Category Archives: market data

blog contains data on market size, growth and/or competitor shares

Over $24 Billion in Spent on Plastic Surgery Worldwide

And that’s just the product sales including implants, fillers, and other products used for aesthetics and reconstruction. It doesn’t include the physician fees, the outpatient site fees and other money spent.

There are two parts to this, of course. Plastic surgery has two faces — reconstruction and aesthetics, the first medically-indicated and the second elective.  Of course, the surgical reconstruction of anatomy and outward appearance to restore what has been lost to disease or trauma (the medically-indicated side of plastic surgery) has  benefitted greatly by the expertise and medtech innovation of aesthetics (the elective side).  Because of this, the market for products in plastic surgery has elements of both the traditional medtech market (reimbursement, economy-independed funding) and consumer markets (elective products, sensitivity to general economic conditions).

Overall, the market for these products is growing at a compound average of 7.9%, which is a strong but not extraordinarily high growth rate for a medtech market. Within it, of course, there is wide variation in the growth rates of plastic surgery product sales. Below is illustrated the aesthetics and reconstructive surgery products market from 2013 to 2018.

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MedMarket Diligence, LLC; Report #S710

 

Use of Surgical Sealants for Cranial and Spinal Dura

Surgical sealants have an enormous range of applications in the treatment of acute and chronic wounds, but while the majority of sealant revenues derives from their use in the hemostasis, closure and sealant of tissues to prevent blood loss…

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Source: MedMarket Diligence, LLC; Report #S190

… a different niche use of sealants is stopping cerebrospinal fluid leaks and other dural wound treatments associated with cranial and spinal procedures. These include their use in:

  • Cranial and spinal dural plastic surgery to prevent CSF fistulas.
  • Dural plastic surgery in residual cavities following tumor removal.
  • Dural lacerations in hemilaminectomy operations

Of this, most of the use is currently in cranial applications, but use in spinal applications is growing considerably faster:

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Source: MedMarket Diligence, LLC; Report #S190

 

 

 

Medtech fundings in April 2014

Fundings for medical technology in April 2014 stand at $418 million, led by the $92.8 million raised by HALT Medical. Below is a list of the month’s top fundings to date:

Company funding Product/technology
HALT Medical, Inc., has rasied $92.8 million in two separate rounds of funding ($29.47 million and $63.34 million) according to twp regulatory filings Radiofrequency thermal ablation of uterine fibroids
TriVascular Technologies, Inc., has raised $78 million in an initial public offering, according to the company Technologies for the treatment of abdominal aortic aneurysms
Holaira, Inc., has raised $42 million in a Series D round of funding according to press reports Catheter based device to treat COPD
Tendyne Holdings, Inc., has raised $25 million in a round of funding according to press reports Transcatheter aortic valve implant for treatment of mitral valve regurgitation
Vapotherm, Inc., has raised $24 million in a round of funding according to press reports Ventilation systems for patients in respiratory distress

For the complete list of medtech fundings during April 2014, see link.

For a full list of the fundings in medtech, by month, since 2009, see link.

Fundings in Medtech 2009-2014: A Contrarian View

Since 2008, medtech has taken a lot of hits. Indeed, when the capital crunch hit, medtech was not viewed as the safest place for investment by a suddenly very risk averse world. Blue chip stock, high volume, low growth, STABLE markets became the norm for a lot of money. But, after a short while, it became apparent that medtech was hardly junk bonds or penny stock, especially considering the battle-hardened innovators of medtech who continued to seize on innovations that provided treatment where there once wasn’t, that accelerated healing, that measurably improved outcomes, that resulted in real cost savings to health systems and insurers, that, in other words, met DEMAND.

So, money came back to medtech. I tracked it then, and I track it now, month by month, funding by funding, company by company. Was it coming back in the pollyanna-esque windfalls of biotech and pharma? No, and I don’t think it ever has or ever will — nor should it. Biotech seems to perennially able to tap the “hope springs eternal” deep pockets of venture capital that can regularly draw individual fundings of $50 million, $75 million or $100 million. Pharmaceuticals don’t seem to go to the VC well as often, but when they do, their funding rounds are no less spectacular.

Medtech excels at crafting plain and simple solutions to disease, suffering, high healthcare costs and clinical need. Not every solution is a blockbuster — in fact, there are more than a few 510(k) products that should probably just be called “me, too”, since they do not distinguish themselves independently, at least not from a clinical or technology standpoint. But medtech has proven its ability to keep pushing the treatment envelope by innovating a little further to gain a bit more edge on outcome or cost or both.

So, medtech regularly pulls in $5 million, $10 million, $25 million at at time — frequently less, but not infrequently more.

My Contrarian View. But let me highlight again that medtech is a moving target and not everyone is thinking apples to your oranges.  What I consider medtech is, at its root, technologies that were traditionally represented as medical device treatments for disease and trauma. (And, yes, so I don’t have to answer this later on, by “medical device” I mean implants, instruments, instrumentation, even capital equipment.)  But medtech is not only medical device, for it is also (at least by my authoritarian definition, since this is my blog, but it is read by many in this field), anything and everything (within reason) that is either adjunctive to medical devices like drug delivery, like biomaterial-based implants/grafts, drug/device hybrids, tissue engineering and cell therapy (this latter is perhaps at the fringe of medtech, bordering on pure biotech).

Where’s the boundary of medtech? In my mind, it is anything and everything that competes with markets that have in the past and are to some extent still served by medical devices, equipment and supplies. For the sake of repetition, this is the definition I have posted on the medtech fundings I report on month by month in this blog (and in the online spreadsheets linked here):

What is “medtech”?: We view medical technology (medtech) as principally medical devices and equipment, but also all technologies that are directly competitive with or complementary to technologies represented by therapeutic or diagnostic medical devices/equipment.

Note: Historic coverage of “medtech” has been limited to medical devices, supplies and equipment. We feel that such a limited definition poorly reflects the true nature of the markets that once were limited to such products. In reality, assessing the markets and competition for medical devices by ONLY considering other medical devices would result in gross underestimations of both competition and market potential. Moreover, this is reflected in both the nature of medical devices (which may be hybrid device/bio/pharm products or products that may not be “devices” at all (especially in the typical definitions defined by material type and function) but that compete head-on with devices.

So, on this more liberal definition of medtech (which some still feel is too restrictive), I can point to a steady stream of investments that has been on an upward trend for the last five years. If you disagree, feel free to come up with your own definition(s), but here is the five year trend of medtech investment:

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Source: MedMarket Diligence, LLC

Looked at from a seasonal standpoint, this data is shown below:

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Source: MedMarket Diligence, LLC

The monthly data underlying both of these charts is at link. If that is not enough data for you, then you can look at a comprehensive listing of the individual fundings behind this at link.

New Technologies at Medtech Startups, March 2014

Below is the list of new medical technologies under development at startups recently identified and included this month in the Medtech Startups Database:

  • Cardiac assist device for patients otherwise needing transplant.
  • Custom surgical implants including using 3D printing.
  • Targeted, localized drug delivery.
  • Hemostatic dressing for non-compressible hemorrhage.
  • High resolution imaging in cancer
  • Image-guided surgery
  • Autologous cell therapy delivered at the intraoperative point of care.
  • Device to harvest bone grafts
  • Device and method for self-collection of samples to screen for HPV, chlamydia, and gonorrhea.
  • Implantable neuromodulation device for the treatment of chronic pain and overactive bladder.
  • Encapsulated pancreatic cells for treatment of type 1 diabetes.
  • Embolization device.
  • Deep brain stimulation for Alzheimer’s and other cognitive disorders.
  • Magnetoencephalography (MEG) and magnetocardiography (MCG).
  • Technologies to manage core temperature in critical care and post-surgical patients
  • New method to use pulse wave velocity to measure arterial stiffness as indicator of heart attack risk.
  • Minimally invasive hip implants and other orthopedic implants.
  • Orthopaedic implants.

For a historical listing of the technologies under development at medtech startups, see link.

Wound Market Analysis, A Case Study in Understanding the Context for Opportunity

Analysis is a funny thing. If done thoroughly, accurately and carefully to represent a subject from all relevant angles, it can reveal very important considerations by those with a vested interest (e.g., in support of expensive investment).

Analysis is often driven by assumption. (“It seems to me that the relative significances of different wound management products vary from one country to another, or one region to another.”) So, analysts go looking for data that would support or reject that assumption. Here, one would be interested in the relative values of different wound product sales in different countries.

Ah, we have that data. Let’s plot the sales, as a percent of each region’s total, for the different categories of wound management products in the Americas, European Union, Asia/Pacific and Rest of World:

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 Source: MedMarket Diligence, LLC; Report #S249.

What striking results, the analyst says. Clearly, negative pressure wound therapy is much more common in the Americas than it is in the Rest of World. Other small-to-significant differences are seen in other product areas.

However, the better analyst would challenge the assumption or at least consider its relevance to important decisions (again, e.g., expensive investment).

This relative data was presented because it answered an assumption, that relative use of different wound management products varies by country/region. Of course, this is indeed true.

But that’s not the whole story.  Here, we have engaged ourselves in a careful analysis of deck chairs on top of a magnificent, unsinkable luxury liner.

The bigger picture, the more relevant context into which this analysis must fit is not simply the relative difference, but the absolute difference. If we take this question of wound product sales by geography and consider not the relative but the absolute differences, the picture changes considerably:

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Source: MedMarket Diligence, LLC; Report #S249.

Which analysis is correct?  Of, course, they both tell the truth, but neither tells the whole truth. One can gain a more comprehensive understanding by considering both and recognizing the significance of actions based on one or the other analysis.

But size and growth are not the only dimensions that factor into the potential interest by manufacturers. There is, of course, the degree to which the market is fragmented — how many competitors are carving up that high volume or high growth niche?  Here are some of the (3^3=9) combinations (of which many are possible):

  • High volume, low growth, fragmented: traditional wound dressings
  • High growth, low volume, unfragmented: growth factors
  • High growth, low volume, fragmented: bioengineered skin and skin substitutes
  • High growth, high volume, unfragmented:  ???

The opportunities available to manufacturers of wound management products clearly derive from each manufacturer’s strengths (technology, market presence, time-to-market, etc.), but the value of those opportunities and whether they should be pursued are factors that are dictated entirely by how each of those strengths match up against others in the market.  The wound management market has a highly diverse makeup of technology types, competitor types, clinical applications, clinical challenges, market forces and, ultimately, different competitive niches for product suppliers.

The increasing problem of chronic wounds, and their medtech solutions

Wounds have many different sources, etiologies and forms and, therefore, demand a range of approaches. By virtue of these differences, they have considerably different costs. At the top of the list of wound culprits driving up cost is the category of chronic wounds. Simply put, these wounds are very slow to heal due to poor circulation at the site (e.g., decubitus stasis, or pressure, ulcers), concomitant health issues (diabetes) and the difficulty in changing the local environment toward one with conditions more conducive to the healing process.

Chronic wounds are not the most common — that is a category represented by surgical wounds, in which the wound has been created medically or surgically in order to excise or otherwise manage diseased tissue. But surgical wounds, traumatic wounds and lacerations are by their nature acute and, especially for surgical wounds, can be surgically managed to create clean wound edges, good vascularization and other conditions that accelerate healing. Therefore, while the volume of surgical and traumatic wounds and lacerations is significant, their costs are manageable and their growth is unremarkable.

But the costs of chronic wounds are higher due to both the types of different products required and the length of time required for those products to be used. Moreover, given the association of chronic wounds with conditions that are growing in prevalence due to increasing incidence of obesity, diabetes and other conditions, combined with an aging population that is increasingly sedentary, the prevalence of chronic wounds is shifting the balance among wound types. Below is the balance of wound types by prevalence worldwide in 2011, followed by the projected balance of wound types in 2025.

Worldwide Share of Wound Prevalence By Type, 2011

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Source: MedMarket Diligence, LLC; Report #S190 and Report #S249.

 

Worldwide Share of Wound Prevalence By Type, 2025

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Source: MedMarket Diligence, LLC; Report #S190 and Report #S249.

Surgical wounds offer the potential for use of devices which can ensure hemostasis, prevent internal adhesions and anastomoses, secure soft tissue, and close the skin. Traumatic wounds also offer potential for skin closure products and for hemostats, and adhesion prevention during post-trauma surgery. New wound-covering sealant products may also offer potential for treatment of cuts, grazes, and burns.

Chronic wounds are generally not amenable to treatment by adhesives, sealants and hemostats unless the wound has either been debrided to a sterile bleeding surface (in which case it becomes like a surgical wound), or the product offers some stimulant activity. Many hemostats exhibit some inflammatory and cytokinetic activity, which has been associated with accelerated healing. However, this inflammatory activity has also been known to burn the patient’s skin. Chronic wounds are instead dealt with often by a combination of debridement, frequent dressing changes, products to address local vascular circulation and pressure (negative and positive) and others. Progress is being made in reducing the associated healing times, but a large opportunity remains.