Mehr als 425 Mio. Menschen leiden heute an Diabetes, das entspricht fast einer Verdreifachung gegenüber 2014. Somit ist einer von 11 Menschen weltweit an Diabetes erkrankt. Vor allem die rapide Zunahme in Regionen wie Afrika und Südostasien wird dazu führen, dass sich diese Zahl bis 2045 auf rund 630 Mio. Patienten erhöhen wird. Die damit verbundenen Belastungen für die Gesundheitssysteme verdeutlicht eine andere Ziffer: 12% der globalen Gesundheitsausgaben von 2017 in Höhe von USD 730 Mrd. entfielen auf die Behandlung von Diabetes, d.h. hauptsächlich auf die Behandlung der Folgeerkrankungen.
Besseres Monitoring in Echtzeit
Am besten lassen sich gesundheitliche Verbesserungen für Diabetiker anhand der sogenannten «Time in Range» messen. Darunter versteht man den Zeitraum über 24 Stunden, in dem sich der Blutzuckerspiegel eines Patienten in einer Bandbreite von 70 bis 180 Milligramm pro Deziliter Blut bewegt. Gesunde Menschen kommen hier auf einen Wert von 90%. Bei Diabetespatienten lassen sich inzwischen Spitzenwerte von 72% erzielen – dank der neuen Hybrid Closed Loop-Systeme. Ein Sensor direkt unter der Haut misst alle 5 Minuten die Gewebeglukose und sendet diesen Wert elektronisch an die Insulinpumpe. Die Informationen werden von einem Algorithmus verarbeitet. Eine drohende Unterzuckerung kann so frühzeitig erkannt und die Insulinabgabe gedrosselt oder gestoppt werden. Im Fall einer Überzuckerung wird die Insulinabgabe erhöht.
Zum Vergleich: bei der klassischen Kombination von Glukosemessungen mittels Fingerpiks und Teststreifen in Verbindung mit mehreren Insulininjektionen täglich liegt die «Time in Range» bei 45%. Die seit einigen Jahren marktreife Kombination von Insulinpumpe und traditioneller Glukosemessung ermöglicht 55%. Der Basal-IQ, also ein einfacher Algorithmus, wie ihn das Unternehmen Tandem Diabetes entwickelt hat, schafft eine «Time in Range» von 65%.
Neue Produkte senken Behandlungskosten
Zahlreiche neue Produkte stehen hier in den nächsten zwei Jahren vor der Marktzulassung, zum Beispiel die Insulinpumpe Tandem t:slim X2 von Tandem Diabetes oder das Advanced Hybrid Closed Loop-System von Medtronic. Noch einen Schritt weiter geht Medtronic mit dem Personalized Closed Loop-System, dessen Markteintritt im 2.Quartal 2021 vorgesehen ist. Bereits im 2. Halbjahr 2020 fällt die Entscheidung für die US-Zulassung der von Insulet entwickelten schlauchlosen Insulinpumpe Omnipod Horizon, einer Einwegpumpe, die direkt auf der Haut getragen wird. Die Produkte adressieren einen Markt, dessen Marktvolumen nach unserer Einschätzung bis 2023 USD 10 Mrd. überschreiten wird. Die kontinuierlichen Glukosesensoren werden dabei im Zeitraum 2017 bis 2023 mit jährlichen Wachstumsraten von 23% auf USD 7 Mrd. die etwas grössere Dynamik bei deutlich höheren Umsatzvolumina aufweisen. Abbott und Dexcom sollen dabei die grössten Umsätze erzielen, gefolgt von Medtronic. Bei den Insulinpumpen und Hybrid Closed Loop-Systemen gehen wir davon aus, dass Insulet und Tandem Diabetes ab 2021 Marktanteile von Medtronic gewinnen werden.
In der Summe liegen die grössten Hindernisse für das künstlichen Pankreas auf der Medikamentenseite. Bei den verfügbaren Insulinen dauert es 30 bis 50 Minuten, bis die vollständige Wirkung einsetzt. Diese Zeitspanne ist nicht schnell genug, wenn etwa nach einer spontanen Mahlzeit der Blutzuckerspiegel schnell steigt. Auf Sicht der nächsten drei bis fünf Jahre sind hier keine marktreifen Lösungen in Sicht. Was die künftige Kostenerstattung angeht, wird die gesamte Behandlung von den Krankenversicherungen noch nicht für alle Versicherte bezahlt. Für den Sensor von Dexcom, der den Blutzuckerspiegel in Echtzeit überwacht, liegen die täglichen Kosten bei USD 8 bis 10. Dazu kommen noch die Kosten für die Insulinpumpe. Demgegenüber stehen die Behandlungskosten für Folgeerkrankungen von Diabetes wie Schlaganfall, Herz- und Niereninsuffizienz. Allein in Nordamerika werden die damit verbundenen Behandlungskosten auf USD 370 Mrd. jährlich geschätzt. Wir sehen es deshalb nur als eine Frage der Zeit, bis mit dem Markteintritt der neuen Produkte die Bereitschaft zur gänzlichen Kostenerstattung steigt.
Diabetesfirmen in unseren Fondsportfolios
Aus Anlegersicht bietet das Diabetesmanagement ein lukratives Potenzial. Hohe Eintrittsbarrieren im Verbund mit signifikantem Potenzial für Kostensenkungen in der Diabetesbehandlung schaffen attraktive Investmentopportunitäten. Der BB Adamant Medtech & Services umfasst die drei Kernthemen Diabetes, robotergestützte Chirurgie und strukturelle Herzkrankheiten. Bei den Services liegt der Fokus auf US-Krankenversicherern. 80% des Portfolios besteht aus Large Caps, per Ende Oktober 2019 waren fast 30% der Portfoliofirmen teils oder ganz in Diabetes tätig. Dabei handelt es sich um Medtronic, Abbott, Becton Dickinson,Dexcom, Insulet und Tandem Diabetes. Der BB Adamant Digital Health ist mit rund 10% des Portfolios im Bereich Diabetes unterwegs. Unser Anlagefokus liegt hier auf Small und Mid Caps, die über 80% der Portfoliofirmen stellen. Im Einzelnen sind es Dexcom, Tandem, Insulet und der Diabetes-Dienstleister Livongo – Firmen also, die beim Umsatz mit einer hohen Wachstumsdynamik glänzen, aber noch nicht alle profitabel sind.
To continue please select your investor category and your country of residence.
Select your Country:
Qualified Investor
This Swiss Fund Platform website is only intended for qualified investors within the meaning of Art. 10 par. 3 and 3ter of the Collective Investment Schemes Act (CISA). Qualified investors are professional clients within the meaning of Art. 4 par. 3-5 and Art. 5 paras. 1 and 4 FinSA as well as private clients who meet the requirements of Art. 10 par. 3ter. In particular, qualified investors are:
- Financial intermediaries under the Banking Act (BankA), the Financial Institutions Act (FinSA) and the CISA;
- insurance companies in accordance with the Insurance Act (ISA);
- Foreign clients subject to prudential supervision such as financial intermediaries and insurance companies;
- Central banks;
- Public corporations with professional treasury services;
- Pension funds and institutions that, according to their purpose, serve occupational pension plans, with professional treasury;
- Company with professional treasury;
- Private investment structures built for high net worth individuals with professional treasury services;
- Institutional clients pursuant to Art. 4 para. 4 FinSA;
- Large companies that meet the requirements of Art. 4 para. 5 lit. a-c FinSA;
- private clients, for whom a financial intermediary within the meaning of Article 4 paragraph 3 letter a FinSA or a foreign financial intermediary subject to equivalent prudential supervision provides asset management or investment advice within the meaning of Article 3 letter c items 3 and 4 FinSA within the framework of a long-term asset management or investment advisory relationship, unless they have declared that they do not wish to be considered as such. The declaration must be in writing or in another form verifiable by text.
LEGAL NOTES
Persons who access information on the website of Swiss Fund Platform AG (hereinafter also referred to as "SFP" or "We" or "Us") agree to the following terms and conditions. Swiss Fund Platform AG acts solely as a platform and does not offer any financial services or advice. The information, newsletters or articles on economic and financial topics published on the SFP website do not constitute an aid to decision-making or a recommendation for economic, legal, tax or other advisory questions, or an offer or invitation to buy or sell investment instruments, to effect transactions or to conclude any legal transaction, and in particular do not constitute investment advice or asset management and cannot replace advice and assessment tailored to the individual case.
For qualified advice, please contact an appropriate professional.
The information published is provided by SFP for personal use and information purposes only and is subject to change without notice. SFP takes great care to ensure that the information contained on this website comes from reliable sources, but makes no warranties (express or implied) as to the accuracy, completeness or timeliness of the information published on the SFP website. In particular, SFP is under no obligation to remove or update any outdated information from the SFP website or to expressly mark it as such.
Swiss Fund Platform recommends that you read this disclaimer regularly in order to familiarize yourself with any changes. The date of the last update is listed below.
ACCESS RESTRICTION BY DOMICILE AND INVESTOR CATEGORY
This Swiss Fund Platform website is only intended for qualified investors within the meaning of Art. 10 par. 3 and 3ter of the Collective Investment Schemes Act (CISA). Qualified investors are professional clients within the meaning of Art. 4 par. 3-5 and Art. 5 paras. 1 and 4 FinSA as well as private clients who meet the requirements of Art. 10 par. 3ter. In particular, qualified investors are:
- Financial intermediaries under the Banking Act (BankA), the Financial Institutions Act (FinSA) and the CISA;
- insurance companies in accordance with the Insurance Act (ISA);
- Foreign clients subject to prudential supervision such as financial intermediaries and insurance companies;
- Central banks;
- Public corporations with professional treasury services;
- Pension funds and institutions that, according to their purpose, serve occupational pension plans, with professional treasury;
- Company with professional treasury;
- Private investment structures built for high net worth individuals with professional treasury services;
- Institutional clients pursuant to Art. 4 para. 4 FinSA;
- Large companies that meet the requirements of Art. 4 para. 5 lit. a-c FinSA;
- private clients, for whom a financial intermediary within the meaning of Article 4 paragraph 3 letter a FinSA or a foreign financial intermediary subject to equivalent prudential supervision provides asset management or investment advice within the meaning of Article 3 letter c items 3 and 4 FinSA within the framework of a long-term asset management or investment advisory relationship, unless they have declared that they do not wish to be considered as such. The declaration must be in writing or in another form verifiable by text.
When accessing the Swiss Fund Platform website for the first time, the user must select his or her country of domicile and confirm the category of investor to which he or she belongs. Access to this website is restricted to professional investors as defined by FinSA, all other persons are not granted access.
PERFORMANCE
Swiss Fund Platform AG and this website serve only as a platform for external third parties who may use it to offer services, obtain information or network.
SFP has no or only limited influence on the services offered by external third parties and does not guarantee their success or performance. Any investment or transaction made in the course of such services is made outside the Platform and at your own risk. SFP is not liable for any damages incurred in this context.
LIMITATIONS OF LIABILITY
Swiss Fund Platform AG disclaims, without limitation, all liability for any loss or damage of any kind, including any direct, indirect or consequential damages, which may be incurred through the use of or access to the SFP website, or any links contained on the SFP website that lead to third-party websites. SFP has no influence whatsoever on the information published on third party websites and excludes any liability in this respect. SFP expressly warns of the risk of viruses and the possibility of targeted hacking attacks. In order to combat viruses, the use of current browser versions and the installation of constantly updated anti-virus software are recommended. SFP disclaims any liability for damages resulting therefrom, in particular for damages caused by viruses, hacker attacks or other manipulations of the EDP system of the Internet user by unauthorized persons.
USE OF THE SFP WEBSITE
The entire content of the SFP website is protected by copyright. You may not reproduce (in whole or in part), transmit or make available (by electronic means or otherwise), modify, link into or use for any public or commercial purpose the SFP website without the prior written permission of Swiss Fund Platform AG.
The use of this website, including any contact forms, does not constitute any contractual relationship between you and SFP or the authors / publishers.
LOCAL LEGAL RESTRICTION
The Swiss Fund Platform Website contains information and documents on numerous collective investment schemes and is intended only for qualified investors in Switzerland and Liechtenstein. The Swiss Fund Platform Website is expressly not directed at any person in any jurisdiction where (by reason of that person's nationality, tax residence or otherwise) the publication of or access to the Swiss Fund Platform Website is prohibited. Persons subject to such local restrictions are prohibited from accessing the Swiss Fund Platform Website. No copies, printouts or stored data from this website may be made available to the aforementioned persons in any other way. Information on collective investment schemes and documents are provided either by Swiss Fund Platform or by the fund company or other companies themselves. If the information and documents are provided by the companies on the Swiss Fund Platform website, they are based on the information provided by the fund companies or other companies in connection with the distribution licenses of the investment funds. Swiss Fund Platform cannot be held liable for incorrect information regarding the distribution license. If the information and documents on the Swiss Fund Platform website are provided by the fund companies or other companies themselves, the fund provider is responsible for the correct distribution licenses.
LINKS TO OTHER WEBSITES
This website may contain links (URLs) to third party websites and social networks. The linked websites and their content are not under the control of Swiss Fund Platform AG. Their accuracy, accessibility and availability are not guaranteed. SFP reserves the right to modify or remove links at any time. Any responsibility for the links and the content of the linked websites and the use of the links and linked content is disclaimed; access to and use of such websites is at your own risk.
INTANGIBLE PROPERTY RIGHTS
The intellectual property rights, in particular copyright and related rights, to this website (text, images, logos, trademarks, files, etc.) are the sole property of the authors / publishers or Swiss Fund Platform AG or other rights holders, unless otherwise stated.
For private, non-commercial use, it is permitted to download, temporarily store (browser cache) and print out the content, provided that it is reproduced unchanged and in full and with reference to the source. Forwarding of printouts for private, non-commercial use is permitted only if the recipient accepts this disclaimer.
Distribution in electronic form is prohibited. The content may not be reproduced, duplicated, copied or distributed in print, electronically or in any other way without the written consent of the copyright holder. This includes, but is not limited to, displaying the content in a frame on a website, creating derivative works, or using the content in any other way for commercial or public purposes. The systematic retrieval or linking of content (automated or manual) to create a collection, database or directory is not permitted without the written consent of Swiss Fund Platform AG.
TECHNICAL DEFECTS
Swiss Fund Platform AG endeavors, but is not obliged, to keep the website accessible and free of technical defects to the extent and for as long as it is published. Swiss Fund Platform AG does not guarantee that the website or the newsletter or other published content is free of harmful components (viruses, worms, etc.).
DATA PROTECTION
You can find all information about data protection in our privacy policy: LINK
UPDATE DATE
This disclaimer was last updated on 08/09/2023.
11/05/2019
Bellevue Asset Management AG
