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This TriMark Publications report examines the disposable syringe markets as well as the supplies utilized in clinics and by patients directly in their homes to diagnose and monitor disease and to administer medications. This analysis is intended to provide basic market data pertaining to the U.S. and worldwide market segments. Each market segment is analyzed to determine size, growth rates, sales projections and factors influencing growth in the U.S. and internationally. Unit and dollar volume are used to indicate market sizes. Additionally, this review examines industry challenges and potential threats to syringe and needle supplies manufacturers and makes strategic recommendations for boosting market share. The emphasis is on those companies actively developing and marketing products to hospitals, physicians and the general public for medically related uses. The disposable syringe market segments are identified as: 1) total reusable needle and syringe market; 2) total disposable needle and syringe market; 3) prefilled syringes; 4) safety syringes; 5) insulin injector pens; 6) needleless injectors; 7) vaccination injectors; 8) blood collection needles and syringes; 9) hypodermic needles and syringes market; 10) insulin needles and syringes market; 11) specialty needles and syringes market; and 12) needleless injector market.

TABLE OF CONTENTS

1. Introduction 18
1.1 Statement of Report 18
1.2 About This Report 18
1.2.1 Scope of the Report 18
1.2.2 Objectives 19
1.2.3 Methodology 20
1.3 Executive Summary 21

2. Syringe Types: An Overview 24
2.1 Disposable Syringes 24
2.2 Safety Syringes 24
2.2.1 Available Safety Syringe Technologies 24
2.2.2 Retrofitted Syringes 25
2.2.3 Automatically Retractable Syringes 25
2.2.4 Manually Retractable Syringes 25
2.2.5 Insulin Syringes 26
2.2.6 Tuberculin Syringes 26
2.2.7 Prefilled Syringes 27
2.2.7.1 Components of a Prefilled Syringe 27
2.2.7.2 Benefits of Prefills 28
2.2.7.3 Prefills: The Future of Drug Delivery 29
2.2.7.4 Wider Applications of Prefilled Syringes 29
2.2.7.5 Making Improvements in Components of Prefilled Syringes 29
2.2.7.6 Biologic Drugs and Overfill 29
2.2.7.7 Benefits of Cyclic Olefin Polymers 30
2.2.7.8 Overcoming Variability in Glass Syringes 30
2.2.7.9 Impact of Silicone Oil on Delivery 30
2.2.7.10 Migrating Risk for Protein Aggregation 30
2.2.7.11 Key Advantages of Prefilled Syringes 31
2.2.8 Production of Standard Prefilled Syringes 31
2.2.8.1 Attachment of Safety Features in Prefilled Syringes 32
2.2.9 Available Prefilled Syringes in the Market 33
2.2.9.1 Baxter Biopharma Solutions 33
2.2.9.2 BD Medical’s Prefilled Segment 34
2.2.9.3 Catalent Pharma Solutions 35
2.2.9.4 Cook Pharma’s Filling and Packaging 35
2.2.9.5 Gerresheimer AG’s Syringe Designs 35
2.2.9.6 Unilife Corporation’s New Approach 36
2.2.9.7 West Pharmaceutical Services, Inc.’s Prefilled Syringes 36
2.3 Pen Injectors 37
2.3.1 Insulin Pens 37
2.3.2 Buyer’s Guide for Reusable Insulin Pens 38
2.3.2.1 Technical Considerations for Insulin Pens 38
2.3.2.2 Technical Considerations for Insulin Cartridges 38
2.3.2.3 Technical Considerations for Pen Needles 39
2.3.2.4 Device Considerations 39
2.3.2.5 User Considerations 40
2.3.3 Market Review of Selected Insulin Pens 41
2.3.3.1 Autopen 24 and Autopen Classic from Owen Mumford 41
2.3.3.2 Humapen Luxura and Luxura HD from Eli Lilly 41
2.3.3.3 Humapen Memoir from Eli Lilly 41
2.3.3.4 Novopen 3 and Novopen Junior/Demi from Novo Nordisk 42
2.3.3.5 OptiClick from Sanofi-Aventis 42
2.3.3.6 OptiPen Pro from Sanofi-Aventis 42
2.4 Advanced Injection Devices 42
2.4.1 Insulin Delivery Device Technology 43
2.4.2 Biologic Delivery Device Technology 43
2.4.3 Alternative Delivery Technologies 44
2.5 Needle-free Injectors 45
2.5.1 Needleless Injector from Injex 45
2.5.2 Jet Syringes from Injex 46
2.5.3 Syrijet 46
2.5.4 PenJet 46
2.5.5 Needle-free Injector for Human Growth Hormones 47

3. Award Winning Syringes 48
3.1 Episure AutoDetect Syringe 48
3.2 ConfiDose 48
3.3 Humatrope Reconstitution Devices 49
3.4 Vascez Plungerless Syringe 49
3.5 PowrSyringe injector 49
3.6 NovoFine Autocover Automatic Safety Pen Needle 50
3.7 RevVac Auto-Retractable Vacuum Safety Syringe 50

4. Syringe Industry: Overview 51
4.1 Common Diseases Transmitted by Unsafe Needle Use and Needlesticks 51
4.2 Most Common Instances of Needstick Injuries 52
4.3 Needle Phobia and Patients’ Anxieties 52
4.4 Global Transition to Safety Medical Devices 52
4.5 U.S. Regulation 53
4.6 Worldwide Regulation 54
4.7 Enforcing Compliance with Sharps Safety Legislation 54
4.8 Example of an OSHA Violation 54
4.9 Target Market Awaiting Premium Products 54
4.10 Current Types of Safety Syringes 55
4.10.1 Safety Syringes with a Needlestick Protection Device 56
4.10.2 Needle Guard 56
4.10.3 Needle Sheath 57
4.10.4 Retractable Syringes 57
4.10.4.1 Spring Based Non-Controlled Retracting Needle Syringe 57
4.11 Global Need for Safety Syringe Products 58
4.12 Limitations of Existing Clinical Syringes 59
4.13 Limitations of Existing Prefilled Syringes 59
4.14 Market Expansion for Safety Syringes 59
4.15 Technological Advancements in Disposable Syringes 59
4.16 Reconstitution inside Sterile Syringes 60
4.16.1 Vetter Lyo-Ject 60
4.17 Plungerless Prefilled Syringes 60
4.18 The Disposable UniJect 60
4.19 Needle-free Injection 61

5. Disposable Syringes: Market Analysis 62
5.1 Volume of Syringes Used in Healthcare 62
5.2 Syringe Sizes Required for Injectable Drugs 63
5.3 Domination of Syringes in Parenteral Drug Delivery Market 63
5.4 Global Market for Disposable Syringes 64
5.4.1 Global Market for Disposable Syringes by Product Segmentation 65
5.4.2 Global Market for Safety Syringes by Segmentation 65
5.4.3 Combined Market for Injection Devices 66
5.5 U.S. Market for Hypodermic Safety Syringes 67
5.5.1 Disposable Syringes: U.S. Market Segments 67
5.5.2 Types of Safety Syringes Used in U.S. Hospitals 68
5.5.3 U.S. Market for Safety Syringes 69
5.5.4 Competitive Landscape in the U.S. 70
5.5.5 Price of Safety Syringes in the U.S. 70
5.5.6 U.S. Disposable Syringe Market 70
5.5.7 U.S. Safety Syringe Market 70
5.6 European Market for Disposable Syringes 71
5.6.1 European Market for Safety Syringes 72
5.7 Prefill Market Trends 73
5.8 The Shift from Vials to Prefilled Syringes 73
5.9 Prefilled Syringes: Market Dynamics 74
5.10 Importance of Prefilled Syringes to Extend Brand Life 75
5.11 Biggest Markets for Prefilled Syringes 75
5.12 Dealing with the Latest Trends in Prefilled Syringe Market 76
5.13 Market Opportunities for Prefilled Syringes 76
5.14 Pharmaceutical Share of Key Prefilled Therapeutic Market 77
5.15 Specialty Pipeline Drugs Targeted for Use with Prefilled Syringes 78
5.16 Therapeutic Usage of Prefilled Syringes 79
5.16.1 Anti-Infectives in Prefilled Syringes 79
5.16.2 Cardiovascular Drugs in Prefilled Syringes 80
5.16.3 Central Nervous System Drugs in Prefilled Syringes 80
5.16.4 Hematology Drugs in Prefilled Syringes 80
5.16.5 Human Growth Hormones in Prefilled Syringes 80
5.16.6 Musculoskeletal Drugs in Prefilled Syringes 80
5.16.7 Obsterics Drugs in Prefilled Syringes 81
5.16.8 Oncology Drugs in Prefilled Syringes 81
5.16.9 Vaccines in Prefilled Syringes 81
5.17 Flexible Administration Requirements of Prefilled Syringes 81
5.18 Biotech Blockbusters Available in Prefilled Syringes 81
5.19 Selected Drugs Available in Prefilled Syringes 82
5.19.1 Ovidrel 82
5.19.2 Enbrell Prefilled Syringe 83
5.19.3 Biocon’s Prefilled Safety Syringes 83
5.19.4 PEGASYS 83
5.19.5 Afluria 84
5.19.6 Enzira 84
5.19.7 FluZone Vaccine 85
5.19.8 Novolin 85
5.19.9 NovoLog 85
5.19.10 Glaxo SmithKline’s Vaccines in Prefilled Syringes 86
5.20 Selected Providers of Syringe Prefilling Services and Products 86
5.20.1 Althea Technologies, Inc. 86
5.20.1.1 Althea’s Clinical Manufacturing 86
5.20.1.2 Althea’s Fill/Finish Services 87
5.20.1.3 Althea’s Contract Manufacturing 87
5.20.2 Baxter International, Inc. 88
5.20.2.1 Baxter’s Contract Manufacturing 89
5.20.2.2 Baxter’s Fill/Finish Services 89
5.20.2.3 Baxter’s Prefilled Syringes Capability 89
5.20.2.4 Baxter’s Vials 90
5.20.2.5 Baxter’s Cartridges 90
5.20.3 Becton Dickinson and Company 90
5.20.3.1 BD’s Prefilled Syringe Services 91
5.20.3.2 BD Hypak SCF Glass Prefillable Syringes 91
5.20.3.3 BD Sterifill SCF Plastic Prefillable Syringe Systems 91
5.20.3.4 BD Physioject Disposable AutoInjector 92
5.20.3.5 BD Liquid Dry Disposable Pen Injector 92
5.20.3.6 BD Pens Customized Self-Injection Systems 93
5.20.3.7 BD Soluvia Prefillable Microinjection System 93
5.20.4 Catalent Pharma Solutions, Inc. 93
5.20.5 Hyaluron Contract Manufacturing 94
5.20.5.1 Hyaluron’s Syringe Filling 94
5.20.5.2 Vetter Pharma Fertigung GmbH 95
5.20.5.3 Vetter’s Development Service 95
5.20.5.4 Vetter’s Commercial Manufacturing 95
5.21 Global Market for Prefilled Syringes 95
5.21.1 Steady Growth in Consumption of Prefilled Syringe Units 96
5.22 U.S. Market for Prefilled Syringes 97
5.23 Rapid Adoption of Prefilled Syringes for Injectables 98
5.24 Pharmaceutical Consumption of Prefilled Syringes 99
5.25 Market for Pharmaceutical Prefilled Syringes 100
5.25.1 Global Market for Prefilled Pain Management Drugs 100
5.25.2 Global Sales of Enbrel in Prefilled Syringes 101
5.25.3 Global Market for Prefilled Psoriasis Drugs 102
5.25.4 Global Market for Prefilled Anemia Drugs 103
5.25.5 Global Market for Prefilled Disposable Insulin Delivery Devices 103
5.25.6 Global Market for Insulin in Prefilled Devices 104
5.25.7 Global Market for Oncology Drugs in Prefilled Syringes 105
5.25.8 Global Market for Multiple Sclerosis (MS) Drugs in Prefilled Syringes 106
5.25.8.1 Market Leaders in Multiple Sclerosis Drugs in Prefilled Syringes 107
5.25.9 Global Market for Prefilled Arthritis Drugs 108
5.25.10 Global Market for Vaccines in Prefilled Syringes 109
5.25.10.1 Market Leaders in Injectable Vaccines 110
5.25.11 Market Leaders in Injectable Anticoagulants 110
5.25.12 Market Leaders in Injectable Anti-Inflammatory Drugs 111
5.25.13 Market Leaders in Injectable Hematology Drugs 112
5.25.14 Market Leaders in Injectable Obstetrics Drugs 113
5.26 Insulin Pens: Market Analysis 113
5.26.1 Disposable Insulin Pens 113
5.26.2 Refillable Pens 114
5.26.3 Pen Needles 114
5.26.4 Benefits and Patient Preferences of Insulin Pens 114
5.26.5 Disadvantages of Pen Syringes 115
5.26.6 Insulin Pens and Hospital Bills 115
5.26.7 Market for Insulin Pen 116
5.27 Global Market for Auto-Injectors/Auto-Infusors 117
5.27.1 U.S. Leaders in Insulin Pump Market 118
5.28 The Growth Market for Self-Injection 119

6. Global Market for Conventional Injectables 120
6.1 Global Market for Drug Delivery Devices 121
6.2 Evolving Trends in Insulin Delivery 122
6.2.1 Alternative Modes of Insulin Delivery 122
6.2.2 Insulin Injection Ports 123
6.2.3 Continuous Subcutaneous Insulin Infusion Pumps 123
6.2.4 Transdermal Patches 124
6.2.5 Inhalable Insulin Devices 125
6.3 Global Burden of Diabetes 125
6.3.1 Market for Insulin Delivery Devices 126
6.3.2 Leaders in Insulin Delivery Devices 126
6.4 Global Insulin Consumption 127
6.4.1 Market Growth for Insulin by Type 128
6.4.2 Market Growth for Modern Insulin Delivery Systems 128
6.4.3 Market Leaders in Insulin by Value 129
6.4.4 Global Insulin Volume Share 130
6.4.5 Diabetes Care in the U.S. by Treatment Class 131
6.4.6 Insulin Types Used in the U.S. 132
6.4.7 Types of Incretin Used in the U.S. 133
6.4.8 Five-Year Growth for OAD, Insulin and GLP-1 133
6.4.9 Five-Year Growth for Long Acting, Premix and Fast Acting Insulins in the U.S., 2006-2011 134
6.4.10 U.S. Insulin Market 135
6.4.11 Modern Insulin and Modern Device Penetration in the U.S. Market 136
6.4.12 Leaders in U.S. Insulin Market 137
6.4.13 U.S. Insulin Value Market Share by Company 138
6.4.14 U.S. Short-Acting Insulin Market Share 138
6.4.15 U.S. Premix Insulin Market 139
6.4.16 U.S. Long-Acting Insulin Market 139
6.4.17 European Diabetes Care Market 140
6.5 European Market Leaders in Diabetes Care 141
6.5.1 Percent Diabetics in Europe Using TDZ, DPP-IV, GLP-1 and Insulin 141
6.5.2 European Insulin Market by Segment 142
6.5.3 European Modern Insulin Market Share by Company 143
6.6 Chinese Diabetes Care Market by Treatment Class 143
6.6.1 Companies Active in Chinese Diabetes Care Market 144
6.6.2 Chinese Insulin Market by Segment 145

7. Company Profiles 146
7.1 Abbott Laboratories 146
7.1.1 Abbott’s Syringe Products 146
7.1.1.1 Precision Sure-Dose Syringes 146
7.1.1.2 Humira Prefilled Syringe 147
7.1.1.3 Humira Pen 147
7.2 Albert David Limited 147
7.3 Alshifa Medical Syringes Manufacturing Company Ltd. 148
7.4 Althea Technologies, Inc. 149
7.5 Baxter International, Inc. 150
7.5.1 Baxter’s Anesthesia Business 150
7.5.2 Baxter’s Clinical Nutrition Business 150
7.5.3 Baxter’s Hemophilia Therapies 151
7.5.4 Baxter’s Infusion Systems 151
7.5.5 Baxter’s Pharmaceuticals and IV Solutions 151
7.5.6 Baxter’s Renal Products 151
7.5.7 Baxter’s Business Performance 151
7.6 Becton, Dickinson & Co. 152
7.6.1 BD’s International Operations 153
7.6.2 BD Medical 153
7.6.3 BD Diagnostics 154
7.6.4 BD Biosciences 155
7.6.5 BD’s Geographic Performance, 2011 156
7.6.6 BD’s Role in Designing Devices for Safe and Effective Injections and Infusions 157
7.6.6.1 BD’s Safety-Engineered Devices 157
7.6.6.2 BD Auto-Disable Syringes 159
7.6.6.3 BD’s Insulin Syringes 160
7.6.6.4 BD’s Allergy Syringes 161
7.6.6.5 BD’s Tuberculin Syringes 162
7.6.6.6 BD’s Syringes and Needles 163
7.6.6.7 BD’s Safety-Lok Safety-Syringes 164
7.6.6.8 BD’s Safety Glide Syringes 165
7.6.6.9 BD’s Eclipse Needles 166
7.6.6.10 BD’s Integra Syringes 167
7.6.6.11 BD’s PosiFlush Prefilled Syringes 167
7.7 B. Braun 169
7.7.1 B. Braun’s Hospital Care Division 169
7.7.2 B. Braun’s Aesculap Division 169
7.7.3 B. Braun’s Out-Patient Market (OPM) Division 169
7.7.4 B. Braun’s Avitum Division 170
7.7.5 B. Braun’s Overall Business Performance 170
7.7.6 Hospital Care Division’s Business 170
7.7.7 Aesculap Division’s Business 170
7.7.8 OPM Division’s Business 171
7.7.9 Avitum Division’s Business 171
7.7.10 B. Braun’s Syringe Products 171
7.7.10.1 Sterican Insulin Needle 171
7.7.10.2 Omnifix 100 Duo 172
7.7.10.3 Omnifix 100 Solo 172
7.7.10.4 Inject 40 Duo 173
7.7.10.5 Injekt 40 Solo 173
7.7.10.6 Omnifix 40 Duo 174
7.7.10.7 Omnifix 40 Solo 174
7.7.10.8 Omnican 100 175
7.7.10.9 Omnican 50 175
7.7.10.10 Omnican 20 176
7.7.10.11 Omnican 40 176
7.7.10.12 Omnican Pen 177
7.7.10.13 Omnican Fine 177
7.8 Bioject Medical Technologies, Inc. 178
7.8.1 Bioject’s Technology 178
7.8.2 Bioject’s Products 178
7.8.2.1 Biojector 2000 178
7.8.2.2 Bioject’s Drug Reconstitution System 180
7.8.2.3 Vitajet 181
7.8.2.4 ZetaJet 181
7.9 Catalent Pharma Solutions, Inc. 181
7.9.1 Catalent’s Development and Clinical Services Segment 182
7.9.2 Catalent’s Oral Technologies Segment 182
7.9.3 Catalent’s Sterile Technologies Segment 182
7.9.4 Catalent’s Packaging Services Segment 183
7.9.5 Catalent’s Syringe Solutions 183
7.10 C.R. Bard, Inc. 184
7.10.1 Bard’s Vascular Business 184
7.10.2 Bard’s Urology Business 184
7.10.3 Bard’s Oncology Business 185
7.10.4 Bard’s Surgical Specialties Business 185
7.10.5 Bard’s Syringe Products 185
7.10.5.1 Bard’s Piston Syringes 185
7.10.5.2 Bard’s Bulb Syringes 186
7.11 Coeur, Inc. 186
7.11.1 Angiographic Syringes from Coeur 186
7.11.2 CT Syringes from Coeur 187
7.12 Covidien Ltd. 188
7.12.1 Covidien’s Medical Device Segment 188
7.12.2 Covidien’s Pharmaceutical Segment 189
7.12.3 Covidien’s Medical Supplies Segment 189
7.12.4 Covidien’s Syringes and Needles 189
7.12.4.1 Magellan Safety Needles 189
7.12.4.2 Magellan Safety Needle and Syringe Combination 190
7.12.4.3 Magellan Insulin Safety Syringe 190
7.12.4.4 Magellan Tuberculin Safety Syringe 190
7.12.4.5 Magellan Safety Blood Collection Device 190
7.12.4.6 Monoject Insulin Safety Syringe 191
7.12.4.7 Monoject Tuberculin Safety Syringe 191
7.12.4.8 Monoject 3mL Safety Syringe 191
7.12.4.9 Monoject 6mL Safety Syringe 192
7.12.4.10 Monoject 12mL Safety Syringe 192
7.12.4.11 SoftPack Hypodermic Needles 192
7.12.4.12 Rigid Pack Hypodermic Needles 192
7.12.4.13 Rigid Blunt Cannulas 193
7.12.4.14 Soft Pack Tuberculin Syringes 193
7.12.4.15 Rigid Pack Tuberculin Syringes 193
7.12.4.16 SoftPack Insulin Syringes 193
7.12.4.17 Rigid Pack Insulin Syringes 194
7.12.4.18 Allergy Trays with Permanently Attached Needles 194
7.13 Henke-Sass, Wolf GmbH 194
7.13.1 Selected Products from Henke-Sass 194
7.13.1.1 Two-Part Disposable Syringes 1-50 mL 194
7.13.1.2 Three-Part Disposable Syringes 1-30 mL 195
7.13.1.3 Disposable Needles HSW FINE-JECT 195
7.14 Hindustan Syringes & Medical Devices Ltd. (HMD) 196
7.14.1 Insulin Syringes from HMD 196
7.14.2 HMD’s Single-Use Needles 196
7.14.3 HMD’s Single-Use Syringes 197
7.15 Hi-Tech Medical Products Ltd. 198
7.16 Hyaluron Contract Manufacturing (HCM) 198
7.16.1 HCM’s Major Markets 198
7.16.2 HCM’s Facility 199
7.16.2.1 Inova SV-122 Syringe Filler 199
7.16.2.2 Inova H3-5V Syringe Filler 199
7.16.2.3 Inova VFVM-3031 Vial Filler 199
7.17 International Medication System Ltd. 200
7.17.1 Delivery Systems from IMS 200
7.17.2 PCA Products from IMS 201
7.17.3 Phtonadione Injection USP 202
7.17.4 Lidocaine HCL Jelly, USP 2% 202
7.18 Life-Shield Products, Inc. 203
7.19 MedPro Safety Products, Inc. 204
7.19.1 MedPro’s Targeted Markets 205
7.19.2 MedPro’s Products 205
7.19.2.1 Blood Collection Safety Needle 205
7.19.2.2 Winged Safety Blood Collection Set 205
7.19.2.3 Safety Syringe with Anti-blunting Feature 206
7.19.2.4 Prefilled Safety Syringes 206
7.19.2.5 Key-Lok Needleless IV Systems 206
7.20 Merit Medical Systems, Inc. 206
7.20.1 Merit’s Inflation Devices 207
7.20.2 Merit’s Hemostasis Valves 207
7.20.3 Merit’s Vascular Access Products 207
7.20.4 Merit’s Diagnostic Catheters, Guide Wires and Torque Devices 207
7.20.5 Merit’s Angiography and Accessories 208
7.20.6 Merit’s Safety and Waste Management Systems 208
7.20.7 Merits Obesity Products 208
7.20.8 Merit’s Drainage Catheters and Accessories 208
7.20.9 Merit’s Parentesis and Pericardiocentesis Catheters 208
7.20.10 Merit’s Therapeutic Infusion Catheters 209
7.20.11 Merit’s Dialysis and Interventional Nephrology Products 209
7.20.12 Coronary Control Syringes 209
7.20.13 Medallion Syringes 209
7.20.14 RXP Syringe 210
7.20.15 VacLok Syringes 210
7.20.16 Merit’s Manufacturing Facilities 210
7.21 Milestone Scientific 210
7.21.1 Milestone Scientific’s Product Platform 211
7.21.1.1 STA Single Tooth Anesthesia System (STA System) 211
7.21.1.2 CompuDent 211
7.21.1.3 CompuMed 212
7.21.1.4 The Wand 212
7.21.1.5 The SafetyWand 212
7.22 Novo Nordisk A/S 212
7.22.1 Novo Nordisk’s Global Diabetes Care Business 212
7.22.1.1 Novo Nordisk’s Diabetes Care Business in North America 213
7.22.1.2 Novo Nordisk’s Diabetes Care Business in Europe 213
7.22.1.3 Novo Nordisk’s International Business in Diabetes Care 213
7.22.1.4 Novo Nordisk’s Diabetes Care Business in Japan and Korea 213
7.22.1.5 Insulin Pens and Needles from Novo Nordisk 213
7.22.2 Pipeline Progress in Novo Nordisk 214
7.22.3 Novo Nordisk’s Modern Insulin Portfolio 215
7.23 Owen Mumford Ltd. 217
7.23.1 Autopen 217
7.23.2 Autoject 2 218
7.23.3 Unifine Pentips 218
7.23.4 UniGuard 219
7.24 Plas-Pak Industries, Inc. 219
7.24.1 Disposable Veterinary Syringes 219
7.24.2 Dual Syringe and Dental Syringe from Plas-Pak 220
7.24.3 Manual Dual Syringes 220
7.25 Retractable Technologies, Inc. 222
7.25.1 Retractable Technologies’ VanishPoint Products 222
7.26 Revolutions Medical Corporation 223
7.26.1 RevVac Safety Syringe 224
7.27 Safety Syringes, Inc. 224
7.27.1 UltraSafe Needle Guards 225
7.27.2 UltraSafe Passive Needle Guard 225
7.27.3 UltraSafe Passive Needle Guards for Luer Lock and Luer Slip Syringe 225
7.27.4 UltraSafe Automated Assembly 226
7.27.5 UltraSafe Product Development 226
7.28 Smiths Medical International/Medex, Inc. 226
7.28.1 Smiths Medical’s Markets 227
7.28.1.1 Smiths’ Medication Delivery Segment 227
7.28.1.2 Smiths’ Vital Care Segment 228
7.28.1.3 Smiths’ Safety Segment 228
7.28.2 Syringes from Smiths 228
7.28.2.1 Hypodermic Needle-Pro Fixed Needle TB Syringe 228
7.28.2.2 Hypodermic Needle-Pro Device 229
7.28.2.3 Hypodermic Needle-Pro Device and Syringe 230
7.28.2.4 Hypodermic Needle-Pro Device for Insulin Injections 231
7.28.2.5 Hypodermic Needle-Pro Fixed Needle Insulin Syringe 232
7.29 Star Syringe Ltd. 233
7.29.1 Star Syringe’ Alliances 233
7.29.2 Star Syringe Products 234
7.29.2.1 K Safety Technology: K1 Auto-disable Syringe Mechanism 234
7.29.2.2 K3 Safety Cap 234
7.29.2.3 K5 Aspiration 235
7.30 Terumo Medical Corporation 235
7.30.1 Terumo’s Syringe Products 235
7.30.1.1 SurGuard2 Syringes with Safety Needle 235
7.30.1.2 SurGuard2 Safety Needles 236
7.30.1.3 Terumo Hypodermic Needles 237
7.30.1.4 Terumo Hypodermic Syringes without Needle 238
7.30.1.5 Terumo Tuberculin Syringes 239
7.30.1.6 Terumo Hypodermic Syringes with Needle 240
7.30.1.7 SurSaver 1CC Syringes with Low Dead Space 240
7.30.1.8 Terumo Dental Needles 241
7.30.1.9 Terumo Spinal Needles 241
7.30.1.10 SurGuard Safety Insulin Syringes 242
7.30.1.11 Terumo Insulin Syringes 243
7.30.1.12 Thinpro Insulin Syringes for Retail Customers 243
7.31 UltiMed, Inc. 244
7.31.1 UltiCare Insulin Syringes 244
7.31.2 UltiCare Pen Needles 245
7.32 Unilife Medical Solutions Ltd. 246
7.32.1 Unilife’s Solutions 246
7.32.2 Prefilled Syringes from Unilife 246
7.32.3 Clinical (Hypodermic) Syringes from Unilife 246
7.32.4 Unilife’s Self Injection Systems 247
7.32.4.1 Auto-Injectors 247
7.32.4.2 Unilife’s Auto-Infusors 247
7.32.5 Unilife’s Products 247
7.32.5.1 Unifill Syringe 247
7.32.5.2 Unitract 1 mL Syringes 248
7.32.5.3 Unifill Select 248
7.32.5.4 Unifill Rita 249
7.32.5.5 Unifill EZMix syringes 249
7.32.5.6 Unilife Autoinfusor 249
7.33 Vetter Pharma-Fertigung GmbH & Co. 249
7.33.1 Vetter Services and Solutions 250
7.33.2 Vetter’s Dual-Chamber Technology 250
7.34 Vita Needle Company, Inc. 250
7.34.1 Disposable Stainless Steel Needle Blunts from Vita Needle 250
7.34.2 Teflon Dispensing Needles 251
7.34.3 Vita Needle’s Polypropylene Needles 251
7.34.4 Vita Needle’s Taper Tip Needles 252
7.35 West Pharmaceutical Services, Inc. 252
7.35.1 West’s Business Segments 252
7.35.1.1 Packaging Systems Segment 252
7.35.1.2 Delivery Systems Segment 253
7.35.2 West’s Syringe Products 254
7.35.2.1 The West ConfiDose Autoinjector System 254
7.35.2.2 West’s Prefillable Syringes 254
7.35.2.3 Plungers 256
7.35.2.4 Needle Shields 256
7.35.2.5 Tip Caps 256
7.36 Wuxi Yushou Medical Appliances Co., Ltd. 256
7.37 Ypsomed Holding AG 257
7.37.1 Future Trends in Self Medication: Ypsomed Holding’s Perceptions 257
7.37.2 ServoPen Insulin Pen 259
7.37.3 YpsoPen Twist 260
7.37.4 UnoPen 260
7.37.5 LyoTwist 260
7.37.6 YpsoMate 261
7.37.7 Mylife OmniPod Insulin Patch Pump 261

Appendix 1: Sharps Safety Products 262
Appendix 1.1: Air Bubble Removal Devices 262
Appendix 1.2: Allergy Syringes 262
Appendix 1.3: Amniocentesis Trays 263
Appendix 1.4: Ampoule Breaker 263
Appendix 1.5: Apheresis Needles 263
Appendix 1.6: Arterial Blood Gas Syringes 264
Appendix 1.7: Arterial Line Draw 264
Appendix 1.8: Automated Filling of IV Syringe Doses 264
Appendix 1.9: Bifurcated Needles 265
Appendix 1.10: Bleeding Time Devices 265
Appendix 1.11: Blood Collection 265
Appendix 1.12: Blood Culture Bottles 266
Appendix 1.13: Blood Donor Needles 266
Appendix 1.14: Blood Slide Preparation Devices 266
Appendix 1.15: Blood Transfer Devices 267
Appendix 1.16: Blunt Suture Needles 267
Appendix 1.17: Bone Marrow Biopsy Needle Kits 267
Appendix 1.18: Bone Marrow Collection Systems 267
Appendix 1.19: Capillary Blood Collection 268
Appendix 1.20: Carpuject Safety Needle Systems 268
Appendix 1.21: Cataract Safety Scalpel 268
Appendix 1.22: Catheter Securement Devices 269
Appendix 1.23: Chemo Waste Sharp Containers 269
Appendix 1.24: Closed Arterial Sampling 269
Appendix 1.25: Closed Venous Sampling 270
Appendix 1.26: Closed System Antineoplastic Systems 270
Appendix 1.27: Cord Clamping Products 270
Appendix 1.28: Cord Blood Collection Products 270
Appendix 1.29: Dental Anesthesia—Automatic 271
Appendix 1.30: Dental Anesthesia Syringe 271
Appendix 1.31: Epidural Needle 271
Appendix 1.32: Epidural Continuous Infusion Trays 271
Appendix 1.33: Fascia Closing Device 271
Appendix 1.34: Finger Protection 271
Appendix 1.35: Finger-Stick Sampling 271
Appendix 1.36: Flu Syringe 272
Appendix 1.37: Puncture Indicator Gloves 272
Appendix 1.38: HeelStick Lancets 272
Appendix 1.39: Hemodialysis Catheter Needles 273
Appendix 1.40: Huber Needles 273
Appendix 1.41: Injection Therapy 274
Appendix 1.42: Insulin Injection 274
Appendix 1.43: Introducer Needles 274
Appendix 1.44: IV Access 275
Appendix 1.45: IV Catheter 275
Appendix 1.46: Knee Tap Syringe 275
Appendix 1.47: Lancet 276
Appendix 1.48: Lumbar Puncture Kits 276
Appendix 1.49: Magnetic Instrument Transfer 276
Appendix 1.50: Magnetic Sharps Retriever 276
Appendix 1.51: Medical Fluid Waste Disposal 277
Appendix 1.52: Medication Reconstitution 277
Appendix 1.53: Microfiltration 277
Appendix 1.54: Minimally-Invasive Laproscopic Suturing Device 277
Appendix 1.55: Myelogram Saftey Trays 278
Appendix 1.56: Needle Counter 278
Appendix 1.57: Needle Disintegration Products 278
Appendix 1.58: Needle-free IV Systems 278
Appendix 1.59: Needle-free IV Bag Spike 279
Appendix 1.60: Needle Parking Device 279
Appendix 1.61: Neuropathy Screening 279
Appendix 1.62: Opthalmic Scalpel 280
Appendix 1.63: Paracentesis, Pneumo Thorax, Thoracentesis Trays 280
Appendix 1.64: Percutaneous Endoscopic Gastrostomy (PEG) 280
Appendix 1.65: Pharmacy Safety Trays 280
Appendix 1.66: PICC Catheter Trays with Safety Components 281
Appendix 1.67: PICC Introducer 281
Appendix 1.68: Prefilled Syringes 281
Appendix 1.69: Pre-procedure Bandages 281
Appendix 1.70: Puncture-resistant Gloves 282
Appendix 1.71: Recapping Devices 282
Appendix 1.72: Scalpels, Retractable 282
Appendix 1.73: Scalpels, Shielded 283
Appendix 1.74: Scalpels, Weighted 283
Appendix 1.75: Scalpel Blade Remover 283
Appendix 1.76: Scalpel Holder 284
Appendix 1.77: Segment Sampling Devices 284
Appendix 1.78: Self-sealing Capillary Tubes 284
Appendix 1.79: Serum Dispenser 284
Appendix 1.80: Sharps Containers, Disposable 285
Appendix 1.81: Sharps Containers, Mail-back 285
Appendix 1.82: Sharps Containers, Pharmaceutical 285
Appendix 1.83: Sharps Containers, Reusable 286
Appendix 1.84: Sharps Securing Device 286
Appendix 1.85: Skin Stapler 286
Appendix 1.86: Spinal Trays 286
Appendix 1.87: Staple Remover 287
Appendix 1.88: Sternum Closing Device 287
Appendix 1.89: Striped Syringe for Labeling Safety 287
Appendix 1.90: Suction Canister System 287
Appendix 1.91: Surgical Floor Aspirator 288
Appendix 1.92: Surgical Instrument Transfer Products 288
Appendix 1.93: Surgical Safety Products 288
Appendix 1.94: Suture Removal Devices 288
Appendix 1.95: Syringe Labeling for Safety 289
Appendix 1.96: Syringe Management System 289
Appendix 1.97: Temporary Sharps Containers 289
Appendix 1.98: Topical Anesthetic Device 289
Appendix 1.99: Transfer Fluid Devices 290
Appendix 1.100: Tuberculin Syringe 290
Appendix 1.101: Tympanocentesis Speculum 290
Appendix 1.102: Umbilical Catheter Tray with Safety Components 291
Appendix 1.103: Umbilical Line Draw 291
Appendix 1.104: Urine Sampling and Collection 291
Appendix 1.105: Vial Access Adapters 291
Appendix 1.106: Winged Set for Blood Collection 292
Appendix 1.107: Wound Closure, Glue 292
Appendix 1.108: Wound Irrigation 292
Appendix 2: Forces of Change in the U.S. Healthcare 294
Appendix 2.1: Expanding Coverage under Healthcare Reform 294
Appendix 2.2: More Coverage under Medicaid 294
Appendix 2.3: Accountability and Incentives 295
Appendix 2.4: Ways to Reduce Cost 296
Appendix 2.5: Better Value for What the Country Spends 296
Appendix 2.6: Primary Care Shortage 296
Appendix 2.7: Medicare Modernization Act (MMA) 296
Appendix 2.8: National Health Expenditure Projections 297
Appendix 2.9: Prescription Drug Trend 299
Appendix 2.10: Growth in Specialty 299
Appendix 2.11: Cost per Day 300
Appendix 2.12: Increased Utilization 300
Appendix 2.13: Prescription Benefit Performance and Trend 301
Appendix 2.14: Possible GDRs of 80% in 2012 301
Appendix 2.15: Impact of New Brands and Formulations 302
Appendix 2.16: Pradaxa 302
Appendix 2.17: OxyContin 302
Appendix 2.18: Cymbalta 302
Appendix 2.19: Crestor 302
Appendix 2.20: Fastest Growing Specialty Line 303
Appendix 3: A Benchmark for Medical Injectables 305
Appendix 3.1: Medical Benefit Drug Formulary 306
Appendix 3.2: Provider Reimbursement 308
Appendix 3.3: Benefit Design 311
Appendix 3.4: Oral vs. Intravenous 313
Appendix 3.5: Distribution Channel Management 317
Appendix 3.6: Utilization Management 318
Appendix 3.7: Trend Drivers 322
Appendix 3.8: Spend Drivers 324
Appendix 3.9: National Trends 325
Appendix 3.10: Drug Pipeline 327
Appendix 4: The Use of Medicines in the U.S. 328
Appendix 4.1: Spending on Medicines 328
Appendix 4.2: Volume of Medicines Consumed 328
Appendix 4.3: Patient Payment for Medicines 329
Appendix 4.4: Comparison of 2010 vs. 2009 Spending 329
Appendix 4.5: Changes in Usage and Spending in Major Therapy Areas 329
Appendix 4.6: Increased Real Spending in 2010 329
Appendix 4.7: Spending Growth in 2010 330
Appendix 4.8: Volume Growth Performance 331
Appendix 4.9: Total Prescription Volume Growth 331
Appendix 4.10: Shift toward Medicare Part D and Medicaid 332
Appendix 4.11: Decline in Copayments and Shift to Generics 332
Appendix 4.12: Spending Changes in Five Major Segments 333
Appendix 4.13: Decline in Volume Growth 333
Appendix 4.14: Spending on Protected Brands 333
Appendix 4.15: Spending on New Brands 334
Appendix 4.16: Brand Launches in 2010 335
Appendix 4.17: Spending on Products before Generic Entry 335
Appendix 4.18: Total Generic Market Share 336
Appendix 4.19: Spending in Leading Therapy Classes 337
Appendix 4.20: Oncology Growth by Area 337
Appendix 4.21: Respiratory Growth by Area 338
Appendix 4.22: Growth of Lipid Regulators 339
Appendix 4.23: Growth in Antipsychotic Spending 339
Appendix 5: Syringe Needle Terminology 340
Appendix 6: Medication Errors and Syringe Safety 342
Appendix 6.1: Injectable Medication Errors 342
Appendix 6.2: Frequency of Syringe Usage 342
Appendix 6.3: Labeling Injectable Medications 342
Appendix 6.4: Challenges of Labeling 342
Appendix 6.5: Benefits of a Write-On Stripe 342
Appendix 6.6: Nurses Influence on Selection of Sharp Devices 343
Appendix 6.7: Needlestick Injuries 343
Appendix 6.8: Prevention of Needlestick Injuries 343
Appendix 6.9: Protection from Needlestick Injuries 344


INDEX OF FIGURES

Figure 2.1: Filling and Packaging of Prefilled Syringes 32
Figure 2.2: Prefilled Syringes with Safety Devices 32
Figure 4.1: Most Common Instances when Needlesticks Occur 52
Figure 4.2: Needlestick Injuries in Massachusetts with Healthcare Facilities with Safety vs. Standard Syringes, 2002-2008 55
Figure 4.3: Indicative Pricing Chart for Safety Features 56
Figure 5.1: Syringe Sizes Required for Injectable Drugs 63
Figure 5.2: Global Market for Disposable Syringes, 2011-2018 64
Figure 5.3: Global Market for Disposable Syringes by Segmentation, 2011 65
Figure 5.4: Global Market for Safety Syringes by Segmentation, 2011 66
Figure 5.5: Combined Market for Drug Delivery Syringe Devices, 2010-2015 67
Figure 5.6: Breakdown of U.S. Syringe Market 68
Figure 5.7: Types of Safety Syringes used in the U.S. Healthcare Facilities 68
Figure 5.8: U.S. Adoption of Safety Syringes, 2011-2018 69
Figure 5.9: The Total Disposable Syringe Market in the U.S., 2011-2018 70
Figure 5.10: The U.S. Market for Safety Syringes, 2011-2018 71
Figure 5.11: European Overall Market for Disposable Syringes, 2011-2018 72
Figure 5.12: European Adoption of Safety Syringes, 2011-2018 73
Figure 5.13: Market Share of Prefilled Syringes by Geography 76
Figure 5.14: Number of Drugs in the Core Therapeutic Areas for Prefilled Syringes 79
Figure 5.15: Global Market for Prefilled Syringes, 2011-2018 96
Figure 5.16: Steady Growth of Global Prefilled Syringe Unit Consumption, 2011-2018 97
Figure 5.17: World vs. U.S. Market for Prefilled Syringes, 2011-2018 98
Figure 5.18: Consumption of Prefilled Syringes by Pharmaceutical Company 98
Figure 5.19: Pharmaceutical Consumption of Prefilled Syringes by Therapeutic Drug Class 99
Figure 5.20: Global Market for Prefilled Pain Management Drugs, 2011-2018 101
Figure 5.21: Global Sales of Enbrel in Prefilled Syringes, 2005-2011 101
Figure 5.22: Global Market for Prefilled Psoriasis Drugs, 2011-2018 102
Figure 5.23: Global Market for Prefilled Anemia Drugs, 2011-2018 103
Figure 5.24: Global Market for Prefilled Insulin, 2011-2018 104
Figure 5.25: Growth of Prefilled Insulin Devices and Decline of Vials and Syringes, 1994-2010 105
Figure 5.26: Global Market for Oncology Drugs in Prefilled Syringes, 2011-2018 106
Figure 5.27: Global Market for Multiple Sclerosis (MS) Drugs in Prefilled Syringes, 2011-2018 107
Figure 5.28: Market Share for Multiple Sclerosis Drugs in Prefilled Syringes by Company, 2011 107
Figure 5.29: Global Market for Arthritis Drugs in Prefilled Syringes, 2011-2018 108
Figure 5.30: Percent Growth of Vaccines in Prefilled Syringes, 2011-2018 109
Figure 5.31: Market Share for Vaccines in Prefilled Syringes by Company, 2011 110
Figure 5.32: Market Share for Anti-Coagulants in Prefilled Syringes by Company, 2011 111
Figure 5.33: Market Share for Anti-Inflammatory Drugs in Prefilled Syringes, 2011 112
Figure 5.34: Market Share for Hematology Drugs in Prefilled Syringes by Company, 2011 112
Figure 5.35: Market Share for Obstetrics Drugs in Prefilled Syringes by Company, 2011 113
Figure 5.36: Global Market for Insulin Pen, 2011-2018 117
Figure 5.37: Global Market for Auto-Injectors/Auto-Infusors, 2011-2018 118
Figure 5.38: U.S. Leaders in Insulin Pumps, 2011 118
Figure 5.39: Market for Self-Injection Syringes, 2011-2018 119
Figure 6.1: Global Market for Conventional Injectables, 2011-2018 121
Figure 6.2: Global Market for Injection, Infusion and Vascular Access Devices, 2011-2018 121
Figure 6.3: Global Burden of Diabetes, 2010-2030 125
Figure 6.4: Global Market for Insulin Delivery Devices, 2009-2016 126
Figure 6.5: Insulin Delivery Devices Worldwide Market Shares, 2011 127
Figure 6.6: Insulin Consumption in Selected Countries, 2000 and 2010 127
Figure 6.7: Growth of Modern Insulin, 1994-2010 128
Figure 6.8: Growth of Modern Insulin Delivery Systems, 1994-2010 129
Figure 6.9: Global Insulin Value Market Share, 2011 130
Figure 6.10: Global Insulin Volume Market Share, 2011 131
Figure 6.11: Treatment of Diabetes in the U.S.: Share of Patients by Treatment Class, 2011 132
Figure 6.12: U.S. Treatment of Diabetes: Share of Insulin by Type, 2011 132
Figure 6.13: U.S. Treatment of Diabetes: Share of Incretin by Type, 2011 133
Figure 6.14: U.S. Diabetes Care Market by Treatment Class, 2006-2011 134
Figure 6.15: U.S. Insulin Volume Market by Segment, 2006-2011 135
Figure 6.16: U.S. Insulin Value Market Growth, 2006-2011 136
Figure 6.17: Modern Insulin and Device Penetration in the U.S. Market, 2006-2011 137
Figure 6.18: U.S. Total Insulin Volume Market Share by Company, 2011 137
Figure 6.19: U.S. Total Insulin Value Market Share by Company, 2011 138
Figure 6.20: U.S. Total Short-Acting Insulin Market Share (Volume) by Company, 2011 139
Figure 6.21: U.S. Total Premix Insulin Market Share (Volume) by Company, 2011 139
Figure 6.22: U.S. Total Long-Acting Insulin Market Share (Volume) by Company, 2011 140
Figure 6.23: European Diabetes Care Market by Treatment Class, 2006-2011 140
Figure 6.24: European Diabetes Care Market Share by Company, 2011 141
Figure 6.25: European Distribution of People with Diabetes Initiating TDZ, DPP-IV, GLP-1 and Insulin 142
Figure 6.26: E.U. Insulin Market by Segment, 2006-2011 142
Figure 6.27: E.U. Modern Insulin Market Share by Company, 2011 143
Figure 6.28: Chinese Diabetes Care Market by Treatment Class, 2006-2011 144
Figure 6.29: Chinese Diabetes Care Value Market Share by Company, 2011 145
Figure 6.30: Chinese Insulin Market by Segment, 2006-2011 145
Figure 7.1: BD Medicals Business Performance by Segment, 2011 153
Figure 7.2: Performance of BD Medical Segment, 2011 154
Figure 7.3: Performance of BD Diagnostics Segment, 2011 155
Figure 7.4: Performance of BD Biosciences, 2011 156
Figure 7.5: BD’s Geographic Performance, 2011 156
Figure 7.6: Share of Bioject’s Business by Customer, 2010 178
Figure 7.7: Bioject’s Business by Product Line, 2010 179
Figure 7.8: Bioject’s Business by Geography, 2010 180
Figure 7.9: Catalent’s Revenue by Segment, 2011 183
Figure 7.10: Retractable Technologies’ Business by Geography, 2010 223
Figure 7.11: Smiths’ Market by Segment, 2011 227
Figure 7.12: Insulin Market by Geography, 2009-2015 258
Figure 7.13: Global Insulin Market by Manufacturers, 2009-2015 259
Figure A2.1: Estimated Health Insurance Coverage without Health Reform, 2019 294
Figure A2.2: Estimated Health Insurance Coverage with Reform, 2019 295
Figure A2.3: Projected National Health Expenditures under ACA, 2009-2019 298
Figure A2.4: Projected Annual Growth Rates in National Health Expenditures (NHE), 2009-2019 298
Figure A2.5: Projected Percentage of Insured, 2009-2019 299
Figure A2.6: Average Wholesale Price (AWP) Inflation, 2008-2010 300
Figure A2.7: Prescription Spend Distribution, 2005 and 2015 304
Figure A3.1: Formularies in Place by Plan Size 306
Figure A3.2: Therapeutic Classes with a Medical Formulary Currently in Place 307
Figure A3.3: Rebates Received by Size of Health Plan 307
Figure A3.4: Therapeutic Classes with Rebates 308
Figure A3.5: Reimbursement Approach 308
Figure A3.6: Reimbursement Approach by Size of Plan 309
Figure A3.7: Development of Drug Reimbursement Strategies 310
Figure A3.8: Duration of Current Reimbursement Strategies 310
Figure A3.9: Payors Who Capitate or Use Case Rates 311
Figure A3.10: Membership Subject to Contribution 311
Figure A3.11: Member Cost Reimbursements Overall 312
Figure A3.12: Member Cost Reimbursement by Plan Size 312
Figure A3.13: Member Contribution Parity 313
Figure A3.14: Genomic Test Requirements 314
Figure A3.15: Screening/Prevention Programs in Place 314
Figure A3.16: HEDIS Prevention Programs Established 315
Figure A3.17: Member Compliance by Screening Program 315
Figure A3.18: End-of Life Programs Provided 316
Figure A3.19: End-of-Life Program Coverage 316
Figure A3.20: Payors Monitoring Member Participation 317
Figure A3.21: Level of Employer Engagement by Plan Size 317
Figure A3.22: Percentage of Medical Claims Billed 318
Figure A3.23: Managing Utilization of Products 319
Figure A3.24: Cancer’s Subjected to Medical Utilization Tools 320
Figure A3.25: Specific Prior Authorization Criteria 321
Figure A3.26: Post-HOC Edits Conducted 322
Figure A3.27: Implementation of Edits 322
Figure A3.28: Spend by Provider Specialty 325
Figure A4.1: Growth in Spending on Medicines, 2001-2010 328
Figure A4.2: Total Real Spending, 2006-2010 329
Figure A4.3: Real Spending per Capita, 2006-2010 330
Figure A4.4: Volume Growth in Injectable Standard Units, 2006-2010 331
Figure A4.5: Prescription Volume Growth, 2001-2010 332
Figure A4.6: Shift Toward Medicare Part D and Medicaid Between 2006 and 2010 333
Figure A4.7: Protected Brand Price Spending Growth, 2006-2010 334
Figure A4.8: New Brand Spending, 2006-2010 334
Figure A4.9: Spending on Products before Generic Entry, 2006-2010 336
Figure A4.10: Generic Share of Total Prescriptions, 2006-2010 336
Figure A4.11: Spending in Leading Therapy Classes, 2010 337
Figure A4.12: Oncology Growth by Area, 2006-2010 338
Figure A4.13: Respiratory Growth by Area, 2006-2010 338
Figure A6.1: Timing of Needlestick Injuries 343


INDEX OF TABLES

Table 2.1: Components of a Prefilled Syringe 28
Table 2.2: Key Advantages of Prefilled Syringes 31
Table 2.3: Insulin Pens Available in the U.S. 38
Table 2.4: Types of Insulins Used in Cartridges 39
Table 2.5: Aspects of Insulin Pens to be considered 39
Table 2.6: User Characteristics of Insulin Pens 40
Table 5.1: Selected Injectable Therapeutics and Vaccines Available in the U.S. Market 74
Table 5.2: Key Advantages of Prefilled Syringes 77
Table 5.3: Pharmaceutical Share of Key Prefilled Therapeutic Market 77
Table 5.4: Key Prefilled Products 78
Table 5.5: Biotech Blockbusters Available in Vials and Prefilled Syringes 82
Table 6.1: Alternative Modes of Insulin Delivery 122
Table 6.2: Types of Insulin Used in Pump Therapy 123
Table 6.3: Insulin Pumps Assessed by AFB TECH Company, 2004 and 2008 124
Table 7.1: Albert David’s Syringes with Needles 148
Table 7.2: Albert David’s Needles 148
Table 7.3: Syringes from Alshifa 149
Table 7.4: BD’s Auto-Disable Syringes 160
Table 7.5: Insulin Syringes from BD 161
Table 7.6: BD’s Allergy Syringes 162
Table 7.7: BD’s Tuberculin Syringes 162
Table 7.8: BD’s Sterile, Single-Use Syringes and Needles 163
Table 7.9: BD’s Safety-Lok Safety-Syringes 165
Table 7.10: BD’s Safety Glide Syringes 166
Table 7.11: BD’s Eclipse Syringes 166
Table 7.12: BD’s Integra Syringe 167
Table 7.13: BD’s PosiFlush Prefilled Syringes 168
Table 7.14: Bard’s Piston Syringes 186
Table 7.15: Bard’s Bulb Syringes and Trays, 2009 186
Table 7.16: Angiographic Syringes from Coeur 187
Table 7.17: CT Syringes from Coeur 187
Table 7.18: HMD’s Dispovan Insulin Syringes 196
Table 7.19: HMD’s Single-Use Needles 197
Table 7.20: HMD’s Single-Use Syringes 197
Table 7.21: Hi-Tech Single-Use Syringes 198
Table 7.22: Hi-Tech’s Single-Use Insulin Syringes 198
Table 7.23: HCM’s Contract Manufacturing Categories 199
Table 7.24: Syringes from IMS 201
Table 7.25: PCA Syringes from IMS 202
Table 7.26: Phytonadione Injection USP from IMS 202
Table 7.27: Lidocaine Prefilled Syringes from IMS 203
Table 7.28: Life-Shield’s Syringe Products 204
Table 7.29: Estimated Market for MedPro’s Targeted Product Sectors 205
Table 7.30: Autopen Products from Owen Mumford 217
Table 7.31: Autoject Products from Owen Mumford 218
Table 7.32: Unifine Products from Owen Mumford 219
Table 7.33: Retractable Technologies’ VanishPoint Syringes 222
Table 7.34: Smiths’ Pro Fixed Needle TB Syringes 229
Table 7.35: Smiths’ Needle-Pro with Needle Protection Devices 230
Table 7.36: Smiths’ Needle-Pro Syringe and Needle with Needle Protection Device 231
Table 7.37: Smiths’ Needle-Pro Needle Protection Device for Insulin Injections 232
Table 7.38: Smiths’ Needle-Pro Fixed Needle Insulin Syringe 232
Table 7.39: SurGard2 Syringes with Safety Needle 236
Table 7.40: Terumo’s SurGard2 Safety Needles 237
Table 7.41: Terumo’s Hypodermic Needles 238
Table 7.42: Terumo’s Hypodermic Syringes without Needle 239
Table 7.43: Terumo’s Tuberculin Syringes 239
Table 7.44: Terumo’s Hypodermic Syringes with Needle 240
Table 7.45 Terumo’s SurSaver 1 cc Syringes with Low Dead Space 241
Table 7.46: Terumo’s Dental Needles 241
Table 7.47: Terumo’s Spinal Needles 242
Table 7.48: Terumo’s SurGard Safety Insulin Syringes 242
Table 7.49: Terumo’s Insulin Syringes 243
Table 7.50: Thinpro Insulin Syringes 244
Table 7.51: UltiMed’s UltiCare Insulin Syringes 245
Table 7.52: UltiCare Pen Needles 245
Table 7.53: Vita Needle’s Stainless Steel Needle Blunts 251
Table 7.54: Vita Needle’s Teflon Dispensing Needles 251
Table 7.55: Vita Needles Polypropylene Needles 252
Table 7.56 Vita Needle’s Taper Tip Needles 252
Table A2.1: Top Five Specialty Categories, 2010 299
Table A2.2: Top Ten Therapeutic Categories, 2010 301
Table A2.3: Blockbuster Brands Going Generic, 2011-2013 301
Table A2.4: Projected Generic Launches, 2011-2015 303
Table A3.1: Common Cancer Types under Formulary 306
Table A3.2: Drug Volume Distributed to Patients via Physician Office 318
Table A3.3: Utilization Management Tools by Class 319
Table A3.4: Management Tools for Common Therapies 320
Table A3.5: Top Medical Injectable Concerns, 2011 321
Table A3.6: Top 25 Injectable Drugs, 2009 323
Table A3.7: Portion of Members who Received a Medical Injectable 324
Table A3.8: Spend by Key Therapeutic Class 325
Table A3.9: Top Five Diagnosis Codes 326
Table A3.10: FDA-approved Injectable Drugs, 2010 327
Table A4.1: Brand Launches by Type, 2010 335