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Healthcare Occams Business Research and Consulting Cardiology Surgical & Interventional Cardiology Devices Market - Cardiac Surgery, Cardiac Rhythm Management, Valvular Heart Disease, Vascular Closure, Cardiac Surgery, CABG, Market Research, Cardiology Medical Devices, Market Size, Market Share, Global Trends & Competitive Analysis, Forecast 2014-2020
Source: OBRC Analysis The global market of cardiovascular surgical devices is expected to grow at CAGR of xxx % from the year 2014 to the year 2020. The surgical devices market includes wide range of devices which are used in surgery and for the surgery such as Imaging devices, cardiovascular stents, Catheter, Cardiac rhythm management devices, Monitoring devices and conventional surgical tools. There are different types of cardiovascular surgeries for which different surgical approaches and devices are required. Report includes Coronary Artery Bypass Grafting (CABG), Transmyocardial Laser Revascularization (TMR), Heart Valve Repair or Replacement, Arrhythmia Treatment, Aneurysm Repair, Heart Transplant and Surgery to Place Ventricular Assist Devices or Total Artificial Hearts. Surgical approaches for these surgeries are Open-Heart Surgery, Off-Pump Heart Surgery and Minimally Invasive Heart Surgery US is the largest market for the Cardiovascular surgery devices with 46% of global share. Europe has captured 27% of market share in the cardiovascular surgery devices. APAC has largest growth in the market which mainly comes from the China and Japan. Global Cardiology Surgery And Interventional Surgery Market, 2013-2020 (in $Million) Cardiology Surgical Stent Grafts CRDM Catheters Surgeries Imaging Structural Heart 2013 2014 2015 2016 2017 2018 2019 2020 CAGR% (2014-2020) Total Drivers of the market 1250.00 XXX XXX XXX XXX XXX XXX XXX XXX Global increase in life style oriented diseases & fatalities: According to W.H.O. people above the age of 50 years are more prone to heart diseases such as CVD, CHD, stroke and other heart diseases. W.H.O. predicted that by 2030, 23.3 million people will lose their lives due to CVD, CHD and other heart diseases. Globally, CVD are considered to be the leading cause for fatalities. According to W.H.O. it is estimated that in 2014, 17.3 million Occams Business Research and Consulting 2
Source: OBRC Research, CDC fatalities are caused annually due to CVD and other heart diseases. Around 80% of the fatalities are attributed to CVD in low and middle income nations. The prevalence of heart diseases globally increases the demand for interventional cardiology surgeries. The cardiology surgeries are costly and have some risk factor attached - there is 3-5% probability of patient's death. The global increase in life style oriented diseases has indirectly put pressure on the economies of the nation. The patient alone does not bear the cost of the treatment. The funding comes from the government health programs, reimbursement policies and health insurances to enable the patient for getting treatment. The increase in life style oriented diseases and fatalities due to it create demand for the surgeries and medical devices. The healthcare companies such as Medtronic, Abbott and Johnson & Johnson contribute in the cardiology surgeries and medical devices to balance their portfolio. In the present scenario with increase in CVD, CHD and other heart diseases the healthcare companies are focusing on emerging economies such as India and China. In the emerging markets the economic growth is also increasing and giving rise to the demand for better healthcare system. According to World Heart Federation, national economies are burdened due to the impact of CVD and other heart diseases. The global direct cost on CVD is estimated to be $470 billion. The burden is increasing for the developing countries; China spends $40 billion (2013) annually on direct health costs related to cardiovascular disease which is around 4% of the gross national income. The U.S. spends highest on CVDs. According to Centers for Disease Control and Prevention, US spends more than $108.9 billion(2013) annually. Fatalities Increasing Due to Life Style Oriented Diseases (in Thousands) Heart Disease Cancer 600 590 150 140 130 80 70 50 50 40 Chronic Lowe Respiratory Diseases Stroke Unintentional Injuries Alzheimer's Disease Diabetes Nephritis and Nephrosis Influenza and Pneumonia Suicide 0 200 400 600 800 Occams Business Research and Consulting 3
Source: OBRC Analysis, W.H.O. & ESC The increase in fatalities due to cardiac related diseases has triggered the cardiology surgery market to grow. There is various heart surgeries performed by the surgeons, globally. The most common surgeries are CABG, TLR, heart valve repair and replacement, arrhythmia treatment, aneurysm repair, heart transplant, MIS and open heart surgeries. The cases of strokes and heart attacks are also increasing; in US alone out of 0.92 million patients 0.25 million people lose their life due to sudden strokes and heart attack annually. Fact Sheet Sr. No. Particular Size 1 Number of fatalities globally in 2014 17.3 million 2 Estimated fatalities annually in 2030 23.3 million 3 4 5 Percentage of fatalities due to CVD in low middle income countries. CVD causes death in 2012 in Europe CVD causes death in 2012 in European Union Medical Tourism: People from developed nations are travelling to low and middle income countries for better and economical treatments for cardiological and other heart related treatments. The common destinations for medical tourism are Thailand, India, Mexico, Malaysia, Cuba, Brazil and Argentina. Medical tourism is most preferred to get quality treatment in economical prices. However, it is not advised for a patient to travel for 10 or more days when the surgery is critical such as interventional cardiology surgeries. The doctors and hospital authorities always advice the patients to take safety measures and precautions while medical tourism. In India, the cost of heart surgeries such as artery-clearing coronary bypass surgery cost around $1583 in US the cost is around $106385 (2013)at Ohio's Cleveland clinic. The disparities in the cost of treatment stimulate the patient to move to the places for quality and economical treatment. 80% 4 million 1.9 million Occams Business Research and Consulting 4
Price difference in India and U.S. (2013) Source: OBRC Analysis. Sr. No. Type of surgery Price in U.S. Price in India 1 Coronary Angiography Test $166 $500 2 Heart Implantation $11666 $50000 3 CABG Surgeries $5000 to $7000 $30000 4 Open Heart Surgeries $1600 to $2000 $20000 to $100000 5 Coronary Angiogram $600 $4000 6 Angioplasty and Stent $6000 $16000 7 Pacemaker $5000 $16000 Medical Tourism Organizations: In order to provide quality healthcare to patients various multinational nonprofit organizations such as the Medical Tourism Association offers their services. MTA or Global healthcare organization provides membership to enable the patient to find the most suitable medical tourism destination. International hospitals, healthcare providers, insurance companies and medical travel facilitators are leveraged to provide transparent, quality and economical medical services. The organization also provides educational training, certification and other awareness programs for the travelers. International Board of Medicine and Surgery (IBMS): IBMS assembles physicians, surgeons and other healthcare professionals in the global healthcare community to offer patient care. The organization has some predetermined goals set for providing quality and economical medical tourism. The main aim of the organization is to establish centers for hospitals and clinics to meet their standards. European Medical Tourism Alliance (EMTA): It is a Hungary based nonprofit organization which is responsible for coordinating with medical travel industry and concern patients. They also serve the European economic interest grouping by providing quality and economic healthcare to the members. EMTA aims to provide alternative solutions for healthcare system of US, Europe and other parts of the world. The US Travel Insurance Association (USTIA): It is an association of insurance carriers, insurance agencies, third party administrators and related business engaged in travel insurance in US. USTIA aims to provide affordable access to medical tourist through travel protection and travel assistance. Occams Business Research and Consulting 5
Source: OBRC Analysis, World Bank Global increase in healthcare spending: According to National Center for Policy Analysis (NCPA), healthcare spending has been increasing globally due to expensive healthcare product and services. According to Organization for Economic Cooperation and Development (OECD) the healthcare spending will continue to increase over the next 50 years. The size of aging population is increasing resulting in increase in consumption of healthcare services. In Spain, Canada and Austria the share of elderly population will double by 2025. The government healthcare expenditures are growing faster than the growth of the economy in all developed nations. Per capita government spending on healthcare is highest in Norway (5.3%), followed by the U.S. (5.1%) and Spain (5.1%). However developed nations have a relatively lower spending such as Sweden and Canada have (2.6% and 3.1%) respectively. According to NCPA, by 2050 the US government will spend one third of its GDP in healthcare system. Geographically, North America and Europe spends highest in healthcare across the world. The healthcare spending in the per capital U.S has been considerably improved over the years and increased to $8895(in 2014) from $8467(in 2010). Moreover, France has increased the healthcare spending to $4690 per person in2014 and has the finest healthcare all over the world. Europe has been adopting latest healthcare system to provide better care and treatment to the patients. Overall the healthcare spending has increased in developed and developing countries. According to the World Bank, following are the health expenditure per capita spending globally. Health Expenditure Per Capita Increased From 2010 to 2014 (in U.S. $) Sr. No. 1 2 3 4 5 6 6 U.S. Canada Country Uruguay Venezuela San Marino Chile Japan Healthcare Spending in 2010 Healthcare Spending in 2014 $8467 $8895 $5656 $5741 $1213 $1308 $487 $593 $3553 $3792 $1022 $1103 $4641 $4752 Occams Business Research and Consulting 6
Increasing awareness to fuel the market: Many hospitals, NGOs, government schemes, private organizations contribute in increasing the awareness for healthy life style. Such organizations encourage patients to opt for surgeries if required to avoid unfavorable consequence. Medtronic's co-founder encourages the survived patients to contribute in making awareness and do philanthropy for the noble cause. The company granted $0.2 million to heroes and cool kids program which serves more than 0.2 million kids each year. Such philanthropy and awareness programs are increasing and giving rise to more surgeries each year. The nonprofit organizations also play important role in creating awareness for heart diseases. Many social campaigns, social events and other competitions are executed by big companies as part of CSR program. Technological advancements in surgeries: Technology plays an important role in healthcare domain. In the present scenario, interventional cardiology surgeries have been equipped with robotic surgeries and 3D virtual reality technologies. The last technology gets replaced by the innovative and enhanced technology in quick succession. The outcome of research and development is lucrative for the healthcare companies and utilitarian for the user. Technology eases the critical surgeries and operations. The robotic surgeries such as minimally invasive surgeries were approved by US FDA in 2001. However, it is being widely used since 2005 in various nations such as US, Canada, UK and Japan. The minimally invasive surgeries enable surgeons to perform complex heart surgeries efficiently and effectively. This technological advancement created huge scope in interventional cardiology surgeries. Minimally invasive direct coronary artery bypass surgery (MIDCAP) enables the surgeons to make small incision in the concerned section of heart. However, in some critical cases of diseased vessel, this technique is avoided by the surgeons for safety. There are various other surgeries being performed through minimally invasive surgery method. Surgeries for prostate cancer, artery bypass, valve repair and replacement, arterial fibrillation, implantation of epicardial pacing wires to boost the pumping action of heart in stroke cases and so on can be performed effectively. The minimally invasive methods are preferred over conventional methods due to Minimally invasive method leaves small scars. It results into less blood loss during surgeries. Small incision results into low risk of infection. Quick recovery from minimal incisions surgeries. Shorter stay in the hospital. Occams Business Research and Consulting 7
Source: OBRC Analysis, US FDA website Interventional cardiology companies such as Medtronic, Abbott uses technology as a tool for market growth. Medtronic in January 2015 offered SmartShock technology for the treatment of patient through implantable cardiac devices. The latest device enables the clinicians to track patient's health with proactive results. As the technology advances it increases the utility of the medical product and eases the medical procedures for the doctors. US FDA approval has boosted the uses of surgical devices: FDA is responsible for assuring the safety and effectiveness of medical devices. If any casualty is registered due to approved devices, FDA looks into the matter very quickly and the panel takes necessary actions. FDA ensures medical device innovation and accelerates patient access to high quality medical devices. It uses a variety of approaches including promotion and adoption of certain standards. In some inspection programs, utilization of post market surveillance is done by FDA. Philips received 510(K) clearance from the US FDA to offer its precision planning application for transcatheter aortic valve implantation treatment (TAVI) The FDA advisory panel meticulously test and analyze the medical devices and drugs to ensure user safety. In the previous year FDA approved many critical surgeries and medical devices. Following are some of the devices approved by FDA in 2014. Some Approvals in 2014 Sr. No. Company Name Device Name and Model Category 1 Medtronic 2 EverFlex IN.PACT Admiral Paclitaxel- Coated PTA Balloon Catheter - P140010 3 Lutonix 4 Xience 5 Sorin Self-Expanding Peripheral Stent System P110023/S007 035 Drug Coated Balloon PTA Catheter - P130024 XIENCE Family of Everolimus Eluting Coronary Stent Systems - P070015/S122 and P110019/S066 Freedom SOLO Stentless Heart Valve and SOLO Smart Stentless Heart Valve - P130011 Percutaneous Transluminal Angioplasty (PTA) Balloon Catheter Stent Angioplasty Stent Stentless heart valve Occams Business Research and Consulting 8
Some Approvals in 2014 (Cont...) Sr. No. Company Name Device Name and Model Category 6 Edwards 7 Medtronic 8 Medtronic List of Tables Table1. SAPIEN XT Transcatheter Heart Valve - P130009 Core Valve System - P130021/S002 CRT-P and CRT-D Devices - P010015/S205 and P010031/S381 Heart valve Aortic Heart valve Pacemaker/Defibrillator Global Cardiac Surgery Market by Region, 2013-2020 (in $Million) Table2. Worldwide Numbers of Coronary Artery Bypass Surgery, 2013 Table3. Country Wise Price Comparison of CABG Surgery, in $ (US) Table4. Global CABG Market by Region, in $Million (2013-2020) Table5. Global Thermo Myocardial Laser Revascularization Market in $Million, by Region (2013-2020) Table6. Global Heart Valve Repair Surgery Numbers, 2013. Table7. Table8. Table8. Global Price Comparison Heart Valve Repair Surgery, in $ {US} Global CRDM Market, by Region, 2013-2020 (in $Million) Global Heart Transplant Market by Region, 2013-2020 (in $Million) Table9. Global Heart Transplant Surgeries, 2013 Table10. Global Price Comparison Heart Transplant Surgery, 2013 Table11. Global Cardiac Surgery Device Market, by Region, 2013-2020 (in $Million) Table12. Global Price Comparison of Cardiac Surgery Devices, 2013 Table13. Global Cardiac Surgery Market by GEOGRAPHY in $Million (2014-2020) Table14. Table14. North America Cardiac Surgery Market, 2013-2020 (in $Million) The U.S. Cardiac Surgery Cost Comparison in Various states,2013 Table15. Cost Cardiac Surgery Across Canada 2013 Table16. Number of Cardiac Surgery Experts in Canada, 2013 Table17. Asia-Pacific Cardiac Surgery Market, 2013-2020 (in $Million) Table18. Europe Cardiac Surgery Market, 2013-2020 (in $Million) Occams Business Research and Consulting 9
List of Figurs Figure1 Market Share of Cardiac Surgery Market, 2013 Figure2 Figure3 Figure4 Figure5 Figure6 Figure7 Figure8 Figure9 Figure10 Figure11 Figure12 Figure13 Figure14 Figure15 Figure16 Infertility Drug Market Share by Region Key buying Criteria for Cardiac Surgery Market. Cause of Cardiac Surgery US in Cardiac Surgery Market, 2013-2020 (in $Million Canada Cardiac Surgery Market, 2013-2020 (in $Million) China Cardiac Surgery Market, 2013-2020 (in $Million) India Cardiac Surgery Market, 2013-2020 ($Million) Japan Cardiac Surgery Market, 2013-2020 ($Million) Japan Cardiac Surgery Market, 2013-2020 ($Million) South Korea Cardiac Surgery Market, 2013-2020 (in $Million) Taiwan Cardiac Surgery Market, 2013-2020 (in $Million) Italy Cardiac Surgery Market, 2013-2020 (in $Million) France Cardiac Surgery Market, 2013-2020 (in $Million) Germany Cardiac Surgery Market, 2013-2020 (in $Million) Spain Cardiac Surgery Market, 2013-2020 (in $Million) Occams Business Research and Consulting 10