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Not So Sweet: Prevalence of Diagnosed Feline Diabetes Mellitus Demographics and Treatments 2013-2015

Diabetes mellitus (DM) appears to be a common disease among cats, with some estimates suggesting prevalence in small animal general practice of around 1:100–1:500.  (https://journals.sagepub.com/doi/full/10.1177/1098612X15571880  2015).  This number comes from a UK study of pets with veterinary insurance.  At commercial American clinics located inside Petsmart stores, the prevalence of diabetes among felines was reported to have increased by 18.1% from 2006 -2015.  This translates into approximately 70 cases per 10,000 cats.  (https://www.banfield.com/banfield/media/pdf/downloads/soph/banfield-state-of-pet-health-report-2016.pdf).  It is suspected that feline diabetes remains under-reported and under-treated at this time. 

Proprietary VI research suggests a feline diabetes prevalence of approximately 1-1.5/100 cats visiting private practice veterinarians in 2015.  This number is higher than that indicated by the Banfield study (0.7/100, above), suggesting that those who bring their cats to private veterinary clinics may be less price sensitive to the cost of treatment when their pets become unwell. Both of these numbers are in line with those of the Sage study (1/00-1/500 see above).  The statistics on feline DM incidence from a provider of veterinary insulin, Vetsulin (0.4/100) are lower than those from other studies, but may not include those animals treated with food alone, which Vet Informatics research finds make up 36% of this market (see below). 

A VetInformatics proprietary study demonstrated that over the 3-year period (2013-2015) an average of 660,000 felines per year were tested for a suspected diagnosis of Diabetes Mellitus (DM) in cats.  However, while the amount of suspected and hence tested Diabetes Mellitus in felines increased over this 3-year period, the number of treated as diagnosed feline diabetic patients did not increase.

A rigorously qualified sample was used to provide this data, which was triangulated to another data source for validation to ensure projections were reliable with +/- 5% level of accuracy. Triangulation to the VMDR case history study sized the Glucogenic Regulator Market at $32 million. Our projection factor was derived from a prequalified group of 588 clinics with invoices for 36 months (2013-2015), containing 1296 veterinarians (from a universe of 57,300 small animal general practice veterinarians) and distributed over the continental US.

Number of suspected or treated diabetic felines:

  2013 2014 2015
Tested or Treated 772,430 818,298 876,314
Growth   6% 7%

Number of felines that received a test but no treatment:

  2013 2014 2015
Tested only 475,086 530,119 579,423
Growth   11.60% 9%

Therefore, over the 3-year period (2013-2015) an average of 660,000 suspected diabetic felines received just over one diabetes test (665,000 tests for 660,000 patients or approximately 1 test/patient).

  2013 2014 2015
Treated 297,344 288,179 296,891

Feline Diagnosed with Diabetes Mellitus Treatment Patient Counts  and Medication Modalities:

These feline diabetic patients received a variety of tests, glucogenic products and prescription diets. There were about 180,000 unique diabetic cats receiving only prescription diets/food.  These patients revisited the clinics many times during the year to obtain on average 708,273 invoiced diet food items, for an average of 4 items per cat per year. The average number of unique cats receiving diet food for treatment, alone or in combination with Glucogenic regulators, is about 240,000 and they come to the clinic about 5 times a year to get those items.

Some felines received only products. There was an average of 20,800 unique cats that received an average of 63,000 Glucogenic Replacement Therapy (GRT) products alone or about 3 products per cat. The number of unique cats receiving GRT, alone or with tests and/or diet food, is 65,954 and they come in 6-7 times a year.

Number of patients receiving each type of treatment:

Treatment Food Food + GRT GRT +
  180,000 240,000 20,800 65,984

Vetinformatics research also provides these Prevalence Insights: The number of pre-existing DM patients versus new patients, as well as how many days of therapy these two groups received were as follows. These prevalence metrics reveal that 77% of the 2015 product-treated patients were pre-existing DM patients and 23% were new. Pre-existing patients received 300 days of therapy, while new patients received 162 days of therapy, for a weighted average of 268 days of therapy. This means 13,850,340 treatment days (65,954 times 268 average days of treatment) at $1.55-1.80 per day. Vetinformatics therefore projects the GRT market at $27.3-31.8 million—about what the feline GRT market is at manufacturer/distributor prices to the veterinarian.  This provides statistical external validation for the number of unique patients being treated with GRT products.

Prozinc has approximately 55% of the market for 2015 or $13-14.6 million. There are 265.5k mentions of GRT products, representing about 60 days of therapy, since these patients are being re-administered about 6 times a year (see above).  This projects to a market size of 15,930,000 treatment days (265,500 mentions x 60 days) at $1.55-1.80 per cat per day, for a market of $24.6-$28.6 million. Both of these methods project close to a similar market size (order of magnitude) and provide external validation for each other.

Veterinary Practice Metrics:

Some felines received all three (tests, Glucogenic Regulators and prescription foods). This segment of the DM market consists of approximately 19,300 cats, receiving 313,730 items or 16 items per patient per year.

Another group of patients received testing and GRT, but no prescription diet.  This segment of the DM market consists of approximately 20,360 cats for an average of 142,000 mentions or nearly 7 items per cat per year (1 test and 6 products per year—one product every 2 months or 60-day treatment interval).

An additional group of patients received tests and food, but no Glucogenic products. This segment of the market consists of approximately 44,000 cats receiving an average of 383,000 items or about 8.7 items per cat per year. (Again consistent with 1-2 tests per year and food almost every 2 months.)

The final patient group received Food and Glucogenic products, but no testing.  This segment of the DM market consists of approximately 9,600 cats receiving an average of 99,000 items. This translates to 10 items per cat per a year. This could be interpreted as 6 diet food items per year (one every 2 months as above) and 4 products per cat per year or one every three months.

Diagnostic Insight: As these cats receive fewer products/year than those not on a prescription diet, this may imply less dosing of insulin when given concomitantly with prescription diet food.  Academic research appears to confirm this Veterinary Insights practice metric finding: Feeding diabetic cats a very low-carbohydrate, high-protein diet improved hyperglycemia, reduced insulin dosage, and increased the rate of diabetic remission. (https://academic.oup.com/jn/article/134/8/2072S/4688883 2004)

“While the number of suspected DM felines increased over this 3-year period, the number of treated feline diabetic patients did not increase.”

Number of patients receiving each type of treatment:

Tested & Treated Test/GRT Test/Food Test/GRT/Food
  20,360 44,000 19,350