Advanced Wound Management Worldwide Driven By Perceived Outcomes, Cost

For centuries, most wound care has been characterized by simple methods to clean and dress wounds to limit infection and otherwise leave the healing process to its natural course.  For a substantial volume of patient caseload globally, this approach will remain in place until modest improvements on inert dressings (e.g., antimicrobials, hydrogels, bioactive ingredients, etc.) are demonstrated to buyers as offering a perceived improvement on outcomes without a substantial increase in cost.  Beyond this, more advanced wound products such as growth factors, engineered skin or other grafts, negative pressure wound therapy and other physical systems (e.g., ultrasound, electrical stimulation, etc.) will not appreciably penetrate routine wound caseload.

Traditional wound management products still represent such a significant share of the total market that considerable improvement in outcomes, improved economic conditions in global markets or drop in the manufacturing cost and distribution of products will have to transpire to dislodge traditional product caseload, despite the fact that advanced products are demonstrating rapid growth.

s249-size-growth

 

Source: Worldwide Wound Management Market, 2013-2021 (Report #S249); MedMarket Diligence, LLC

Growth of wound care product sales worldwide

Wound care product sales are growing at wildly variable rates around the world, with extremes spanning from the emergence of new technologies in rapidly growing economies to the technologies with low innovation in sluggish economies.

MedMarket Diligence’s global analysis of wound care products, technologies, companies and markets reveals the full spectrum of growth rates for well established to rapidly emerging products.

Below is illustrated the high growth country/product segments in wound management, reflecting the rapid adoption of new technologies such as growth factors and bioengineered skin, as well as older products such as alginates that are gaining sales in rapidly developing economies.

wound-country-high

Source: MedMarket Diligence, LLC; Report #S249, “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.”

At the other end of the extreme are those very well established products growing at less than anemic rates in countries where the economy is not as robust and/or where the growth has been superseded by sales of more novel products. Conventional dressings and bandages offer considerably less demand than do growth factors, bioengineered skin and skin substitutes and similar new products.

wound-country-low

Source: MedMarket Diligence, LLC; Report #S249

Of course, growth of sales in wound management products (and any product) is defined as the percentage change in sales volume over time. Smaller markets (typically soon after they have formed as a result of their initial commercialization) tend to grow on a percentage basis much faster. Indeed, a $1 dollar sale in year 1 followed by a $2 sale in year 2 represents a 100% growth rate, while a $1 increase in sales from year 1 to year 2 for a $100 million market represents virtually zero growth. Conversely, a 1% increase in a $1.75 billion market is a $17.5 million increase. This is indeed obvious, but must be kept in mind when considering the growth rates discussed above.

Technologies at Recently Identified Medtech Startups

Below is a list of the technologies under development at companies recently identified and included in the Medtech Startups Database:

  • Cranial support device to reduce pediatric (infant) pressure ulcers and plagiocephaly.
  • Developing a leadless implantable cardioverter defibrillator.
  • Device and algorithm to determine the apnea-hypopnea index in diagnosis of sleep apnea.
  • Ventricular catheters for CSF shunts and drains.
  • Implant remote sensor technology.
  • Lumbar interbody spine fusion
  • Intramedullary rods and other orthopedic implants.
  • Single-use device to prevent postpartum hemorrhage.
  • Minimally invasive treatment for mitral regurgitation.
  • Laparoscopic suture technology.
  • Catheters and stent grafts for percutaneous femoral artery bypass.
  • Fracture fixation and other orthopedic devices.
  • Low cost kyphoplasty technology.
  • Fluorescence-based, non-invasive monitoring of glomerular filtration rate for point-of-care use in nephrology

For a detailed listing of technologies at previously identified medtech startups see link.

 

 

Wound management: current and future markets

The global wound care market is expected to always be represented by sizeable share of basic products in wound dressings and bandages, which for the majority of wound types have clearly proven to be cost effective in producing acceptable time-to-healing and other clinical outcomes. However, advanced wound products to address complex wound types – many of which may simply evolve from otherwise simple wounds that have been neglected – are increasingly demonstrating their potential for accelerating the pace and therefore reducing the cost of wound healing.

The result is that well established wound care products that have largely tapped most of their potential patient populations have relative flat growth in sizable current sales. Emerging technologies, on the other hand, are in various stages of being developed and introduced, so they have considerable potential yet to be realized.

Illustrating this are the graphs below representing the current market size of major wound segments and the compound sales growth over the 2013-2021 forecast period, respectively.

Wound_segment_size-2013

 Source: MedMarket Diligence, LLC; Report #S249.

 Wound_segment_growth_2021

 Source: MedMarket Diligence, LLC; Report #S249.

But factors other than cost-consciousness are driving the advanced wound care market. Patients’ desire for less scarring, as well as an increased awareness of infection issues, drive the development of advanced dressings and biomaterials that reduce bacteria and heal wounds faster. An aging world population and lifestyle changes that contribute to disease frequency also factor into the market’s continued growth.

Still, there are some market restraints, primarily the high cost of new technologies. 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 more advanced wound management technologies. Improved wound prevention and a lack of regulation on tissue engineering in the EU are also expected to withhold the development of new technologies.

Medtech Fundings for August 2013

Medtech fundings for August 2013 got off to a fast start with the huge ConforMIS funding. Fundings for the month now stand at $462 million. The top fundings are shown below:

  • ConforMIS has raised $167.7 million (patient-specific total knee replacement)
  • Tengion has raised $74.3 million (tissue regeneration technologies)
  • Organovo Holdings has raised $46.6 million (“organ printing” technology)
  • SetPoint Medical has raised $31 million (bioelectronics for neuromodulation)
  • InfraReDx, Inc., has raised $25 million in a private funding from Nipro Corporation (intravascular imaging)

For the complete list of August 2013 medtech fundings, see link.

[For historic medtech funding data during the 2009-2013 period, see link.]

Wound management technologies, worldwide growth

The global wound care market is expected to always be represented by sizeable share of basic products in wound dressings and bandages, which for the majority of wound types have clearly proven to be cost effective in producing acceptable time-to-healing and other clinical outcomes. However, advanced wound products to address complex wound types – many of which may simply evolve from otherwise simple wounds that have been neglected – are increasingly demonstrating their potential for accelerating the pace and therefore reducing the cost of wound healing.

But factors other than cost-consciousness are driving the advanced wound care market. Patients’ desire for less scarring, as well as an increased awareness of infection issues, drive the development of advanced dressings and biomaterials that reduce bacteria and heal wounds faster. An aging world population and lifestyle changes that contribute to disease frequency also factor into the market’s continued growth.

Still, there are some market restraints, primarily the high cost of new technologies, which therefore must demonstrate better outcomes and/or lower long-term costs. 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 more advanced wound management technologies. Improved wound prevention and a lack of regulation on tissue engineering in the EU are also expected to withhold the development of new technologies.

A high number of manufacturers competing for market share have also driven down prices. In 2009, the top wound care companies included Johnson and Johnson, Kinetic Concepts Inc. (KCI), Hill-Rom and Smith & Nephew. These four companies were responsible for 60 percent of total market revenue in 2009. However, mergers, acquisitions and sales of intellectual property can rapidly change the market share picture. In June 2009, Hill-Rom sold its intellectual property relating to negative pressure wound therapy to KCI. By end 2012, about 56% of the wound care market was held by Johnson and Johnson, 3M, Smith & Nephew, and Systagenix.

Below is illustrated the global market for traditional and advanced products in wound management, with the compound growth rate in sales of individual product types ranging from a low of under 3% to a high of 19% through the forecast period (i.e., to 2021).

wound-2012-2021

Source: MedMarket Diligence, LLC; Report #S249, “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”.

Technologies at Recent Medtech Startups

Below is a list of the technologies under development by startups recently identified and included in the Medtech Startups Database:

  • Monitoring catheters during minimally invasive (interventional) cardiovascular surgery.
  • Biomatarials for bone regeneration.
  • Adult stem cell-based implant to stimulate bone regrowth.
  • Percutaneously transplanted valve for treatment of congestive heart failure.
  • 3D live, microscopic imaging technology for in vitro and in vivo use.
  • Devices for prevention of nasal MRSA colonization.
  • Undisclosed neuro technology.
  • Devices for treatment of vascular occlusion and embolization.
  • Hypothermia for hypoxic-ischemic brain and spinal cord trauma.
  • Transcatheter interarterial shunt for treatment of diastolic heart failure.

For a historical list of technologies at medtech startups see link.