Growth of Ablation Technologies, Applications, Worldwide

The growth in sales of a medical technology is dictated by a unique combination of a specific technology in a specific clinical application in a specific geographic market.

In the Smithers Apex report, The Future of Tissue Ablation Products to 2020, the markets for the different ablation technology types were assessed per application in each of the major world geographies. See the groupings, below:

Ablation Types and Clinical Applications:

  • Electrosurgical/radiofrequency
    • Cardiac
    • Surgical
  • Microwave
    • Oncologic
    • Urologic
  • Laser
    • Aesthetic
    • Ophthalmic
    • Surgical
  • External Beam Radiation Therapy (EBRT)
    • LINAC Systems
    • Cobalt-60
  • Cryoablation
    • Cardiac & Vascular
    • Oncologic Surgery
    • GYN Surgery
    • Dermal/Cutaneous Surgical
  • Ultrasound
    • Ophthalmic (Cataract) Surgical
    • Multipurpose Surgical
    • Urologic Surgical
    • Multipurpose High Intensity Focused Ultrasound (HIFU)

Geographic Areas:

  • United States & Other Americas
  • Largest Western & European States
  • Major Asian States
  • Rest of World

The Smithers Apex report contains the detailed assessment of ablation technology sales in each combination of technology, geography and clinical application. Below is illustrated graphically, sorted by compound annual growth rate in sales, each of the combinations.

Growth of Ablation Technologies by Clinical Application and Geography, 2014-2020

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Source: Smithers Apex

 

Ablation and other energy-based technologies with multiple clinical applications

Manufacturers of ablation and other energy-base therapeutics are both witnessing and driving a steady evolution of multiple technologies with potential to produce therapeutic (or, in some cases, simply cosmetic) tissue effects, with different energy types competing head-on for caseload.  These innovators have continued to improve their understanding of the nature of each energy type’s impact on the target tissue(s) and have optimized the delivery to improve outcome, improve ease of use and minimize adverse collateral tissue effects or other complications.

To illustrate the breadth of applications for energy-based technologies, see the excerpt below from the table of contents to the MedMarket Diligence report #A125, "Ablation Technologies Worldwide Market, 2008-2017: Products, Technologies, Markets, Companies and Opportunities." 

 

SECTION 1:  ENERGY-BASED THERAPIES BY DISEASE STATE AND TECHNOLOGY
1.1  Cancer
1.1.1  Brachytherapy
1.1.2  Cryotherapy
1.1.3  Microwave Ablation
1.1.4  Radiation Therapy
1.1.5  Radiofrequency Ablation
1.1.6  Stereotactic Surgery
1.1.7  Laser Ablation
1.1.8  Photodynamic Therapy
1.1.9  Ultrasonic Ablation
1.2  Cardiovascular Disease
1.2.1  Angina Pectoris
1.2.2  Atrial arrhythmias
1.2.2.1  Cryoablation
1.2.2.2  Electrical Cardioversion
1.2.2.3  Microwave Ablation
1.2.2.4  RF Ablation
1.2.2.5  Temperature Controlled
1.2.2.6  Fluid Cooled
1.2.3  Bradycardia
1.2.4  Critical Ischemia
1.2.5  Vascular Occlusive Disease
1.2.6  Ventricular Arrhythmias
1.2.6.1  About ICD, CRT and CRT-D
1.2.7  Wolf-Parkinson-White Disease
1.3  Elective Surgery
1.3.1  Cosmetic Surgery
1.3.1.1  Laser Hair Removal
1.3.1.2  Port Wine Stains
1.3.1.3  Psoriasis
1.3.1.4  Varicose Veins
1.4  Ophthalmic Surgery
1.4.1  Capsulotomy Surgery
1.4.2  Laser In-Situ Keratomileusis (LASIK)
1.4.3  Laser Epithelial Keratomileusis (LASEK)
1.5  General Surgery
1.5.1  Fecal Incontinence
1.5.2  Gastroesophageal Reflux Disease (GERD)
1.6  Gynecological Applications
1.6.1  Hysterectomy
1.6.2  Menorrhagia
1.6.3  Fibroids
1.6.4  Bladder Neck Suspension
1.7  Urological Applications
1.7.1  Urinary Tract Stones
1.7.2  Benign Prostatic Hypertrophy
1.7.2.1  TUMT
1.7.2.2  TUNA
1.7.2.3  Photoselective Vaporisation of the prostate (PVP)
1.7.2.4  HoLAP
1.7.2.5  CoreTherm
1.7.2.6  TMX 3000
1.7.2.7  Prolieve
1.7.2.8  Prostiva RF Therapy
1.7.2.9  Water-Induced Thermotherapy
1.8  Tonsillectomy
1.9  Orthopedic Applications
1.9.1  Capsular Shrinkage
1.9.2  Carpal Tunnel Syndrome
1.9.3  Chondroplasty
1.9.4  Debridement
1.9.5  Epicondylitis and Tendinitis
1.9.6  Inflammatory Conditions
1.9.6.1  Nucleoplasty
 
See the report’s complete description, table of contents, and list of exhibits here.

 

Ablation and Other Medtech Developments: How to Do Things Differently, Sometimes Better

 [Insight:  One of the more fascinating aspects of medical technology development is the penchant in the industry for finding different ways to accomplish traditional tasks in medical and surgical care.  While certainly some technologies can be oversold for their putative clinical benefits — driving up healthcare costs and giving the industry a bad rap — some medtech advances indeed provide clinically better outcomes that few can legitimately argue, IMHO, as not being cost effective.  These include major technology paradigm shifts like laparoscopic surgery.  Another area that has shown a progressive set of changes to medical and, especially, surgical care, has been ablation technologies, the use of energy-based and other technologies to accomplish the dissection of tissue, the destruction of cancerous and other lesions and other functional alternation of tissue (e.g., in arrhythmia ablation) that was in most cases previously accomplished by, for the most part, a scalpel only (OK, a little simplified, but you get the idea).  These ablation technologies now represent a pretty strong market or collection of market segments that are changing the way surgeons manipulate tissue.  Below are some highlights of how the market breaks down by different modality.  We also present some of the recent M&A activity in this industry.  For additional details on ablation technologies, see the tag or category of  "ablation" (or any of the separate modalities) in this blog. – Patrick Driscoll, Founder, MedMarket Diligence]


The worldwide high energy therapies market represents a $25 billion opportunity in 2008. The category consists of therapeutic devices and equipment that deliver the controlled application of one or more modalities of energy to tissue. 

Global Ablation and Other Energy-Based Therapies 
Market Share and Compound Annual Growth Rate by Modality

 

Energy Modality
% Total Market
CAGR
2003-2013
Electrical
42%
12%
Radiation
24%
7%
Light
10%
11%
RadioFrequency
 9%
18%
Ultrasonic
 7.5%
16%
Cryogenic
 5%
18%
Thermal
 1.25%
18%
Microwave
 0.75%
22%
Hydromechanical
 0.5%
12%
 Total
100%
11%

Source:  MedMarket Diligence report #A125, "Worldwide Ablation Technologies 

The field of energy-based companies is well populated, partly because there are several different categories of energy application in clincial medicine, and because companies tend to be focused on single or tightly-focused energy applications. Thus there are companies specialising in cryoablation, thermal ablation, electrosurgery, brachytherapy and so on. Many companies have entered this field offering a new technology in one particular form of energy application.

A growing tendency in recent years has been the acquisition by larger, multifunctional medical device companies of smaller and often newer energy-based companies, as a means of adding a new technology to their portfolio. The past five years have seen many mergers and acquisitions of this kind involving energy-based companies. Exhibit 4-1 shows some examples of M&A activity from the past three years. 

M&A Activity Among Energy-based Companies
 
Acquirer
Target
Year
Technology
Cytyc
Proxima Therapeutics
2005
Radiation Therapy
Angiodynamics
RITA
2007
RFA
Hologic
Cytyc
2007
Endometrial ablation
St Jude
EP Medical Systems
2008
Cardiac electrophysiology
Boston Scientific
Guidant
2006
Pacemakers, defibrillators, etc
Olympus
Gyrus
2007
Radiofrequency
HealthTronics
Advanced Medical
Partners
2008
Cryotherapy
American Medical Systems
Laserscope
2006
Laser therapy
Galil Medical
Oncura
2006
Cryoablation
Guidant
AFx
2004
Microwave
Warburg Pincus
Bausch & Lomb
2007
Excimer laser
Valleylab (Covidien)
Vivant
2005
Microwave
Olympus
Celon
2004
Radiofrequency thermotherapy
TheraGenics
Galt Medical
2006
 
Gyrus
ACMI
2005
Thermal therapy
Guidant
AFx
2004
Microwave
Boston Scientific
Cryocor
2008
Cryoablation
HealthTronics
Endocare
2008 (pending)
Cryoablation

Source:  MedMarket Diligence report #A125, "Worldwide Ablation Technologies