Global Markets and Technologies for Home Medical Equipment--Focus on Japan
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INTRODUCTION
Home medical equipment (HME) is a multibillion-dollar market. Since BCC published its last study of the HME market in 2010, the market has continued to evolve, as populations age and a growing number of older people wish and are financially able to live in their own homes for as long as possible, rather than going into a nursing home or other institutional care facility. These demographic and attitudinal shifts in the health care market are reinforced by technological developments such as wireless home monitoring, and economic trends, like the rising cost of institutional care and a growing receptivity to home health care among physicians and private and public insurers.
Since the prior research study was published, the market has continued to evolve, due to factors such as an aging population, increased incidence of heart disease and other conditions requiring close patient monitoring and technological developments such as wireless remote monitoring.
STUDY BACKGROUND
These trends are global, at least in advanced industrial nations. However, most published analyses of the HME market focus on the U.S. market. Since U.S. medical equipment manufacturers are among the largest suppliers to the global health care market, they need to gain the most detailed understanding of international markets for their products, including HME.
STUDY GOALS AND OBJECTIVES
This report is intended to provide an objective, quantitative analysis that addresses the global market for HME in the context of technological change and an evolving market. More specific objectives are to
Identify and segment the main types of HME that have been commercialized to date.
Analyze the historical and current value of shipments of each of these product segments in specified applications, end-user and geographical markets.
Identify and evaluate the impact of demographic, technological, regulatory and other factors that will drive future demand in each of these segments.
Forecast the value of future shipments in each segment.
Identify promising new technologies and products still in the development and testing stage that are likely to be commercialized successfully in the next five years.
Identify leading HME vendors.
INTENDED AUDIENCE
The report has been written for the entire medical and health care interest community, but it is tailored especially for readers with an interest in the marketing and management dimensions of home medical equipment, such as
Manufacturers and distributors of HME.
Regulators and health insurers.
Investors.
The financial and analyst community.
SCOPE AND FORMAT
This report is an analytical business tool whose primary purpose is to describe and analyze the dynamics of the global market for home medical equipment. Home medical equipment is defined as durable equipment (i.e., equipment with an expected service life of at least three years) that:
Can withstand repeated use.
Is primarily and customarily used to serve a medical purpose.
Generally is not useful to a person in the absence of an illness or injury.
Is not implanted inside the patient's body.
Is appropriate for use in the home.
Does not require a trained medical professional to operate.
Usually requires a doctor's prescription to buy (e.g., excludes most canes, walkers and other elderly and disabled assistive devices).
Generally does not include drugs and other consumables.
While the report's coverage is global, it focuses on selected international markets for HME, including:
North America (United States, Canada).
European Union (France, Germany, Italy, U.K., other European countries).
Japan.
BRIC nations (Brazil, Russia, India, China).
Rest of the world.
The report includes sections on the following topics:
Major product types and applications, both commercial and developmental.
Market size and segmentation, including historical data on sales by product type and geographical market.
Market drivers and constraints.
Detailed market projections through 2016.
Patent analysis.
Competitor profiles.
METHODOLOGY AND INFORMATION SOURCES
This study was prepared using both primary and secondary research methodologies. The findings and conclusions of this report are based on information gathered from manufacturers and distributors of HME, multilateral and government agencies, caregivers, insurance companies and other knowledgeable sources. Interview data were combined with information gathered through an extensive review of secondary sources such as trade publications, trade associations, company literature and online databases to produce the baseline market estimates contained in this report.
The base year for analysis and projection is 2010. With 2010 as a baseline, market projections were developed for 2011 to 2016. These projections are based on a combination of a consensus among primary research sources and our understanding of key market drivers and their impact from a historical and analytical perspective. The analytical methodologies used to generate the market estimates are described in detail in the section titled Detailed Market Projections.
All dollar projections presented in this report are in 2010 constant dollars.
ANALYST CREDENTIALS
The author of this report is Andrew McWilliams. Mr. McWilliams is a partner in the Boston-based international technology and marketing consulting firm, 43rd Parallel LLC. In addition to being the author of the previous (2007 and 2010) editions of this report, Mr. McWilliams is the author of several other Business Communications Company studies of health care and related industries. These include HLC016D Microelectronic Medical Implants: Products, Technologies and Opportunities; HLC036D Medical Robotics and Computer-assisted Surgery: The Global Market; HLC038C Patient Monitoring; HLC047C Disabled and Elderly Assistive Technologies; HLC051F The Market for Minimally Invasive Medical Devices; HLC070A Preventive Healthcare Technologies, Products and Markets; and AVM050B Smart and Interactive Textiles.
TABLE OF CONTENTS
CHAPTER ONE: INTRODUCTION 1
STUDY BACKGROUND 1
STUDY GOALS AND OBJECTIVES 1
INTENDED AUDIENCE 2
SCOPE AND FORMAT 2
METHODOLOGY AND INFORMATION SOURCES 3
ANALYST CREDENTIALS 3
RELATED BCC RESEARCH 4
BCC ON-LINE SERVICES 4
DISCLAIMER 5
CHAPTER TWO: EXECUTIVE SUMMARY 6
SUMMARY TABLE GLOBAL SALES OF HOME MEDICAL
EQUIPMENT, THROUGH 2016 ($ MILLIONS) 6
SUMMARY FIGURE HOME MEDICAL EQUIPMENT SHARES BY
REGION, 2009–2016 (%) 7
CHAPTER THREE: OVERVIEW 8
GENERAL DESCRIPTION 8
DEFINITIONS 8
PRODUCT SEGMENTS 8
ASSISTIVE DEVICES 9
Wheelchairs and Scooters 9
Wheelchairs 9
Scooters 10
Home Care Beds 11
INFUSION PRODUCTS 11
Insulin Pumps 12
RESPIRATORY THERAPY PRODUCTS 12
Inhalers 12
Metered Dose Inhalers 13
Dry Powder Inhalers 13
Nebulizers 13
Oxygen Concentrators 14
Gaseous Oxygen System 14
Continuous Positive Airway Pressure (CPAP) Devices 15
Home Ventilators 16
Suction Machines 16
DIALYSIS EQUIPMENT 17
Hemodialysis 17
Dialysis Machine 18
Peritoneal Dialysis 18
CCPD Cycler 18
HOME DEFIBRILLATORS 19
MONITORS AND SENSORS 20
Blood Pressure Monitors 20
Aneroid Monitors 21
Digital Blood Pressure Monitors 21
Peak Flow Meters 22
Glucose Monitors 22
Glucose Monitors (Continued) 23
Glucose Monitors (Continued) 24
Apnea and SIDS Monitors 24
Cholesterol Monitors 25
Fetal Monitors 26
Home Cardiac Monitors 26
New Home Monitoring Technologies 27
Embedded Monitors 27
Elderly Walkers 27
Wearable Monitors 28
TELEMETRY DEVICES 29
Telehomecare 30
Mobile Phone-Based Technologies 30
Bluetooth 31
ZigBee 31
Signal Transmission via Human Skin 32
MISCELLANEOUS TYPES OF HME 32
Lymphedema Pumps 33
HEALTH CONDITIONS THAT AFFECT THE MARKET FOR HME 33
MOBILITY IMPAIRMENTS 34
Types of Mobility Impairment 34
Paralysis 34
Arthritis 34
Osteoporosis 35
Age-Related Loss of Strength/Balance/Coordination 35
Surgical Recovery and Rehabilitation 35
Neuromuscular Disorders 36
HME Used to Increase Mobility 36
Prevalence of Mobility Impairments 37
FIGURE 1 LEADING CONDITIONS ASSOCIATED WITH
WHEELCHAIR/SCOOTER USE (PERCENTAGE OF TOTAL
WHEELCHAIR USERS) 38
TABLE 1 GLOBAL PREVALENCE OF MOTION IMPAIRMENTS
REQUIRING THE USE OF A WHEELCHAIR OR SCOOTER,
THROUGH 2016 (MILLION PEOPLE) 39
TABLE 2 TRENDS IN PREVALENCE OF MOTION IMPAIRMENTS
REQUIRING A WHEELCHAIR OR SCOOTER, BY GEOGRAPHICAL
MARKET, THROUGH 2016 (MILLION PEOPLE) 40
TABLE 2 (CONTINUED) 41
OBESITY 41
HME Used in the Management of Obesity 41
Prevalence of Obesity 41
TABLE 3 OBESITY LEVELS IN SELECTED COUNTRIES (% OF
ADULT POPULATION) 42
HYPERTENSION 42
Types of HME Used in Treatment of Hypertension 43
Prevalence of Hypertension 43
TABLE 4 TRENDS IN PREVALENCE OF HYPERTENSION, THROUGH
2016 (MILLION CASES) 44
CARDIOVASCULAR DISEASE 44
Arrhythmia 45
Tachyarrythmia 45
Brachycardia 46
HME Used in the Treatment of Arrhythmia 46
Prevalence of Arrhythmia 47
TABLE 5 TRENDS IN PREVALENCE OF ARRHYTHMIA, THROUGH
2016 (MILLION CASES) 47
TABLE 5 (CONTINUED) 48
DIABETES 48
Types of Diabetes 48
HME Used to Treat Diabetes 49
Prevalence of Diabetes and Future Trends 49
TABLE 6 TRENDS IN PREVALENCE OF DIABETES, THROUGH 2016
(MILLION CASES) 50
HIGH CHOLESTEROL 50
HME Used in the Management of High Cholesterol Levels 51
Prevalence of High Cholesterol Levels 51
SLEEP DISORDERS 51
Types of Sleep Disorders 52
HME Used in Connection with Sleep Disorders 52
HME Used in the Treatment or Management of Sleep
Disorders 52
Prevalence of Sleep Disorders and Future Trends 53
FETAL DISORDERS 53
HME Used in the Treatment or Management of Fetal
Disorders 53
Prevalence of Fetal Disorders and Future Trends 54
FIGURE 2 MISCARRIAGES AND STILLBIRTHS IN THE U S , 2010 (%
OF TOTAL CONFIRMED PREGNANCIES) 54
ASTHMA 55
HME Used in the Treatment or Management of Asthma 56
Prevalence of Asthma and Future Trends 56
TABLE 7 TRENDS IN THE PREVALENCE OF ASTHMA, THROUGH
2016 (MILLION CASES) 57
CHRONIC OBSTRUCTIVE PULMONARY DISEASE 57
HME Used in the Treatment or Management of COPD 58
Prevalence of COPD and Future Trends 58
KIDNEY FAILURE 58
HME Used in the Treatment of Kidney Failure 59
Prevalence of Kidney Failure and Future Trends 59
TABLE 8 TRENDS IN DIALYSIS PATIENT POPULATION, THROUGH
2016 (THOUSAND PEOPLE) 60
FIGURE 3 GLOBAL DIALYSIS PATIENT POPULATION TREND, 2010–
2016 (MILLION PATIENTS) 61
LYMPHEDEMA 62
Types of Lymphedema 62
Primary Lymphedema 62
Secondary Lymphedema 62
HME Used in the Management of Lymphedema 62
Prevalence of Lymphedema 63
DEMOGRAPHICS AND ECONOMICS 63
TOTAL POPULATION 63
TABLE 9 TRENDS IN TOTAL POPULATION, BY COUNTRY,
THROUGH 2016 (MILLION PEOPLE) 63
TABLE 9 (CONTINUED) 64
FIGURE 4 GLOBAL POPULATION TRENDS, 2010–2016 (MILLION
PEOPLE) 64
ELDERLY PEOPLE 65
TABLE 10 TRENDS IN POPULATION OF PEOPLE AGE 65 YEARS
AND OLDER, BY COUNTRY, THROUGH 2016 (MILLION PEOPLE) 65
TABLE 10 (CONTINUED) 66
FIGURE 5 TRENDS IN THE GLOBAL POPULATION AGE 65 YEARS
AND OLDER, 2010–2016 (MILLION PEOPLE) 66
OLDER PEOPLE LIVING IN THEIR OWN HOMES OR WITH
CHILDREN 67
FIGURE 6 PERCENTAGE OF PEOPLE AGE 65 AND OLDER LIVING
IN THEIR OWN HOMES OR WITH CHILDREN BY COUNTRY, 2002
(%) 67
FIGURE 6 (CONTINUED) 68
FIGURE 7 TRENDS IN THE PERCENTAGE OF AMERICANS 65 AND
OLDER REMAINING IN THEIR HOMES, 1985-2009 (%) 69
HOUSEHOLD INCOME 70
FIGURE 8 TRENDS IN THE MEDIAN INCOME OF U S ELDERLY
HOUSEHOLDS, 2003–2009 ($ THOUSANDS) 70
FIGURE 9 DISTRIBUTION OF U S ELDERLY HOUSEHOLDS BY
INCOME LEVEL, 2000 AND 2008 (% OF TOTAL ELDERLY
HOUSEHOLDS) 71
EXPENDITURES ON HOME HEALTH CARE 72
FIGURE 10 TRENDS IN U S EXPENDITURES ON HOME HEALTH
CARE, 2002–2010 ($ BILLIONS) 72
OTHER FACTORS DRIVING THE HME MARKET 73
PHYSICIAN ATTITUDES TOWARD HOME CARE 73
FIGURE 11 TREND IN THE NUMBER OF MEDICARE-PAID
PHYSICIAN HOUSE CALLS, 2000 AND 2010 (MILLION HOUSE
CALLS) 73
HOSPITAL/NURSING HOME COSTS 74
FIGURE 12 TRENDS IN U S HOSPITAL AND NURSING HOME
COSTS, 2000–2010 ($) 74
FIGURE 12 (CONTINUED) 75
REGULATORY AND LEGISLATIVE ISSUES 75
U S 75
New Devices 76
New Devices (Continued) 77
Existing Devices 78
European Union 79
European Union (Continued) 80
Japan 81
HEALTH INSURANCE 82
U S 82
Medicare and Medicaid 82
Types of HME Covered 82
Recent Legislation 83
Medicare Prescription Drug,
Improvement and Modernization
Act of 2003 83
Changes in Reimbursement 84
Competitive Bidding 84
Accreditation Requirement 84
Deficit Reduction Act of 2005 85
Challenges 85
Medicare Improvements for Patients
and Providers Act of 2008 86
Reimbursement for Home Dialysis 86
Patient Protection and Affordable
Health Care Act 87
Patient … (Continued) 88
Other Countries 89
FIGURE 13 PER CAPITA EXPENDITURES ON HME, 2010 ($) 89
FIGURE 13 (CONTINUED) 90
CHAPTER FOUR: GLOBAL HME MARKETS 91
SUMMARY 91
GLOBAL MARKET TRENDS 91
TABLE 11 GLOBAL HME SALES BY TYPE OF EQUIPMENT,
THROUGH 2016 ($ MILLIONS) 91
FIGURE 14 TRENDS IN THE GLOBAL HME MARKET, 2010–2016 ($
BILLIONS) 92
MARKET BY HME SEGMENT 92
FIGURE 15 HME MARKET BY TYPE OF HME, 2010 AND 2016 (%) 93
FIGURE 15 (CONTINUED) 94
MARKET BY DISEASE/CONDITION TREATED 94
TABLE 12 HME MARKET BY TYPE OF DISEASE/CONDITION
TREATED, THROUGH 2016 ($ MILLIONS) 95
FIGURE 16 HME MARKET BY TYPE OF DISEASE/CONDITION
TREATED, 2010 AND 2016 (%) 95
FIGURE 16 (CONTINUED) 96
MARKET BY GEOGRAPHICAL SEGMENT 97
TABLE 13 MAJOR GEOGRAPHICAL MARKETS FOR HME, THROUGH
2016 ($ MILLIONS) 97
FIGURE 17 HME MARKET BY REGION, 2010 AND 2016 (%) 98
Market by Geographical … (Continued) 99
CHAPTER FIVE: THE JAPANESE MARKET 100
SUMMARY 100
TABLE 14 JAPANESE MARKET FOR HME, THROUGH 2016 ($
MILLIONS) 100
ASSISTIVE DEVICES 100
TABLE 15 JAPANESE MARKET FOR ASSISTIVE DEVICES,
THROUGH 2016 ($ MILLIONS) 101
WHEELCHAIRS AND SCOOTERS 101
TABLE 16 JAPANESE MARKET FOR WHEELCHAIRS AND
SCOOTERS, THROUGH 2016 ($ MILLIONS) 101
HOME CARE BEDS 101
TABLE 17 JAPANESE MARKETS FOR HOME CARE BEDS, THROUGH
2016 ($ MILLIONS) 102
INFUSION PRODUCTS 102
TABLE 18 JAPANESE MARKET FOR INSULIN PUMPS, THROUGH
2016 ($ MILLIONS) 102
RESPIRATORY THERAPY PRODUCTS 102
TABLE 19 JAPANESE MARKET FOR RESPIRATORY THERAPY
PRODUCTS, THROUGH 2016 ($ MILLIONS) 103
DIALYSIS EQUIPMENT 104
TABLE 20 JAPANESE HOME DIALYSIS MACHINE MARKET,
THROUGH 2016 ($ MILLIONS) 104
HOME DEFIBRILLATORS 104
TABLE 21 JAPANESE HOME DEFIBRILLATOR MARKET, THROUGH
2016 ($ MILLIONS) 104
MONITORS AND SENSORS 105
TABLE 22 JAPANESE MARKET FOR HOME MONITORING DEVICES
BY TYPE OF DEVICE, THROUGH 2016 ($ MILLIONS) 105
TELEMETRY DEVICES 106
TABLE 23 JAPANESE HOME TELEMETRY EQUIPMENT MARKETS,
THROUGH 2016 ($ MILLIONS) 106
OTHER TYPES OF HME 106
TABLE 24 JAPANESE HOME LYMPHEDEMA PUMP MARKET,
THROUGH 2016 ($ MILLIONS) 106
APPENDIX A: PATENT ANALYSIS 107
TABLE 25 U S HME PATENTS ISSUED SINCE 1975 107
FIGURE 18 U S HME PATENTS ISSUED SINCE 1975 (%) 108
FIGURE 19 LARGEST HME PATENT HOLDERS (% OF TOTAL HME
PATENTS ISSUED THROUGH MARCH 25, 2010) 109
APPENDIX B: COMPANY PROFILES 110
A&D MEDICAL/LIFESOURCE 110
ABBOTT LABORATORIES, INC 110
AEROTEL MEDICAL SYSTEMS, LTD 110
ALLIED HEALTHCARE PRODUCTS, INC 111
AMERICAN TELECARE, INC 111
ANALOGIC INC 111
ARADIGM CORP 112
BAXTER INTERNATIONAL, INC 112
CARD GUARD AG 113
CARETRENDS 113
CYBERNET MEDICAL CORP 114
ECHO THERAPEUTICS 114
FRESENIUS MEDICAL CARE AG & CO KGAA 115
HEALTH FRONTIER, INC 115
HONEYWELL HOMMED 115
INVACARE CORP 116
LIFESCAN, INC 116
MEDLINE INDUSTRIES, INC 117
MEDTRONIC, INC 117
MEDTRONIC MINIMED 117
NIPRO DIAGNOSTICS INC 118
NXSTAGE MEDICAL, INC 118
NONIN MEDICAL, INC 119
OBS MEDICAL 119
OMRON HEALTHCARE, INC 120
PARI PHARMA 120
PHILIPS HEALTHCARE 120
POLYMER TECHNOLOGY SYSTEMS 121
PREMD INC 121
PRIDE MOBILITY PRODUCTS CORP 121
PULSE METRIC INC 122
RESMED, INC 122
ROCHE DIAGNOSTICS 122
SCOTTCARE CORP 123
SENSATEX INC 123
SOLIANIS MONITORING AG 123
SUNRISE MEDICAL INC 124
VECTURA GROUP PLC 124
VIVOMETRICS INC 125
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