The pace of many industries, even those in health, has slowed in recent times as a result of the global credit crisis. In many cases there have been a number of surprises, where R&D may have flourished and surprise successes failed. But in the global cardiovascular devices market, the blood is still pumping at a similar rate to before, buoyed by conditions that can't be slowed by economics.
Areas such as cardiovascular surgery, peripheral vascular devices and cardiovascular prosthetic devices are only adding to this demand, and helping to paint a healthy economic picture of growth for the industry, which apart from stalwart US interest, is gaining popularity in Australia, France, Germany, India, Italy and the UK.
According to research from a new report by Global Markets Direct, 'Global Cardiovascular Devices Investment Opportunities, Analysis and Forecasts to 2012', makers of devices that treat heart disorders could actually escape a recession unharmed, especially with insurers, private and public funding paying for the majority of these devices.
Furthermore, the cardiovascular devices market is increasingly being driven by technological advances. The market has 674 pipeline products in different stages of development and leads all other medical device markets in terms of technological advances and generating interest in the medical devices space.
Comprising of interventional cardiology, cardiac rhythm management (CRM), cardiovascular surgery, peripheral vascular devices, cardiovascular prosthetic devices, electrophysiology and cardiovascular diagnostic and monitoring devices, the market overall was valued at $30bn in 2007.
Forecasts for growth show this figure could rise by 5.4% annually from 2007 to 2012 to reach $39bn in 2012.
Drug-eluting stents (DES) and CRM (pacemakers, implantable cardiovertor defibrillators, cardiovascular leads and so on) are leading the market for cardiovascular devices.
Revival of the stents
The regained health in the DES market should ensure that the overall interventional cardiology market continues to ensure robust return from the depths of despair to all its market stakeholders. Interventional cardiology is the largest segment in the global cardiovascular devices market, led by Abbott Laboratories, Boston Scientific, Cordis and Medtronic with revenues of $11.1bn in 2007.
The interventional cardiology devices market – consisting of the cardiac catheters, coronary stents and percutaneous transluminal coronary balloon catheters segments – is forecast to reach $14.4bn in 2012 with an annual growth rate of 5.3% from 2007 to 2012.
The introduction of DES in 2002 spurred a huge growth in the coronary stents market that has continued. Because of a marked reduction in restenosis rate, DES quickly gained healthcare professionals' acceptance and the device is increasingly viewed as a treatment option for atherosclerotic coronary artery disease.
No other medical equipment market in the past few years has been as dynamic as the DES market in the US. More than 100% growth in 2004, a huge decline in 2007, a monopolistic landscape then and a fiercely competitive landscape now – the market has seen it all. During 2005–2006 the market was grappling with concerns over late-stage thrombosis following the use of DES.
The results of the COURAGE trial in March 2007 only worsened the situation, making stent sales fall to a record level. The market, which showed the first signs of revival in the second quarter of 2008, recorded a positive yearly growth over 2007.
Positive clinical outcomes from Abbott Vascular's XIENCE™ V Everolimus Eluting Coronary Stent and Medtronic's Endeavor® Zotarolimus-Eluting Coronary Stent and the subsequent launch helped stabilise the US (DES) market in 2008.
This revival should be further aided by a number of high-value product launches in coming years, offering hope that the global interventional cardiology market will continue to grow at a steady pace.
Heart rhythm management devices
The CRM market remained the second-largest category in the cardiovascular devices market in 2007. The global CRM market, lead by Medtronic, St Jude Medical, Boston Scientific and Biotronik is valued at $8.3bn in 2007 and is forecast to grow by 5.1% annually during 2007-2012 to reach $10.7bn by 2012.
Historically, advances in imaging technology improved the safety and accuracy level of cardiac surgeries and device implantation, leading to an increase in CRM procedures. Now the CRM devices market is driven by the growing patient awareness of cardiac resynchronisation therapy (CRT), patients' active role in exploring the treatment options, and high disease incidence of congestive heart failure (CHF), with more than half a million new such cases being identified every year in the US alone.
Following product recalls in 2005 due to safety concerns over device malfunctions, the CRM devices market slowed in 2006 and 2007. With medical device companies addressing safety issues and no significant recalls happening since late 2007, surgeons' and consumers' confidence has risen. Within the overall CRM devices market, CRT devices are expected to be in high demand compared to single and dual-chamber models of pacemakers, due to the perceived advantages of biventricular pacing.
Electrophysiology devices market requires boost
One market not doing quite as well as the others, however, is the global electrophysiology devices market. It was valued at $1.4bn in 2007 and forecast to grow by 7.7% annually from 2007 to 2012, to reach $2bn by 2012.
The electrophysiology devices market comprises of electrophysiology labs, electrophysiology diagnostic catheters and electrophysiology ablation catheters. Electrophysiology diagnostic catheters and ablation catheters are forecast to have strong growth for the next three to five years owing to positive demographics, public and private reimbursement and a fast-ageing population. Technological advances such as the use of robot systems for diagnostic and ablation procedures is expected to have a positive impact on market growth.
The economic downturn across the globe is, however, having a negative impact on capital equipment markets such as electrophysiology lab systems. Limited availability of funds and borrowings and reduced hospital budgets is expected to lead to a decline in their market segment growth.
Despite this, M&A activity is high in this market with major players acquiring small and niche companies. Medtronic has been very active with its acquisition of Cryocath Technologies in 2008 and Ablation Frontiers in 2009. Product expansion plans to meet the demands of physicians, strong pipeline products of targeted companies, inorganic growth opportunities and the desire to enter new market segments are acting as strong drivers for heightened activity on the electrophysiology M&A landscape.
A safe bet?
While significant activity is expected in the interventional cardiology, CRM and electrophysiology devices categories, high growth forecasts in other categories such as cardiovascular surgery, peripheral vascular devices and cardiovascular prosthetic devices will ensure that the overall cardiovascular devices market continues to grow at a steady pace.
Factors like an ageing population, increasing patient awareness for heart-related diseases and high success rates of available treatment options – all unavoidable in today's day and age – are leading to continuous growth in the global cardiovascular devices market. It is a healthy place to be for the healthcare firms that battled out the storms of the past.
The Global Markets Direct report is available for purchase at 'Global Cardiovascular Devices Investment Opportunities, Analysis and Forecasts to 2012'. For more Global Markets Direct reports, see www.global-market-research.net.