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Home » Healthcare » Pharmaceuticals » HPH-2340316

  • Global Viscosupplementation Market Insights, Opportunities, Analysis, Market Shares and Forecast 2017 – 2023

  • Publish: February 2017 | Report Code: HPH-2340316

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Viscosupplementation is a non-surgical procedure that involves the injection of Hydraulic acid doses in the synovial fluid of the affected joint.  The global Viscosupplementation market was $1756.0 million in 2014 and is expected to reach impressive levels by 2022 growing at an eye popping CAGR in the forecasted period. Viscosupplementation with hydraulic acid has emerged as an alternative therapy to knee replacement surgery in osteoarthritis in the last decade.

On the basis of course of treatment the global Viscosupplementation market is categorized into Single injection and multiple injections. The single injection which is premium priced continues to be more popular in the forecast period as compared to the 3 and 5 injection procedure, which has its dominant presence only in some regions due to various reasons such as reimbursement, differences in the access to products and more. In terms of osteoarthritis; it is segmented into knee, shoulder, hip and ankle. 

Major drivers of the global Viscosupplementation market include strong healthcare facilities and infrastructure, growing awareness among the patients about the new drugs, and increasing geriatric population. Growing obesity worldwide is also a key reason for the growth of Viscosupplementation market as obese patients are also likely to suffer joint problems due to overweight. Aggressive marketing technique adopted by the suppliers, the growing trend and booming demand for the non-surgical treatment. Also one of the strong drivers of the global Viscosupplementation market is the cost effectiveness of the Viscosupplementation process as compared to the knee replacement surgeries.

The major restraining factors of the global Viscosupplementation market are the lack of safety and efficacy associated with Viscosupplementation process products. Also, the lack of enthusiasm of the surgeons related to Viscosupplementation process and the reimbursement challenges also hamper the growth of the global Viscosupplementation market.

North America holds the largest market for the global Viscosupplementation market due to the high demand and acceptance of the product. US hold the largest Viscosupplementation market share among the ten major markets of North America. Asia Pacific is projected to grow in the forecasted period in terms of volume as Japan is considered to be the second largest market for Viscosupplementation. Europe is the next leading market for Viscosupplementation due to acceptance of premium priced products. China also has contributed significantly in the growth of APAC Viscosupplementation market volume in the past decade.

There is intense competition in the global Viscosupplementation industry, so the companies continuously strive for launching new products and to enhance the existing drugs. The key market players of the global Viscosupplementation market are BioPolymer GmbH & Co. KG, Anika Therapeutics Inc., Chi2Gel Ltd., Flex Biomedical, Synolyne Pharma, Cocoon Biotech Inc., Alcon Inc., Moebius Medical Ltd., Carbylan Therapeutics Inc., Euflexxa, OrthogenRx Inc., Fidia Farma USA Inc., Supartz, Ferring Pharmaceuticals Inc., Synvisc-one and more.

1.    INTRODUCTION
 
1.1.    EXECUTIVE SUMMARY
 
1.2.    ESTIMATION METHODOLOGY
 
 
 
2.       MARKET OVERVIEW
 
2.1.    MARKET DEFINITION AND SCOPE
 
2.2.    KEY FINDINGS
 
2.3.    PARAMETRIC ANALYSIS
 
2.3.1. RAW MATERIAL SUPPLIER
 
2.3.2. PRODUCTION GEOGRAPHICALLY
 
2.3.3. ADOPTION ACROSS VARIOUS INDUSTRIES
 
2.4.    KEY MARKET INSIGHTS
 
2.4.1. TOP 3 EMERGING COUNTRIES
 
2.4.2. TOP 3 REVENUE GENERATING SEGMENTS
 
2.4.3. TOP GROWING MARKETS AND EMERGING TRENDS
 
2.4.4. TOP 3 GEOGRAPHY
 
2.5.    COMPETITIVE LANDSCAPE
 
2.5.1. MARKET SHARE ANALYSIS
 
2.5.2. TOP WINNING STRATEGIES
 
2.5.3. CASE STUDIES: TOP COMPETITIVE MOVES
 
2.6.    PORTER’S FIVE FORCE MODEL
 
2.6.1. THREAT OF NEW ENTRANTS
 
2.6.2. THREAT OF SUBSTITUTE PRODUCTS OR SERVICES
 
2.6.3. BARGAINING POWER OF BUYER
 
2.6.4. BARGAINING POWER OF SUPPLIER
 
2.6.5. INTENSITY OF COMPETITIVE RIVALRY
 
2.7.    KEY BUYING CRITERIA
 
2.8.    STRATEGIC RECOMMENDATION
 
2.9.    STRATEGIC CONCLUSIONS
 
 
 
3.       MARKET DETERMINANTS
 
3.1.    MARKET DRIVERS
 
3.1.1.  INCREASE IN THE PREVELANCE OF AO
 
3.1.2.  SIDE EFFECT CAUSED BY CORTICOSTEROIDS, NSAIDS & NARCOTICS
 
3.1.3   HELPS IN DELAYING TOTAL KNEE REPLACEMENT
 
3.1.4   DIRECT-TO-COSUMER ADVERTISING
 
3.2.    MARKET RESTRAINTS
 
3.2.1. UNFAVOURABLE REIMBURESEMENT STRUCTURE
 
3.2.2  LESS COST OF PHARMOCOLOGICAL THERAPIES
 
3.2.3  INCEASING DEMAND OF PRP INJECTIONS NEGTIVELY AFECTING DEMAND OF VISCOSUPPLEMENTATION
 
3.2.4  LESS SPENDINGS ON HEALTHCARE BY EMERGING NATIONS
 
3.3.    MARKET OPPORTUNITIES
 
3.3.1. ENTRY OF NEW HA DERIVATIVES
 
3.3.2  INCREASED USAGE OF VISCOSUPPLEMENTATION AFTER ARTHOSCOPIC SURGERIES
 
3.3.3  INCEASING DEMAND IN EMERGING NATIONS
 
3.3.4  INCREASING TENDENCY OF SELF PAY
 
3.3.5  GROWING DEMAND IN EMERGING REGIONS LIKE APAC.
 
3.4.    MARKET CHALLENGES
 
3.4.1.  LACK OF AGREEMENT ON THE EFFECTIVENESS OF VISCOSUPPLEMENTATION IN KNEE OA
 
3.4.2   LACK OF EVIDENCES REGARDING THE EFFECTIVENESS OF VISCOSUPPLEMENTATION IN OTHER JOINTS
 
3.5.    PARENT MARKET
 
3.6.    COMPETITOR MARKET
 
3.7.    ALTERNATIVE MARKET
 
 
 
4.       MARKET SEGMENTATION
 
4.1.    BY MARKET SEGMENT
 
         
 
         4.2.1. GLOBAL VISCOSUPPLMENTATION MARKET FOR ONE-INJECTION 2014-2023 ($ MILLION)
 
         4.2.2.  GLOBAL VISCOSUPPLMENTATION MARKET FOR THREE-INJECTION 2014-2023 ($ MILLION)
 
         4.2.3.  GLOBAL VISCOSUPPLMENTATION MARKET FOR FIVE-INJECTION 2014-2023 ($ MILLION)
 
4.2.    BY GEOGRAPHY
 
         4.3.1. NORTH AMERICA VISCOSUPPLMENTATION MARKET 2014-2023 ($ MILLION)
 
         4.3.2. APAC VISCOSUPPLMENTATION MARKET 2014-2023 ($ MILLION)
 
         4.3.3. EUROPE VISCOSUPPLMENTATION MARKET 2014-2023 ($ MILLION)
 
         4.3.4. ROW VISCOSUPPLMENTATION MARKET 2014-2023 ($ MILLION)
 
 
 
5.       GEOGRAPHIC ANALYSIS
 
5.1.   NORTH AMERICA VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)
 
5.1.1. UNITED STATES (US) VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)
 
5.2.   EUROPE VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)
 
5.2.1. UNITED KINGDOM (UK) VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)
 
5.2.3. FRANCE VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)
 
5.2.4. GERMANY VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)
 
.2.5. SPAIN VISCOSUPPLMENTATION MARKET 2014-2023 ($ MILLION)
 
.2.6. ITALY VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)
 
5.3.   ASIA PACIFIC VISCOSUPPLMENTATION MARKET 2014-2023 ($ MILLION)
 
5.3.1. INDIA VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)
 
5.3.2. CHINA VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)
 
5.3.3. JAPAN VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)
 
5.4.   REST OF THE WORLD VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)
 
5.4.1  BRAZIL VISCOSUPPLMENTATION MARKET  2014-2023 ($ MILLION)    
 
 
 
6.     COMPANY PROFILES
 
6.1          SEIKAGAKU CORPORATION       
 
6.2          BIOVENTUS       
 
6.3          DEPUY SYNTHES              
 
6.4          ZIMMER BIOMET INC    
 
6.5          SANOFI
 
6.6          ANIKA THERAPEUTICS  
 
6.7          CHUGAI PHARMACEUTICAL       
 
6.8          FERRING INTERNATIONAL CENTER S.A. 
 
6.9          FIDIA FARMACEUTICI S.P.A.       
 
6.10        MEDA AB            
 
 
 
LIST OF TABLES
 
 
 
TABLE # 1             US PROCEDUREAL TRENDS FOR VISCOSUPPLEMENTATION, BY JOINT TYPE, 2014-2023    
 
TABLE # 2             US PROCEDUREAL TRENDS FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014-2023               
 
TABLE # 3             5EU PROCEDUREAL TRENDS FOR VISCOSUPPLEMENTATION, BY JOINT TYPE, 2014-2023 
 
TABLE # 4             EUROPE PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014-2023               
 
TABLE # 5             APAC PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY JOINT TYPE, 2014-2023   
 
TABLE # 6             APAC PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014-2023               
 
TABLE # 7             BRAZIL PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY JOINT TYPE, 2014-2023
 
TABLE # 8             BRAZIL PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014-2023               
 
TABLE # 9             DIFFERENCES BETWEEN US FDA APPROVAL AND EU CE MARKING OF MEDICAL DEVICES               
 
TABLE # 10          US MEDICARE ASPS* FOR VISCOSUPPLEMENTATION PRODUCTS (2014–2015)    
 
TABLE # 11          PROBLEMS ASSOCIATED WITH KNEE REPLACEMENT       
 
TABLE # 12          SIDE-EFFECTS CAUSED BY NSAIDS            
 
TABLE # 13          SIDE EFFECTS OF CORTICOSTEROIDS       
 
TABLE # 14          SIDE EFFECTS OF NARCOTICS     
 
TABLE # 15          VISCOSUPPLEMENTATION DOSING        
 
TABLE # 16          MEDICAL NECESSITIES FOR THE PROCESS             
 
TABLE # 17          TOTAL HEALTH EXPENDITURE PER CAPITA INCOME IN $ IN 2015
 
TABLE # 18          PRODUCT PROFILE (ADANT)      
 
TABLE # 19          PRODUCT PROFILE (ARTHRUM)
 
TABLE # 20          ARTHRUM COMPOSITION AND RATIO IN CAPSULES       
 
TABLE # 21          PRODUCT PROFILE (CURAVISC)
 
TABLE # 22          PRODUCT PROFILE (DUROLANE)              
 
TABLE # 23          PRODUCT PROFILE (EUFLEXXA)
 
TABLE # 24          PRODUCT PROFILE (FERMATHRON)        
 
TABLE # 25          PRODUCT PROFILE (GEL-ONE)   
 
TABLE # 26          PRODUCT PROFILE (GO-ON)      
 
TABLE # 27          PRODUCT PROFILE (JONEXA)     
 
TABLE # 28          PRODUCT PROFILE (JONEXA)     
 
TABLE # 29          PRODUCT PROFILE (NEOVISC)   
 
TABLE # 30          PRODUCT PROFILE (ORTHOVISC AND MONOVISC)          
 
TABLE # 31          PRODUCT PROFILE (OSTENIL)    
 
TABLE # 32          PRODUCT PROFILE (RECOSYN)  
 
TABLE # 33          PRODUCT PROFILE (RENEHAVIS)              
 
TABLE # 34          PRODUCT PROFILE (SUPARTZ/ARTZ)      
 
TABLE # 35          PRODUCT PROFILE (SUPLASYN)
 
TABLE # 36          PRODUCT PROFILE (SUVENYL)  
 
TABLE # 37          PRODUCT PROFILE (SYNOCROM)             
 
TABLE # 38          PRODUCT PROFILE (SYNOLIS V-A)           
 
TABLE # 39          PRODUCT PROFILE (SYNOVIAL)
 
TABLE # 40          PRODUCT PROFILE (SYNVISC AND SYNVISC-ONE)            
 
TABLE # 41          EACH 1 ML OF GEL-SYN CONTAINS:        
 
TABLE # 42          SEIKAGAKU CORPORATION PRODUCTS PORTFOLIO        
 
TABLE # 43          SCOT ANALYSIS - SEIKAGAKU CORPORATION    
 
TABLE # 44          BIOVENTUS LLC PRODUCTS PORTFOLIO
 
TABLE # 45          SCOT ANALYSIS - BIOVENTUS LLC            
 
TABLE # 46          DEPUY SYNTHES PRODUCTS PORTFOLIO               
 
TABLE # 47          SCOT ANALYSIS - DEPUY SYNTHES           
 
TABLE # 48          ZIMMER BIOMET INC PRODUCTS PORTFOLIO    
 
TABLE # 49          SCOT ANALYSIS - ZIMMER BIOMET INC 
 
TABLE # 50          SANOFI PRODUCTS PORTFOLIO
 
TABLE # 51          SCOT ANALYSIS - SANOFI            
 
TABLE # 52          ANIKA THERAPEUTICS PRODUCTS PORTFOLIO   
 
TABLE # 53          SCOT ANALYSIS - ANIKA THERAPEUTICS
 
TABLE # 54          CHUGAI PHARMACEUTICALS PRODUCTS PORTFOLIO     
 
TABLE # 55          SCOT ANALYSIS - CHUGAI PHARMACEUTICALS  
 
TABLE # 56          FERRING HOLDINGS PRODUCTS PORTFOLIO       
 
TABLE # 57          SCOT ANALYSIS - FERRING HOLDINGS   
 
TABLE # 58          FIDIA FARMACEUTICI S.P.A.  PRODUCTS PORTFOLIO      
 
TABLE # 59          SCOT ANALYSIS - FIDIA FARMACEUTICI S.P.A.    
 
TABLE # 60          MEDA AB PRODUCTS PORTFOLIO            
 
TABLE # 61          SCOT ANALYSIS - MEDA AB         
 
TABLE # 62          GLOBAL VISCOSUPPLEMENTATION MARKET BY REGION, 2014-2023 ($ MILLION)              
 
TABLE # 63          GLOBAL VISCOSUPPLEMENTATION MARKET REVENUE ($ MILLION), BY SEGMENT, 2014-2023     
 
TABLE # 64          SINGLE INJECTION IN VISCOSUPPLEMENTATION COST AND DIFFERENT BRAND 
 
TABLE # 65          ONE-INJECTION MARKET, BY REGION 2012–2021($MILLION)      
 
TABLE # 66          THREE-INJECTION MARKET, BY REGION 2012–2021($ MILLION) 
 
TABLE # 67          MULTIPLE INJECTIONS IN VISCOSUPPLEMENTATION     
 
TABLE # 68          GLOBAL VISCOSUPPLEMENTATION MARKET BY GEOGRAPHY, 2014-2023 ($ MILLION)     
 
TABLE # 69          US VISCO SUPPLEMENTATION MARKET BY REVENUE ($ MILLION) 2014-2023      
 
TABLE # 70          FRANCE VISCO SUPPLEMENTATION MARKET BY REVENUE ($ MILLION) 2014-2023            
 
TABLE # 71          GERMANY VISCO SUPPLEMENTATION MARKET BY REVENUE ($ MILLION), 2014-2023     
 
TABLE # 72          SPAIN VISCOSUPPLEMENTATION MARKET BY REVENUE ($ MILLION), 2014-2023               
 
TABLE # 73          UK  VISCO SUPPLEMENTATION MARKET BY REVENUE($ MILLION), 2014-2023     
 
TABLE # 74          JAPAN  VISCOSUPPLEMENTATION MARKET BY REVENUE ($ MILLION), 2014-2023             
 
TABLE # 75          BRAZIL  VISCOSUPPLEMENTATION MARKET BY REVENUE($ MILLION), 2014-2023              
 
TABLE # 76          CHINA VISCO SUPPLEMENTATION MARKET BY REVENUE($ MILLION), 2014-2023              
 
TABLE # 77          INDIA VISCOSUPPLEMENTATION MARKET BY REVENUE ($ MILLION), 2014-2023
 
 
 
 
 
FIGURES LIST
 
FIGURE # 1          GLOBAL VISCOSUPPLEMETATION PROCEDURAL TRENDS BY TREATMENT REGIME (%) 2014 AND 2023               
 
FIGURE # 2          GLOBAL VISCOSUPPLEMENTATION PROCEDURAL TRENDS BY JOINT TYPE (%) 2014 AND 2023      
 
FIGURE # 3          US ADOPTION TREND FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014  
 
FIGURE # 4          US PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014–2023 
 
FIGURE # 5          5EU PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY JOINT TYPE, 2014 
 
FIGURE # 6          5EU ADOPTION TRENDS FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014             
 
FIGURE # 7          5EU PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014–2023               
 
FIGURE # 8          APAC PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014–2023               
 
FIGURE # 9          APAC PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY JOINT TYPE, 2014              
 
FIGURE # 10       APAC ADOPTION TREND FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014            
 
FIGURE # 11       BRAZIL PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY JOINT TYPE, 2014           
 
FIGURE # 12       BRAZIL ADOPTION TREND FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014         
 
FIGURE # 13       BRAZIL PROCEDURE TRENDS FOR VISCOSUPPLEMENTATION, BY TREATMENT REGIMEN, 2014–2023               
 
FIGURE # 14       GLOBAL VISCOSUPPLEMENTATION MARKET ACCESS BY REGION 2014-2023 (%) 
 
FIGURE # 15       PAYER MIX FOR VISCOSUPPLEMENTATION IN THE US, 2014        
 
FIGURE # 16       PAYER MIX FOR VISCOSUPPLEMENTATION IN FRANCE, 2014      
 
FIGURE # 17       PAYER MIX FOR VISCOSUPPLEMENTATION IN THE UK, 2014        
 
FIGURE # 18       PAYER MIX FOR VISCOSUPPLEMENTATION IN SPAIN, 2014          
 
FIGURE # 19       PAYER MIX FOR VISCOSUPPLEMENTATION IN CHINA, 2014         
 
FIGURE # 20       LIFE TIME RISK OF SYMPTOMATIC OSTEOARTHRITIS       
 
FIGURE # 21       GLOBAL PREVALENCE ARTHRITIS BY AGE (%) IN 2014      
 
FIGURE # 22       COMMONLY USED NSAIDS, CORTICOSTEROIDS, NARCOTICS       
 
FIGURE # 23       ADVANTAGES OF DIRECT-TO-CONSUMER MARKETING 
 
FIGURE # 24       THE COMMON PHARMACOLOGICAL THERAPIES AVAILABLE FOR OA       
 
FIGURE # 25       AVERAGE PER CAPITA INCOME IN DEVELOPED AND DEVELOPING COUNTRIES IN 2014   
 
FIGURE # 26       HYALURONIC ACID DERIVATIVES             
 
FIGURE # 27       STEPS INCLUDED IN SELF PAY MARKET  
 
FIGURE # 28       GROWTH OF VISCOSUPPLEMENTATION MARKET IN APAC REGION IN US $ MILLION 2014-2023
 
FIGURE # 29       FEATURES OF NEOVISC
 
FIGURE # 30       US VISCOSUPPLEMENTATION MARKET BY JOINT TYPE IN 2014(%)            
 
FIGURE # 31       FRANCE, GERMANY, ITALY SPAIN AND UK VISCOSUPPLEMENTATION MARKET GROWTH 2014-2023($ MILLION)            
 
FIGURE # 32       INDIA, CHINA AND JAPAN VISCOSUPPLEMENTATION MARKET GROWTH 2014-2023($ MILLION)
 
FIGURE # 33       GLOBAL VISCOSUPPLEMENTATION ONE-INJECTION MARKET REVENUE ($M) 2014–2023               
 
FIGURE # 34       GLOBAL VISCOSUPPLEMENTATION THREE-INJECTION MARKET REVENUE ($M), BY REGION, 2014–2023      
 
FIGURE # 35       FIVE-INJECTION MARKET, BY COUNTRY 2012–2021($ MILLION) 
 
FIGURE # 36       GLOBAL VISCOSUPPLEMENTATION FIVE-INJECTION MARKET REVENUE ($ MILLION), BY REGION, 2014–2023          
 
FIGURE # 37       GROWTH IN NUMBER OF PATIENTS SUFFERING FROM OSTEOARTHRITIS BY GENDER (2005-2030)               
 
FIGURE # 38       FRANCE VISCOSUPPLEMETATION MARKET REVENUE $ MILLION 2014-2023        
 
FIGURE # 39       CAUSES OF OSTEOARTHRITIS     
 
FIGURE # 40       GERMANY VISCOSUPPLEMENTATION MARKET REVENUE $MILLION 2014-2023  
 
FIGURE # 41       HIP REPLACEMENT SURGERY PER 100 000 POPULATION 2013      
 
FIGURE # 42       ITALY VISCOSUPPLEMETATION MARKET REVENUE $ MILLION 2014-2023              
 
FIGURE # 43       REDUCTION IN PAIN AND STIFFNESS AFTER MONO INJECTION  
 
FIGURE # 44       SPAIN VISCOSUPPLEMETATION MARKET REVENUE $ MILLION 2014-2023            
 
FIGURE # 45       NUMBER OF OSTEOARTHRITIS PATIENTS IN SPAIN BY AGE          
 
FIGURE # 46       KNEE OPERATIONS FOR OBESE PEOPLE IN 2012-13 BY GENDER   
 
FIGURE # 47       UK VISCOSUPPLEMETATION MARKET REVENUE $ MILLION 2014-2023   
 
FIGURE # 48       JAPAN VISCOSUPPLEMETATION MARKET REVENUE $ MILLION 2014-2023           
 
FIGURE # 49       PREVALENCE OF KNEE OSTEOARTHRITIS IN JAPAN BY GENDER IN 2014  
 
FIGURE # 50       BRAZIL VISCOSUPPLEMETATION MARKET REVENUE $ MILLION 2014-2023           
 
FIGURE # 51       HEALTH EXPENDITURE AS PERCENTAGE OF GDP IN 2013               
 
FIGURE # 52       INDIA VISCOSUPPLEMETATION MARKET REVENUE $ MILLION 2014-2023

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