Whenever we complete a new analysis of the global wound management market, as we have just done, we like to present top line findings, such as the top “region-wound segment” growth markets.
We assess the 10-year sales size and growth for 13 different wound product segments worldwide, in major geographic regions and individual countries — USA, Rest of N. America, Latin America, Europe, United Kingdom, Spain, France, Germany, Italy, Rest of Europe, Asia/Pacific, Japan, Korea, China, Rest of Asia/Pacific, Rest of World.
Below we show the top 15 combinations of regional market and product segments in descending order of their compound annual growth rate from 2017 to 2026.
As becomes clear, the greatest relative growth in sales in the area of wound management is in several wound care product types — bioengineered skin & skin substitutes, growth factors — and the geographic regions of Japan, Rest of World, China, Germany, Asia-Pacific. This reflects the high level of investment and attention in Asian markets, especially China.
[The complete set of wound market forecast data, from 2016 to 2026, is available at 2018 Wound Management Report #S254. The associated full report, including this data, will be publishing February 2018.]
Over the 2017 to 2026 period, the compound annual growth rate for the entire wound management market will approach 6%, a respectable rate of growth for an established market, though not quite high enough to encourage investment in the market as a whole.
Of course, the total wound market is comprised of a number of VERY large, slow-growing segments, like traditional adhesive dressings, gauze dressings, and non-adherent dressings, which have annual sales at $3.8 billion, $3.2 billion, and $1.3 billion, respectively.
The large volume, slow growth of the aggregate masks growth in the following segments:
Bioengineered skin and skin substitutes
These wound care segments have had, and will continue to have, annual growth rates at or near double-digit through 2026.
The end result of variable growth rates is that the 2026 Wound Care Market (worldwide), by comparison to 2017, will show the following changes (up/down) in each segment’s share of the total market.
Bone Morphogenetic Proteins (BMPs) are a group of growth factors and cytokines known for their ability to induce the formation of bone and cartilage. Dr. Marshal Urist initially discovered the activity of bone morphogenetic proteins in 1965. Since then, a number of types of BMP have been discovered; some have found therapeutic uses in areas such as spinal fusion. The use of BMPs adds from $6,000 to $10,000 to the cost of surgery, but this may be slight relative to the cost of repeated surgical interventions that may be needed if BMPs are not used.
Bone growth stimulatory proteins, peptides and devices
Bone Growth Protein (AC-IOO)
B2A Peptide combined with HA/TCP (Amplex)
Bone Growth Protein (UCB-I)
Growth Differentiation Factor 5 (GDF-5)
Medtronic Sofamor Danek
Bone Morphogenetic Protein-2 (InFuse)
STO 1 Spine Fusion Device
Osteogenic Protein- 1 (OP-I)
Source: MedMarket Diligence report #M510, Worldwide Spine Surgery 2008-1017.
BMPs are the only known proteins capable of inducing new bone formation. In some tests, they have demonstrated bone growth stimulation superior to that of autogenous bone graft. Two recombinant rhBMPs and associated carrier/delivery systems have received approval from the FDA: OP-1 (Stryker) and the InFUSE™ system (Medtronic). OP-1 consists of rh-BMP-7 and bovine collagen, which is reconstituted with saline to form a paste. The addition of carboxymethylcellulose forms a putty. The InFUSE™ system consists of rh-BMP-2 on an absorbable collagen sponge carrier. To date, rhBMP-2 has been approved by the FDA for the treatment of L5-S1 degenerative disease and used along with titanium spacers (cages) placed anteriorly. The anterior approach was chosen because it is the easiest way to shelter the BMP within the spine. By using a collagen sponge soaked with BMP and then placing it within the cage, there is decreased possibility that the material could seep into other places and form bone where it is not needed or wanted. Use of BMPs in spine fusion has significantly changed spinal fusion, in that there is less blood loss, less pain, shorter surgery times, shorter recovery times and frequently better fusion than when autologous grafts are harvested from the iliac crest.
OP-1 received on-label indications for use as an alternative to autograft in recalcitrant long bone non-unions where use of autograft is unfeasible and alternative treatments have failed; and for use as an alternative to autograft in compromised patients requiring revision posterolateral lumbar spinal fusion, for whom autologous bone and bone marrow harvest are not feasible or are not expected to promote fusion. Depending upon the insurance system, examples of compromising factors may include osteoporosis, smoking and diabetes.
A recent study by JR Dimar and colleagues (Spine. 2006; 31(22):2534-2539) involved 98 subjects randomized to receive either autologous bone graft or rhBMP-2 for single-level posterolateral fusions of the lumbar spine for degenerative disease. The authors report a higher fusion rate at 24 months (88% vs. 73%), faster surgical times and less blood loss for the rhBMP group. No other measures were significantly different, including Sf-36 scores, Oswestry Index measures, or pain index scores. The InFUSE Bone Graft has received FDA approval when used in conjunction with 1 of 2 interbody fusion devices, in other words, with either the LT-Cage Lumbar Tapered Fusion Device or the Inter Fix RP Threaded Fusion Device, in spinal fusion procedures in skeletally mature patients with degenerative disc disease at 1 level from L2-S1, and for the treatment of acute, open fractures of the tibial shaft.
Both OP-1 and the InFUSE Bone Graft/LT-Cage Lumbar Tapered Fusion devices are contraindicated in patients who are pregnant, who may be allergic to any of the materials contained in the devices, who have an infection near the area of the surgical incision, who have had a tumor removed from the area of the implantation site or currently have a tumor in that area, or who are skeletally immature. These contraindications reflect continued concern that BMPs may cause unwanted bone growth in adolescents, whose skeletal systems are still growing, or in or near tumors or where tumors used to be.
The global market for wound management includes many products that fall into more than one category. For simplicity sake, however, product-based revenues can be assembled into categories including 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.
The total wound management market worldwide yields revenues in the range $13-14 billion. The aggregate market is forecast to grow at a modest annual rate through 2016. While some well established wound care product segments will grow at barely more than inflationary rates, the aggregate market growth will be driven predominantly through exceptional growth in advanced wound management (roughly $5 billion in 2005) and in active therapy areas (roughly only $900 million in 2005).
The charts below illustrate the size and evolution of the Advanced Wound Care market from 2007 to 2016.
Advanced Wound Care Market, by Segment, 2007 & 2016
Source: See Report #S245, "Worldwide Wound Management, 2007-2016."
Excerpt from MedMarket Diligence report #S245, “Worldwide Wound Management, 2007-2016.” See link for more information. Available for purchase online.
Technologies developed and in use for the management of acute and chronic wounds have diversified from traditional dressings, bandages and wound closure techniques to include an increasing number of diverse technologies ranging from tissue engineering, growth factors, physical therapies (e.g., negative pressure) and others.Traditional dressings and bandages have evolved to contain more active elements contributing to wound healing, with products including films, hydrocolloids, foams, alginates, hydrogels, non-adherents and antimicrobials. Wound closure is a specific area of intense development and market growth beyond traditional suturing and more recent stapling technologies and has seen proliferation and high market growth for surgical sealants, glues and hemostasis products.
The size of the worldwide wound management market is ultimately driven 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 venous stasis (as in chronic venous ulcers) is put at over $3 billion, while the decubitus ulcer (e.g., bedsores) market is in excess of $2 billion. Sales of products used to treat diabetic foot ulcers are estimated around $1.5 billion, and the market for burns dressings is approximately $60 million.
It should be noted that a large proportion of worldwide wound product sales are accounted for by traditional types of wound management products. An estimated two-thirds of the worldâ€™s physicians are not making routine use of advanced wound management products, with availability playing only a minor role in limiting their use. Conversely, while the U.S. healthcare market is characterized by an almost overindulgent attitude toward new technologies, 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 advanced wound care market is significantly higher than the U.S. share.
Market Growth in Wound Management Product Segments Until recently, the product categories with most growth potential were alginates and foams; both have substantial shares of the total market and both are set to increase their shares substantially between 2007 and 2016. Hydrocolloids had a considerable market share in 2007 but their star is in decline; it is anticipated that they will lose several percentage points in the market share table by 2016. (Segment growth in chart from MedMarket Diligence report #S245, “Worldwide Wound Management, 2007-2016,” publishing November 2007. See link for description, table of contents.)
The most significant market entrants are growth factors and, even more dramatically, physical therapies â€“ specifically, negative pressure (also known as VAC therapy) devices. This market sector grew from a small base to gain $1.2 billion by 2007 and is set to capture an estimated 20% of the advanced woundcare market by 2016.
Films, antimicrobials and non-adherent dressings will maintain steady growth although their shares of a vigorously expanding market will decline.
Report #S245, “Worldwide Wound Management” is available for purchase online or via Google Checkout, below.