Growth versus volume in medtech

One of the more interesting aspects of well-established markets that have significant volume in medical technology product sales is that the revenue and the caseload are sufficient to drive fairly a continuous range of technologies that will meet patient demand. As a result, there tends to be a continuum between high-volume, low-growth and low-volume high-growth. This significance should be apparent to active or potential market participants.

This continuum can be represented in two noteworthy ways, each of which illustrates the inverse relationship between the size of a market segment and its growth. For example, one of the most well established medtech markets is traditional bandages and dressings in wound management. These are simple to manufacturer, applicable to a wide range of wound types, require little clinician knowledge to use and, therefore, widely used throughout the world. They represent very large volume, in the $billions worldwide. At the other end of this spectrum are emerging technologies such as the use of growth factors in wound management. They have a large, as yet untapped potential, so their anticipated growth is high, while their current volume still remains very low, at least by comparison to traditional wound dressings.

Here is how these two technologies appear at the ends of the spectrum in wound management, between which are large numbers of different wound management technologies.
20140523-114241-42161375.jpg
Source: MedMarket Diligence, LLC; Report #S249.

The second way this can be represented is the relative share of the market represented by each as they change over time given their differing sales growth rates. Below is an illustration of the net change in share of the total market for wound management products by each product type. Again, there is a noticeable continuum.

20140523-114506-42306054.jpg

Source: MedMarket Diligence, LLC; Report #S249.

Wet wounds or dry wounds: film dressings in wound management

From "Worldwide Wound Management, 2008-1017," Report #S247

Prior to the late 1970s it was thought that wounds needed to dry out to prevent infection, form a scab, and subsequently heal well underneath the scab. In the late 1970s new work on occlusive film materials demonstrated that wounds heal better if a moist environment is maintained. A number of transparent film dressings are now commercialized under brand names such as Bioclusive, Opsite, and Tegaderm. Transparent film dressings can be made to have moisture vapor transmission levels from zero g/24h/m2 (occlusive) to levels beyond 3000 g/24h/m2 (semi-occlusive). If the speed of exudates production by the wound exceeds the moisture vapor permeability (MVP), then the film dressing effectively proves an occlusive barrier, although technically the dressing is still semi-occlusive. Indeed, gases will still be transmitted across the wound dressing. All film dressings provide a covering that is impermeable to microbes and therefore they protect the wound from infectious agents such as bacteria, viruses and fungi.

Transparent films that create a moist wound environment provide a semi-occlusive barrier that allows active wound fluid and cells to function in a physiological environment. Film dressings prevent scab formation, isolate the wound from contamination by microbes, and allow more rapid granulation and epithelialization of the wound surface. Film dressings are used to protect from friction and shear, and can serve as barriers to moisture. They are also useful as retention dressings and provide the proper environment for autolytic debridement. Film dressings in larger sizes serve as surgical drapes during surgery or in smaller sizes as I.V. catheter retention dressings. These applications for film dressings are designed to prevent movement of microbes from surrounding skin to the injury site. This is important because many microbes have an almost commensal relationship with normal skin. To remove them completely often requires injury to the skin, and yet if they are allowed to grow in wounds they can reach concentrations that become pathologic.

Companies in the Films Dressings Wound Management Market

  • 3M Health Care
  • Advanced Medical Solutions
  • AmeriDerm
  • B. Braun
  • BSN medical
  • DermaRite Industries
  • DeRoyal
  • Hartmann
  • Kendall (Covidien)
  • Lohmann & Rauscher
  • Medline Industries
  • Molnlycke
  • Smith & Nephew
  • Swiss American Products/Elta
  • Systagenix Wound Management*
  • Uromedical

Most film dressings on the market today are made of polyurethane film with acrylic adhesives and a disposable support or application system integrated into the design. The support function may provide a secondary function such as serving as a wound-tracing device for record keeping. Films differ in MVTR and extensibility or elasticity. Wound dressings generally provide a low to moderate MVTR (500 to 2,000 gm/24h/m2), whereas film dressings with MVTRs greater than 3000 gm/24h/m2 are produced for specialty applications such as surgical drapes or catheter retention dressings. These dressings are specially designed to allow all moisture at the surface of the skin to escape from the skin surface, to keep infectious agents out of the site, and to prevent the natural skin flora from infecting the wound site.

See Report #S247


Purchase for download: "Wound Management 2009 (PDF)" — $3,250.00
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Advanced wound care technologies target high costs, according to new MedMarket Diligence report

September 21, 2009 (For Immediate Release)

While the huge $5 billion global market for wound management technologies may not suggest it, many of its products are designed to target the high cost of wound healing. Chronic wounds and non-healing wounds. See the 2009 MedMarket Diligence report.

FOOTHILL RANCH, CA — Advanced wound management technologies — those used in the clinical management of wounds (not OTC) — represent a $5 billion global market that will triple in the next ten years.  These technologies have continued to evolve beyond simple dressings and bandages to be able to accelerate wound healing, improve clinical outcomes and, in particular, attempt to reduce the cost of managing wound types like arterial, venous, diabetic and stasis ulcers.

The distribution of the advanced wound care market across these different wound care types has continued to shift, especially with the development and application of more expensive wound care technologies, which have been incentivized by the high cost of chronic wounds.  Physical therapies, which include negative pressure devices, positive pressure devices, mechanically assisted wound closure, hydrotherapy, electrical stimulation, ultraviolet therapy and others, are demonstrating the largest relative growth.

The MedMarket Diligence report, "Worldwide Wound Management, 2009:  Established and Emerging Products, Technologies and Markets in the U.S., Europe, Japan and Rest of World," published September 2009, details the complete range of products and technologies used in wound management and wound care, from dressings, bandages, hydrogels, tissue engineered products, physical treatments and others. The report details current clinical and technology developments in this huge worldwide market with high growth sectors, with data on products in development and on the market; market size and forecast; competitor market shares; competitor profiles; and market opportunity. The report provides full year (actual) 2008 market size and share data, with forecast market data to 2017, for the U.S., Europe, Asia/Pacific and Rest of World.

"The intense focus of healthcare reform on the cost of medical technologies might examine wound management as a cost driver, but the reality of products and development in this area is that the high cost of chronic or non-healing wounds is the prime target of the wound management industry’s efforts," says Patrick Driscoll of MedMarket Diligence, publisher of the 2009 Worldwide Wound Management Market report.  According to Driscoll, the high direct and indirect costs of chronic wounds have created an economic opportunity that sustains advanced technology development.  This does not make wound care exempt from the focus of healthcare reform, but does weaken the argument against the "high costs" of advanced technology development.

The report is described in detail at http://mediligence.com/rpt/rpt-s247.htm. It may be purchased online at http://www.mediligence.com/store/page31.html or it may be ordered via fax order form http://mediligence.com/order_forms/s247_order.pdf.

Tags: woundcare, wound management

 

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Purchase for download: "Wound Management 2009 (PDF)" — $3,250.00
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Growth in non-U.S. wound management markets

The U.S. market for wound management products, like many markets, towers over all other country markets, but outside the U.S., the largest markets for wound management technologies are Germany and Japan, and these two markets are remarkably similar in size and growth, if not in cultural or economic drivers.

Japan 

It is estimated that more than 1 million people in Japan are treated for wounds every day. There are roughly 5,500 new cases of diabetes every year. There are now roughly 8.2 million Japanese suffering from diabetes with a total 18.7 million people including pre-diabetic subjects, according to The Japan Diabetes Society.

The potential market opportunity offered by the caseload of decubitus ulcers may be gauged from the fact that the total of infirm elderly is expected to be 3.5 million in 2010. Among elderly individuals who are bedridden, 75% have been in this situation for more than one year and 53% for more than three years.

Germany

Patients in Germany have free access to physicians and this means that patient preference influences prescribing, so “patient-friendly” products have an advantage. There is a tendency to favor the longer-established products in the AWM category in order to control costs; thus hydrocolloids are growing at around 5% per annum while films and hydrogels are growing only slowly, while alginate and foam products have seen vigorous sales growth.

Wound healing agents have the biggest share of the German non-prescription medical market. The aggregate German advanced wound care market is estimated to grow at over 12% per year from a value of $592.1 million in 2008.

Below are the major non-U.S. markets for wound management, mapped by size and growth (CAGR 2008-2017).
 

wound-management-non-US

Source:  MedMarket Diligence, LLC;  Report #S247, "Worldwide Wound Management Market, 2008-2017."


Purchase for download: "Wound Management 2009 (PDF)" — $3,250.00
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Industry report on global wound management publishing this week

Worldwide Wound Management, 2008-2017: Established and Emerging Products, Technologies and Markets in the U.S., Europe, Japan and Rest of World

 250 pages · 60 Exhibits · 60 Company Profiles · Report #S247 · September 2009

This report details the complete range of products and technologies used in wound management and wound care, from dressings, bandages, hydrogels, tissue engineered products, physical treatments and others. The report details current clinical and technology developments in this huge worldwide market with high growth sectors, with data on products in development and on the market; market size and forecast; competitor market shares; competitor profiles; and market opportunity.

This report details the current and projected market for wound management products, including dressings, closure devices, debridement, pharmacological products, tissue engineered products and others. Particular emphasis is placed on advanced and leading edge developments (i.e., those approaching wound management from novel perspective) such as growth factors, stem cells, gene therapy and other approaches, while baseline data (current and forecast market size and current competitor market shares) is provided for established segments — multiple dressings types (film, foam, alginate, antibacterial, non-adherent), hydrogels, hydrocolloids, pharmaceuticals, and physical treatments. The report details the clinical and technology developments underlying the huge and evolving worldwide wound care market, with data on products in development and on the market; market size and forecast; competitor market shares; competitor profiles; and market opportunity. Separate size, growth and competitor data are presented for the U.S., leading western European countries, Japan and the Rest of World category. The report profiles leading and emerging companies, with profiles providing detailed profile information on major competitors, brief profiles of companies with less sizeable current or potential positions in the market, and additional profiles of companies with novel or advanced wound care research activities in the market.

The report establishes the current worldwide market size for major technology segments as a baseline for and projecting growth in the market over a ten-year forecast and assesses and projects the composition of the market as technologies gain or lose relative market performance over this period.

 

See link for report description, complete table of contents and list of exhibits.

 

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Surgical, traumatic, burn, and chronic wounds driving wound care products market

See also the 2013 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”.

Wound management encompasses a wide range of products: fabric dressings, first aid dressings, dressings and internal wound management products for surgery, advanced wound management products, active pharmaceutical wound care products, tissue engineering, physical therapies for wound care, and pressure relief products and skin treatments, for preventative wound management.

MedMarket Diligence is finalizing its analysis (publication September 2009) of the global market for wound management products (Report #S247).  Following is an excerpt from the 2007 analysis (provided as a point of reference only;  more current data is under review).


WOUND PREVALENCE

Surgical Wounds

Surgical wounds account for the vast majority of skin injuries. We estimate that there are over 100 million surgical incisions a year requiring some wound management treatment. Approximately 80% of these wounds use some form of closure product (sutures, staples, and tapes). Many employ hemostasis products, and use fabric bandages and surgical dressings.

Surgical wounds are projected to increase in number at an annual rate of 3.1%, but overall the severity and size of surgical wounds will continue to decrease over the next ten years as a result of the continuing trend toward minimally invasive surgery.

Surgical procedures generate a preponderance of acute wounds with uneventful healing and a lower number of chronic wounds, such as those generated by wound dehiscence or post-operative infection. Surgical wounds are most often closed by primary intention, using products such as sutures, staples, or glues, where the two sides across the incision line are brought close and mechanically held together. Surgical wounds that involve substantial tissue loss or may be infected are allowed to heal by secondary intention where the wound is left open under dressings and allowed to fill by granulation and close by epithelialization. Some surgical wounds may be closed through delayed primary intention where they are left open until such time as it is felt it is safe to suture or glue the wound closed.

A significant feature of all wounds is the likelihood of pathological infection occurring. Surgical wounds are no exception, and average levels of infection of surgical wounds are 7 to 10 percent dependent on the procedure. These infections can be prevented by appropriate cleanliness, surgical discipline and skill, wound care therapy, and antibiotic prophylaxis. Infections usually lead to more extensive wound care time, the use of more expensive products and drugs, significantly increased therapist time, and increased morbidity and rehabilitation time. A large number of wounds will also be sutured to accelerate closure, and a proportion of these will undergo dehiscence and require aftercare for healing to occur.

Traumatic Wounds

There are estimated to be 1.5 million cases of traumatic wounding every year. These wounds required cleansing and treatment with low adherent dressings to cover them, prevent infection, and allow healing by primary intention. Lacerations are a specific type of trauma wound that are generally more minor in nature and require cleansing and dressing for a shorter period of healing. Lacerations occur frequently (approximately 19 million cases a year) as a result of cuts and grazes and can usually be treated within the doctor’s surgery and outpatient medical center and hospital accident and emergency department.

Burns

Burn wounds can be divided into minor burns, medically treated, and hospitalized cases. Out-patient burn wounds are often treated at home, at the doctor’s surgery, or at outpatient clinics. As a result a large number of these wounds never enter the formal health service system. We estimate that approximately 3.3 million burns in this category do enter the outpatient health service system and receive some level of medical attention. These burns use hydrogels and advanced wound care products, and may even be treated with consumer based products for wound healing. Medically treated burn wounds usually get more informed care to remove heat from the tissue, maintain hydration, and prevent infection. Advanced wound care products are used on these wounds. Approximately 6.3 million burns like this are treated medically every year. Hospitalized burn wounds are rarer and require more advanced and expensive care. These victims require significant care, nutrition, debridement, tissue grafting and often tissue engineering where available. They also require significant aftercare and rehabilitation to mobilize new tissue, and physiotherapy to address changes in physiology.

Chronic Wounds

Chronic wounds generally take longer to heal and care is enormously variable, as is the time to healing. There are approximately 7.4 million pressure ulcers in the world that require treatment every year. Many chronic wounds around the world are treated sub-optimally with general wound care products designed to cover and absorb some exudate. The optimal treatment for these wounds is to receive advanced wound management products and appropriate care to address the underlying defect that has caused the chronic wound; in the case of pressure ulcers the causal effect is pressure and a number of advanced devices exist to reduce pressure for patients. There are approximately 11 million venous ulcers, and 11.3 million diabetic ulcers in the world requiring treatment. Chronic wounds are growing in incidence due to the growing age of the population, and due mostly to awareness and improved diagnosis. At present these factors are contributing to growth of this pool of patients faster than the new technologies are reducing the incidence of wounds by healing them.

Wound management products are also used for a number of other conditions including amputations, carcinomas, melanomas, and other complicated skin cancers, which are all on the increase.

Worldwide Wound Prevalence by Etiology

wound-prevalence

Source:  MedMarket Diligence report #S247 (See also the 2013 report #S249)


(See also the related report #S175 on “Worldwide Surgical Sealants, Glues and Wound Closure, 2009-2013.”)

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Worldwide Wound Management, 2009-2018

Wound management demands globally are as considerable as the range and diversity of therapeutic options to deal with them. Surgical, traumatic, burn, ulcer and other wound types are highly prevalent, growing in caseload and expensive when they fail to promptly heal.  epidermisNew products are steadily impacting the market, while development continues on many fronts including novel wound closure, debridement, dressings, physical therapies and others. MedMarket Diligence's 2009 report, "Worldwide Wound Management, 2009-2018:  Established and Emerging Products, Technologies and Markets in the U.S., Europe, Japan and Rest of World" (see link) is a thorough analysis of the current and forecast market for these products. 

See report description:

This report details the complete range of products and technologies used in wound management and wound care, from dressings, bandages, hydrogels, tissue engineered products, physical treatments and others. The report details current clinical and technology developments in this huge worldwide market with high growth sectors, with data on products in development and on the market; market size and forecast; competitor market shares; competitor profiles; and market opportunity. (Continued at link.)