Multiple sclerosis (MS) is a disabling autoimmune disease affecting the brain and the spinal cord, eventually causing nerve deterioration or permanent damage. The types of MS include relapsing-remitting MS (RRMS), primary progressive MS (PPMS) and secondary progressive MS (SPMS). RPMS is the most common type characterized by defined attacks with increasing neurological symptoms, PPMS is the rare form characterized by gradual progression of disease, whereas SPMS is commonly identified in people living with relapsed-remitting MS. The most common symptoms of the disease include partial or complete vision loss, prolonged vision loss, lack of coordination and slurred speech.

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A combination of genetic and environmental factors is responsible for the occurrence of the condition. According to a study by International Progressive Alliance, 2013, MS is two to three times more common in women than in men, suggesting that hormones play a significant role in determining susceptibility to the disease.

Multiple sclerosis is a widespread disabling neurological condition, mostly diagnosed in people in the age group 20–50 years. According to the Multiple Sclerosis Foundation, 2017, this autoimmune condition affects 2.5 million people with the global incidence of around 7 cases per 100,000 people per year. The study also states that prevalence rates varies between ethnic and geographical latitudes, ranging from 50 to 120 people per 100,000 population. North America dominates the multiple sclerosis therapeutics market owing to the high prevalence of the condition and the rising economic burden of the disease leading to the adoption of novel therapeutics.

According to the Multiple Sclerosis Foundation, 2015, an estimated 400,000 people live with the disease in U.S., and about 200 new cases are diagnosed every week. According to a survey by Healthline Media, 2015, multiple sclerosis ranks second after congestive heart failure with direct and indirect health care costs ranging from US$ 8,528 to US$ 54,244 per patient per year. Higher therapy cost is restraining the growth of the multiple sclerosis therapeutics market.

Image guided therapy or image guided interventions help surgeons by navigating the devices inside the body of patients and provides a three dimensional image of the targeted area, making the surgery safer and less invasive. The constant flow of information enables surgeons to plan for surgery, make minute adjustments to treat across various therapeutic areas, including cardiac, vascular, endovascular, pain, trauma, urology, orthopedics, spine, and neurology. Image guided therapy devices also can be potentially used in the treatment of hypertension through renal denervation.

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All these therapeutic areas rely on powerful imaging modalities, including computed tomography (CT), magnetic resonance imaging (MRI), fixed interventional X-ray, and mobile C-arms. Each modality has advantages and limitations and differs according to its mode of operation, level of complexity, and price point. As the fields of minimally-invasive interventions, interventional imaging, and image-guided surgery (IGS) continue to mature, the advancements in integration of image guided therapy system market with therapeutic modalities in real time is expected to lead to major growth over the forecast period.

Image guided therapy systems provides doctors and technicians with access to patient database records and accordingly develop exact detailed surgical plan or the optimal path to the targeted area. In addition, ultrasound recording during surgery makes the image guided therapy safer and helps the surgeon to operate on the targeted area avoiding any critical injury to the nearby parts of the area. Various hospitals are focusing on installing image guided system to offer wide range of interventional procedures to patients.

For instance, in November, 2017, UnityPoint Health, a network of hospitals, clinics and home care services in Iowa, Illinois, U.S. and Wisconsin installed Infinix-i-4-D CT (computed tomography) system, a product by Toshiba Medical which offers fast, safe and accurate interventional radiology (IR) and oncology procedures, such as tumor therapy, embolization, arterial interventions, dialysis and stent placement. These rising demand among the hospitals expected to fuel the growth of the image guided therapy system market.

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Key Vendors:

General Electric Company, Toshiba Medical Systems, Siemens AG, Medtronic plc, Brain lab AG, Image Guided Therapy, and Ziehm Imaging, Koninklijke Philips N.V., Varian Medical System, Inc.

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Radiotherapy, also known as radiation therapy, uses ionizing radiations that deliver targeted beams of radiation to kill and destroy cancer cells. The advanced technology used in radiotherapy works by bombarding cancerous cells with radiation to kill them, while minimizing damage to the healthy cells around them. Radiotherapy is the most potent and cost-effective treatment for cancer, and when integrated with advanced technologies such as image guided therapy, leads to enhanced control over tumor and toxicity.

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Several types of radiotherapies such as external beam radiation therapy, internal beam radiation therapy/ brachytherapy, and systemic radiation therapy, are available to combat various types of cancers prevalent globally. External beam radiation therapy is used to treat various types of cancers, including brain tumors, bladder cancer, and bone cancers. Brachytherapy is often used to treat cancers of the head and neck, breast, cervix, prostate, and eye, while systemic radiation therapy is often used to treat certain types of thyroid cancers using radioactive iodine.

Rising prevalence of oncology diseases such as prostate cancer, lung cancer, and breast cancer, globally is increasing the demand for timely management to reduce mortality associated with such conditions. This in turn, is a major factor augmenting growth of the radiotherapy market. The International Cancer Association, 2014, states that cancer kills more people every year than AIDS, tuberculosis, and malaria combined. This indicated the growing demand for adopting advanced technologies for cancer management.

According to the World Cancer Research Fund Organization, 2015, lung cancer is among the most prevalent cancers worldwide contributing 1.9 million or 13% of the total number of new cases diagnosed in 2012. It further states that breast cancer is the second most common cancer prevalent among women, with 1.7 million new cases diagnosed in 2012. Moreover, increasing prevalence of cancer among children is expected to increase the demand for radiation therapy, as it is a highly recommended therapy due to fewer adverse effects associated with it than chemotherapy to accelerate growth of the market as considering the major adverse effects of chemotherapy. According to the International Union against Cancer (UICC) Report, 2017, around 160,000 children are estimated to be diagnosed with cancer and at least 90,000 children are estimated to die of cancer globally.

Parenteral are sterile dosage form that are administered through route other than oral route of administration. They are injected into one or more layer of skin and active ingredient directly come in contact with tissue or blood vessel. Large volume parenteral are of two types, small volume parenteral are single or multi dosage preparation with volume 100 ml or less quantity whereas large volume parenteral has volume more than 100 ml. Large volume parenteral comes in bag or bottle for intravenous administration and are used for correction of fluid/electrolyte balance, providing nutrition such as dextrose.

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Increasing demand for palliative care worldwide is expected to drive growth of the large volume parenteral market, owing to use of large volume parenteral to provide electrolyte balance and nutritional fluids. According to World Health Organization (WHO), 2017, an estimate of 40 million people need palliative care worldwide. Around 78% among those people, live in low- and middle-income economies and only 14% of people in need of palliative care receives it. Disease which require high palliative care are cardiovascular diseases (38.5%), cancer (34%), chronic respiratory diseases (10.3%), AIDS (5.7%) and diabetes (4.6%), kidney failure, chronic liver disease.

This creates potential opportunity for large volume parenteral market players. Increasing number of surgeries are expected to propel growth for the large volume parenteral market worldwide. For instance, according to World Bank statistics, in 2012, around 4511 surgeries were performed per 1,00,000 population across the globe. As per Lancet Commission for Global Surgery, 2015, an estimate of 143 million unmet surgical need per year, surgical need in turn drives large volume parenteral market as they are essential part of pre and post-operative care.

Regional segmentation of the large volume parental market by Coherent Market Insights consist of North America, Europe, Asia Pacific, Latin America, Middle East, and Africa. North America is expected to dominate the large volume parenteral market, owing to increasing number of hospital admissions and cost associated with such admission (an estimated US$ 1900 in 2013 as per Kaiser Health fact). According to American Hospital Association factsheet 2018, an estimated 35,158,934 hospital admissions were reported in 2017, large volume parenteral is integral part of any admission procedure, as nutrition and electrolyte support is essential in most of the cases.

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Key Vendors:

Baxter International Inc., Teva Pharmaceutical Industries Limited, Kelun Pharmaceutical Inc., BAG Healthcare GmbH, Hospira, Inc., Patheon Inc., Otsuka Pharmaceutical, Wockhardt Ltd., Southwest Pharmaceutical Co. Ltd., and Cook Pharmica LLC.