AN INTRODUCTION TO THE

MEDICAL FOODS INDUSTRY

A Market Research Project conducted in collaboration with Coller IP
REBECCA PULLON
University of Oxford
Supervised by: Jackie Maguire and Robert Gleave
May 24, 2013
Executive Summary
Medical foods are dened as foods that are specially formulated to meet the underlying nutritional
deciencies of a specic disease, rst produced over fty years ago. This report investigates the market for
medical foods and relevant patenting activity, to provide initial information for newly emerging companies
considering entering this market. The medical foods market has grown signicantly in the last fteen
years, bringing it to the exciting and emerging eld that it is today. Many large food and healthcare
companies are moving into the medical foods area, notably Nutricia, Nestle and Abbott Laboratories.
There are also smaller companies who primarily focus on the development of medical foods, such as
Targeted Medical Pharma and Pamlab. The United Sates is the pioneer of medical foods, where the term
is more readily understood than in the rest of the world, yet one of the main barriers to market expansion
still appears to be the lack of understanding and awareness of medical foods, both by the consumer and
medical professional. Market drivers for medical foods include the rise in aging population, a shift to
enteral nutrition and a demand for personalised medicine.
The patent landscape for medical foods is a challenge to dene because there is no single classication
code that identies a medical food. Relevant patent applications are instead often classied by active
ingredient, and as a nutritionally modied food. A search by classication code therefore necessarily
includes those relating to dietary supplements and other nutraceuticals, but it appears that the trends in
patenting activity of this wider nutritional foods industry can be considered to be representative of the
medical foods subset. A keyword patent search for medical foods has some limitations, but shows an
overall increase in recognition of the medical foods industry.
Within this report, further information is provided about the denition of medical foods, market trends
and inuencing factors, and patent search strategies. From this analysis, the strengths, weaknesses,
opportunities and threats of the medical foods market can be drawn.
In conclusion, the market and industry for medical foods is expanding, seen through the shift of major
food and healthcare companies to include medical food products, and an increase in patenting activity.
The market is following in the wake of other nutritional foods, with strong market drivers, and looks well
placed to continue to develop rapidly.
i
Contents
1 Purpose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2 Introduction to Medical Foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
2.1 History of medical foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.2 Regulating medical foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
2.3 Examples of medical foods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
3 The Medical Foods Market . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3.1 Size and nature of market . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3.2 Active companies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
3.3 Market trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
3.4 Factors inuencing the market . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
3.4.1 Drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
3.4.2 Opportunities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
3.4.3 Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
4 Patent Investigation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
4.1 Search strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
4.1.1 Patent classication . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
4.1.2 Medical food classications . . . . . . . . . . . . . . . . . . . . . . . 11
4.1.3 Generation of patent sets . . . . . . . . . . . . . . . . . . . . . . . . 13
4.2 Themescape maps of IP landscape . . . . . . . . . . . . . . . . . . . . . . . . . 14
5 Analysis of Patent Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
5.1 Search 1: Classication codes for nutritional foods . . . . . . . . . . . . . . . . 14
5.2 Search 2: Classication codes for nutritional food and certain ingredients . . . . 16
5.3 Search 3: Medical foods keyword search . . . . . . . . . . . . . . . . . . . . . 18
6 Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Appendix A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
ii
1 Purpose
This report is prepared as part of a market research project between Coller IP and the University of Oxford,
to investigate the nature of the medical foods industry. Industry dynamics are assessed through analysis of
market trends and drivers, and investigation of patent activity. This report is intended to provide initial
information to future investors or companies interested in entering this eld
1
.
2 Introduction to Medical Foods
A medical food is a specially formulated food that meets the nutritional requirements of a specic disease.
The concept is more than fty years old, born out of catering for the nutritional deciencies of certain
genetic diseases, to become an emerging discipline that surrounds the medical foods industry of today.
The nutritional needs of the human body have been the subject of research for many years, and a focus on
adequate nutrition, to keep people healthy, has led to the decline of multiple nutritional deciency diseases
such as rickets, scurvy or goitre
[1]
. It is now known that most diseases impose nutritional requirements
that are different to those of a healthy individual; so medical foods were developed through the corporate
efforts of the medical community, nutritionists, dietitians and food scientists, to full the underlying
nutritional deciencies of a specic disease
[2]
. Medical foods have now been developed for many types of
diseases, from neurological disorders such as Alzheimers disease, Parkinsons or depression, to general
physiological disorders such as hypertension, viral infections or pain and inammation. Ailments such as
food intolerances, insomnia or fatigue, are also treated by specic medical foods.
The medical food industry lies between pharmaceutical drugs and the food industry, a separation that has
historically been clearly dened by law and until 1972, there was no additional recognised categorisation
[3]
.
Medical foods are included in the nutraceutical industry, a wider eld that encompasses foods with health
benets or added nutritional value
[4]
. Also included in the nutraceutical industry are dietary supplements
and functional foods which medical foods are often confused with, the latter of which refers to foods with
an added substance that provides a benecial function such as disease prevention or health promotion.
Another name for a medical food is a food for special medical use, but medicinal foods refers to
something different, synonymous with nutraceuticals. Medical foods can be used for medical nutrition
therapy, and can be considered as an integrative medicine (as opposed to traditional or alternative medicine)
because medical evidence of effect is required.
Medical foods are prepared from GRAS (Generally Recognised As Safe) substances, to be taken eternally
(absorption through the gastrointestinal tract) for the partial or exclusive feeding of a patient. There must
be medical evidence that medical foods meet the specic needs of a disease state that cannot be achieved
with a simple dietary shift. Medical foods are thus distinct from dietary supplements intended for normal,
healthy adults, and are not a blanket term for all foods fed to sick patients. They also must only be used
under medical supervision. The medical foods journey will continue to be described in the next few
sections
[5,6]
.
1
This report has been made available for research purposes and those entering the eld are recommended to carry out further
due diligence. Coller IP and the University of Oxford accept no liability for any subsequent actions taken.
1
2.1 History of medical foods
Medical foods were rst developed in the 1950s, originally designed for those with genetic diseases that
could not handle certain nutrients
[7]
. The American Food and Drug Administration (FDA) originally
regulated medical foods as drugs, because they were intended to affect the structure or function of the body.
One of the rst medical foods was Lofenalac, an infant formula produced by Mean Johnson Nutrition in
1957, for the dietary management of phenylketonuria (PKU). Lofenalac was regulated as a drug under
the 1938 Federal Food, drug and Cosmetic Act (FFDCA) 201(g)(1)(B), yet it challenged the denition
of a drug, partly because the strict regulations concerning the levels of active ingredients in drugs were
difcult to achieve for nutrition formulas. In 1972, Lofenalac was the rst substance classied as a food
for special dietary use under the revised FDA denition. This allowed medical foods to be exempt from
the strict clinical trial phase required for individual drug regulation, and aimed to encourage innovation in
the medical food area.
It wasnt until the Orphan Drug Amendments of 1988 (Act 21 U.S.C. 260ee (b) (3)) that the term
medical food was coined along with a statutory denition. Medical foods were then made exempt
from the nutrition labelling, health claim and nutrient disclosure requirements of most other foods, in the
Nutrition Labelling and Education Act of 1990. This further distinguished the medical food category from
conventional food products. In 1996 the FDA expressed concern about the number of products under
the medical food category, many with inadequate scientic support, so put forward the Announcement
of New Proposed Regulations (ANPR). This was withdrawn in 2004, along with other similar notices,
because the FDA no longer considered it to be a viable candidate for further Agency action. A revised
guidance document was issued in 2007 to answer frequently asked questions about medical foods and
further dene the category. Medical foods have slowly been similarly regulated across the world, although
America is unique in using the medical food phrase to describe these products
[5,7,8,9]
.
2.2 Regulating medical foods
The medical foods denition started in the United States, but has spread and taken on different names and
forms all over the world. This section briey describes the regulations for medical foods in a few key
countries.
The American Food and Drug Administration (FDA) clearly dene a medical food as:
A food which is formulated to be consumed or administered enterally through the supervision
of a physician and which is intended for the specic dietary management of a disease or
condition for which distinctive nutritional requirements, based on recognized scientic
principles, are established by medical evaluation.
Medical foods are substances which diagnose, cure, mitigate, treat, or prevent disease
[8,9]
. As stated
earlier, they are made from GRAS (Generally Recognised As Safe) substances to ensure their safety.
Protein-based medical foods are the most common, nutrients are also popular ingredients (such as Omega
3 fatty acids, isoavones, or chelated zinc), and vitamins and minerals are often added (such as thiamine
and folic acid)
[10]
. Medical foods must comply with all applicable requirements for the manufacture of
foods. They are exempt from the labelling requirements for health claims and nutrient content claims,
but must contain the same necessary information as any other product, and can be labelled for specic
medical conditions, unlike dietary supplements. Medical foods do not have to undergo premarket approval
by the FDA, they do not require specication as an IND (Investigational New Drug), and do not have
2
to be registered individually with the FDA. However, medical foods are required to support all medical
benet claims with appropriate laboratory and clinical science
[11]
.
The FDA classies medical foods into four major categories
[12]
:
1. Nutritionally complete products usually contain a protein source, carbohydrate source, and fat
source with possible vitamins, minerals or electrolytes. These are taken as a complete food, so do
not need to be supplemented with other food sources, most commonly used for patients who are
tube feeding.
2. Nutritionally incomplete products these contain a single food group, such as carbohydrates only
or vitamins only. It is necessary to consume additional food sources for a complete diet. This food
group may be taken by patients who are at home and still able to eat normal foods.
3. Formulas for metabolic (genetic) disorders The majority of medical foods treat metabolic disorders,
targeting signalling pathways. They are typically formulas with unique nutrients removed or added.
4. Oral rehydration solutions these help the body absorb nutrients by shifting the osmolarity of an
oral solution so that the gastrointestinal tract retains uid. They typically contain sodium, chloride,
potassium citrate, dextrose and water.
The medical food denition is often confused with that of a drug and a dietary supplement, and under-
standably so since there is some overlap. Table 1 shows the distinction between these three categories as
dened by the FDA.
The term medical food is unique to FDA regulations, but the same sorts of substances have become
regulated all over the world. The European Food Safety Authority (EFSA) distinguishes dietary foods for
special medical purposes (FSMPs) under the Foods for Particular Nutritional Uses Directive 2009/39/EC
(an amendment of Directive 1999/21/EC). These foods are specically formulated, processed and intended
for the dietary management of diseases, disorders or medical conditions. They must be used under medical
supervision, and are specically for those individuals whose nutritional requirements cannot be met
by normal foods. The Directive gives guidance to the minimum and maximum levels of vitamins and
minerals and details the labelling requirements, specically that the label must unambiguously mention
whether the product is intended to be the sole source of energy and nutrients for the person. The EFSA
also assigns food for special medical purposes into three categories relating to whether the food is
intended for exclusive or partial nourishment, and whether is consists of a nutrient-adapted formulation or
not
[2,13,14,15]
.
Australia and New Zealand similarly dene foods for special medical purposes; foods that manage the
diets of people with certain diseases, disorders or medical conditions, again for people whose nutritional
requirements cannot be met by normal foods. The composition, labelling and sale of food for special
medical purposes are regulated by Standard 2.9.5 of the Food Standards Code. Most medical foods
are manufactured abroad and then imported into Australia and New Zealand, so the standard aligns
as much as possible with the relevant regulations of the European Union and the United States of
America
[16,17]
.
Canadian regulations are not so clear, with medical foods under the wide banner of foods for special
dietary use 9.9 [B.24.001, FDR]. These are foods specially processed or formulated for a person who
either: has an existing physical or physiological condition resulting from disease or injury; or can obtain
a particular effect by a controlled intake of foods
[18]
. In Japan, medical foods are regulated under the
foods for specied health uses title, a subcategory of foods with health claims, regulated under Article
5 of the Food Sanitation Act, 2001
[19]
.
3
Table 1: The distinction between of pharmaceutical drugs, medical foods and dietary supple-
ments
[5,8,11]
.
Drugs Medical foods Dietary supplements
Governing
regulation
Federal Food, Drug and
Cosmetic Act
Orphan Drug Act
(amendments, 1988)
Dietary Supplements
Health & Education Act
IND required Yes No
No (needed for health
claims)
Pre-market scientic
testing
Preclinical and clinical
studies (phases I, II, III)
Medical evaluation in
patients with the specic
disease being targeted
No
Ingredients
Mostly synthetic, can be
nutritional
Nutritional, not in
ordinary diet
Nutritional
NDA/BLA required Yes No No
Claims
Negotiated with FDA and
dependent on pivotal
clinical trial data
Dietary management of a
specic disease
Support healthy function
Intended target
population
Diseased - for patients
with a specic indication
or symptoms
Diseased - for meeting
nutritional requirements
of a specic diseased
population
Normal, healthy adults
Safety and
pharmacovigilance
Need to establish through
clinical trials and post
market surveillance
GRAS and post market
surveillance
General expectation of
safety and through
monitoring of consumer
complaints
Physician
supervision
Required if prescription
drug, not for OTC
medications
Required None
Dosing Any Oral or enteral Oral
Distribution
Hospitals, retail
pharmacies
Hospitals, retail
pharmacies
Health food stores, mass
market
4
Medical foods are regulated differently around the world. Europe and other jurisdictions distinguish
medical foods under regulations for nutritional foods or foods for dietary use, but the FDA has no such
classication so regulate them under the Orphan Drug Act. Some medical foods are also recognized as
medical nutrition therapy (MNT) by the Older Americans Act, Administration on Aging
[8]
. A similar
trend is seen with the functional foods industry where Japan, Canada and others have a distinct category,
but Europe and the USA focused on concept rather than function, so classied it under existing food
categories. Despite this, medical foods are becoming a recognised class all over the world.
2.3 Examples of medical foods
There are many medical foods available for medical professionals to prescribe for patients. A few examples
of widely prescribed medical foods are described below, detailing the disease they aim to treat, and the
mechanism by which that occurs.
Axona (Accera)
Axona was developed by Accera (USA) as a medical food to provide the necessary nutrients for patients
with Alzheimers Disease (AD). AD is the leading cause of dementia
[6]
, a neurodegenerative disease
characterized by a decline in the ability of the brain to metabolize glucose, even in its early stages.
Glucose is the primary fuel source for the brain, so a decit causes cerebral atrophy and consequently,
the symptoms associated with AD. Axona is made from caprylic triglyceride and other medium-chain
triglycerides, which are converted to ketone bodies by the liver, an alternative energy source for cerebral
neurons
[20]
. Ketone bodies are naturally occurring compounds and are mainly produced by the liver from
fatty acids. Axona has been clinically shown to improve cognitive function in some patients with AD
and does not increase metabolism
[21,22]
. This product is now being developed in partnership with Nestl e
Health Science.
Axona is a powder, taken orally dissolved in water once a day. Improvements in cognition and alertness
are anticipated to peak 2 hours after consumption, and there are few side effects. An estimated 30,000
people are already using Axona.
Limbrel (Primus Pharmaceuticals)
Limbrel is a medical food developed for the nutritional management of the metabolic processes associated
with osteoarthritis. It was launched in 2006, developed by Primus Pharmaceuticals
[23]
. Osteoarthritis is
the mechanical loss of function associated with the degradation of articular cartilage and bone in synovial
joints. Damaged joints release excess phospholipids, which increase the production of prostaglandins
and leukotrienes, leading to an inammatory response. Limbrel contains avocoxid, a commonly
occurring ingredient in foods, which inhibits the enzymes responsible for the production of inammatory
irritants, lipoxygenase and cyclooxygenase, therefore reducing the pain and inammation associated with
osteoarthritis
[5,24]
.
Limbrel comes as a capsule, containing 250 or 500 mg of avocoxid and 50 mg of citrated zinc bisglycinate.
It is only available by prescription.
Deplin (Pamlab)
Deplin was developed as an adjunctive therapy to antidepressant drugs in treating depression, by Pamlab
Inc. Major depressive disorder is the fourth leading disease burden worldwide and while considered
treatable, reoccurrences are common
[25]
. Depression is long understood to be related to the imbalance of
neurotransmitters in the brain such as dopamine, norepinephrine or serotonin. Folate is a water soluble
5
essential vitamin that is a crucial co-factor for neurotransmitter synthesis, and numerous studies have
shown that more than 50% of those who are depressed and dont respond to antidepressants, have a folate
deciency
[26,27,28]
. Deplin contains L-methylfolate (MTHF), the only biologically active form of folate
which is able to cross the blood-brain barrier, and thus allows the continued production of neurotransmitters.
This differs from the action of anti-depressant drugs which work to allow neurotransmitters to remain
available to the brain. There has been some dispute about the effectiveness of Deplin, especially as an
adjunctive to antidepressants. Few clinical trials have been carried out, the most recent study
[25]
showed
impressive results but there was no placebo group
[29,30]
.
Deplin comes in two dosage forms (7.5 mg and 15 mg tablets), taken once a day. Initial studies have
found Deplin to be well tolerated and showing no side effects. The cost for a 30 day supply of Deplin is
$80-$100.
Lofenalac (Mead Johnson Nutrition)
Lofenalac was one of the rst medical foods developed in the late 1950s by Mead Johnson Nutrition. It
was designed for the dietary management of pehylketonuria (PKU), a genetic defect in the metabolism
of phenylalanine hydroxylase enzyme which converts the amino acid phenylalanine (Phe) to tyrosine
[8]
.
Phe is in protein and many other foods, so a patient with PKU experiences rapid accumulation of toxic
concentrations of Phe in the blood if left untreated, leading to neurocognitive damage
[31]
. Lofenalac is
produced from an enzymatic hydrolysate of casein that is low in phenylalanine (0.08%). It is supplemented
with proteins, carbohydrates, vitamins and minerals, so provides nutritional support without requiring
the breakdown of Phe. Lofenalac is designed to replace milk, and comes as a powder to be dissolved in
water. Lofenalac is no longer produced for management of PKU as other medical foods and drugs have
been developed in the last forty years, such as three other casein hydrolysate-based products developed in
the UK: Albumaid XP (Powell and Scholeeld Ltd.), Cymogran (Alan and Hanburys Ltd.) and Minafen
(Cow & Gate).
A list of other medical food products currently available can be found in Appendix A.
6
3 The Medical Foods Market
3.1 Size and nature of market
The size of the medical foods market is unclear and hard to estimate. The Global Industry Analysts
projected global sales to be just less than $9 billion in 2011
[6]
. Medical food revenue in the United States
was estimated at $2.1 billion in 2011 by the bioStrategies Group, and expected to grow at a rate of 10%
[6]
.
The FDA also predicts strong growth in the medical foods industry due to the use of medical foods in
long-term care and an aging population. There is a scarcity of public data in the medical foods sector
which make market assessment challenging.
3.2 Active companies
Many companies are moving into the medical foods area, including large food and healthcare companies
such as Nutricia, Nestle and Abbott Laboratories, and smaller companies specialising in medical foods
such as Targeted Medical Pharma and Pamlab.
Nutricia specialise in the delivery of advanced medical nutrition to all age groups, and are the largest
specialist nutrition company in Europe. They form the medical division of the Danone group since
their acquisition in 2007. Nutricia have been pioneers in the concepts of specialised medial nutrition,
developing nutrition products to help support patients with specic diseases. Currently, they have a few
specic medical food products on the market, such as Souvenaid for patients with Alzheimers disease,
and are rapidly developing more products in this area
[32,33]
.
Nestle is the largest food and beverage company in the world, with products sold in more than 130
countries. Nestle aims to become the worlds leader in nutrition, health and wellness. Nutrition in
particular has always been at the core of Nestle, since their initial focus on milk products more than 150
years ago. In 2010, Nestle Health Science was created to focus on the prevention and treatment of chronic
medical illnesses based on scientic research and personalised nutrition. One of their aims is to break into
the industry between nutraceutical drugs and nutritional foods. Therefore, since their beginning, Nestle
Health Science have acquired or begun partnerships with seven companies, including Vitao, CM&D
Pharma, Prometheus Laboratories, Pamlab, Vital foods, Accera and Nutrition Science Partner. Some of
these specically focus on medical foods, and others are similarly researching links between nutrition and
disease
[34,35]
.
Abbott Laboratories are diversied healthcare company, based in the United States. They have four
core business focuses which include medical diagnostics, medical devices, nutrition, and pharmaceuticals.
Within their nutrition division, Abbott Laboratories aim to offer science-based nutrition products for every
stage of life. Medical foods make up a large portion of this business focus, products named specialist
feeds under their therapeutic nutrition category
[36]
.
Targeted Medical Pharma are a small company, founded in 1999, that develop prescription medical
foods for the treatment of chronic disease, such as pain syndromes, peripheral neuropathy, hypertension,
obesity, sleep and cognitive disorders. They specialise in technology that promotes the production of
neurotransmitters despite reduced concentrations of amino acids. Targeted Medical Pharma currently
market ten medical foods which are manufactured and distributed by Physician Therapeutics across North
America, Japan and the Middle East
[37]
.
7
Primus Pharmaceutials Inc. are a company which aim to be the pioneers of prescription metabolic
products. They develop branded prescription drugs and medical foods that are effective in chronic or
recurring diseases, such as Limbrel for targeting nutritional needs of osteoarthritis. Primus Pharmaceuticals
are currently based in the United States, but open to international distribution options
[38]
.
Pamlab are now owned by Nestl e Health Science, they are a biomedical company that specialise in per-
sonalised medicine by developing medical foods. They have an interest in pharmacogenetics, combining
genetic information with pharmacology to ultimately create personalised medicine. Currently Pamlab
have a handful of medical food products on the market, such as Deplin (depression) and Metanx (diabetes),
and anticipate more products to follow
[39]
.
Accera have just begun a partnership with Nestl e Health Science. They are a biotechnology company,
focused on treating central nervous system disorders, particularly Parkinsons disease and Alzheimers
disease. Currently their only product on the market is Axona, a medical food for Alzheimers disease
which has quickly gained public recognition. Other products in the pipeline include a medical food to
target memory impairment, and drugs for Parkinsons and Huntingtons diseases. Accera are based in the
United States, but are looking for worldwide commercial partners, particularly to market Axona
[22]
.
There are many other companies involved in the production of medical foods, such as NattoPharma
[40,41]
,
Prismic Pharmaceuticals Inc.
[42]
and Soho Flordis International
[43]
. Many of the smaller companies that
focus on medical foods (such as Pamlab, Targeted Medical Pharma and Prismic Pharmaeuticals) have
prepared fact sheets and pamphlets about medical foods, available on their websites. There are other
informational websites such as www.medicalfoods.com that provide current clinical data and applications
about medical foods, aiming to educate both patients and physicians about the important links between
nutrition and disease
[44]
. The Medical Nutrition Industry
[45]
brings together companies that focus on
specialised nutritional products and services. Activity in the medical foods industry is primarily observed
in the United States, perhaps because medical foods are easily dened, but is not limited to them.
3.3 Market trends
Trends currently observed in the medical foods industry include a movement to mainstream medical use,
and growing awareness of medical foods.
Medical foods are now offered in tablet and capsule form, which enables them to be easily distributed
by prescription. Online ordering is beginning to occur, although medical foods must still be prescribed
by a physician. Some healthcare plans in the United States, and often Medicare or Medicaid, reimburse
medical food products which is also aiding the move to mainstream medical use
[8,9]
.
Medical foods are becoming recognised products, particularly in the United States, less so elsewhere.
This is seen through the organisation of a Medical foods conference in 2011, hosted by the National
Organisation of Rare Diseases (NORD); websites and corporations designed to increase communication
between medical food providers and inform patients and physicians about medical foods
[44,45]
; and
companies producing pamphlets and information sheets about medical foods, such as Targeted Medical
Pharma, Pamlab and Nutricia.
8
3.4 Factors inuencing the market
There are many factors that inuence the medical foods market. These are separated into market drivers,
opportunities and issues.
3.4.1 Drivers
The main drivers identied for the medical food industry are as follows:
1. Rise in aging population
The life expectancy has been steadily increasing over the last few decades, and the older population
is growing at a signicantly higher rate than the total population. Over the next half a century the
proportion of older persons is projected to more than double
[46]
. Unfortunately the healthy life
expectancy has not increased as fast as life expectancy, putting strain on healthcare services
[47]
.
Surgical areas of cardiothoracic, ophthalmology and urology are particularly expected to be bur-
dened
[48]
. This raises the question of how to keep people healthy for longer. Medical foods and
other nutritional substances are becoming valuable solutions, especially when long term effects of
medication are important
[4]
.
2. Shift to enteral nutrition
There has been a shift to using enteral nutrition methods (absorption through the gastrointesti-
nal tract) rather than total parental nutrition (absorption not through the GI tract, for example,
intravenous administration) for a number of reasons. Enteral administration is safer compared
to parental options as there is less risk of infection, and offers physiological benets such as the
maintenance of small intestine mass and pancreatic function. Technology advances have allowed
enteral drug administration to become cost-effective. Enteral feeding devices have improved, such
as pumps becoming lightweight, constructed from materials that alleviate cracking in high-stress
applications, they are easy to use and easy to clean. A variety of feeding tubes are also available
(varied length, diameter and material) which allow convenient access and administration of liquid
products. Nutrients can also be delivered in various formats, such as tablets of capsules instead of
sterile liquids or rehydratable powders. This is due to technological advances in the availability of
some chemical constituents to allow microencapsulation
[2,49]
.
3. Demand for personalised medicine
One of the outstanding issues of medical treatment is that each person responds differently. Person-
alised medicine is about catering for a smaller, subset of the population by incorporating genetic
information into treatment strategies. Ethnic and socioeconomic factors also contribute to de-
veloping personalised medicine. Genomic data is being linked with a variety of industries, and
much research is being undertaken to minimise side effects for an individual based on their genetic
disposition. The area of nutrition is no exception, as it was an interest in providing the nutritional
needs of genetic defects that rst spurred the birth of medical foods over fty years ago. Drugs often
have severe side effects, so developing nutritional alternatives to treat the underlying cause is a way
to personalise medicine, and in addition, possibly incorporate genetic information. Pamlab is using
an interest in pharmacogenetics to drive their development of medical foods
[40]
. The personalised
medicine driver is also seen in the shift from institutional care to community care. Emphasis is
placed on building a service that caters to an individuals needs, empowering a community to look
after each other, rather than solely relying on formal institutionalised care
[49]
.
9
3.4.2 Opportunities
There are several other research and commercial opportunities that contribute to a favourable risk to
benet ratio for medical foods, and are believed to create an environment that will foster the continued
use and expansion of medical foods
[8]
.
Some drug therapies are not completely successful in the treatment of disease.
Medical foods are cheaper to produce than drugs because of the difference in regulatory require-
ments. When medical foods were awarded orphan drug status by the FDA, it reduced the costs and
time associated with bringing medical foods to market, particularly in regards to the clinical trial
stages
[10]
.
Natural, plant-based ingredients have been shown to be successful in managing metabolic processes
associated with many conditions or diseases. This leads people to seek for natural, nutritional
supplements and alternatives to other medication.
Medical foods are composed of GRAS ingredients, which generally have a low toxicity, so there is
already an element of safety for the food. In contrast, drugs can be harmful and cause severe side
effects.
Advances in food technology allow expansion in medical food manufacturing
[10]
.
3.4.3 Issues
As with all products, there are some issues preventing the spread and uptake of medical foods. Most
importantly there is a general lack of awareness and understanding of medical foods in the medical
community. This prevents doctors from prescribing and using medical foods. The general public also lack
understanding of medical foods, and their attitudes affect their willingness to consume a new product. A
study on the socio-economic inuences for the functional foods market found that an individuals beliefs
(such as in the food-disease prevention concept, or impacts of personal health), and knowledge of benets,
signicantly affect their choice to consume a product
[50]
. It is expected this is similar to medical foods
and other nutritional products.
Another issue is that some scientic support is required for the regulation of medical foods. While not
as extensive as drug regulation, medical evidence takes time and slows innovation. Finally, some health
services and insurers dont cover the cost of nutritional products for disease prevention or management
[10]
.
This means the nal decision making regarding the consumption of medical foods is with consumers and
patients, even if physicians describe them.
10
4 Patent Investigation
One way to investigate the main trends in the medical food industry is to identify what Intellectual Property
is being led, as it is representative of the areas and ideas that companies recognize as important to protect.
The aim of the current research is to identify a set of patents that represent the medical foods industry,
allowing the development of a patent landscape and thus the identication of the main trends.
4.1 Search strategy
Thomson Innovation software was used to search for patent documents relevant to the medical foods
industry in the last ten years, since recent activity is of the most interest. Patent applications led in the
United States and Europe, and international (PCT) applications were considered, because major innovation
in the medical foods industry has been observed in these territories. A primary search was conducted
using classication codes that had been identied as relevant to medical foods, and then key words were
added to see if that rened the results set further.
4.1.1 Patent classication
Patent classications are used to organise and index the technical content of patent specications, so that
an area or topic of technology can be identied easily and accurately
[37]
. Each region denes their own
set of classication codes. Of particular note are the International Patent Codes (IPC) which are governed
and maintained by the World Intellectual Property Organisation (WIPO). One or more of the 70,000
IPC classications are applied to all international (PCT) applications. Recently, the Cooperative Patent
Classication (CPC) system was introduced, a scheme jointly developed by the European Patent Ofce and
the United States Patent and Trademark Ofce. The CPC classications are largely based on the previous
European Classications (ECLA) and combine features of the European and US patent classication
systems to provide a united, detailed scheme with more than 210,000 subdivisions
[51,52]
.
4.1.2 Medical food classications
Some key products and their corresponding patents were identied in the medical foods industry to extract
classication codes that are regularly used for medical foods. The table below (see table 2) lists these
patents with the IPC codes that have been assigned to them.
It was observed from patents of known medical foods, that they are often classied by the active ingredient
in the food, and sometimes as a food formulation for a specic purpose or consumer group. There is no
unique or distinct classication for a medical food, the codes are varied across the medical food patents,
and the words medical food are not always used in the description of the invention.
The CPC codes were also analysed and those that seemed to be relevant to medical foods highlighted.
From the combination of IPC codes from known medical food patents and relevant CPC codes, the
following table (see table 3) is believed to be the most representative set for classifying medical foods.
There are two main categories, rstly classifying the product as a food with modied nutritive qualities
(A23L); and secondly by the ingredients that compose the medical food (A61K).
11
Table 2: Five patents that were identied as examples of medical foods, corresponding to products
currently on the market. The publication number and brief details are given as well as all the IPC
codes assigned to the patent.
Publication
number
Brief Description Assignee
Patent led in
other countries
IPC Codes
US7514469B2
Formulation for
Limbrel, for
osteoarthritis
Unigen
Pharmaceuticals
Inc.
AT, AU, BR, CA,
CN, DK, EP, ES,
HK, JP, KR, MX,
NZ, RU, US, WO
A61K31/553
A61K 31/7048
A61K 31/353
A61K 31/352
A61K 31/05
A61K 31/35
A61K 31/08
US7838042B2
Updated formulation
for Fosteum, for
osteoporosis
Albion
International Inc.
DE, EP, US, WO
A61K 33/00
A61K 33/26
A61K 33/30
A61K 33/32
A61K 33/34
A01N 59/00
US7674482B2
Amino acid based
medical foods,
targeting
neurotransmitters
Targeted Medical
Pharma
AU, EP, JP, US,
WO
A61K 36/00
A61K 36/16
A61K 31/14
A61K 31/221
A61K 47/00
A23L 1/30
Many more
US7943163B2
Method of
manufacturing medical
food for diabetes
Response Scient
Inc.
US
A61K 31/381
A61K 31/15
A61K 9/50
A61P 3/10
US6835750B1
Treating Alzheimers
Disease (Axona)
Accera Inc.
AT, AU, BR, CA,
CN, DK, EP, ES,
US, WO, JP, MX,
NZ, RU, ZA
A61K 31/12
A61K 31/20
A61K 31/205
A61K 31/215
A61K 31/22
A61K 31/221
A61K 31/23
A61K 31/25
A61K 45/06
12
Table 3: The IPC/CPC classication and corresponding description for those codes believed to be
common among patents for medical foods
[52]
.
IPC/CPC code Description
A23L 1/29 Modifying nutritive qualities of foods; Dietetic products
A23L 1/296 ...Complete food formulations for specic consumer groups or for specic purposes
A23L 1/30 ...Containing additives (includes vitamins, inorganic salts, minerals, amino acids)
A61K 9/00 Medicinal preparations characterised by special physical form
A61K 31/00 Medicinal preparations containing organic active ingredients
A61K 33/00 Medicinal preparations containing inorganic active ingredients
A61K 36/00
Medicinal preparations of undetermined constitution containing material from algae,
lichens, fungi or plants, or derivatives thereof, e.g. Traditional herbal medicines
A61K 38/00 Medicinal preparations containing peptides
4.1.3 Generation of patent sets
Initial searches were carried out using the classication codes that had been identied as relevant and
common to medical foods. Since these fall into two main categories, patents relating to each were
investigated individually and then were combined to review the intersection of the two sets. These were
investigated to see if the results would yield a set that only encompassed medical foods, or at least relevant
and representative of the movement of the medical food industry.
Two classication code searches were therefore carried out using the IPC/CPC codes identied as relevant
and common to medical foods.
The rst search (search 1) searched for all patent documents that had the classication codes A23L
1/29* and A23L 1/30* assigned, to identify patents relating to food with modied nutritive qualities.
(* is a truncation operator).
The second search (search 2) was a subset of search 1, requiring the patents to also have one of the
codes associated with medicinal preparations containing ingredients commonly found in medical
foods, A61K 31/00* or A61K 33/00* or A61K 36/00* or A61K 38/00*.
It was found that the classication codes used in these searches also encompass pharmaceutical drugs,
dietary supplements, functional foods, food devices and methods for preparing normal foods. No search
combination was found that uniquely returns medical foods, and sometimes it is hard to distinguish which
patents actually describe medical foods and ingredients for medical foods.
For comparison, a key word search was also performed. It has been noted that patents relating to medical
foods often include the medical food phrase in the description of the invention, especially if it is an
ingredient that can be utilised for many products. It was found that searching for the medical food
phrase returned unusual patents, such as relating to protective garments, so the word search was limited
by broad classication codes to exclude those completely unrelated patents.
Therefore this third search (search 3) searched for the phrase, medical food in all text elds, and
A23L* or A61K* in all assigned IPC/CPC codes.
13
4.2 Themescape maps of IP landscape
Thomson Innovations Themescape mapping tool was used to create landscapes for the patent sets returned
from each search criteria. Landscape maps are constructed from key themes, words or phrases that are
common to patent documents in the document set. The data is transformed using the Thomson Innovation
software to represent the data in a two-dimensional landscape map. In general, areas of activity that
are technically similar are placed close together on a map whilst unrelated areas are further apart. The
peaks represent areas of concentrated patenting activity, for which a key word or theme can be identied.
Landscapes were prepared for all searches using word themes from the title, abstract and claims.
5 Analysis of Patent Results
5.1 Search 1: Classication codes for nutritional foods
Search 1 used classication codes for foods with modied nutritive qualities, and returned 37020 records
in 13420 DWPI (Derwent World Patent Index) families with publication dates within the last ten years.
Note that a DWPI family is a group of patents containing the same technical content usually claiming the
same priority dates
[53]
. This includes overseas patents and divisional applications. We are interested in
the rate of innovation in the medical foods industry, so it is appropriate to analyse the results by patent
family, rather than individual patent documents.
Analysis of this document set reected that this is representative of the wider nutraceuticals and functional
foods industry, of which medical foods is included. This is expected since the search terms included all
foods with modied nutritive qualities. Figure 1 shows the number of patents led per company. Of note
are Nestec who have led almost twice as many patents in this set as Nutricia and any other company.
Nestec incorporates the research and development centre of Nestl e, taking care of much of the intellectual
property of the company
[54]
. For information on Nutricia and Abbott Laboratories, who also signicantly
feature in this set, please see Section 3.2. Other companies that have not yet been identied as in the
medical foods industry are described below:
Unilever have many patents led in the nutritional food sector. They are a large company with
laboratories all over the world and invest 1 billion euros into research and development each year.
Unilever spans a wide range of health sectors, including community education, with an overall focus
on health, wellbeing and sustainability. A strong nutrition policy has been part of Unilever since 2000,
acting to improve the nutrition of all their products and advocate healthy heart, healthy weight and
healthy growth and development. Medical foods do not feature specically in Unilevers products at
the moment, and its unclear if they have plans to move in this direction
[55]
.
DSM is also a large contributor to this area. DSM is the leading global producer of ingredients and
vitamins for the pharmaceutical industry, also utilised for medical foods. They are a large company
but currently do not directly deal with medical foods, although their inclusion is in DSMs future
business plan
[56]
.
Anjinomoto is a Japanese based company that aims to contribute to human health globally through
sustainability, securing food resources and promoting healthy lifestyles. They have a core focus on
amino-acids which form the base of their pharmaceutical products. It is unclear whether these are
medical foods or not
[57]
.
14
Figure 1: Number of DWPI patent families led per Assignee/Inventor for wide nutritional food
industry (search 1).
In summary, this search identied companies that are active in manufacturing nutritional foods. The
patent landscape is dominated by large food companies that are active all over the world, with dedicated
resources for research and development in nutrition. It is evident that about half of these companies
produce medical foods, and others are beginning to recognise the medical food industry and move in that
direction. While this set does include medical food products, it reects a much wider movement in the
nutraceutical industry, so a narrower search is necessary to more purely segment the trends relevant for
medical foods.
A brief analysis of the patent landscape (not shown) reects the broad spread of the companies interests,
particularly Nestec, Unilever and DSM that are involved in many sectors. Nutricias patents are gathered
around products composed of probiotics and targeted towards infants. Abbott Laboratories also appear to
focus on milk and infant products on this landscape. A keyword search for different diseases in the DWPI
titles of the patents, showed that nutritional foods in all areas can be used to treat or prevent diseases.
Diabetes is the most commonly targeted disease and related patents are clustered around a peak that
focuses on treating metabolic disorders.
The rate of patent ling for this search is shown in gure 2. The application year of the earliest DWPI
family member has been used because we believe that this best reects innovation rate since it plots
when the invention was rst patented. The ling rate appears reasonably steady with a slight increase,
particularly in 2010. This consistency is expected because of the large and well-established nutritional
food industry that this set represents. Note that the data for 2012 is not yet complete as patents are
published 18 months after the initial ling date.
15
Figure 2: Rate of patent ling (application year of earliest DWPI family member). Note that data for
2012 is incomplete as patents are published 18 months after the initial ling.
5.2 Search 2: Classication codes for nutritional food and certain ingredients
Search 2 was a sub-search of search 1, additionally including classication codes relating to medicinal
preparations containing ingredients that were identied as commonly found in medical foods. This search
returned 8709 patents in 2944 DWPI families.
It is believed that the set returned by this search is a closer representation of the medical foods industry
compared to set 1, although still includes some pharmaceutical drugs, dietary supplements and other
functional foods. However, because the search has been limited by classication codes relating to
ingredients and a much small patent set has been returned, the trends observed in this set seem to be more
reective of what is expected in the medical foods area, and what has been suggested by other sources.
The set is difcult to rene further because medical foods are classied by ingredients, do not have a
unique code, and because it is an emerging eld, it is expected that at the time of patenting an ingredient
or other invention, the possibilities for using it as a medical food may not have been apparent, but could
become evident in the future. To that end, it is difcult to ascertain on a macroscopic scale, which patents
actually do relate to medical foods.
A sub search for the phrase medical food in any text eld yielded 90 DWPI families. This indicates
that even within this set that is largely believed to reect the trends of medical foods, the identication
of an invention for use in or as a medical food is not widely used so cannot be relied upon to identify
relevant patents. It is also acknowledged that outside of the USA, the term medical food is not widely
used.
The top assignees to patents in this set are shown in gure 3. These are similar to the results in set 1,
indeed the top ve companies (Nestec, Nutricia, Abbott Laboratories, Ajinomoto and DSM) were all large
contributors to the wider nutritional foods industry. This further emphasises the trend of large health and
food companies moving into the medical foods sector.
The rate of application ling is fairly steady (see gure 4), with between 200-250 patent families originally
led each year. This steady trend is somewhat surprising, as other market research has shown the
nutraceutical industry rapidly gaining popularity with strong market drivers. The rate of patent ling is
either behind this trend, the market expansion is not due to or generating new inventions, or there is a shift
within the set where a larger percentage of patents led relate to nutritional foods.
16
Figure 3: Patent count per assignee for the narrower nutritional foods (search 2).
Figure 4: Rate of ling for Search 2 results (application year of the earliest DWPI family member).
Note that data for 2012 is incomplete as patents are published 18 months after the initial ling.
Thomson Innovations Themescape mapping tool was used to portray a landscape for this set of data (see
gure 7). The peaks reect areas of high patenting activity, grouped by word themes. Analysis of this
map shows that the peaks are largely grouped by ingredient. These are all likely to be classied as GRAS
substances since they are naturally occurring, such as plant materials, fruit extracts, herbal extracts, oils
and fats. Other observations from the landscape map are as follows:
Some peaks include action for a specic disease, for example in between the natural extracts, there
is a peak that groups of all the natural extracts used for their anti-inammatory actions.
The companies are sparsely spread over this landscape. However Nutricia and Nestl e both have
high patenting activity around the use of oils, fats and probiotics for therapeutic action.
Targeted Medical Pharma has 5 DWPI patent families on this map, all grouped together (north of
Inammation disorders peak). These all refer to compositions aimed to enhance neurotransmitter
activity, taken orally. Targeted Medical Pharma have 7 DWPI patent families in total, therefore
supporting the market research ndings that their purpose is focused on developing medical foods.
17
A sub search was performed to see if diseases grouped on the landscape. It was found that the
diseases were quite spread (and sparse). Diabetes was again the most commonly quoted disease
application in patents, and was largely grouped around the peak for controlling blood glucose.
Results from searching arthritis and asthma vaguely clustered around the two anti-inammatory
peaks.
5.3 Search 3: Medical foods keyword search
A keyword search was also carried out, searching for the phrase medical food in any text eld of patents
published in the last ten years. The search was limited to patents with classication codes A23L* and
A61K*. 1850 records were returned in 926 DWPI families.
A startling observation from the results of this search is the presence of the Swiss company Mondobiotech.
They are responsible for 312 of the 926 DWPI patent families, all focusing on the use of naturally
occurring peptides as therapeutic agents to treat rare diseases. Mondobiotech is primarily a drug company,
founded in 2001 with the sole purpose of nding treatments for rare diseases, and they use mathematical
algorithms to search and match peptides to diseases. They do varying amounts of development of the
drug, but always licence their patented Medicinal Product Candidates to strategic partners for regulatory
approval and commercialisation. These products are not medical foods. However, they are primarily
composed from peptides (many of which are classied as GRAS substances), target a specic disease, and
in the United States are regulated under the Orphan Drug Act, yet not as a medical food as far as one can
tell. All the patents have been returned in the search because in the description they include the phrase
medical food in reference to the possibility of using the invention in an infant product, sometimes called
a medical food
[58]
.
It is interesting that Mondobiotech led all 312 patents in 2008. The reason for this is unclear. Perhaps
motivated by becoming a public company in 2009, or maybe their research had progressed far enough that
they could start to patent and licence their inventions and expand. Mondobiotech now have ve wholly
owned subsidiaries in Switzerland as well as one in Liechtenstein and the United States, and this year
acquired Pierrel Research International AG
[59]
. In summary, Mondobiotech has patented many peptides,
and although they are not described as medical foods the potential for these drugs to move into the
medical food industry is high. It is therefore not appropriate to remove them from this patent set, but they
do skew the results because of their ling strategy.
Apart from Mondobiotech, the main companies in this search set are Nutricia, Du Pont and Abbott
Laboratories (see gure 5). Nutricia and Abbott Laboratories have featured in the previous searches under
nutritional food classication codes, but this is the rst time that Du Pont have appeared signicantly
on this landscape. Du Pont is another large company with activity in over 90 countries, and is involved
in many industries one of which is food and beverages. Within their food sector they have a focus on
improving the nutritional value of food, therefore produce many nutritional foods and dietary supplements.
Some of their products are ingredients that are sometimes used in medical foods, such as probiotics or
vitamins, but Du Pont currently do not appear to market medical foods
[60,61]
.
The patent landscape of this keyword search shows patents by Du Pont grouped by another of their
research areas, the construction of polynucleotides (see gure 8). These are used particularly for the
formation of fatty acids or oils, which can be included in medical foods or other pharmaceutical products.
Mondobiotech take up a large portion of the landscape, all relating to the use of peptides for treating disease.
18
Figure 5: Rate of ling for search 3 results (application year of the earliest DWPI family member).
Nutricia are also grouped, surrounding the peaks of nutritional compositions containing nucleosides and
lipids, often to treat frailty and neurotrauma diseases, and foods in liquid form.
The peaks of the patent landscape are mostly grouped by ingredient, similar to the set from search 2. Key
active ingredients identied from the landscape include fats, oils and lipids; nucleotides, nucleosides and
agrobacterium; peptides; and probiotics.
The rate of patent ling is shown in gure 6. Notice the large peak in 2008 which is where Mondobiotech
led 312 patents. Taking this into account, there is a general increase in the rate of patenting, doubling
from 2009 to 2011. We believe this indicates that the application of medical foods is being increasingly
considered when companies are patenting their products, reecting a general increase in the recognition
of the medical food industry.
Figure 6: Patent count per assignee in medical foods keyword results (by DWPI assignee). The dotted
line in 2008 indicates the patent count for that year excluding Mondobiotech. Note that data for 2012
is incomplete as patents are published 18 months after the initial ling.
19
Overall, this search set gives some information about the rate of recognition of the medical foods industry.
However, it also highlights limitations of a key word search. Primarily, it relies on the patent attorney
identifying the invention as related to medical foods and thus including the words in the patent; analysis
on this basis is therefore not guaranteed. This key word search has missed out on those ingredients that
are used in drugs and medical foods but not necessarily named for the latter, or where a medical foods
application may not have been considered at the time of ling but becomes apparent several years later
and thus is now relevant. Patents that arent specically related to medical foods have been included,
because the phrase is mentioned in their description as an alternative name for one possible use of the
invention. Medical foods is also unique to food regulations in the United States, so this search will most
likely have missed relevant patents that originated elsewhere in the world. Due to these limitations of
this search, it is believed that the second search is the most representative of the current trends in medical
foods. This is not dependent on keywords, uses classication codes that are common for medical foods,
and the wider nutritional foods that were included in the results have similar market drivers and trends to
medical foods.
20
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22
6 Conclusions
The market and patent landscape analysis as described in this report indicate that there is increasing
interest in the medical foods industry.
The strengths of this market include the growth in patenting activity and increased recognition of medical
foods over the last fteen years. Companies are able to protect innovative products by patenting, for
example ingredients or method for formulation. Extensive patent activity has been observed in this area,
particularly in the United States. Medical foods are also becoming more accessible for use as a prescribed
substance, and via marketing by large food and healthcare companies starting to market specically in this
area. Other strengths are the robust market drivers that suggest the medical foods market is well placed to
continue developing rapidly. These drivers are similar to those of the wider nutritional foods industry and
include an emphasis on healthy living by the aging population, a shift to enteral nutrition and a demand
for personalised medicine. Finally, the concept of medical foods has become widely regulated around
the world, which encourages global innovation and provides a strong foundation for the medical foods
industry.
Market analysis has also revealed some weaknesses of the medical food industry. A major weakness is
the lack of understanding and awareness of medical foods by medical professionals and consumers. This
prevents physicians from prescribing medical foods and consumers are less likely to seek medical foods if
they are not educated about medical foods, particularly if a large cost is associated with it because their
healthcare system or insurance does not cover the cost. Another weakness is the challenge of dening the
medical foods market and industry. The patent landscape activity is unclear due to the absence of a specic
classication code, and the overlap with dietary supplements and other nutritional foods. Therefore there
is a difculty in determining the freedom to operate. The regulatory requirement for medical evidence
of medical foods is another weakness. This takes time and restricts innovation rate compared to dietary
supplements or functional foods, however it is less regimented than that for a pharmaceutical drug.
Despite the apparent weaknesses in the medical foods industry, many opportunities are also present.
Advances in enteral feeding technology have resulted in a preference for this administration method
compared to other parental methods. Medical foods are required to be administered enterally, so can
make use of the emphasis of this delivery method. New microencapsulation technology also allows the
easy administration of medical foods. Another opportunity arises from issues with drugs use, primarily
severe side effects and incomplete success of treatment. Medical foods are cheap to produce and a safe
alternative. The small size of the market also provides opportunities for expansion, as it seems likely that
market saturation has not been reached, especially outside the United States.
As with any industry, there are also threats to the medical foods industry. One apparent threat is that
the market is currently cornered by a small number of large companies, with large patent portfolios,
which provides a limitation for new innovators. The medical foods industry is also competing with other
nutritional food products at a consumer level, and with drug companies with large sales and marketing
operations. In many countries the healthcare budget is also shrinking which threatens the availability and
priority of medical foods.
Overall, analysis of the medical foods market and patent landscape has allowed a number of conclusions
to be made. It seems likely that the medical foods sector will expand to form a signicant part of the
wider healthcare industry.
23
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Appendix A
There are many medical food products currently available, that treat a wide range of diseases. Some of the
products available are listed in the table below (see Table 4) with the specic disease/s that they target.
This is not a complete product list, but aims to give an indication of the range of products being developed,
with a focus on the companies that have been mentioned in this report.
Table 4: Some medical food products currently available for purchase.
Company Product Disease targeted
Abbott Laboratories Ensure Cancer, Celiac disease
Abbott Laboratories Glucerna Diabetes
Abbott Laboratories Juven Diseases that cause weight loss (eg. Sarcopenia)
(Juven acts to support lean body mass)
Abbott Laboratories Oxepa Acute Lung Injury (ALI), Acute Respiratory
Distress Syndrome (ARDS) and/or Systemic
Inammatory Response Syndrom (SIRS)
Abbott Laboratories ProSure Cancer (to help manage weight loss)
Abbott Laboratories Pulmocare Pulmonary disease
Abbott Laboratories Suplena Chronic kidney disease (stages 3 and 4)
Abbott Laboratories Vital HN Chronically impaired gastrointestinal function (eg.
maldigestion, malabsorption)
Accera Axona Alzheimers disease
Axcan Pharma Ultrase MT Cystic brosis
Nutricia Souvenaid Alzheimers Disease
Pamlab CerefolinNAC Cognitive Impairment
Pamlab Deplin Depression
Pamlab Metanx Diabetes
Pamlab NeevoDHA High-risk pregnancy
Primus Pharmaceuticals Fosteum Osteoporosis
Primus Pharmaceuticals Limbrel Osteoarthritis
Primus Pharmaceuticals Vasculera Chronic Venus Insufciency
Targeted Medical Pharma AppTrim insulin resistance and other forms of metabolic
dysfunction
Targeted Medical Pharma GABAdone Insomnia
Targeted Medical Pharma Hypertensa Hypertension
Targeted Medical Pharma Lister V Viral infections and other diseases causing
impaired immune function
Targeted Medical Pharma Pulmona Asthma and pulmonary hypertension
Targeted Medical Pharma Sentra AM Fatigue and cognitive dysfunction
Targeted Medical Pharma Sentra PM Sleep disorders associated with depression
Targeted Medical Pharma Theramine Pain and inammation syndromes
Targeted Medical Pharma Trepadone Pain and inammation syndromes, particularly
arthritis
Upsher-Smith Folgard RX 2.2 Cardiovascular disease, stroke
Vitao Vitaquick Dysphagia (swallowing difculties)
27