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Forecasting the burden of disease

For pharmaceutical companies it is important to know how patient-populations for different diseases develop in the future. Datamonitor Healthcare develops reports including patient-based forecasts for both developed and emerging countries, but also background to diseases in order to explain the results. Since 2013 I am part of their epidemiology team that develops these reports.

I started to work for Datamonitor Healthcare mid 2013 writing a report on the epidemiology of osteoarthritis in the seven major markets (7MM) (US, Japan and the five European (5EU) markets - France, Germany, Italy, Spain, UK). What followed were reports on Alzheimers disease in China and Brazil, pulmonary arterial hypertension in the 7MM and in the beginning of 2014 age-related macular degeneration in the 7MM.

The approach to writing these reports is in general as follows:

As the forecast of the burden of disease is the most important part, I start searching in Pubmed and Google if there are population-based studies conducted in the different countries reporting on the prevalence of the respective disease. Sometimes, e.g. in the case of pulmonary arterial hypertension, no population-based studies have been conducted, but  you have to rely on registries for diagnosed cases.

Once the studies are found, the best data for each country should be selected. Preferably the survey is nationally representative, includes a large sample, uses widely accepted criteria to diagnose / classify disease, and presents age-sex-specific prevalence rates. Especially the latter is not always the case, and then these rates should be estimated e.g. using data from another country. If no data at all is available for a country, prevalence rates from another country - with similar demographic and economic characteristics - is used.  This is described in the Sources and methodology section of the report.

Once the age-sex-specific prevalence rates are retrieved, these are entered into an MS Excel model. This model e.g. includes the population projections for each of the countries. Based on this the forecast for the number of people with a certain disease is made up to 2030, for the different countries. This will be presented overall, by age groups, and by gender. If it is of importance, forecasts can also be made for e.g. different severity classes or subtypes of a disease.

The above leads to the Results (Forecast) section of the report and in the Discussion section these data will be interpreted by comparing the estimates with those provided by others (if available), discussing possible limitations of the calculations, and highlighting the implications of the results.

However, for the reader it is also important to have a wider picture of the disease then just the number of cases. Therefore, the reports always start with a section where the disease is described: definition, diagnosis, classification. Focus is on those diagnostic techniques and classification criteria used in the population surveys. Then the most important risk factors are discussed, which are also important for future development of the disease burden. Lastly a brief overview about variations in prevalence and incidence globally is given, as well as morbidity due to disease or mortality / survival.

Following good academical practice, all resources used in the report are referenced at the end.

This together gives pharmaceutical companies a good overview of the current and future burden of a disease and therefore the need for treatment.

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Support the development of an applied epidemiology course

I am currently supporting I-TECH South Africa and the University of Washington with the development of an applied epidemiology distance learning course. One of the main tasks it to provide technical expertise related to the South African clinical and epidemiology contexts.

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    Lucille Robert


    I work for Mundipharma South Africa as a Brand Manager.

    Mundipharma has particular expertise in drug delivery systems, the research, development, manufacturing and commercialization of pain management products and products for the treatment of cancer, antiseptics and laxatives. In South Africa after launching OxyContin®, OxyNorm® and Sovenor®, we will relaunch OTC products like Betadine and Teejel.

    We would be interested by defining our target population from an epidemiology point of view.

    Feel free to send me information about your services.

    regards, Lucille ROBERT


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