Cardiology Surgical & Interventional Cardiology Devices Market

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

Cardiology Surgical & Interventional Cardiology Devices Market - Forecast 2014-2020

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TABLE OF CONTENTS

1. EXECUTIVE SUMMARY

2. CARDIAC SURGICAL DEVICES MARKET OVERVIEW

2.1. INTRODUCTION

2.2. VALUE CHAIN ANALYSIS

2.2.1. SUPPLIERS

2.2.2. MANUFACTURERS

2.2.3. DISTRIBUTERS

2.2.4. RETAILERS

2.2.5. END USERS

2.2.5.1. DIAGNOSTIC CENTERS

2.2.5.2. HOSPITALS

2.2.5.3. PATIENTS

2.3. RESEARCH AND DEVELOPMENTS

2.4. KEY BUYING CRITERIA

2.4.1. OBJECTIVE

2.4.2. PRICE

2.4.3. TECHNOLOGY

2.4.4. AVAILABILITY

2.4.5. HEALTH CONCERN

3. MARKET DETERMINANTS

3.1. KEY MOTIVATORS

3.2. KEY RESTRAINS

3.3. KEY OPPORTUNITIES


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3.4. KEY CHALLENGES

4. MARKET SEGMENTATION

4.1. TYPE OF CARDIAC SURGERY

4.1.1. CORONARY ARTERY BYPASS GRAFTING (CABG)

4.1.2. TRANSMYOCARDIAL LASER REVASCULARIZATION (TMR)

4.1.3. HEART VALVE REPAIR OR REPLACEMENT

4.1.4. ARRHYTHMIA TREATMENT

4.1.5. ANEURYSM REPAIR

4.1.6. HEART TRANSPLANT

4.1.7. SURGERY TO PLACE VENTRICULAR ASSIST DEVICES OR TOTAL ARTIFICIAL

HEARTS

4.2. SURGICAL APPROACHES

4.2.1. OPEN-HEART SURGERY

4.2.2. OFF-PUMP HEART SURGERY

4.2.3. MINIMALLY INVASIVE HEART SURGERY

4.3. RISK ASSOCIATED WITH DIFFERENT SURGICAL PROCEDURE

4.4. DEVICE TYPES BY APPLICATION

4.4.1. IMAGING DEVICE

4.4.1.1. STILL IMAGING

4.4.1.2. REAL TIME IMAGING

4.4.2. CARDIOVASCULAR STENT

4.4.2.1. STENT GRAFT

4.4.2.2. SELF EXPANDING STENT

4.4.3. CATHETER

4.4.4. CARDIAC RHYTHM MANAGEMENT DEVICES

4.4.5. SURGICAL DEVICES

4.4.6. MONITORING DEVICES


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5. COST ANALYSIS

5.1. COST OF SURGERY

5.2. DEVICE COST ANALYSIS

5.3. RECOVERY

6. MARKET STRATEGIES

6.1. KEY STRATEGIES

6.2. RECENT ACTIVITIES BY COMPANIES

6.3. STRATEGIC RECOMMENDATION

7. MARKET SHARE

7.1. KEY COMPANY ANALYSIS

7.2. KEY STRATEGIES

8. GEOGRAPHY ANALYSIS

8.1. NORTH AMERICA

8.1.1. U.S.

8.1.2. CANADA

8.2. EUROPE

8.2.1. UK

8.2.2. GERMANY

8.2.3. ITALY

8.2.4. FRANCE

8.2.5. SPAIN

8.2.6. ROE

8.3. APAC

8.3.1. CHINA

8.3.2. JAPAN


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8.3.3. INDIA

8.3.4. SOUTH KOREA

8.3.5. TAIWAN

8.3.6. ROA

8.4. ROW

9. PATENT ANALYSIS

9.1. PATENT ANALYSIS BY TECHNOLOGY

9.2. PATENT ANALYSIS BY COMPANY

10. CORPORATE PROFILE

10.1. ABBOTT CARDIOVASCULAR

10.2. BOSTON SCIENTIFIC CORP.

10.3. C.R. BARD, INC.

10.4. COOK MEDICAL

10.5. MEDTRONIC. INC

10.6. TOSHIBA CORP

10.7. COVIDIEN

10.8. BIOSENSE WEBSTER, INC.

10.9. EDWARDS LIFESCIENCE CORP.

10.10. PLC MEDICAL SYSTEMS

10.11. LOMBARD MEDICAL,

10.12. ATRICURE INC.,

10.13. ATRIUM MEDICAL CORPORATION.,

10.14. JOHNSON AND JOHNSON,

10.15. GE HEALTHCARE (INTERVENTIONAL IMAGING) ,

10.16. PHILIPS HEALTHCARE(INTERVENTIONAL IMAGING),


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10.17. SMITHS MEDICAL(INTERVENTIONAL IMAGING),

10.18. ST. JUDES MEDICAL,

10.19. HANSEN MEDICAL,

10.20. BERLIN HEART,

10.21. CAMBRIDGE HEART


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TABLE LIST

TABLE1. 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. GLOBAL PRICE COMPARISON HEART VALVE REPAIR SURGERY, IN $ {US}

TABLE8. GLOBAL CRDM MARKET, BY REGION, 2013-2020 (IN $MILLION)

TABLE8. LOBAL 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. NORTH AMERICA CARDIAC SURGERY MARKET, 2013-2020 (IN $MILLION)

TABLE14. 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)


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FIGURES LIST

FIGURE1 MARKET SHARE OF CARDIAC SURGERY MARKET, 2013

FIGURE2 INFERTILITY DRUG MARKET SHARE BY REGION

FIGURE3 KEY BUYING CRITERIA FOR CARDIAC SURGERY MARKET.

FIGURE4 CAUSE OF CARDIAC SURGERY

FIGURE5 US IN CARDIAC SURGERY MARKET, 2013-2020 (IN $MILLION

FIGURE6 CANADA CARDIAC SURGERY MARKET, 2013-2020 (IN $MILLION)

FIGURE7 CHINA CARDIAC SURGERY MARKET, 2013-2020 (IN $MILLION)

FIGURE8 INDIA CARDIAC SURGERY MARKET, 2013-2020 ($MILLION)

FIGURE9 JAPAN CARDIAC SURGERY MARKET, 2013-2020 ($MILLION)

FIGURE10 JAPAN CARDIAC SURGERY MARKET, 2013-2020 ($MILLION)

FIGURE11 SOUTH KOREA CARDIAC SURGERY MARKET, 2013-2020 (IN $MILLION)

FIGURE12 TAIWAN CARDIAC SURGERY MARKET, 2013-2020 (IN $MILLION)

FIGURE13 ITALY CARDIAC SURGERY MARKET, 2013-2020 (IN $MILLION)

FIGURE14 FRANCE CARDIAC SURGERY MARKET, 2013-2020 (IN $MILLION)

FIGURE15 GERMANY CARDIAC SURGERY MARKET, 2013-2020 (IN $MILLION)

FIGURE16 SPAIN CARDIAC SURGERY MARKET, 2013-2020 (IN $MILLION)


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Chap# 1. INTRODUCTION

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.

TABLE # 1 GLOBAL CARDIOLOGY SURGERY AND INTERVENTIONAL SURGERY

MARKET, 2013-2020, (IN $MILLION)

Cardiology Surgical

2013 2014 2015 2016 2017 2018 2019 2020 CAGR

Stent Grafts 1250.00 xxx xxx xxx xxx xxx xxx xxx xxx

CRDM xxx xxx xxx xxx xxx xxx xxx xxx xxx

Catheters xxx xxx xxx xxx xxx xxx xxx xxx xxx

Surgeries xxx xxx xxx xxx xxx xxx xxx xxx 10%

Imaging xxx xxx xxx xxx xxx xxx xxx xxx xxx

Structural

Heart xxx xxx xxx xxx xxx xxx xxx xxx xxx

Total xxx xxx xxx xxx xxx xxx xxx xxx xxx


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# 1.1. DRIVERS OF THE MARKET

# 1.1.1. GLOBAL INCREASE IN L IFE 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 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.


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FIGURE # 1 FATALITIES INCREASING DUE TO LIFE STYLE ORIENTED

DISEASES (IN THOUSANDS)

Source: OBRC Research, CDC

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.

40

50

50

70

80

130

140

150

590

600

0 100 200 300 400 500 600 700

Suicide

Influenza and pneumonia

Nephritis and nephrosis

Diabetes

Alzheimer's disease

Unintentional injuries

Stroke

Chronic lowe respiratory diseases

cancer

Heart disease


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# 1.2. FACT SHEET

S.No. Particular Size

1 Number of fatalities globally in 2014 17.3 million

2 Estimated fatalities annually in 2030 23.3 million

3 Percentage of fatalities due to CVD in low middle income countries. 80 %

4 CVD causes death in 2012 in Europe 4 million

5 CVD causes death in 2012 in European Union 1.9 million

Source: OBRC Analysis, W.H.O. & ESC

# 1.2.1. 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.

TABLE # 2 PRICE DIFFERENCE IN INDIA AND US (2013)

S.No. Type of surgery Price in India Price in US

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


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S.No. Type of surgery Price in India Price in US

6 Angioplasty and stent $6000 $16000

7 Pacemaker $5000 $16000

Source: OBRC analysis

# 1.2.2. MEDICAL TOURISM ORGA NIZATIONS

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.


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# 1.3. 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.

TABLE # 3 HEALTH EXPENDITURE PER CAPITA INCREASED FROM

2010 TO 2014 (IN US $)

S.No. Country Healthcare spending in

2010 Healthcare spending in

2014

1 US $8467 $8895

2 Canada $5656 $5741

3 Uruguay $1213 $1308

4 Venezuela $487 $593

5 San Marino $3553 $3792

6 Chile $1022 $1103

7 Japan $4641 $4752

Source: OBRC Analysis, World Bank


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# 1.4. 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.

# 1.5. 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.


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Quick recovery from minimal incisions surgeries.

Shorter stay in the hospital.

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.

# 1.6. 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.

TABLE # 4 SOME APPROVALS IN 2014

S.No. Company name Device name and model Category

1 Medtronic IN.PACT Admiral Paclitaxel-coated PTA

Balloon Catheter - P140010

Percutaneous

Transluminal

Angioplasty (PTA)

Balloon Catheter

2 EverFlex Self-Expanding Peripheral Stent System

– P110023/S007 Stent

3 Lutonix 035 Drug Coated Balloon PTA Catheter

- P130024 Angioplasty

4 Xience

XIENCE Family of Everolimus Eluting

Coronary Stent Systems -

P070015/S122 and P110019/S066

Stent


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S.No. Company name Device name and model Category

5 Sorin

Freedom SOLO Stentless Heart Valve

and SOLO Smart Stentless Heart Valve -

P130011

Stentless heart valve

6 Edwards SAPIEN XT Transcatheter Heart Valve -

P130009 Heart valve

7 Medtronic Core Valve System - P130021/S002 Aortic Heart valve

8 Medtronic CRT-P and CRT-D Devices -

P010015/S205 and P010031/S381 Pacemaker/Defibrillator

Source: OBRC Analysis, US FDA website


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Cardiology Surgical & Interventional Cardiology Devices Market