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JULY 2017 • 5TH EDITION
Table of Contents:
JULY 2017 • 5TH EDITION
Table of Contents of the worldwide Orthopaedic Contract manufacturing Market 2016-2021 &
Top 100 player profiles
275+ pages – 450+ exhibits
July 2017 – 5th edition
I- Worldwide orthopaedic market, players, drivers & limiters and forecasts by 2021 Important notice
Aim of the survey
Table of contents
Methodology
Countries in the perimeter of the survey: five main countries
The countries taken into account in the survey for Europe are the 17 strongest economies
Methodology: 3 Dimensions operating model for orthopaedics end market
Methodology: Manufacturing Operating model
Methodology: Example of results from our operating model
Synopsis
Executive summary………………………………………………………………………………………………………………………………………………………….…15
Orthopaedics Ecosystem
Worldwide orthopaedic markets in 2016 by products
The Worldwide orthopaedics market: Growth 2000 - 2010 CAGR, 2010 - 2013 CAGR, 2013 - 2016 CAGR
Worldwide implants market in 2016 in value (B$): Knee, hip, spine and by area, USA, Europe, Row
Worldwide implants & Orthobiologics market in 2016 in value (B$): Trauma & CMF, extremities, Orthobiologics and by
area, USA, Europe, Row
Worldwide orthopaedic market in 2016: competition
Worldwide competition by product in 2016: Market share
Three types of Challengers competing with the Majors: type 1 (country leader), type 2 (country player), type 3 (local
vendors)
The challengers gained market share continuously: 2013-2014-2015-2016 and hip, knee, spine, trauma & CMF
Hip Europe market share 2008-2016 : Depuy Synthes, Zimmer Biomet, Stryker, Smith & Nephew & other
Knee Europe market share 2008-2016 : Depuy Synthes, Zimmer Biomet, Stryker, Smith & Nephew & other
Majors Vs Challengers : Revenues CAGR, market share
Majors Vs Challengers: 2016 picture
Challengers growing Vs majors
Challengers growing Vs majors: the reasons
Market Drivers
Global population growth 1950-2050 and people over 65
The market drivers: Demographic & Economic
Ratio of hip & knee for 10,000 inhabitants by area: USA, Europe, Japan, Australia, South Korea, China, other countries
Innovation and new products pull the market
Innovative surgeons are looking for new products, % of the surgeons by category in each type of country
Product Mix pulls the market up
The revision driver: more and more people have more than one implant in their life
The market limiters
Reimbursement and pricing regulation
HIP average price trend in Europe 2003-2016 : France, Germany, UK, Italy, Average Europe
Regulatory, Certification
Reimbursement price decreases over the last 18 years
Group purchasing in Europe in Germany, in France and Italy and in USA
Knee Europe forecasted market share 2014-2020
Hip Europe forecasted market share 2014-2020
The life cycle of the orthopaedic products: Growth forecasts by 2020 for hip, knee, spine, extremities
Worldwide orthopaedic market forecasts 2016-2021 for hip, knee, extremities, trauma, spine, orthobiologics
Contract manufacturing product segmentation: 11 segments & 40 sub-segments
JULY 2017 • 5TH EDITION
Worldwide contract manufacturing market………………………………………………………………………………………………………………………69
Contract manufacturing market value chain
OEM contract manufacturing strategy: Stryker
Stryker facilities
Contract Manufacturing Rate
Implants, instruments cases & trays, coating, ceramics, packaging
OEM contract manufacturing needs: Stryker
In-House: Forging
In-House: casting
In-House: Machining
Contract Manufacturing: Forging
Contract Manufacturing: Casting
Contract manufacturing: Machining
OEM contract manufacturing needs: Stryker
Spine & Trauma machining In-House, number of pieces
Spine & Trauma machining Contract Manufacturing , number of pieces
Instruments machining In-House, number of sets
Instruments machining Contract manufacturing, number of sets
Coating, In-House, number of pieces
Coating, Contract Manufacturing, number of pieces
OEM contract manufacturing strategy: Depuy-Synthes
Depuy-Synthes facilities
Contract Manufacturing Rate
Implants, instruments cases & trays, coating, ceramics, packaging
OEM contract manufacturing needs: Depuy-Synthes
In-House: Forging
In-House: casting
In-House: Machining
Contract Manufacturing: Forging
Contract Manufacturing: Casting
Contract manufacturing: Machining
OEM contract manufacturing needs: Depuy-Synthes
Spine & Trauma machining In-House, number of pieces
Spine & Trauma machining Contract Manufacturing , number of pieces
Instruments machining In-House, number of sets
Instruments machining Contract manufacturing, number of sets
Coating, In-House, number of pieces
Coating, Contract Manufacturing, number of pieces
OEM contract manufacturing strategy: Zimmer Biomet
Zimmer Biomet facilities
Contract Manufacturing Rate
Implants, instruments cases & trays, coating, ceramics, packaging
OEM contract manufacturing needs: Zimmer Biomet
In-House: Forging
In-House: casting
In-House: Machining
Contract Manufacturing: Forging
Contract Manufacturing: Casting
Contract manufacturing: Machining
OEM contract manufacturing needs: Zimmer Biomet
Spine & Trauma machining In-House, number of pieces
Spine & Trauma machining Contract Manufacturing , number of pieces
Instruments machining In-House, number of sets
Instruments machining Contract manufacturing, number of sets
Coating, In-House, number of pieces
Coating, Contract Manufacturing, number of pieces
JULY 2017 • 5TH EDITION
OEM contract manufacturing strategy: Smith & Nephew
Smith & Nephew facilities
Contract Manufacturing Rate
Implants, instruments cases & trays, coating, ceramics, packaging
OEM contract manufacturing needs: Smith & Nephew
In-House: Forging
In-House: casting
In-House: Machining
Contract Manufacturing: Forging
Contract Manufacturing: Casting
Contract manufacturing: Machining
OEM contract manufacturing needs: Smith & Nephew
Spine & Trauma machining In-House, number of pieces
Spine & Trauma machining Contract Manufacturing , number of pieces
Instruments machining In-House, number of sets
Instruments machining Contract manufacturing, number of sets
Coating, In-House, number of pieces
Coating, Contract Manufacturing, number of pieces
OEM contract manufacturing needs: Medtronic
Spine & Trauma machining In-House, number of pieces
Spine & Trauma machining Contract Manufacturing , number of pieces
Instruments machining In-House, number of sets
Instruments machining Contract manufacturing, number of sets
Coating, In-House, number of pieces
Coating, Contract Manufacturing, number of pieces
OEM contract manufacturing needs: Challengers
In-House: Forging
In-House: casting
In-House: Machining
Contract Manufacturing: Forging
Contract Manufacturing: Casting
Contract manufacturing: Machining
OEM contract manufacturing needs: Challengers
Spine & Trauma machining In-House, number of pieces
Spine & Trauma machining Contract Manufacturing , number of pieces
Instruments machining In-House, number of sets
Instruments machining Contract manufacturing, number of sets
Coating, In-House, number of pieces
Coating, Contract Manufacturing, number of pieces
Forging Contract Manufacturing market 2016……………………………………………………………………………………………………………………87
Forging Contract Manufacturing market 2012-2021 by products: hip stem, hip cup, tibial knee, Trauma locking Plates,
Trauma LF Plates & vertebral disks & by customers : Depuy Synthes, Zimmer Biomet, Stryker, Smith & Nephew & other
Forging Contract Manufacturing market share in 2016: Tecomet, Marle, Lisi, Orchid, etc.
Forging Contract Manufacturing market: OEMs relationships with their suppliers
Casting Contract Manufacturing market 2016
Casting Contract Manufacturing market 2012-2021 by products: knee femoral, knee tibial, Hip cups & hip stems casted and
by customers: Depuy Synthes, Zimmer Biomet, Stryker, Smith & Nephew & other
Casting Contract Manufacturing market share in 2016: Orchid, Tecomet, Marle, etc.
Casting Contract Manufacturing market: OEMs relationships with their suppliers
Hip machining & finishing Contract Manufacturing market 2016…………………………………….…………………………………………………95
Hip machining & finishing Contract Manufacturing market 2012-2021 by products : hip stems, hip heads, hip liners, hip
cups (fully & secondary) & by customers : Depuy Synthes, Zimmer Biomet, Stryker, Smith & Nephew & other
Knee machining & finishing Contract Manufacturing market 2016
JULY 2017 • 5TH EDITION
Knee machining & finishing Contract Manufacturing market 2012-2021 by products: knee femoral, knee insert, knee tibial
(fully & secondary) & by customers : Depuy Synthes, Zimmer Biomet, Stryker, Smith & Nephew & other
Spine and Trauma implants machining & finishing market 2016
Spine and Trauma implants machining & finishing market 2012-2020 by products : Fusion lumbar, trauma screws, trauma
plates, cervical screws & cages, cervical plates & by customers : Depuy Synthes, Zimmer Biomet, Stryker, Medtronic, Smith
& Nephew & other
What are orthopaedic instruments?.....................................................................................................................................101
Spine orthopaedic instruments - product segmentation
Knee orthopaedic instruments segmentation
The Major OEMs have a different outsourcing strategy Vs the challengers. The challengers outsource almost all their
instruments
Instruments life cycle: New OEM projects lead to instruments set manufacturing. When an OEM postpones the launch of
its new projects (for example during the 2008 & 2011 crisis), it also drastically reduces its instruments manufacturing
Instruments machining Contract Manufacturing market 2016
Instruments machining Contract Manufacturing market 2012-2021 by products: hip instruments, knee instruments, spine
instruments, trauma instruments & by customers : Depuy Synthes, Zimmer Biomet, Stryker, Medtronic, Smith & Nephew
& other
Instruments Contract Manufacturing top 20 market share in 2016: Tecomet, Greatbatch, Paragon, etc..
Cases & trays Contract Manufacturing market 2016
Cases & trays Contract Manufacturing market 2012-2021 by products: hip cases, knee cases, spine cases, trauma cases,
and by customers Depuy Synthes, Zimmer Biomet, Stryker, Medtronic, Smith & Nephew & other
Cases & trays Contract Manufacturing top 15 market share in 2016: Tecomet, Greatbatch, Paragon, etc..
Ceramics Contract Manufacturing market 2016……………………………………………………………………………………………………………….112
Ceramics Contract Manufacturing market 2012-2021 by products: hip head, hip liner, and by customers Depuy Synthes,
Zimmer Biomet, Stryker, Smith & Nephew & other
Coating Contract Manufacturing market 2016
Coating Contract Manufacturing market 2016-2021 by products: hip stems, knee femoral, knee tibial, hip cups and by
customers Depuy Synthes, Zimmer Biomet, Stryker, Smith & Nephew & other
Coating Contract Manufacturing market share in 2016: DOT, APS Materials, Eurocoating, etc.
Marking Packaging & Sterilization –MPS- Contract Manufacturing market 2016
Marking Packaging & Sterilization –MPS- Contract Manufacturing market 2012-2021 by products: Knee MPS, hip MPS,
Spine MPS, trauma MPS
Contract Manufacturing market value chain…………………………………………………………………………………………………………………….119
Contract Manufacturers worldwide orthopaedics revenues in 2016 (in M US$): Top 20 players, revenues in orthopaedics,
other revenues
Contract Manufacturing competitor ranking & dispersion: Top 15 analysis, top 16-100 analysis, from 101 to 1,000 analysis
Heavy trend: The OEM facility disinvestments
More outsourcing is a heavy trend for all the orthopaedic companies
Outsourcing rate of the Major OEMs increases continuously: 2000-2020 Outsourcing rate of different orthopaedic
component & by manufacturing process
Orthopaedic Contract Manufacturing concentration by acquisition: Tecomet, Orchid, Greatbatch 1963-2016
The risk of moving to LLC by 2020: Developed countries & Low Labor Cost countries for the following products, Generic
orthopaedic instruments, Complexes & customized Orthopaedic instruments, Implants forging & casting, Implants hip &
knee machining, Spine & trauma implants machining
Contract Manufacturing LLC impact: OEM point of views, Stryker, Zimmer Biomet, Depuy Synthes
Contract Manufacturing LLC impact: CM point of views, Orchid, Greatbatch, Paragon, Intech
Contract Manufacturing price range dashboard Europe
Europe: Forging all products
Europe: Casting all products
Europe: machining all products Europe: Spine & Trauma machining all products
Europe: Instruments all products
Europe: coating all products
Contract Manufacturing price range dashboard USA
Europe: Forging all products
Europe: Casting all products
Europe: machining all products
Europe: Spine & Trauma machining all products
Europe: Instruments all products
Europe: coating all products
Prices
Dashboard
JULY 2017 • 5TH EDITION
Contract Manufacturing market historical revenues & forecasts (M US$): 2010-2020 Implants, instruments, cases & trays
Orthopaedics Contract Manufacturing market is growing faster than In-house manufacturing: 2010-2020 Orthopaedics
Contract Manufacturing (B US$), 2010-2020 Orthopaedics In-house Manufacturing (B US$)
II- Additive Manufacturing & Trabecular in Orthopaedics……………………………………………135 Additive Manufacturing & Trabecular in Orthopaedics
Additive Manufacturing history in Orthopaedics
Story of Zimmer and Trabecular Tantalum
Zimmer, Trabecular Metal related implants
Metal Additive Manufacturing: Technologies and major competitors
Arcam EBM installed base for orthopaedic industry
Beijing AK MEDICAL
Illustrative build-up speed and resolution of selected Metal Additive Manufacturing systems: Electron Beam Melting Vs
Selective Laser Melting
Smith & Nephew uses Additive Manufacturing for customized cutting blocks
Stryker’s History of 3D Printing: STRYKER scheduled to build 3-D printing manufacturing facility for $400 million to $450
million in 2016
Stryker current products made by 3D printing
Depuy Spine uses Additive Manufacturing for prototyping of complex surgical tools
DePuy Synthes has acquired 3D printing technology from Tissue Regeneration Systems Inc.
XILLOX
Equipment suppliers for Orthopaedics: Installed base per customer and per supplier
Addressable market should increase with lower Additive Manufacturing cost
Additive Manufacturing is attractive for the revision hip cup (addressable market) to accelerate and improve osteo-
integration. The AM cups will impact slightly the forging and casting
Number of implants produced using Additive Manufacturing
FDA clearance for medical devices using Additive Manufacturing in USA
Additive Manufacturing represented in 2016 only a small % of all orthopaedic products manufactured
Additive Manufacturing cups and impact on forging and casting in 2016
Cages Raw Materials in the five main countries in Europe: When Peek and Titanium lose market share, Additive
Manufacturing cages will increase dramatically
Conclusion: Additive Manufacturing for orthopaedics
Synopsis
III- Contract manufacturing competitor ranking, Top 200 profiles and SWOT analysis of the
leaders…………………………………………………………………………………………………………………….159
Example of profiles :
