Med-Tech Innovation Advanced Wound Care
Traditional dry* 38%
Moist 38%
as well as by Smith & Nephew, ConvaTec, Mölnlycke Health Care, Systagenix Wound Management (previously Johnson & Johnson Wound Management) and Coloplast, all of which are predominately focused on moist wound care products. With many companies not disclosing their advanced wound care sales, it is difficult to provide exact market share percentages for every company. However, Espicom believes KCI held 27% of the market in 2009, Smith & Nephew 16.5%, ConvaTec 10%, Mölnlycke 9%, and both Systagenix and Coloplast 6%, and 25% was held by smaller and privately held companies.
Other 1%
Professional wound care market by product type, 2009
NPWT 19%
Source: Espicom internal estimates *Estimates are based on dry traditional product sales in the professional healthcare market only
Biologics 4%
Merges and acquisitions
Diabetic ulcers. The number of elderly patients and people with diabetes is increasing and expected to continue to rise. This leads to a corresponding rise in the number of diabetic ulcers requiring treatment and a strong demand for advanced wound care products in the future, as well as more interest in the development of better products. The International Diabetes Federation estimates that
there were 285 million people with diabetes globally in 2009 and that the total number will exceed 435 million in 2030 if current rates of growth continue unchecked. Developed world studies have estimated that 15% of people with diabetes will ultimately have diabetic foot ulcers. Pressure ulcers. On the basis of available data, new
pressure ulcers are estimated to occur in 4 to 10% of patients admitted to acute hospitals in the UK. In the community, it is not known what proportion of people is affected by new pressure ulcers because reliable data are not available. However, a review by Kaltenthaler and colleagues in 2001 found the rates of pressure ulcers in the community in the UK vary between 4.4 and 6.8%. To treat pressure ulcers, the UK’s National Institute of Clinical Excellence recommends the use of advanced wound care dressings such as hydrocolloids, hydrogels and foams in preference to basic dressings such as gauze, paraffin gauze and simple dressing pads. Sometimes other treatments may be needed, including electrical stimulation and NPWT. Venous stasis ulcers. These are the most common form of leg ulcers. It has been estimated that more than 600,000 people are treated for venous leg ulcers each year in the US. However, this number is likely to be an underestimation of the true prevalence of venous ulceration because many patients fail to seek medical care. Estimates range from 1 to 2% of populations studied.
Market competitors Currently, the advanced wound care market is dominated by Kinetic Concepts (KCI) and its NPWT products,
34 ¦ April 2011
Mergers and acquisitions play a critical role in the wound care industry. They have enabled the market leaders to expand their technology to address new sections of the market or provide them with access to new technologies so they are not left behind. Transactions in 2010 included Healthpoint’s purchase of two cell-based technologies from Intercytex and Mesoblast agreeing to acquire Angioblast. This provided it with new stem cell-based technology in development mainly for cardiac regeneration, but also for treating skin ulcers. These transactions provide Healthpoint and Mesoblast with new intellectual property and development pipelines in the promising area of biologics. One company to have recently gained a presence in the advanced wound care market is Israeli pharmaceutical company, Teva Pharmaceutical Industries. Teva has shares in MediWound, which has developed the Debrase Gel Dressing, a bromelain-based enzymatic debriding agent. In June 2010, MediWound signed a memoranda of understanding with Polyheal, a company that has developed a microsphere-based technology for treating hard-to-heal wounds. Under the terms of the agreement, MediWound would gain an exclusive licence to manufacture and develop Polyheal’s products, which Teva would exclusively commercialise.
Future growth
Given the fragmented nature of the wound care market and the number of private companies operating in this area, it can be challenging to quantify the market. However, based on all available data, Espicom conservatively estimates that in 2009, the advanced wound care market was worth US$5.1 billion. Although the advanced wound care market saw double-digit growth before 2008, the growth rate has slowed more recently. The number of patients requiring treatments for chronic and challenging wounds has and will continue to rise. However, growth in terms of sales volumes is being affected by increasing competition that is bringing down selling prices. In addition, the market is seeing declines in reimbursement levels as governments seek to reign in healthcare expenditure. Given the fact that pricing is likely to remain weak at least in the short term, but some growth will come from the increasing numbers of chronic wounds and the introduction of new products, Espicom is predicting market growth of approximately 4% for 2011.
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