Growth of modalities in tissue ablation

An examination of the future markets for technologies used in therapeutic ablation has support for a general and sustained growth in ablation technology revenues:

Ablation-modality-growth-revenues

Source: Report #A145

However, when considering the relative growth of each of the modalities in tissue ablation, it is clear that some modalities are growing more aggressively than others:

Ablation-modality-growth-shares

Source: Report #A145

The “traditional” types of tissue ablation — electrosurgery and radiation therapy — are losing relative share as new modalities are able to penetrate caseload of other modalities, or even tap previously untreated patients and increase the aggregate caseload. In particular, radiofrequency and cryotherapy will demonstrate the highest growth over the 2011 to 2019 period.

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Tissue ablation is predominantly cancer therapy

Tissue ablation is defined as the “removal of a body part or the destruction of its function, as by surgery, disease, or a noxious substance.” Put more simply, ablation is considered to be a therapeutic destruction and sealing of tissue.

The technologies representing the majority of physical (rather than chemical) ablation are comprised of the following:

  • Electrical
  • Radiation
  • Light
  • Radiofrequency
  • Ultrasound
  • Cryotherapy
  • Thermal (other than cryotherapy)
  • Microwave
  • Hydromechanical

Source: Report #A145, "Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities."

The largest share of the market for energy-based ablation devices is used in cancer therapy, primarily using the radiation therapy modality. Following that is general surgery with its use of electrocautery and electrosurgical devices, RF ablation, cryotherapy, etc. Cardiovascular is thought to be third, even though cardiovascular is making the most noise in the medical press with RF and cryoablation of atrial fibrillation, this segment is thought to be third in share order. The remaining applications are relatively small and fall in line behind the three leading sectors.

Growth in the Asia/Pacific Market for Ablation Technologies

 

The Asia-Pacific market for ablation technologies looks quite different from the Americas and European Union. Here, at present, the largest market is Japan, which accounts for the majority of the market, although by population and current growth rates, the People’s Republic of China has the greatest potential. Its greater than 1.3 billion population and, more importantly, the healthcare infrastructure that the government is putting into place ensure that China will continue to comprise an ever greater share of this market.

Asia-pacific-ablation

Data in the exhibit is drawn from MedMarket Diligence report #A145, "Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities."

 

 

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Ablation technology markets

Ablation technologies are used to destroy ("ablate") diseased or traumatized tissue for therapeutic benefit.  This includes destruction of cancerous tumors, ablation of endometrial tissue associated with endometriosis or abnormal uterine bleeding, creation of myocardial lesions to block the errant electrical signals in arrhythmia, and numerous others.

The largest share of the market for energy-based ablation devices is used in cancer therapy, primarily using the radiation therapy modality. Following that is general surgery with its use of electrocautery and electrosurgical devices, RF ablation, cryotherapy, etc. Cardiovascular applications are growing, particularly for cryoablation and radiofrequency ablation for arrhythmia, and now represent hold the third largest clinical area of ablation. The remaining applications are relatively small and fall in line behind the three leading sectors.

In the aggregate (i.e., for each modality worldwide), the largest segment is radiation-based ablation technologies, based to a large degree on the cost of the systems and their well-established use in clinical practice. 

Below is a chart of the 2011 markets for ablation technologies by modality, with their projected compound annual growth rates (CAGRs) from 2011 to 2019.

Source: "Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities" (MedMarket Diligence Report #A145)

Ablation technologies proliferate from their many clinical benefits

Surgical management of soft tissues via "ablation" therapies, in which alternative energy types (radiation, electrosurgcal, ultrasound, etc.) are applied to excise, destroy, or otherwise produce a therapeutic effect at the tissue level has undergone a proliferation in development with all of these alternatives vying for caseload in clinical applications as diverse as tumor ablation, arrhythmia ablation, endometrial ablation for treatment of endometriosis, ophthalmic procedures for vision and disease treatment, cosmetic, and many others.

The alternatives run the gamut from well established, high volume, low growth procedures like conventional x-ray to emerging, relatively low volume, high growth procedures like microwave ablation in cancer and arrhythmia ablation, and every other type of procedure in between.

Below illustrates the growth versus market size distribution of ablation technology alternatives.

ablation-bubbles

Source:  MedMarket Diligence, LLC; Report #A125, "Ablation Technologies Worldwide:  Products, Technologies, Markets, Companies and Opportunities."

 

Select technologies in ablation are among the most dynamic growth markets in the entire medtech sector.  The therapeutic and other benefits with these technologies included that they are typically less invasive than traditional surgery and are generally employed without the need for an implant. The therapies can be precisely metered and can be repeated. Emerging energy modalities therefore have the potential to grow at significant, double-digit rates over the next decade as delivery systems evolve.

Energy-based therapeutics markets by clinical application

Energy-based therapeutics include technologies to effect the destruction or treatment of tissues to remove pathology or otherwise modify tissue (e.g., for creating lesions that block the aberrant signals in arrhythmia).  These technologies include radiofrequency, microwave, laser/light, microwave, cryo, hydromechanical, ultrasound and thermal.

Some sectors of the energy-based market are growing steadily, others more rapidly. RF ablation is seeing lively growth, as are cryotherapy and microwave therapy. Overall, the market is estimated to be increasing at more than 11% per annum, which is significantly higher than growth of the medical device market overall. The buoyancy in the energy-based sector is due partly to increased uptake of these technologies and partly due to introduction of technology refinements, which in turn lead to increased usage. There is also the demographic factor; many of the conditions for which ablation products are used are commoner among older than younger patients, and lengthening life expectancy makes its own contribution to market growth.

Certain clinical sectors demonstrate a more significant share of the ablation market due to the prevalence of diseases and disorders that are amenable to these treatments.  See the current segmentation of the ablation market by clinical application.

energy-by-applicatoins

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

Cardiovascular applications represent the most significant application, due to the existing caseload and the adoption of ablation technologies, especially in arrhythmia management.  Secondarily, but perhaps with an even greater upside potential, is cancer therapeutics.  

Below see the current distribution of ablation therapy markets across different solid tumor types.

solid-cancers-ablation

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

 

High Growth Markets in Ablation Technologies

A cursory review of data in the recent MedMarket Dilgence report #A125 reveals the countries with the highest expected growth rates in markets for ablation technologies.

Based on the growth in the ablation modality segments (e.g., radiofrequency, microwave, cryosurgery, thermal, ultrasound, etc.)  that comprise each country’s total ablation market, the countries with the highest ablation market growth are India and China.  The high growth in these countries ensues from how nascent these markets are, since potential application of ablation in these countires have yet to be tapped to any significant extent (the current market for ablation in India is $190 million compared to the U.S. market at $12.9 billion).

 

Ablation Technologies Market by Country
Compound Growth Rate 2008 to 2017

 

 
Country/Region
CAGR 2008-2017
India
23.2%
China
22.6%
BeNeLux
22.2%
Mexico
19.6%
Spain
19.3%
Australia
18.5%
Italy
17.6%
France
16.5%
Brazil
15.9%
United Kingdom
15.9%
Japan
15.1%
Germany
14.7%
Canada
14.6%
U.S.A.
12.5%
Rest of World
12.1%
 
Source: Report #A125, Worldwide Ablation Technologies