Market fragmentation and growth, decline in wound management

The market for wound management products — as varied as negative pressure wound therapy, skin grafts, hydrogel dressings, and growth factors — is a sort of free-for-all of offerings designed to accelerate healing, reduce treatment costs, yield better outcomes, or all of these and more. With so many sectors, and with well-established ones tending toward commodity, there can be many competitors, with few having significant market shares. Yet in several areas, quite remarkable growth is still available.  Excluding traditional bandage and dressings, three companies — S&N, Acelity and Mölnlycke — control over half the worldwide market.

Global Advanced Wound Market Market Shares

Source: MedMarket Diligence, LLC; Report #S251. Order online.

Growth is coming in the advanced areas of bioengineered skin, the ever-needed antimicrobials, and the great demand for foam dressings.


Source: MedMarket Diligence, LLC; Report #S251. Order online.

 

Viewed another way, with size and growth mapped relative to each other…

 

Source: MedMarket Diligence, LLC; Report #S251. Order online.

The U.S. remains the biggest consumer of wound management products, and this is not expected to materially change. Europe is seeing relative decline, however, as Asia Pacific demand ramps up:

Source: MedMarket Diligence, LLC; Report #S251. Order online.


The MedMarket Diligence report #S251, “Worldwide Wound Management, Forecast to 2024: Established and Emerging Products, Technologies and Markets in the Americas, Europe, Asia/Pacific and Rest of World,” is detailed at link and is available for purchase and download online

Wound management regional growth (“rest of north america”)

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From Report S251 (see global analysis and the above detail for Americas (with detail for U.S., Rest of North America and Latin America), Europe (United Kingdom, Germany, France, Spain, Italy, and Rest of Europe), Asia/Pacific (Japan, Korea, and Rest of Asia/Pacific) and Rest of World.

Do you wish to see excerpts from “Worldwide Wound Management, Forecast to 2024: Established and Emerging Products, Technologies and Markets”?

Top Growth Wound Care Product Sales By Country

Whether sales growth arises by a preferred adoption of one technology over another or by better than average economic conditions — or both, sales of wound management products are driven by technology adoption rates that vary by country, clinical practice patterns, reimbursement and other variables.

We assessed current and forecast sales for the following products:

  • Traditional Adhesive Dressings
  • Traditional Gauze
  • Traditional Non-Adherent
  • Film
  • Foam
  • Hydrogel
  • Hydrocolloid
  • Alginate
  • Antimicrobial
  • Negative Pressure Wound Therapy
  • Bioengineered Skin & Skin Substitutes
  • Growth Factors

For all product segments but the traditional adhesive, gauze, and non-adherent wound care products (which were assessed only at the global level), we assessed growth in each of the following countries/regions: Americas (USA, Rest of North America, Latin America), Europe (United Kingdom, Germany, Italy, France, Spain, Rest of Europe), Asia/Pacific (Japan, Korea, Rest of Asia/Pacific), and Rest of World.

From our examination (report #S251) of the global market for wound management products, below are the top product-country cohorts in terms of projected compounded sales growth from 2015 to 2024.

Source: MedMarket Diligence, LLC; Report #S251.

 

Growth versus volume in medtech

See also the December 2015 report, “Worldwide Wound Management, Forecast to 2024:
Established and Emerging Products, Technologies and Markets
in the Americas, Europe, Asia/Pacific and Rest of World”, Report #S251.


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.

See the December 2015 report #S251, “Wound Management, and the July 2016 report #S290, “Sealants, Glues, Hemostats, 2015-2022.”

Global wound care market segmentation, drivers

Products and technologies used in advanced wound management have found varying degrees of success in global markets, stemming from differences in clinical practices, cultures, sensitivities, demographics and other geographically-driven differences.  At the macro view, the size of the advanced wound management market by countries falls in a typical pattern based on the relative size of the populations and healthcare markets:

world-wound-pie-countries

Source: MedMarket Diligence report #S247

The differences between these markets in their relative adoption and use of advanced wound management technologies is illustrated in the graph below, showing the percent of each country's total market that is represented by each wound product type.

wound-countries-and-segments

Source: MedMarket Diligence report #S247.

 

The size of the wound care market is ultimately determined by the clinical need for advanced wound management products. That need is most clearly reflected in the prevalence of chronic wounds and burns. Current estimates put the total annual incidence of chronic wounds at almost 9 million worldwide, and there are 177 million cases of diabetes worldwide; 10%–15% of diabetic patients will develop ulcers at some point. The market for products used in the management of specific wound types are, in decreasing size, venous stasis (as in chronic venous ulcers) decubitus ulcer (e.g., bedsores), diabetic foot ulcers and lastly (despite their acute nature) burn wonds.

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It should be noted that a large proportion of wound product sales are accounted for by traditional types of wound management products. It has been estimated that two-thirds of the world’s physicians are not making routine use of advanced wound management products. Perhaps surprisingly, U.S. physicians are much more conservative in their approach to advanced wound healing technologies than their European counterparts. For this reason, the European share of the AWC market is significantly higher than the U.S. share.

The implication is that there is significant market potential, if barriers such as cost and entrenched attitudes can be overcome. It is not yet widely appreciated, even in some parts of the developed world, that the relatively high initial cost of managing hard-to-heal wounds with advanced techniques is more than offset by the savings achieved with shorter treatment periods and reduction in the demand for skilled medical attention.

 

(From "Worldwide Wound Management, 2008-2017: Established and Emerging Products, Technologies and Markets in the U.S., Europe, Japan and Rest of World", report #S247.)

Products used in advanced wound management

The skin is our protection from the environment. The skin is a complex organ, providing protection against chemical, biological and physical insult, keeping organs and tissues in their place, and regulating various secretions including sweat (to control temperature), and pheromones (to act as sexual attractants). It is constantly renewed and maintained. Injuries to the skin cause the potential for infection and significant disruption to the healthy functioning of the tissues beneath. Healing of the skin has been an essential pre-requisite for evolutionary and individual survival, and complex biochemical systems have evolved for repair of the skin.

Injuries to the skin are caused primarily due to surgical incisions (acute wounds), whether for treatment of disease or trauma to underlying tissues or for treatment trauma to the skin.  Injuries may also be the result of burns and chronic wounds (e.g., ulcers).

Treatment of these wounds is accomplished by a wide array of product types.  Wound dressings can be divided into categories using a number of different classification systems. In this report we focus our product, marketing, and technology review on the category known as Advanced Wound Management. This includes Film dressings, Hydrocolloids, Foam dressings, Alginate Dressings, Hydrogels, Non-Adherent Dressings, Antimicrobial dressings, Cleansing and debridement products, Tissue engineered products, Pharmacological products, (including Pain control, Antibiotics, Growth Factors, Non-Growth Factor Modulators, Gene Therapy, and Scarring Modulators), Physical treatments (like pressure devices, hydrotherapy, electrical stimulation, electromagnetic stimulation, ultraviolet therapy, hyperbaric oxygen therapy, mechanically assisted wound closure devices, ultrasound, laser and information systems. Some of these product categories are well established; others are in development.

Significant growth will occur in specific market segments like the use of growth factors, physical therapies, and tissue engineering.  See the current distribution of revenues by product segment, with expanded shares of those specific segments through 2016.

 

wound-segments

Source:  MedMarket Diligence report #S245, "Worldwide Wound Management, 2007-2016: Established and Emerging Products, Technologies and Markets in the U.S., Europe, Japan and Rest of World."


See also the 2009-2013 report #S175 on surgical sealants, glues, hemostasis, wound closure and anti-adhesion.