Size of the Market:

In a 1999 market analysis on the Pharmaceutical Industry in Canada and the U.S.A. by IMS (a Dunn & Bradstreet Company), the sales of prescription medications used to treat osteoarthritic pain exceeded $3,964 million CDN.

In response to the increasing costs of medical care, and in particular the growing cost of "drug therapy" for the aging population, governments, employers and insurance companies in North America have continued to implement initiatives designed to shift the burden of "drug" expenses back to the patient or consumer.

This shift, combined with an increase in the incidence of osteoarthritis in the context of the aging population, resulted in sales of Over-the-Counter (OTC) "internal analgesics" that exceeded $195 million CDN in the Canadian drugstore retail channel alone, a 7% overall increase in 1999*.

The Medical Associations, Consensus/Advisory Committees and the medical literature have all documented the role of analgesics (including NSAIDs) in the management of pain associated with osteoarthritis. However, the clinical literature also documents that analgesics such as aspirin and NSAIDs inhibit cartilage repair, accelerate cartilage destruction** and their ingestion is associated with a number of unwanted side effects.

As such, medical researchers and consumers/patients have looked to the role of exercise; diet and dietary nutritional supplementation to arrest the underlying cause of osteoarthritis and address pain management.

The result has been the dramatic growth and market penetration of Glucosamine sulphate (GLS) and MSM (Methyl Sulfonyl Methane).

While no specific data is currently available to identify the actual size of the Glucosamine Sulphate market there are over 30 brands and as many private label offerings of tablets and capsules currently in the market. It is generally accepted that the sales of Glucosamine Sulphate contribute a substantial component of the $7 billion USD vitamin/nutritional supplement category in the U.S.A.

According to the Canadian Arthritis Society and the American Arthritis Foundation, before the end of the current decade the number of individuals suffering from osteoarthritis in North America will be in excess of 50 million.

What is responsible for the market growth?

The primary vehicle driving market growth is consumer/patient awareness, education and demand pertaining to an "integrated approach" to the prevention of and treatment of the underlying cause of Osteoarthritis. This is a mandate that is heavily funded by governments, insurance companies and pharmaceutical houses as well as established patient and medical advocacy groups and associations (e.g. Osteoarthritis Societies and Foundations, National Institute of Health (NIH), Canadian Medical Association, etc.) For example, in response to consumer/patient demand, as well as the demand of the medical community for more "clinical evidence based" information pertaining to the role of glucosamine sulphate in cartilage regeneration, in December 2000 the "NIH announced that it will fund a $14 million USD study to determine if popular "natural" supplement (glucosamine) work against osteoarthritis."

For more third party information pertaining to glucosamine sulphate refer to www.arthritis.com -headline news or www.medcenter-usa.com/departments/arthritis- click on Arthritis Foundation.

Is there clinical evidence for the role of glucosamine sulphate and MSM in the prevention and management of Osteoarthritis?

Numerous clinical studies have shown that glucosamine sulphate and MSM will produce equal or better results than placebo or NSAIDs in the management of pain associated with osteoarthritis.

For clinical information pertaining to the effective of MSM in degenerative arthritis visit the website www.msm.com and click on "Health Benefits- Scientific Studies.

The clinical work pertaining to glucosamine sulphate in osteoarthritis spans decades of work.

In a 1982 study by Vaz et al a double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthritis of the knee was reported. In this study, by week four of therapy the group of patients receiving glucosamine sulphate was doing significantly better than the ibuprofen group.

In a 1992 study by Rovati short and long term trials with "disease-modifying drugs in osteoarthritis demonstrated that glucosamine sulphate was more effective than placebo and equally as effective as ibuprofen (the most used NSAID).

A report in the Janurary 27th 2001 issue of The Lancet found that amoung patients with knee osteoarthritis, long term use of glucosamine sulphate seems to put off changes in joint structure and greatly improves symptoms. Dr. Jean Yves Reginster conducted this study in 212 patients.

Based on the popularity of this supplement, and the substantial use by consumers/patients in the prevention and management of osteoarthritis, it is not surprising that the NIH has committed $14 million USD to further study the benefits of this important dietary nutrition supplement.