Double-digit sales growth rates in spine surgery products

In many Western markets, spine surgery represents a mature market, with significant penetration of potential patients and caseload. Manufacturers have been able to produce innovations that have been able to command respectable premiums for a long time, and while they still represent some of the strongest growth rates in medical technology, overall revenue growth rates in spine surgery have been squeezed by procedure limitations and pressure on pricing.

Not so much the case in Asia/Pacific, Central/Latin America, and markets elsewhere in the world, where double digit spine surgery growth rates are the evident now, and will continue for the near future.

Below is illustrated the top growth (2014-2021) combinations of technologies and regional markets in spine surgery, in descending order.

Screen Shot 2015-10-06 at 11.10.30 AM

Source: MedMarket Diligence, LLC; Report #M540.

Global Spine Surgery Finding Double Digit Growth from Innovation, Economics, and Clinical Trends According to MedMarket Diligence Report

[August 21, 2015 — Mission Viejo  CA — MedMarket Diligence has published its 2015 global report on spine surgery. For details, see link.]

Decades of clinical research and medtech innovation have combined to offer solutions for every segment of the spine.  Economics and innovation have also made spine surgery one of the strongest growth of all medtech markets. MedMarket Diligence’s new global report on spine surgery device markets reveals opportunities for established, emerging, and potential medtech players.

Screen Shot 2015-08-24 at 2.03.50 PM

Screen Shot 2015-08-24 at 2.10.34 PMThe $9.17 billion global market for cervical fusion, thoracolumbar Implants, MIS spine fusion, interbody fusion, and orthobiologics has evolved dramatically over the last several decades as a result of significant advances in the understanding of spinal biomechanics, the proliferation of sophisticated spinal instrumentation devices, surgical advances in bone fusion techniques, refinement of anterior approaches to the spine and the emergence and development of microsurgical, minimally invasive methods and robotics. As a result of these advances it is now possible to stabilize every segment of the spine successfully, regardless of the offending pathology. The global market for spine surgery devices is detailed in the MedMarket Diligence report, “Global Market for Medical Device Technologies in Spine Surgery, 2014-2021.” See Report #M540.

“While this market may be dominated by the bigs — Medtronic, DePuy, Stryker, Zimmer-Biomet, et al. – there remains more than enough business in spine technology to attract a remarkably large number of mid-tier and smaller market participants,” says Patrick Driscoll of MedMarket Diligence. “And there are ample participants who do not accept the status quo, by aggressively innovating and introducing clinical and economic improvement in spine surgery.”

Spine fusion is the fastest growing technology in spine surgery and with growth in spine surgery being fastest in the Asia-Pacific and Central/Latin America, the growth of spine fusion in those areas is double-digit. The improvements in spine surgery and technology development have produced steady growth in volumes of surgeries, supported by reimbursement and clinical outcomes (and the increasingly active aging population). Spine surgery, with its exponential growth, has been the answer to an orthopaedic industry seeking to optimize earnings and add value for shareholders.

The MedMarket Diligence report, “Global Market for Medical Device Technologies in Spine Surgery, 2014-2021: Established and Emerging Products, Technologies and Markets in the Americas, Europe, Asia/Pacific and Rest of World,” (report #M540) is a detailed market and technology assessment and forecast of the products and technologies in the management of diseases and disorders of the spine. The report describes the diseases and disorders of the spine, characterizing the patient populations, their current clinical management, and trends in clinical management as new techniques and technologies are expected to be developed and emerge.

The report details the currently available products and technologies, and the manufacturers offering them. The report details the products and technologies under development and markets for each in spine surgery. The report provides a current and forecast assessment by region/country of procedures and manufacturer revenues for, specifically, Americas (United States, Rest of North America, Latin America), European Union (United Kingdom, Germany, France, Italy, Spain, Rest of Europe), Asia-Pacific (Japan, China, India, Rest of Asia/Pacific) and Rest of World. The forecast addresses the product- and country-specific impacts in the market of new technologies through the coming decade.

The report profiles 38 of the most notable current and emerging companies in this industry, providing data on their current products, current market position and products under development. The products and activities of numerous additional startup and emerging companies are also detailed in the report.

The report is described in detail at http://mediligence.com/m540/ and may be ordered for immediate download from https://mediligence.com/store/page51.html.


Until August 28, 2015, Report #M540 is available for $500 off the list price. See Spine Surgery 2015 (M540) $500 off early release

Reference reports in Ophthalmology, Coronary Stents and Tissue Engineering

MedMarket Diligence has added three previously published, comprehensive analyses of  medtech markets to its Reference Reports listings. The markets covered in the three reports are:

  • Ophthalmology Diagnostics, Devices and Drugs (see link)
  • Coronary Stents: Drug-Eluting, Bare, Bioresorbable and Others (see link)
  • Tissue Engineering, Cell Therapy and Transplantation (see link)

Termed “Reference Reports”, these detailed studies were initially completed typically within the past five years. They now serve as exceptional references to those markets, since fundamental data about each of these markets has remained largely unchanged. Such data includes:

  • Disease prevalence, incidence and trends (including credible forecasts to the present)
  • Clinical practices and trends in the management of the disease(s)
  • Industry structure including competitors (most still active today)
  • Detailed appendices on procedure data, company directories, etc.

Arguably, a least one quarter of every NEW medtech report contains background data encompassing the data listed above.  Therefore, the MedMarket Diligence reports have been priced in the single user editions at $950 each, which is roughly one quarter the price of a full report.

See links above for detailed report descriptions, tables of contents, lists of exhibits and ordering. If you have further questions, feel free to contact Patrick Driscoll at (949) 859-3401 or (toll free US) 1-866-820-1357.

See the comprehensive list of MedMarket Diligence reports at link.

 

Growth in posterior pedicle screw fusion systems in spine surgery

Posterior pedicle screw fusion systems are used extensively in spine surgery; eight or more screws may be used in a single procedure.

The posterior pedicle screw fusion system will continue to be used in spine surgery for the foreseeable future. Industry managers believe that, even as new treatments come on to the market, spinal fusion will continue to be the gold standard treatment for degenerative disc disease unresponsive to conservative measures.

The global market for posterior pedicle screw fusion systems was nearly $3 billion 2012, and is forecast to reach a value of almost $6 billion by 2020. The average selling price (ASP) is expected to drop over this period, due largely to strong competition and the sheer number of companies manufacturing and selling these devices.

pedicle-screw

Source: MedMarket Diligence, LLC: Report #M520.

A variable number of pedicles screws are used in each procedure but this number on average will remain the same through 2020.  Consequently, with prices being squeezed, unit growth will outpace dollar volume sales growth.

The global leader for posterior pedicle screw fusion systems is Zimmer, followed by Medtronic, with the two companies controlling almost 75% of the market. There are many smaller companies in this market, and all of these are targeting the same customers, creating intense pricing pressure for devices that are generally ‘me-too’ and leading to consolidation as manufacturers hit their lowest limits on cost.

 

High and low growth wound care sales by country

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.

The biggest revenue streams in spine surgery are not the fastest growing

Put simply, regardless of the relative share, differences in market growth rates or other metrics, some spine surgery technologies will generate substantially more sales than others during the 2012 to 2020 timeframe.

Looking at the MedMarket Diligence, “Worldwide Spine Surgery Data Forecast, 2010-2020”, posterior pedicle screw fusion systems and artificial cervical discs will generate the largest revenue increases over this period, since even at modest growth rates the size of the penetrated market results in big gains from 2012 to 2020. In other words, while AxiaLIF represents one of the fastest growing spine surgery device markets, the aggregate change in AxiaLIF revenues from 2010 to 2020 is only $270 million versus $2.97 billion for posterior pedicle screw fusion systems,  Here a growth rate of under 10% on such a large existing market greatly eclipses the absolute impact of a dramatic growth rate (i.e., >30%) of an emerging market.

Source: MedMarket Diligence, LLC; “Spine Surgery Worldwide Data Forecast, 2010-2020.” See link.

On a country-by-country basis, these differences are more pronounced.

Spine Surgery Geographic Markets

Technologies employed in the treatment of spine disorders and trauma have varying levels of acceptance globally.  These variations in the overall balance of different surgical spine technologies arise from the plethora of differences in local markets, even on a per capita basis.

Considering two very well developed markets — the USA and Germany — one would expect to see very similar levels of utilization of spine surgery technologies. The reality, however, is that the clinical practices, demographics, reimbursement schemes, regulatory environment, presence of locally active manufacturers and distributers and other characteristics differ enough so that the two countries have noticeably different markets for spine surgery products as represented by each country’s segmentation of the total market by spine surgery technology type. See below:

Source: MedMarket Diligence, LLC; Report #M520, “Worldwide Spine Surgery: Products, Technologies, Markets and Opportunities 2010-2020”.

[Note: The MedMarket Diligence Report #M520 details the worldwide spine surgery market by the Americas (USA, Canada, Mexico, Brazil), European Union (United Kingdom, Germany, France, Italy, Spain, Rest of Europe), Asia-Pacific (Japan, China, India, Australia/New Zealand) and Rest of World.]

Worldwide Spine Surgery Devices Market

For active or potential participants developing or marketing devices for use in spine surgery, there is no better reference source than MedMarket Diligence’s comprehensive, worldwide report on the spine surgery market.  Produced in mid-2011, the report, “Worldwide Spine Surgery: Products, Technologies, Markets & Opportunities, 2010-2020” (described in detail at link) accurately forecasts the status of the current (2012) market and provides a compelling case for its forecasts of individual technology and geographic markets through 2020.

(This report is now available at a 30% discount. Just order online and at checkout enter the coupon code “1262720736”.)

The report details the current and forecast markets, with market shares, for the following spine surgery product segments:

  • Posterior Pedicle Screw Fusion Systems
  • Anterior Cervical Plate Systems
  • Anterior Thoracolumbar Plate Systems
  • Anterior Lumbar Interbody Fusion (ALIF) devices
  • Transforaminal Lumbar Interbody Fusion (TLIF) devices
  • Posterior Lumbar Interbody Fusion (PLIF) devices
  • Axial Lumbar Interbody Fusion (AxiaLIF) devices
  • Interspinous Process Spacers (ISPs)
  • Cervical Artificial Discs
  • Lumbar Artificial Discs
  • Vertebroplasty
  • Balloon Kyphoplasty
  • Allografts
  • Demineralized Bone Matrix (DBM)
  • Bone Morphogenetic Proteins (BMPs)

The report details the products and technologies under development and markets for each in spine surgery. The report provides a current and ten-year forecast by region/country of procedures, unit sales, average selling price and manufacturer revenues for, specifically, Americas (USA, Canada, Mexico, Brazil), European Union (United Kingdom, Germany, France, Italy, Spain, Rest of Europe), Asia-Pacific (Japan, China, India, Australia/New Zealand) and Rest of World. The forecasts address product- and country-specific impacts in the market of new technologies through the coming decade. The report profiles 46 key companies in this industry, providing data on their current products, current market position and products under development.

(This report is now available at a 30% discount. Just order online and at checkout enter the coupon code “1262720736”.)

 

Anterior cervical plate systems in spine surgery

Anterior cervical plate (ACP) systems are one of several types of devices used to stabilize the spine following surgery. Others may include posterior cervical plates, posterior cervical wiring, anterior cervical interbody cages or post-operative cervical braces. An ACP is a small plate that can be attached to the front of the spine. Although this is a simple procedure, it adds significant stability to the spine. Anterior plates were first developed in the 1980s, and were initially restricted to use in long or multi-level spine fusions. Now surgeons are routinely using ACPs for single-level fusions. Attaching an ACP protects the bone graft and adds additional stability, without adding much time or labor to the cervical fusion procedure itself. ACPs tend to be fairly expensive, but they also help contribute to a speedier recovery and faster return to normal activities.

Anterior cervical plate systems are virtually commodity products. The global market for these products was $923 million in 2011, and is forecast to increase with a CAGR of 3.26% to be worth over $1.2 billion by 2020.

Source: “Worldwide Spine Surgery:  Products, Technologies, Markets and Opportunities, 2010-2020.” Report #M520.

Like many device markets, the ACP market’s biggest revenue source is the USA, followed by Japan:

Source: “Worldwide Spine Surgery:  Products, Technologies, Markets and Opportunities, 2010-2020.” Report #M520.

Key competitors in this market include Aesculap Spine, Biomet, Custom Spine, DePuy, K2M, Medtronic, NuVasive, Orthofix, Stryker and Synthes.

Global spine surgery market to shift through 2020

Driven by aging populations and technological advances leading to improved devices and less invasive surgery, and despite the current economic challenges, the overall global market for spine surgery devices is expected to see modest growth through 2020. In addition, spine surgery will increasingly be represented by minimally invasive procedures, which will be a factor in the increase in younger (under 50) patients deciding to undergo spine surgery. Then, too, many of these younger patients wish to return to the activities that may have caused their back problems in the first place. They are therefore open to undergoing spine surgery procedures, in preference to adoption of a more sedentary lifestyle.

The principal devices in spine surgery are:  posterior pedicle screw fusion systems, anterior cervical plate (ACP) systems, anterior lumbar interbody fusion (ALIF) devices, transforaminal interbody fusion (TLIF) devices, posterior lumbar interbody fusion (PLIF) devices, axial lumbar interbody fusion (AxiaLIF) devices and interspinous process spacers, cervical artificial discs, lumbar artificial discs, vertebroplasty, balloon kyphoplasty, allografts, demineralized bone matrix (DBM) and bone morphogenetic proteins (BMPs).

MedMarket Diligence’s comprehensive study of the global spine surgery market details, for all of these devices, the products on the market and in development, the active and hopeful competitors and the current and forecast markets for these products in the Americas (USA, Canada, Mexico and Brazil), the European Union (United Kingdom, Germany, France, Spain, Italy and Rest of Europe), Asia-Pacific (Japan, China, India and Australia/New Zealand) and Rest of World.

The compound annual growth rate for the entire market as defined in this study is forecast to be a modest 7% for 2011-2020, but it will be driven by higher growth in Posterior Pedicle Screw Fusion Systems and Cervical and Lumbar Artificial Discs, and lesser growth in some sectors which are of significant size, including Balloon Kyphoplasty, Allografts and DBM.  As a result, the makeup of the global spine market will be noticeably different by 2020.

Source: “Worldwide Spine Surgery:  Products, Technologies, Markets and Opportunities, 2010-2020.” Report #M520.