5.3.4.2 Pioglitazone
5.3.4.3 BRL 49653
5.3.4.4 JTT-501
5.3.4.5 G1-262570
5.3.5 alpha-glucosidase inhibitors
5.3.5.1 Acarbose
5.3.5.2 Miglitol
5.3.5.3 Voglibose
5.3.6 Amylin analogues
5.3.6.1 The natural hormone
5.3.6.2 Pramlintide
5.3.6.3 Amylin blockers
5.3.7 GLP-1
5.3.7.1 Companies developing GLP-1 as a therapy for diabetes
5.3.8 IGF-1
5.3.9 Oral antidiabetic agents on the horizon
5.3.9.1 Ergoset
5.3.9.2 a-amylase inhibitors
5.3.9.3 Tyrosine phosphatase inhibitors
5.3.9.4 Carnitine palmitoyl-transferase inhibitors
5.3.9.5 Protein kinase C inhibitors
5.3.9.6 Glucose lowering agents (GLA)
5.3.9.7 Cytokine regulating agents
5.3.9.8 High dose chromium
5.3.9.9 Vanadium salts
5.3.9.10 Plant extracts
5.3.9.11 TER-3938
5.3.9.12 Miscellaneous drugs
5.4 Gene therapy
5.5 Developments in prevention and treatment of Type 1 diabetes
5.5.1 GAD
5.5.2 Vaccine development
5.5.3 Nicotinamide
5.5.4 Apogens
5.5.5 Immunotherapeutic agents
5.5.5.1 MHC Class II inhibitors
5.5.5.2 Other immunotherapeutic agents in development
5.6 Drugs to treat diabetes complications
5.6.1 ACE inhibitors
5.6.1.1 ACE inhibitors and nephropathy
5.6.1.2 ACE inhibitors and retinopathy
5.6.1.3 ACE inhibitors in combination with calcium channel blockers
5.6.2 Aldose reductase inhibitors
5.6.2.1 Early aldose reductase inhibitors
5.6.2.2 Epalrestat
5.6.2.3 Zopolrestat
5.6.2.4 Zenarestat
5.6.2.5 Other aldose reductase inhibitors in development
5.6.2.6 Aldose reductase inhibitors: a meta-analysis
5.6.3 Advanced glycation end product (AGE) formation inhibitors
5.6.3.1 Pimagedine
5.6.3.2 Carnosine
5.6.4 Glycosaminoglycans (GAGs) and diabetic nephropathy
5.6.4.1 What are GAGs?
5.6.4.2 Biological role of GAGs
5.6.4.3 Significance of GAGs in diabetic nephropathy
5.6.5 Essential fatty acids
5.6.6 Angiogenesis inhibiting drugs
5.6.7 Nerve growth factors
5.6.8 Molecular chaperones
5.6.9 Other potentially useful drugs in development

CHAPTER 6 COMPANY PROFILES
6.1 Alizyme plc
6.1.1 Agreements re diabetes products
6.1.2 Financial highlights
6.1.3 Diabetes products in development
6.2 Alteon
6.2.1 Agreements re diabetes products
6.2.2 Financial highlights
6.2.3 Diabetes products in development
6.3 Amylin Pharmaceuticals Incorporated
6.3.1 Agreements re diabetes products
6.3.2 Financial highlights
6.3.3 Diabetes products in development
6.4 Bayer AG
6.4.1 Agreements re diabetes products
6.4.2 Financial highlights
6.4.3 Diabetes products in development
6.4.4 Diabetes products marketed
6.4.5 Other products manufactured and in development
6.5 Biobrás SA
6.5.1 Agreements re diabetes products
6.5.2 Financial highlights
6.5.3 Diabetes products in development
6.6 Bristol-Myers Squibb
6.6.1 Agreements re diabetes products
6.6.2 Financial highlights
6.6.3 Diabetes products marketed
6.6.4 Other pharmaceuticals marketed
6.7 Ergo Science Corporation
6.7.1 Financial highlights
6.7.2 Products in development for diabetes and diabetes-related diseases
6.8 Glaxo Wellcome plc
6.8.1 Agreements re diabetes products
6.8.2 Financial highlights
6.8.3 Diabetes products in development
6.8.4 Diabetes products marketed
6.8.5 Other pharmaceuticals marketed and in development
6.9 Hoechst Marion Roussel
6.9.1 Agreements re diabetes products
6.9.2 Financial highlights
6.9.3 Diabetes products in development
6.9.4 Diabetes products marketed
6.9.5 Other pharmaceuticals marketed and in development
6.10 Eli Lilly & Company
6.10.1 Agreements re diabetes products
6.10.2 Financial highlights
6.10.3 Diabetes care
6.10.4 Diabetes products in development
6.10.5 Diabetes products manufactured
6.10.6 Other products marketed and in development
6.11 Novo Nordisk A/S
6.11.1 Agreements re diabetes products
6.11.2 Financial highlights
6.11.3 Diabetes care
6.11.4 Diabetes products manufactured
6.11.5 Diabetes products in development
6.11.6 Other products marketed
6.12 Pfizer Inc
6.12.1 Agreements re diabetes products
6.12.2 Financial highlights
6.12.3 Diabetes products manufactured
6.12.4 Diabetes products in development
6.12.5 Other pharmaceuticals manufactured
6.13 Shaman Pharmaceuticals Inc
6.13.1 Financial data
6.13.2 Other drugs in development
6.14 Takeda Chemical Industries Ltd
6.14.1 Agreements re diabetes products
6.14.2 Financial highlights
6.14.3 Diabetes products manufactured
6.14.4 Other major pharmaceuticals manufactured and in development
6.15 Warner-Lambert Co
6.15.1 Agreements re diabetes products
6.15.2 Diabetes products in development
6.15.3 Other products marketed

CONCLUSIONS
REFERENCES
COMPANY ADDRESSES

LIST OF TABLES
Table 2.1 Distinguishing characteristics of Type 1 and Type 2 diabetes
Table 3.1 Global estimates of diabetes in 1997 (in thousands)
Table 3.2 Diabetes estimates by region in 1997 (in thousands)
Table 3.3 Diabetes Type 1 and Type 2 prevalence in developed countries, 1997 (in thousands)
Table 3.4 Global estimates and projections of total diabetes 1995-2010 (in thousands)
Table 3.5 Global estimates and projections of Type 1 and Type 2 diabetes - 1995-2010 (in thousands)
Table 3.6 Global estimates and projections of Type 1 and Type 2 diabetes 1995-2010 according to world region (in thousands)
Table 3.7 Estimates and projections of Type 1 and Type 2 diabetes prevalence in developed countries 1995-2010 (in thousands)
Table 3.8 Global estimates of total diabetes and IGT where available in 1997 (in thousands)
Table 3.9 US diabetes prevalence data
Table 3.10 Percent of adults with diabetes by race and ethnicity (diagnosed and undiagnosed)
Table 3.11 Number of diabetic patients among residents of Tayside on 1 January 1996 by age and type of diabetes
Table 3.12(a) World population total and population aged 65 years and over (in thousands), 1996 and 2020 by WHO region
Table 3.12(b) World population total and population aged 65 years and over (in thousands), 1996 and 2020 by level of development
Table 3.13 Deaths from diabetes according to sex and age per 100,000 population
Table 3.14 The cost of treating Type 1 diabetes in the UK in 1997 ($ million)
Table 3.15 Insulin use in the world
Table 3.16 Estimates and projections of the potential annual global insulin markets (1995-2010) in thousands of millions of units.
Table 3.17 Insulin world market according to region, 1996 ($ million)
Table 3.18 World market share in 1996 according to company ($ million)
Table 3.19 Lilly's sales distribution worldwide in 1996 ($ million)
Table 3.20 Novo Nordisk's sales distribution worldwide in 1996 ($ million)
Table 3.21 US sales of insulin by company in 1996 ($ million)
Table 3.22 US insulin market according to product $ million (1995-1996)
Table 3.23 Sales predictions for Humulin and Humalog in 1997-1998 ($ million)
Table 3.24 The world oral hypoglycaemics market in 1996 ($ million)
Table 3.25 US oral hypoglycaemic market $ million (1995-1996)
Table 3.26 Companies featuring in the European oral hypoglycaemics market in 1996 ($ million)
Table 4.1 Physical activity types and their intensity
Table 4.2 Targets for management of glucose control
Table 5.1 Some short acting insulins available
Table 5.2 Some intermediate and long acting insulins available
Table 5.3 Intermediate acting biphasic insulins available
Table 5.4 Sulphonylurea drugs available and in development
Table 5.5 Alizyme's programme for the development of Type 2 diabetes/obesity drugs
Table 5.6 Other drugs in development for the possible treatment of Type 2 diabetes
Table 5.7 ACE inhibitors available
Table 5.8 Aldose reductase inhibitors for the treatment of diabetes complications
Table 5.9 Other compounds in development for treatment of diabetes complications
Table 6.1 Alizyme's products in development for diabetes and related disorders
Table 6.2 Alteon's financial figures for 1993-1996 ($ thousands)
Table 6.3 Amylin's financial figures 1994-1996 ($ million)
Table 6.4 Bayer's financial highlights 1993-1996 ($ million)
Table 6.5 Bayer's sales by region ($ million)
Table 6.6 Bayer's sales by division 1995-1996 ($ million)
Table 6.7 Biobrás sales figures for the internal and export markets 1993-1996 ($ million)
Table 6.8 Biobrás sales by business segment 1996 ($ million)
Table 6.9 Bristol-Myers Squibb's financial highlights ($ million) 1993-1996
Table 6.10 Bristol-Myers Squibb's sales by business segment ($ million) 1994-1996
Table 6.11 Bristol-Myers Squibb's sales by geographic area ($ million) 1994-1996
Table 6.12 Ergo Science's financial highlights 1993-1996 ($ thousands)
Table 6.13 Glaxo Wellcome's financial figures 1993-1996 ($ million)
Table 6.14 Glaxo Wellcome's sales by region (1996) $ million
Table 6.15 Hoechst's financial highlights 1993-1996 ($ million)
Table 6.16 Hoechst Marion Roussel's sales by division and affiliate for 1995-1996 ($ million)
Table 6.17 Hoechst Marion Roussel's sales by region 1995-1996 ($ million)
Table 6.18 Lilly's financial figures ($ million)
Table 6.19 Lilly's sales by geographical area ($ million)
Table 6.20 Lilly's sales by therapeutic category ($ million)
Table 6.21 Novo Nordisk's financial highlights 1993-1996 ($ million)
Table 6.22 Novo Nordisk's net turnover by business segment 1993-1996 ($ million)
Table 6.23 Novo Nordisk's geographical distribution of turnover, 1995-1996 ($ million)
Table 6.24 Novo Nordisk's sales of diabetes care products ($ million)
Table 6.25 Pfizer's financial figures 1993-1996 ($ million)
Table 6.26 Pfizer's net sales by geographic area
Table 6.27 Pfizer's net sales by business segment ($ million)
Table 6.28 Pfizer's worldwide sales of diabetes products ($ million)
Table 6.29 Financial data for Shaman Pharmaceuticals Inc, 1995-1996 ($ thousands)
Table 6.30 Takeda's financial figures 1993-1996 ($ million)
Table 6.31 Takeda's sales by region in 1996 ($ million)
Table 6.32 Takeda's sales by business segment in 1996 ($ million)
Table 6.33 Warner-Lambert's financial highlights 1993-1996 ($ million)
Table 6.34 Warner-Lambert's sales by business segment 1994-1996 ($ million)
Table 6.35 Warner-Lambert's sales by geographic areas 1994-1996 ($ million)
Table 6.36 Warner-Lambert's pharma sales by region 1996 ($ million)

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