Market competition and
changing reimbursement rates are affecting procedure volumes, sales
volumes, and market values of medical devices
Today, Europe’s move to a diagnosis-related group (DRG) based
reimbursement system underscores the importance of developments in
minimally invasive surgery. With the current state of healthcare
funding and limited hospital bed access, there has never been more of an
emphasis on decreasing postoperative patient recovery times. If a
cholecystectomy procedure still required a four- to six-day hospital
stay and a four- to six-week postoperative recuperation, the current
volume of patients – not including the anticipated infusion of aging
pensioners – would stretch the current European medical infrastructure
to its breaking point. With superior recovery times, and decreased
postoperative pain, laparoscopy is in a prime position to experience
rapid growth over the next decade.
Growth In Laparoscopic Devices Market To Accompany Increasing Procedural Volumes
Over the last few years, procedural volumes have spiked in gynecology
and obesity interventions across Europe. The market for bariatric
procedures grew over 7% in 2013, greatly outpacing the 2.5% growth in
the overall number of laparoscopic procedures. In tandem with these
increases in procedural volumes, sales of laparoscopic devices in Europe
have increased to almost €1.87 billion in 2013.
Obesity Treatments Soon to Become #1 Treatment in EU and Asia.
As is the case with many laparoscopic procedures, increases in
bariatric surgeries did not correlate with country-specific obesity
rates, but instead with the number and skill level of bariatric
surgeons. For example, 23% of the adult population in the U.K. is obese,
but the country has one of the lowest surgery rates in Europe. This is a
trend that can be traced back to the poor development of laparoscopy in
the country, a trend that forces many British citizens to go abroad to
Belgium or France for surgery.
Ultimately, the main driver behind
increasing procedural volumes is the combination of an aging generation
of baby boomers who are demanding less invasive surgery, and surgeons
who are receiving better training in laparoscopy than in the past however, the outlook for laparoscopy is extremely favorable.
Total Laparoscopic Procedures vs. Total Laparoscopic Device Market (2010 – 2020)
Trend Toward Multifunctional Devices Driving Growth
As the pressure of increasing obesity and the push to cut costs rises across Europe, every device entering a
hospital needs to justify its cost with proven efficiency gains. New
medical devices are attempting to meet these demands by providing
surgeons with high-efficiency multifunctional devices that cut costs
over time.
Obesity medical devices like
Onciomed's GVS system in clinical evaluation in Latin America is getting ready for EU clinical sites and CE mark. Surgeons who were supporters of Sleeve Gastrectomy are seeing not only early complications but even late complications like chronic fistulas after months of the surgery, patients cannot imagine the idea of cutting portions of the stomach. This is where
Onciomed's GVS plays a role of a next generation technology. Experts believe GVS is the next big technology in the obesity and diabetes space.
Europe is certainly going to be the big user of laparosopic devices.
This statement is best exemplified by the fastest growing market in
laparoscopy, namely the market for direct energy devices. In 2013, the
overall market grew by 5.6%, while the fastest growing portion of this
market, the market for advanced bipolar devices, grew even faster.
Advanced bipolar devices are multifunctional devices that allow surgeons
to both seal and grasp vessels. They represent 61% of the overall
market by value, and are expected to grow substantially through 2020.
Olympus’s introduction of the Thunderbeat device combines both
ultrasonic and advanced bipolar energy, making it the only device in the
world that can both rapidly dissect and seal vessels at the same time.
Covidien and Ethicon Endo-Surgery are the other prominent competitors in
this market and are market leaders in advanced bipolar and ultrasonic
energy respectively.
These devices represent the marriage of multiple laparoscopic
instruments into one, resulting in decreased operating times, and even
greater surgical efficiency. While sales volumes of advanced bipolar
devices are increasing, average sales prices (ASP) are decreasing, as
Olympus,
Covidien, Ethicon Endo-Surgery and a slew of smaller
manufacturers compete for market share in this lucrative market. The
overall market for direct energy and ultrasonic devices was valued at
€453 million in 2013, and will be worth over €590 million by 2020.
Changes In The Competitive Landscape For Laparoscopic Devices Looming
The European market for laparoscopic devices has been contested by
numerous major corporations for over a decade. Ethicon Endo-Surgery,
Covidien, Karl Storz, Applied Medical, Richard Wolf, Olympus, and
Stryker are some of the major market competitors that compete in this
multi-billion dollar industry.
Ethicon Endo-Surgery was the leading market competitor in 2013. The
company relies on its stellar reputation for high-quality products,
especially in the ultrasonic and stapling devices market. The company
generally prices its products well above the market average, avoiding
competition-based pricing when possible. A large part of its revenue
stems from its Harmonic ultrasonic instruments, which have monopolized
the ultrasonic device market for years. Despite intense competition from
Covidien and Olympus in the market for tissue management systems,
Ethicon Endo-Surgery continues to dominate the market, a testament to
the strength of its direct sales force, and the faith that end users
have in its products.
Covidien was the other major competitor. Sales of its Ligasure
devices allowed the company to gain a commanding position in the direct
energy device segment. Covidien is working to enhance growth through
research and development, as well as further acquisitions. Sales of its
access devices have suffered over the last few years, a trend that is
not representative of the whole market, but perhaps attributable to the
aggressive sales strategies of Applied Medical – a prominent competitor
in the market for access devices.
Over the next few years, competition in the market for direct and
ultrasonic energy devices will ramp up considerably. Olympus’ entry into
the market with its Thunderbeat device signals the company’s pivot to
the medical device market. Olympus is best known for its diagnostic
endoscopes, for which it controls about 70% of the global market, but
the company is betting on growth in their medical businesses to help
rebuild the firm after its 2011 corporate corruption scandal.
Leading Competitors, Laparoscopic Device Market
Thirty-five per cent of those screened were obese and a further 32% were
overweight. These figures were similar to those in America, but,
worryingly, Emiratis were fatter at younger ages. Some 18% of those
screened had diabetes and a further 27% were at high risk of developing
it. 
