Global Markets and Technologies for Home Medical Equipment--Focus on North America
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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, 2010–2016 (%) 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
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 28
Wearable Monitors 28
Wearable Monitors (Continued) 29
TELEMETRY DEVICES 30
Telehomecare 30
Mobile Phone-Based Technologies 31
Bluetooth 31
ZigBee 32
Signal Transmission via Human Skin 32
MISCELLANEOUS TYPES OF HME 33
Lymphedema Pumps 33
HEALTH CONDITIONS THAT AFFECT THE MARKET FOR HME 33
MOBILITY IMPAIRMENTS 34
Types of Mobility Impairment 34
Paralysis 34
Arthritis 35
Osteoporosis 35
Age-Related Loss of Strength/Balance/Coordination 35
Surgical Recovery and Rehabilitation 36
Neuromuscular Disorders 36
HME Used to Increase Mobility 37
Prevalence of Mobility Impairments 37
FIGURE 1 LEADING CONDITIONS ASSOCIATED WITH
WHEELCHAIR/SCOOTER USE (PERCENTAGE OF TOTAL
WHEELCHAIR USERS) 37
FIGURE 1 (CONTINUED) 38
TABLE 1 GLOBAL PREVALENCE OF MOTION IMPAIRMENTS
REQUIRING THE USE OF A WHEELCHAIR OR SCOOTER,
THROUGH 2016 (MILLION PEOPLE) 38
TABLE 1 (CONTINUED) 39
TABLE 2 TRENDS IN PREVALENCE OF MOTION IMPAIRMENTS
REQUIRING A WHEELCHAIR OR SCOOTER, BY GEOGRAPHICAL
MARKET, THROUGH 2016 (MILLION PEOPLE) 40
OBESITY 40
HME Used in the Management of Obesity 41
Prevalence of Obesity 41
TABLE 3 OBESITY LEVELS IN SELECTED COUNTRIES (% OF
ADULT POPULATION) 41
TABLE 3 (CONTINUED) 42
HYPERTENSION 42
Types of HME Used in Treatment of Hypertension 42
Prevalence of Hypertension 43
TABLE 4 TRENDS IN PREVALENCE OF HYPERTENSION,
THROUGH 2016 (MILLION CASES) 43
TABLE 4 (CONTINUED) 44
CARDIOVASCULAR DISEASE 44
Arrhythmia 44
Tachyarrythmia 44
Brachycardia 45
HME Used in the Treatment of Arrhythmia 46
Prevalence of Arrhythmia 46
TABLE 5 TRENDS IN PREVALENCE OF ARRHYTHMIA, THROUGH
2016 (MILLION CASES) 47
DIABETES 47
Types of Diabetes 48
HME Used to Treat Diabetes 48
Prevalence of Diabetes and Future Trends 48
TABLE 6 TRENDS IN PREVALENCE OF DIABETES, THROUGH 2016
(MILLION CASES) 49
TABLE 6 (CONTINUED) 50
HIGH CHOLESTEROL 50
HME Used in the Management of High Cholesterol Levels 50
Prevalence of High Cholesterol Levels 50
SLEEP DISORDERS 51
Types of Sleep Disorders 51
HME Used in Connection with Sleep Disorders 51
HME Used in the Treatment or Management of Sleep
Disorders 52
Prevalence of Sleep Disorders and Future Trends 52
FETAL DISORDERS 53
HME Used in the Treatment or Management of Fetal
Disorders 53
Prevalence of Fetal Disorders and Future Trends 53
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 55
Prevalence of Asthma and Future Trends 55
TABLE 7 TRENDS IN THE PREVALENCE OF ASTHMA, THROUGH
2016 (MILLION CASES) 56
CHRONIC OBSTRUCTIVE PULMONARY DISEASE 56
HME Used in the Treatment or Management of COPD 57
Prevalence of COPD and Future Trends 57
KIDNEY FAILURE 57
HME Used in the Treatment of Kidney Failure 58
Prevalence of Kidney Failure and Future Trends 58
TABLE 8 TRENDS IN DIALYSIS PATIENT POPULATION, THROUGH
2016 (THOUSAND PEOPLE) 59
FIGURE 3 GLOBAL DIALYSIS PATIENT POPULATION TREND, 2010–
2016 (MILLION PATIENTS) 60
LYMPHEDEMA 61
Types of Lymphedema 61
Primary Lymphedema 61
Secondary Lymphedema 61
HME Used in the Management of Lymphedema 61
Prevalence of Lymphedema 62
DEMOGRAPHICS AND ECONOMICS 62
TOTAL POPULATION 62
TABLE 9 TRENDS IN TOTAL POPULATION, BY COUNTRY,
THROUGH 2016 (MILLION PEOPLE) 62
TABLE 9 (CONTINUED) 63
FIGURE 4 GLOBAL POPULATION TRENDS, 2010–2016 (MILLION
PEOPLE) 63
ELDERLY PEOPLE 64
TABLE 10 TRENDS IN POPULATION OF PEOPLE AGE 65 YEARS
AND OLDER, BY COUNTRY, THROUGH 2016 (MILLION PEOPLE) 64
TABLE 10 (CONTINUED) 65
FIGURE 5 TRENDS IN THE GLOBAL POPULATION AGE 65 YEARS
AND OLDER, 2010–2016 (MILLION PEOPLE) 65
OLDER PEOPLE LIVING IN THEIR OWN HOMES OR WITH
CHILDREN 66
FIGURE 6 PERCENTAGE OF PEOPLE AGE 65 AND OLDER LIVING
IN THEIR OWN HOMES OR WITH CHILDREN BY COUNTRY, 2002
(%) 66
FIGURE 6 (CONTINUED) 67
FIGURE 7 TRENDS IN THE PERCENTAGE OF AMERICANS 65 AND
OLDER REMAINING IN THEIR HOMES, 1985-2009 (%) 68
HOUSEHOLD INCOME 69
FIGURE 8 TRENDS IN THE MEDIAN INCOME OF U S ELDERLY
HOUSEHOLDS, 2003–2009 ($ THOUSANDS) 69
FIGURE 9 DISTRIBUTION OF U S ELDERLY HOUSEHOLDS BY
INCOME LEVEL, 2000 AND 2008 (% OF TOTAL ELDERLY
HOUSEHOLDS) 70
EXPENDITURES ON HOME HEALTH CARE 71
FIGURE 10 TRENDS IN U S EXPENDITURES ON HOME HEALTH
CARE, 2002–2010 ($ BILLIONS) 71
OTHER FACTORS DRIVING THE HME MARKET 72
PHYSICIAN ATTITUDES TOWARD HOME CARE 72
FIGURE 11 TREND IN THE NUMBER OF MEDICARE-PAID
PHYSICIAN HOUSE CALLS, 2000 AND 2010 (MILLION HOUSE
CALLS) 72
HOSPITAL/NURSING HOME COSTS 73
FIGURE 12 TRENDS IN U S HOSPITAL AND NURSING HOME
COSTS, 2000–2010 ($) 73
FIGURE 12 (CONTINUED) 74
REGULATORY AND LEGISLATIVE ISSUES 74
U S 74
New Devices 75
New Devices (Continued) 76
Existing Devices 77
European Union 78
European Union (Continued) 79
Japan 80
HEALTH INSURANCE 81
U S 81
Medicare and Medicaid 81
• Types of HME Covered 81
• Recent Legislation 82
– Medicare Prescription Drug,
Improvement and Modernization
Act of 2003 82
– Changes in Reimbursement 83
– Competitive Bidding 83
– Accreditation Requirement 83
– Deficit Reduction Act of 2005 84
– Challenges 84
– Medicare Improvements for
Patients and Providers Act of 2008 85
– Reimbursement for Home Dialysis 85
– Patient Protection and Affordable
Health Care Act 86
Patient … (Continued) 87
Other Countries 88
FIGURE 13 PER CAPITA EXPENDITURES ON HME, 2010 ($) 88
FIGURE 13 (CONTINUED) 89
CHAPTER FOUR: GLOBAL HME MARKETS 90
SUMMARY 90
GLOBAL MARKET TRENDS 90
TABLE 11 GLOBAL HME SALES BY TYPE OF EQUIPMENT,
THROUGH 2016 ($ MILLIONS) 90
FIGURE 14 TRENDS IN THE GLOBAL HME MARKET, 2010–2016 ($
BILLIONS) 91
MARKET BY HME SEGMENT 91
FIGURE 15 HME MARKET BY TYPE OF HME, 2010 AND 2016 (%) 92
FIGURE 15 (CONTINUED) 93
MARKET BY DISEASE/CONDITION TREATED 93
TABLE 12 HME MARKET BY TYPE OF DISEASE/CONDITION
TREATED, THROUGH 2016 ($ MILLIONS) 94
FIGURE 16 HME MARKET BY TYPE OF DISEASE/CONDITION
TREATED, 2010 AND 2016 (%) 94
FIGURE 16 (CONTINUED) 95
MARKET BY GEOGRAPHICAL SEGMENT 96
TABLE 13 MAJOR GEOGRAPHICAL MARKETS FOR HME, THROUGH
2016 ($ MILLIONS) 96
FIGURE 17 HME MARKET BY REGION, 2010 AND 2016 (%) 97
Market by Geographical … (Continued) 98
CHAPTER FIVE: THE NORTH AMERICAN MARKET 99
SUMMARY 99
TABLE 14 NORTH AMERICAN MARKETS FOR HME BY COUNTRY,
THROUGH 2016 ($ MILLIONS) 99
TABLE 15 NORTH AMERICAN MARKETS FOR HME BY TYPE OF
DEVICE, THROUGH 2016 ($ MILLIONS) 100
ASSISTIVE DEVICES 100
TABLE 16 NORTH AMERICAN MARKETS FOR ASSISTIVE DEVICES,
THROUGH 2016 ($ MILLIONS) 100
WHEELCHAIRS AND SCOOTERS 100
TABLE 17 NORTH AMERICAN MARKETS FOR WHEELCHAIRS AND
SCOOTERS, THROUGH 2016 ($ MILLIONS) 101
FIGURE 18 U S WHEELCHAIR AND SCOOTER MARKET, 2010
(PERCENT OF TOTAL SALES) 102
HOME CARE BEDS 102
TABLE 18 NORTH AMERICAN MARKETS FOR HOME CARE BEDS,
THROUGH 2016 ($ MILLIONS) 103
INFUSION PRODUCTS 103
TABLE 19 NORTH AMERICAN MARKETS FOR INSULIN PUMPS,
THROUGH 2016 ($ MILLIONS) 103
RESPIRATORY THERAPY PRODUCTS 104
TABLE 20 NORTH AMERICAN MARKETS FOR RESPIRATORY
THERAPY PRODUCTS BY COUNTRY, THROUGH 2016 ($
MILLIONS) 104
TABLE 21 NORTH AMERICAN MARKETS FOR RESPIRATORY
THERAPY PRODUCTS BY TYPES OF PRODUCT, THROUGH 2016
($ MILLIONS) 105
CPAP AND OTHER POSITIVE AIRWAY PRESSURE
DEVICES 105
TABLE 22 NORTH AMERICAN POSITIVE AIR PRESSURE DEVICES
MARKETS, THROUGH 2016 ($ MILLIONS) 106
VENTILATORS 106
TABLE 23 NORTH AMERICAN HOME VENTILATOR MARKETS,
THROUGH 2016 ($ MILLIONS) 106
NEBULIZERS 107
TABLE 24 NORTH AMERICAN NEBULIZER MARKETS, THROUGH
2016 ($ MILLIONS) 107
OXYGEN CONCENTRATORS 108
TABLE 25 NORTH AMERICAN HOME OXYGEN CONCENTRATOR
MARKETS, THROUGH 2016 ($ MILLIONS) 108
GASEOUS OXYGEN SYSTEMS 108
TABLE 26 NORTH AMERICAN MARKETS FOR HOME GASEOUS
OXYGEN SYSTEMS, THROUGH 2016 ($ MILLIONS) 109
AIRWAY SUCTION MACHINES 109
TABLE 27 NORTH AMERICAN HOME SUCTION MACHINE
MARKETS, THROUGH 2016 ($ MILLIONS) 109
DIALYSIS EQUIPMENT 110
TABLE 28 NORTH AMERICAN HOME DIALYSIS MACHINE
MARKETS, THROUGH 2016 ($ MILLIONS) 110
HOME DEFIBRILLATORS 110
TABLE 29 NORTH AMERICAN HOME DEFIBRILLATOR MARKET,
THROUGH 2016 ($ MILLIONS) 111
MONITORS AND SENSORS 111
TABLE 30 NORTH AMERICAN MARKET FOR HOME MONITORING
DEVICES BY TYPE OF DEVICE, THROUGH 2016 ($ MILLIONS) 111
TABLE 31 NORTH AMERICAN MARKETS FOR HOME MONITORING
PRODUCTS, THROUGH 2016 ($ MILLIONS) 112
GLUCOSE MONITORS 112
TABLE 32 NORTH AMERICAN MARKETS FOR GLUCOSE SELFMONITORING
DEVICES, THROUGH 2016 ($ MILLIONS) 112
BLOOD PRESSURE MONITORS 113
TABLE 33 MARKETS FOR HOME BLOOD PRESSURE MONITORS,
THROUGH 2016 ($ MILLIONS) 113
APNEA AND OTHER TYPES OF SLEEP MONITORS 113
TABLE 34 NORTH AMERICAN MARKETS FOR SLEEP APNEA
MONITORS, THROUGH 2016 ($ MILLIONS) 114
CHOLESTEROL MONITORS 114
TABLE 35 NORTH AMERICAN HOME CHOLESTEROL ANALYZER
MARKETS, THROUGH 2016 ($ MILLIONS) 114
FETAL MONITORS 114
TABLE 36 NORTH AMERICAN HOME FETAL MONITOR MARKETS,
THROUGH 2016 ($ MILLIONS) 115
PEAK FLOW (ASTHMA) MONITORS 115
TABLE 37 NORTH AMERICAN PEAK FLOW (ASTHMA) METER
MARKETS, THROUGH 2016 ($ MILLIONS) 116
HOME ECG MONITORS 116
TABLE 38 NORTH AMERICAN HOME ECG MONITOR MARKETS,
THROUGH 2016 ($ MILLIONS) 116
TELEMETRY DEVICES 117
TABLE 39 NORTH AMERICAN HOME TELEMETRY EQUIPMENT
MARKETS, THROUGH 2016 ($ MILLIONS) 117
OTHER TYPES OF HME 117
TABLE 40 NORTH AMERICAN HOME LYMPHEDEMA PUMP
MARKETS, THROUGH 2016 ($ MILLIONS) 118
APPENDIX A: PATENT ANALYSIS 119
TABLE 41 U S HME PATENTS ISSUED SINCE 1975 119
FIGURE 19 U S HME PATENTS ISSUED SINCE 1975 (%) 120
FIGURE 20 LARGEST HME PATENT HOLDERS (% OF TOTAL HME
PATENTS ISSUED THROUGH MARCH 25, 2010) 121
APPENDIX B: COMPANY PROFILES 122
A&D MEDICAL/LIFESOURCE 122
ABBOTT LABORATORIES, INC 122
AEROTEL MEDICAL SYSTEMS, LTD 122
ALLIED HEALTHCARE PRODUCTS, INC 123
AMERICAN TELECARE, INC 123
ANALOGIC INC 123
ARADIGM CORP 124
BAXTER INTERNATIONAL, INC 124
CARD GUARD AG 125
CARETRENDS 125
CYBERNET MEDICAL CORP 126
ECHO THERAPEUTICS 126
FRESENIUS MEDICAL CARE AG & CO KGAA 127
HEALTH FRONTIER, INC 127
HONEYWELL HOMMED 127
INVACARE CORP 128
LIFESCAN, INC 128
MEDLINE INDUSTRIES, INC 129
MEDTRONIC, INC 129
MEDTRONIC MINIMED 129
NIPRO DIAGNOSTICS INC 130
NXSTAGE MEDICAL, INC 130
NONIN MEDICAL, INC 131
OBS MEDICAL 131
OMRON HEALTHCARE, INC 132
PARI PHARMA 132
PHILIPS HEALTHCARE 132
POLYMER TECHNOLOGY SYSTEMS 133
PREMD INC 133
PRIDE MOBILITY PRODUCTS CORP 133
PULSE METRIC INC 134
RESMED, INC 134
ROCHE DIAGNOSTICS 134
SCOTTCARE CORP 135
SENSATEX INC 135
SOLIANIS MONITORING AG 135
SUNRISE MEDICAL INC 136
VECTURA GROUP PLC 136
VIVOMETRICS INC 137
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