Marketstrat, Inc.

Computed Tomography (CT) Fastest Growing Medical Imaging Technology?

Market Size and Trends

According to Marketstrat, the United States market for computed tomography (CT) scanning systems is estimated to touch $3.6 billion by the end of 2009. The US accounts for over 50.0 percent of the market. Cardiac imaging is a fast expanding CT application due to its utility in emergency medicine, perfusion studies and CT angiography.

While hospitals started out as the original care site where scanning was done, independent imaging centers and physician’s offices offering scanning have become widespread in the US over the last decade. With the advent of portable and mobile CT scans, access and availability of this imaging modality has increased significantly. Rural hospitals and those with smaller budgets are now able to offer CT and other medical imaging to patients who previously had to travel elsewhere for this service. Currently it is estimated that about 25% of scanning stations are in private practices and imaging centers that are not part of a hospital. Most hospitals have a range of scanners from low-slice to high-slice. The overall trend is towards acquiring high-slice scanners which can be similar in terms of capital costs but far superior in function.

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Computed Tomography (CT) Systems will continue to be the fastest growing technology in the medical imaging arena around the world in the upcoming decade. The new Marketstrat ® report expected to be launched in early May 2009, provides revenues and forecasts for high-slice, mid-slice and low-slice CT scanners for the 2008-2016 period. Also presented in this report will be competitive strategies, purchase considerations, emerging business models, market shares, market drivers & restraints and benchmarks. The greatest momentum is expected in the high-slice segment, due to the high ROI, improved workflow and superior imaging capability (volumetric imaging, high spatial and temporal resolution and relative procedural ease). Despite the faltering economic climate in the US and abroad, imaging markets are expected to weather any short term impacts and stay resilient over the longer term.

The CT market is dominated by GE, Siemens, Toshiba and Philips. The computed tomography research report presents market shares of these leaders and discusses the role of niche players such as Neurologica Corp., Shimadzu and Neusoft Medical Systems Co. Ltd. Service providers and companies providing refurbished CT scanners are also discussed.

While demand for minimally invasive diagnostic techniques has skyrocketed over the last few decades,  Marketstrat sees increasing rates of cardiovascular disease and cancer in the face of a population explosion worldwide has created a need for screening and early diagnosis of these conditions. Cardiology and Radiology fields are the forefront of this technology, although the high-resolution, dynamic volume images are finding new applications in trauma and women’s health, etc. New applications of CT technology include Image Guided Radiotherapy (IGRT) and Image-guided surgery. The latest technological innovations in CT systems are the 320-slice AquilionONE (Toshiba), 256-slice Brilliance iCT (Philips), Light Speed VCT Series (GE) and the CereTom Portable CT (Neurologica ).

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Regional variation for the various CT technologies exists; the high-slice scanners segment is growing at the highest rate in the US while the mid-slice and low-slice scanner segments are growing in the emerging medical markets of Asia and Latin America. Marketstrat Inc. provides market size estimates and forecasts (US $, 2008-2016) for CT scanner systems by product category (High-slice, Mid-slice and Low-slice). Data is segmented by country/region for: USA; Europe; Japan and the Rest of the World (ROW). Revenue forecasts are also presented by imaging location (hospitals versus imaging centers) and revenue category (CT scanner units, Parts & Accessories and Services).

Many European countries including the UK and France, are using mobile CT due to the high capital equipment costs. Emerging medical markets in developing nations such as India and China also provide good growth opportunities for CT, as economic growth, healthcare spending and population size drive demand for high technology. Refurbished CT scanners account for a large majority of sales in these countries. While demand is set to grow in these countries, unit shipments are likely to stay static in the coming years. Overall growth in medical imaging technologies will also fuel growth in picture archiving and communication systems (PACS) and radiology information systems (RIS).

Research by analysts at Marketstrat finds that utilization rates are highest in the US and Japan, with an estimated 80 scanners per million people in the US versus about 90 scanners/ million people in Japan. The US has over 20,000 installed CT scanners. It is estimated that almost 69 million CT scans were done in the US in 2007. One of the fastest growing applications is CT angiograms, currently at an annual rate of about half a million in the US. Pediatric usage is also growing. An estimated 6 million CT scans per year are done for pediatric cases. Of these, about 600,000 are done for head and abdominal examinations.

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Cardiology and Radiology fields are at the forefront of this technology, although the high-resolution, dynamic volume images are finding new applications in trauma and women’s health, etc.

Market Participants - CT Sytstems

3mensio Medical Imaging BV; Acceleware Corp; Accurate Medical Diagnostics; Analogic Corp; Beekley Corp; Capintec Inc; CardiArc; CNMC Co Inc; Composites Horizons Inc; Computerized Imaging Reference Systems Inc; Covidien Imaging Solutions; DeJarnette Research Systems Inc; Eckert & Ziegler Isotope Products; Eizo Nanao Corporation; Fluke Biomedical; Gammex, Inc.; GE Healthcare; HansO Mahn& Co; Health Physics Northwest Inc; Hitachi Medical Corp; Hitachi Medical Systems America; IBA Dosimetry GmbH; Imaging3 Inc JRT Association; King's Medical Group; Koning Corporation; Mavig GmbH; Medical Coaches Inc; Medrad Inc.; MEI Development Corp; Mercury Computer Systems Inc; NEC Display Solutions; NeuroLogica Corp; Neusoft Medical Systems Co Ltd; Orthometrix Inc; Philips Healthcare; QR s.r.l; Radcal Corp; Radiology Support Devices Inc; Sandstrom Trade & Technology Inc; Scanco Medical AG; Siemens Healthcare; Siemens-Asahi Medical Technologies Ltd; Siemens Medical; Shimadzu Corporation; Smit Mobile Equipment bv; Spacelabs Healthcare; Syntermed Inc; The Phantom Laboratory Inc.; Toshiba Medical Systems Corporation; Unfors Instruments AB; Xoran Technologies Inc;

Good Times for the Exam Glove Industry? The Mad Scramble for Exam Gloves Continues Despite High Prices

What do you think?

The world market for disposable exam gloves received an unexpected boost due to the H1N1 pandemic in 2009, reaching close to $2 billion towards the end of the year.  In addition to infectious outbreaks over the recent years including SARS and avian flu which followed the HIV epidemic, the growing world population and increase in occupational and personal hygiene standards are creating increasing demand for exam gloves.

The world market for disposable exam gloves received an unexpected boost due to the H1N1 pandemic in 2009, reaching close to $2 billion towards the end of the year.  In addition to infectious outbreaks over the recent years including SARS and avian flu which followed the HIV epidemic, the growing world population and increase in occupational and personal hygiene standards are creating increasing demand for exam gloves.   

World Market for Disposable Medical Gloves (Surgical & Exam Gloves)

According to a recently released report on the Worldwide Disposable Medical Gloves Markets by Marketstrat Inc., the medical gloves market is going through a number of transitions.  Market and technology trends in both exam gloves and surgical gloves are discussed in this report.  Some of the significant trends are as follows:

• Powdered-latex gloves, both exam and surgical, are becoming a relic of the past.  Many European governments and health agencies have banned already them. The US FDA is likely to ban them in the future.
• The most popular medical gloves currently are low-protein, powder-free latex gloves, followed by vinyl and nitrile.
• Hospitals concerned with avoiding latex products are targeting the easiest and most obvious medical latex product, replacing them with vinyl or nitrile, an even better material which is now more affordable.
• The surgical glove market has been invaded by a variety of synthetic gloves.  In addition to nitrile, new generation polymers such as polychloroprene and polyisoprene with superior comfort and tactile sensitivity present a viable alternative to latex surgical gloves.
• Large manufacturers are responding to changing market demands by shifting manufacturing operations to synthetics.

Prices of all types of gloves rose over recent years as raw material prices and fuel prices skyrocketed.   Despite the economic slowdown in many countries, increasing demand has been driving this industry. High demand helped offset price increases due to production costs, with the most significant change happening in the nitrile glove segment.   Users started buying nitrile when production shortages and plagued the two popular materials, latex and vinyl.   As sales of nitrile started to climb, end-users began to notice that vinyl offered poor barrier protection, and the best hypoallergenic, affordable alternative to latex was nitrile.  Nitrile also offers better barrier protection against both chemicals and microbes. Nitrile is now the preferred material in many medical settings.  Unit sales of nitrile exam gloves are expected to grow at a cumulative average growth rate over 6 percent over the 2008 to 2016 period, about three times more than powder-free latex versions.    In the surgical glove segment however, nitrile has to compete with far superior synthetic materials made of copolymers.

Latex manufacturers are fighting hard to retain market share, offering new materials such as coated low-protein latex.  For the next few years, the global demand for gloves will help latex gloves weather the storm.  In the longer term, however, manufacturers will need to focus on technology aimed at reducing allergenicity even further, without compromising the natural comfort and fit of latex.

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Medical Ultrasound Systems - Is the World Market Growing?

Medical Ultrasound Systems Markets Worldwide

The Medical Ultrasound market is expected to grow to more than $5.3 billion by 2016, driven primarily by growth in hand-carried ultrasound (HCU) devices and expansion in emerging geographic and clinical markets. Overall growth in medical imaging will also continue due to growing populations of elderly people worldwide, accompanied by a concurrent rise in chronic disease rates. Main restraints in the ultrasound market include the slow economy in many countries, reimbursement restrictions and intense competition from MRI and CT.

Leading competitors in the ultrasound market recognize the significance of lateral expansion through miniaturization. This is helping ultrasound gain new ground in medical imaging and stave off competition from CT and MRI, in areas of overlap in diagnostic imaging. The wide range of hand-carried or handheld devices ultrasound devices have been the most significant technological innovation in ultrasound. They range from laptop-sized devices that can be mounted on a cart or folded and carried to pocket ultrasound. HCU s will allow ultrasound to effectively monopolize a vast range of applications in point-of-care imaging. After Sonosite Inc. first introduced hand-carried ultrasound in 1999, the global leader in medical imaging GE, jumped on board, quickly establishing a broad base in this segment with a wide range of HCUs. The original devices offered portability although image quality was compromised. The latest HCUs are now poised to capture a large share of the ultrasound market across the globe. As the leaders in HCU, GE and Sonosite, expand their range and offer greater functionality and enhanced performance at a lower cost, other imaging giants such as Philips, Siemens and Toshiba are launching new products to tap into this market, in addition to well-established niche players such as Aloka, Esaote, Zonare, etc.

Medical Ultrasound Systems Markets Worldwide

Other notable trends in the ultrasound markets include the following:

• Pricing pressures are forcing manufacturers to slash prices off established product lines and offer high-tech compact ultrasound devices at the expense of their own cart-based systems.
• Greatest opportunities exist in emerging clinical applications requiring point-of-care imaging, the expanding healthcare markets of Asia and Latin America and in services including maintenance, repair, upgrade, etc.
• The ultrasound contrast agents market is negatively impacted by warnings from the US FDA and the European Agency for the Evaluation of Medicinal Products contraindicating their use in certain cardiology applications.
• Consolidation trend is likely to continue.
• Specialized hardware and software for cardiology, breast ultrasound, emerging clinical applications and 3D/ 4D imaging will be in high demand.

Growth in the ultrasound market will be driven by demand for hand-carried ultrasound devices and penetration of emerging geographic and clinical markets. Overall growth in medical imaging will also continue due to growing populations of elderly people worldwide, with a concurrent rise in chronic disease rates, which presents new opportunities for growth and expansion. Main restraints in the ultrasound market include the sluggish economy in many countries, reimbursement restrictions and competition from MRI and CT.

This new report published by Marketstrat Inc. discusses these and other trends in the Medical Ultrasound market worldwide, with market estimates and forecasts for the 2008-2016 period. Higher growth rates towards the end of this period are projected as economic conditions stabilize leading to sizeable increases in healthcare expenditures.

The report discusses the contribution of technological innovation in driving the ultrasound market forward, with hand-carried ultrasound (HCU) systems being the most significant. After Sonosite Inc. first introduced hand-carried ultrasound in 1999, the global leader in medical imaging GE, jumped on board, quickly establishing a broad base in the compact and hand-carried device segment with a wide range of HCUs. The original devices were focused on providing portability, although image quality was compromised. The latest HCUs are now poised to capture a large share of the ultrasound market across the globe. As the leaders in HCU, GE and Sonosite expand their range and offer greater functionality and improved performance at a lower cost, other imaging giants such as Philips, Siemens and Toshiba are launching new products to tap into this market, in addition to well-established niche players such as Aloka, Esaote, Zonare, etc.

Medical Ultrasound Systems Markets Worldwide

In an era where medical imaging markets are battling reduced capital expenditures in the traditionally safe markets such as the US, Europe and Japan, HCUs and convertible compact cart-based ultrasound offer new opportunities both in these regions and in the emerging healthcare markets of Asia and Latin America. These latter regions will continue to see healthcare facility expansion to meet growing healthcare needs, and will be the primary markets for new equipment purchases. A number of features make HCUs attractive in the imaging market in all regions:

Price - Available at a fraction of the cost of a large cart-based system, HCUs are more accessible to providers in developing countries. Elsewhere, the low price of HCUs are attractive to smaller physician’s offices as well as hospitals looking to acquire more imaging devices.

Portability - Miniaturization expands utility significantly, making the HCU an indispensible tool. Hand-held or hand-carried devices can be used for a wide range of point-of-care applications, from the Emergency Room (ER) to the Operating Room(OR) to the patient’s bedside or physician’s office.

Ease of use - Technological advances makes them easy to use by non-radiology physicians.

Improved functionality - High-end devices feature improved resolution, color dopplers and volumetric imaging along with specialized diagnostic software that improves accuracy, sensitivity and specificity comparable to large cart-based systems.

One hurdle in the advancement of ultrasound is the issue of contrast agents. Contrast agents can greatly enhance image quality and diagnostic efficacy. Contrast agents are routinely used in MRI and CT. However, the ultrasound contrast agents Optison ™, DEFINITY® and SonoVue are caught in the middle of a controversy. The US FDA and the European Agency for the Evaluation of Medicinal Products have recently issued warnings contraindicating use of contrast agents for certain cardiology applications.

Medical experts are lobbying hard against these rulings, since cardiac ultrasound was the main use prior to the regulatory warnings. Until the regulatory hurdles are removed, the current market and growth of ultrasound contrast agents will be impacted significantly in the next few years. New applications such as contrast-enhanced liver and breast ultrasound will take time to become established procedures.

The new Marketstrat report discusses current and future trends in ultrasound market in a wide range of clinical segments. These include traditional applications such as General Ultrasound, Cardiology, and Women’s Health (Ob/Gyn and Breast), in addition to emerging segments such as Emergency Medicine, Surgery, Anesthesia and Critical Care. Data is also presented for transducers, maintenance services and contrast agents. Geographic segments presented in this report include US, Europe, Japan and the rest of the world (ROW).

Medical Ultrasound Systems Markets Worldwide

Urinary Incontinence Management - What Next?

Urinary Incontinence Rates Increase Worldwide as Awareness Grows About Treatment Options; Urethral Slings a Popular Alternative When Medications Fail

Marketstrat recently published a new report titled, “Incontinence Devices Markets Worldwide.”  The report specifically addresses world markets for clinical devices used to treat and manage urinary incontinence.

Incontinence Devices Markets Worldwide Market Report

The global UI devices market is expected to grow at a CAGR of over 4 percent between 2008 and 2016, reaching about $2 billion by the end of 2016.  This is despite the fact that the UI market is one of the most underpenetrated medical markets.  About 30% of women all over the world are affected, yet about two thirds of cases are estimated to remain undiagnosed.  Although a wide variety of treatment options are available, from medication and exercise to surgery, patients largely remain unware or feel too uncomfortable to seek medical help.  This is by far the biggest restraint in the urinary incontinence device market.    However, changing demographics and campaigns to raise awareness of UI treatments are expanding market opportunities in this segment.  Reimbursement is available in full or part in many countries.  With growing numbers of elderly around the world and increasing rates of chronic conditions that lead to incontinence, the demand for minimally invasive, cost-effective UI devices is going to increase in the forseeable future.

Some of the important trends in the UI market are:

• Growing awareness about treatment options for UI has been spurring an increase in the rates of diagnosis.
• Popularity of slings has been growing; however recent reports of complications form vaginal mesh slings led to FDA warnings about their use.
• There is high demand for technologically advanced, cost-effective options that work longer than current options such as bulking agents and slings for mild and moderate UI.
• The market has generally slowed down over the past year due to the economic slump, especially in the US, which constitutes the biggest share of the UI market.  
• The emerging medical markets of Asia, Latin America and the Middle East have been growing and will have the best opportunities for UI devices in the long run.  

There are only a handful of companies in that provide the technologically advanced UI devices and multiple providers of drainage products.  Leading providers of UI devices are American Medical Systems, C.R. Bard, Ethicon, Hollister, Medtronic and Uroplasty.  This Marketstrat report provides sales estiimates and forecasts for 2008-2016 for different types of UI devices including artificial sphincters, urethral bulking agents, male slings, female slings, neuromodulators and urine drainage products (cathters and drainage bags).   The report also discusses global market shares, technological and clinical trends as well as market size and forecasts in US dollars for 2008 to 2016.  Data is segmented by product category and by geographical segment, namely the US, Europe, Japan and the ROW.

World GI Endoscopy Devices Market Expected To Reach $2.9 Billion By The End Of 2009

GI tract diseases are some of the most common causes of hospitalization, with an estimated 70 million people annually treated in the US alone.  Colorectal cancer is the second most common cause of cancer deaths in the US, 60 percent of which are preventable with early detection. Prevalence of IBD or inflammatory bowel disease in the US is 1 million and 10 new cases per 100,000 people are diagnosed each year. IBD accounts for 700,000 physician visits per year and 100,000 hospitalizations annually in the US.  Demand for minimally invasive, sensitive diagnostic and surgical methods such as endoscopy are on the rise.  A newly published report by Marketstrat Inc. on Gastrointestinal Endoscopy Markets Worldwide projects a CAGR of more than 6 percent in the world GI endoscopy market over the 2008 to 2016 period.

GI Endoscopy Devices Markets Worldwide Market Report

Gastrointestinal disorders comprise a wide array of acute and chronic disorders in people of all ages.   Endoscopy has become the gold standard for diagnosis and treatment of many of these conditions; one of the main uses is screening for colorectal polyps and their subsequent removal.  Government programs worldwide and healthcare advocates are encouraging routine screening for older people thought to be at an elevated risk. More than 14 million colonoscopies are performed annually in the US.  The colonoscopy market is estimated to grow worldwide as new research findings validate the usefulness of early intervention that can save millions of lives.   GI endoscopy is also useful for diagnosing GERD, IBS, IBD, blockages in the pancreatic and bile ducts, unblocking other sections of the gut by removing strictures, foreign objects, etc.

Examples of GI Endoscopic devices and their applications:

• ERCP devices – Biliary stone lithotripters, balloon dilators and stone removal devices among others can be used to remove obstructions from the Biliary and pancreatic ducts.  The world market for ERCP devices will exhibit strong growth in the upcoming years.
• Esophageal dilation balloons can be introduced through the endoscope and inflated to remove obstructions.
• Colonoscopes are flexible endoscopes that can be inserted through the anus to help detect and remove polyps that can grow into malignant tumors.   The main driver for growth worldwide for GI endoscopes market will be the demand for colonoscopes, sigmoidoscopes and ultrasound endoscopes.  The EUS market will have the greatest growth in the upcoming years.
• Polypectomy snares are used to remove polyps.  The polypectomy snare market is projected to grow at a CAGR of over 5 percent over the 2008 to 2016 period.
• Hemostasis devices help control bleeding in the intestine; these include various devices inserted through an endoscope including bands and clips, argon plasma coagulation Probes or radiofrequency probes and sclerotherapy needles.  The high growth segments in the world market for GI hemostasis devices are expected to be ligation bands and ligation clips.
• GI Stents that may be metal or plastic also help keep the GI tract open.  Metals stents such as the SEMs (self-expandable metallic stents) are slowly replacing plastic stents in many parts of the world.  The GI stents market will also grow steadily over the next few years.  Off-label use for cardiovascular stenting has been documented and causing great concern.  In the US, about one million off-label uses of biliary stents are thought to have occurred from 2003 through 2006 leading to adverse events.
• Biopsy forceps are used to remove unwanted tissue and foreign objects.  Moderate growth is expected over the next few years in the GI biopsy forceps market.
• Reprocessed biopsy forceps are single use forceps that have been reprocessed.  These are in great demand as end-users look to cutting costs.  The world market for reprocessed biopsy devices will skyrocket over the next few years, comprising the largest growth segment in GI endoscopy.
• Retrieval devices are baskets and nets used to help remove stones, tissue and foreign objects.
• Enteral feeding devices are pumps and accessories.  The enteral feeding market is expected to grow due to rising rates of neurological conditions and other chronic diseases like diabetes and stomach cancer.
• Capsule endoscopes are ingestible endoscopes that wireless transmit images to help diagnose GI disorders.  This is an emerging technology, contributing greatly to the overall growth of the GI endoscopy devices market.  The capsule endoscopy market is expected to be one of the fastest growing segments.
• Virtual colonoscopy is CT colonoscopy which presents a good alternative to traditional colonoscopy.  Since it is only useful for screening purposes, definitive diagnosis and surgery still require traditional colonoscopy.  The CT colonoscopy market is expected to grow worldwide although growth in the US will be negatively impacted by lack of Medicare reimbursement.

The report presents estimates and forecasts in US dollars for all the above product segments and their sub-segments by geographical region including the US, Europe, Japan, and Rest of the World.