The worldwide market for products in wound management, as reflected in the MedMarket Diligence report #S249, encompasses twelve discrete product segments:
- Traditional Adhesive Dressings
- Traditional Gauze Dressings
- Non-Adherent Dressings
- Film Dressings
- Foam Dressings
- Hydrogel Dressings
- Hydrocolloid Dressings
- Alginate Dressings
- Antimicrobial Dressings
- Negative Pressure Wound Therapy Devices
- Bioengineered Skin and Skin Substitutes
- Wound Care Growth Factors
These segments include traditional wound care products, like dressings and bandages, but also include their more evolved forms with embedded components or constructions to enhance wound healing by shortening healing times or improving outcomes. But, wound care has also evolved to included equipment/device-mediated care as in NPWT as well as biologically-derived or engineered products in regenerative medicine.
The MedMarket Diligence report details the current and forecast wound market by product type in North and South America, the European Union, Asia/Pacific and Rest of World, and looks at markets and growth rates by product and country for the years 2012-2021.
The world market in 2012 stood at approximately $12.45 billion. By 2021, the total wound management market represented by the segments listed above is projected to be worth over $21.85 billion million, reflecting a 2013-2021 CAGR over 7%.
Source: Report #S249.
There are some market restraints at work, primarily the high cost of the new technologies. Not all country healthcare budgets can afford advanced wound care products, even if they are proven to decrease healing times and hospital costs over the longer run. The development of substitute products threatens existing product categories, while a lack of sufficient clinical and economic evidence backing new technology hinders growth and acceptance of some of the more advanced wound management technologies. In addition, improved wound prevention and a lack of regulation on tissue engineering in the EU are also expected to hold back the development of new technologies.
In addition to market restraints, there are a number of drivers that are expected to shape this market in the years to come. One of the primary drivers is the aging of the global population. Chronic diseases, such as circulatory conditions, anemias and autoimmune diseases influence the healing process as a result of their influence on a number of bodily functions. Illnesses that cause the most significant problems include diabetes, chronic obstructive pulmonary disease (COPD), arteriosclerosis, peripheral vascular disease (PVD), heart disease, and any conditions leading to hypotension, hypovolemia, edema, and anemia. While chronic diseases are more frequent in the elderly, wound healing will be delayed in any patient with underlying illness. Happily, most wounds heal without any problems. However, chronic wounds may take months or years to fully close, or may never close. Chronic wounds adversely affect the individual’s quality of life, and are a leading cause of burgeoning healthcare costs.
Type 2 diabetes represents 85-95% of all diabetes in developed countries, and accounts for an even higher percentage in developing countries. There were 26 million diabetic patients in the US in 2012 and 285 million patients globally. Of these patients, approximately 15% will develop a diabetic foot ulcer and 50% of these will become infected, representing an estimated 2 million patients. Diabetic foot infections are currently treated with systemic antibiotics, but the estimated failure rate of antibiotics for diabetic foot ulcers is in excess of 22%.
A patient with diabetes is at significant risk of damage to tissues caused by impaired homeostasis due to the disease process. For example there is a tendency for such tissues to develop blockages in smaller blood vessels, which reduces the ability of these vessels to provide sufficient oxygen to tissues already under stress due to compromised nutrient supply and the diabetic condition. These patients then develop arterial ulcers. They may also have a tendency to suffer from venous ulcers, due to the underlying poor condition of cells as a result of the diabetes.
The diabetic foot is the most common cause of non-traumatic lower extremity amputations in the US and Europe: there is an average of 82,000 amputations per year in the U.S., costing an estimated $1.6 billion annually. The estimated cost of foot ulcer care in the U.S. ranges from $4,595 per ulcer episode to more than $28,000 and the total annual cost of foot ulcer care in the US has been estimated to be as high as $5 billion.
Pressure, or decubitus, ulcers are another of the most common types of chronic wounds. The treatment of pressure ulcers places a major burden on healthcare systems worldwide, with an emerging additional cost of litigation increasing in importance over recent years. Healthcare practitioners need to be aware of both the direct and indirect costs and consider how the implementation of prevention protocols may offer cost savings in the longer term. The cost of a dressing for example as a prevention tool is minimal in comparison to the costs of treating an established pressure ulcer.
Following are a few hard numbers on the true financial cost of pressure ulceration:
- The estimated cost to the US hospital sector is $11 billion per annum
- The estimated cost to the UK national health service is estimated at £1.4-£2.1 billion annually (4% of total NHS expenditure)
- Lawsuits remain common in both acute and long term care — with high payments in certain cases
- The average cost to treat an individual with an unstageable ulcer or a deep tissue injury is estimated to be $43,180
- The average length of stay in hospital is almost three times longer for chronic wounds
- The mean hospital cost for management of pressure ulcers in the U.S. is $14,426. In comparison, the same cost in Korea is identified as $3,000-$7,000.
The cost of treating chronic wounds is one element driving the development and utilization of advanced wound care technologies. Other drivers are the aging of the population, and the obesity epidemic, which is expected to produce a wave of diabetics in the years to come.
Worldwide Wound Management Market, Segment Size & Growth, 2013-2021
Source: Report #S249.
In 2009, four companies (Johnson and Johnson, Kinetic Concepts Inc., Hill-Rom and Smith & Nephew) were responsible for about 60 percent of total market revenue. However, mergers, acquisitions and sales of intellectual property have rapidly changed the market share picture. By the end of 2012, more than half of the global wound care market was held by Johnson and Johnson, 3M, Smith & Nephew, and Systagenix. In addition, competition on price has driven down prices in the well established (i.e., traditional wound care) markets, while novel technologies are taking hold with introductory revenues and generating high, early stage growth rates.
For the complete analysis of the worldwide wound management market, see “Wound Management, Worldwide Market and Forecast to 2021: Established and Emerging Products, Technologies and Markets in the Americas, Europe, Asia/Pacific and Rest of World” (Report #S249).