France is Europe’s biggest importer and exporter of medical devices. However, current reforms are driving cost reduction and efficiencies. Medtech Business in association with Espicom takes a look at the French market for medical technologies.

France is one of the top five medical device markets in the world, accounting for around 3.9% of the global market.* Within Europe, the market ranks behind Germany and is a similar size to that of the UK.

The country has a well-developed healthcare system, combining public hospitals with commercial clinics that are the main providers of elective surgical treatment. While the public sector is the largest purchaser of most diagnostic and therapeutic equipment, the private sector is the dominant purchaser of surgical equipment and supplies.

The high level of healthcare expenditure (11.8% of GDP) and the substantial health deficit are major concerns that have prompted various reform programmes aimed at curtailing costs and improving efficiency in the healthcare system. For this reason, the medical market is only likely to see moderate growth, rising from US$8.3 billion in 2011 to US$9.8 billion by 2016.

Despite several high-profile investment programmes, France continues to lag behind its European neighbours in some high-technology fields, most notably imaging and radiotherapy equipment. A second five-year cancer plan has now been launched which aims to increase the numbers of scanners.

With flagging domestic production in several sectors the French medical device market is increasingly reliant upon imports, which now account for around 80% of consumption. However, many imported products are re-exported to other countries.

 

The market in 2011

In 2011, the French medical device market (see Figure 1) is valued at US$8,280 million. Consumables is the largest product category, accounting for 20.9% of the overall market, followed by diagnostic imaging (19.8%).

Espicom estimates that the medical device market will grow at an average annual growth rate of 3.5% between 2011 and 2016 – bringing the total market value to US$9.8 billion by 2016.

Orthopaedic and prosthetic devices are expected to continue to be the most dynamic sector of the market, with growth forecast to be more than double the rate for the overall market. Conversely, diagnostic imaging is forecast to have the lowest growth during the 2011–16 period.

 

Predictions for market segments

Figure 2 shows Espicom’s predictions for the major segments of the medical device market.

1. Consumables. The market for medical consumables is estimated at US$1,729 million. The consumables market grew at an annual rate of 5.1% in US dollar terms between 2006 and 2010. Imports supply the greater part of the market. Espicom estimates the consumables market will continue to grow by an average of 3.5% over the next few years.

The wound care products market is forecast to grow at an average annual rate of 2.9% in US dollar terms during the 2011–16 period. Syringes, needles & catheters has been the fastest growing sector of the consumables market and will continue to be, with a CAGR of 4.1% to 2016.

2. Diagnostic imaging apparatus. The market for diagnostic imaging is estimated at US$1,636 million. The market grew at an annual rate of 2.8% between 2006 and 2010. France lags behind its European neighbours in the diagnostic imaging field, though the second cancer plan aims to increase provision of MRI, CT and PET scanners.

Imports supply the greater part of the market, though their market share is lower for radiation apparatus due to the strength of the domestic manufacturing industry. The USA and Germany are the major sources of supply. Espicom estimates that the imaging market will grow by an average of 2.1% between 2011 and 2016.

3. Dental products. The market for dental products is estimated at US$859 million, equal to 10.4% of the total medical device market. The dental products market grew at an annual rate of 4.2% between 2006 and 2010. It is forecast to grow at an annual rate of 3.5% over the next few years, taking the total to US$1,020 million by 2016.

4. Orthopaedic & prosthetic devices. The market for orthopaedic & prosthetic devices is estimated at US$1,336 million, equal to 16.1% of the total medical device market. The orthopaedic & prosthetic devices market grew at an annual rate of 9.2% between 2006 and 2010.

Imports have seen particularly high growth in recent years, though a corresponding increase in exports in this sector indicates that not all imported products are destined for the domestic market. The majority of orthopaedic imports are supplied by Switzerland and the USA.

The orthopaedic & prosthetic devices market is forecast to grow at an annual rate of 6.1% in US dollars over the next few years, taking the total to US$1,794 million by 2016.

5. Patient aids. The market for patient aids is estimated at US$1,131 million, equal to 13.7% of the total medical device market. The patient aids market grew at an annual rate of 4.5% between 2006 and 2010.

French imports of patient aids far exceed the value of the domestic market due to a high level of re-export activity, particularly for pacemakers. Switzerland and the USA are the leading suppliers of portable aids, whilst the USA and China are the major sources of supply for therapeutic appliances.

The patient aids market is forecast to grow at an annual rate of 3.9% over the next few years, taking the total to US$1,367 million by 2016.

 

Imports

The value of French medical device imports has recorded a steady rise over the past decade, reaching US$10.4 billion in 2008 before falling back to US$10.3 billion in 2009.

Imports of consumable items amounted to US$1,780.6 million in 2009. Imports fell by 1.0% over 2008 in US dollar terms (though they increased in euro terms). Syringes, needles, catheters & cannulae are the largest subcategory.

Diagnostic imaging imports totalled US$1,564.0 million in 2009, equal to 15.2% of the total. This was the weakest performing category in 2009, with a fall of 16.4%.

Imports of orthopaedic & prosthetic devices were worth US$1,549.1 million in 2009, equal to 15.1% of total medical device imports. This was the fastest growing category in 2009, with a rise of 26.6%. All three subcategories – artificial joints, orthopaedic appliances and other artificial body parts – recorded strong growth.

Patient aids are the largest import category, with imports worth US$2,624.1 million in 2009, equal to 25.5% of total medical device imports. Pacemakers accounted for 54.7% of imports in this category in 2009, but also accounted for more than half of patient aid exports.

The leading suppliers of French medical imports in 2009 were the USA, Switzerland and Belgium, with the UK ranking eighth as a supplier with imports worth US$288,964 (2.8% of the total).

 

Exports

In 2009, medical device exports registered a 3.0% fall in value to US$9.2 billion, having recorded steady growth in previous years with a CAGR of 6.8% for the 2005–2009 period.

In 2009, 69.5% of all French medical device exports were sent to the rest of the EU, with the Netherlands taking a 17.6% share, followed by Germany with 14.4%. The UK took 6.6% of French medical device exports.

Outside Europe, the leading destination is the USA, which accounted for 9.1% of exports. The USA is the leading destination for French exports of diagnostic imaging apparatus.

Next month, Medtech Business will look at the medical technologies market in Germany.

This article is based on information from Medical Market Outlook reports published quarterly by Espicom Business Intelligence. *All figures are in US $. For further details of the 66 markets covered, please visit www.espicom.com/outlookm1

Bolton-based medical consumables company Vernacare has emphasised the importance of teamwork and partnership for their development of the world’s first pulp wash bowl, which won a Queen’s Award for Enterprise 2011.

The Vernacare wash bowl (pictured) is used by hospitals in more than 270 NHS Trusts and across the globe for patient care, wound and continence care, hand washing and surface cleaning.

In a study reported in the BMJ, Vernacare’s wash bowls were among a package of measures that led to a 50% fall in cases of C. difficile at Salford Royal NHS Foundation Trust over 12 months.

Karen Haslam, Chief Executive of Vernacare (pictured, left), praised the company’s team and the clinicians who had helped them to develop and trial the product. “We developed our single-use wash bowl in response to customer demand,” she said. “Nurses told us they were concerned that re-using plastic wash bowls without properly cleaning and drying was a significant infection risk.

Vernacare’s previous pulp products were permeable to warm soapy water, she added. “This was a major challenge that took our in-house team two years of painstaking research and trial and error to overcome.”

Heather Dakin, Senior Nurse Infection Control at Colchester Hospital, said of the product: “Nursing staff found that they had more time for patient care and didn’t have to worry about decontaminating plastic bowls. They also found that wards looked much tidier as the pulp can be stacked on racking provided by Vernacare rather than hanging from lockers or beds collecting dust.”

Vernacare provides single-use pulp products for patient waste management and a macerator for disposal. The products are used in over 90% of UK hospitals and more than 50 countries.

The photo shows Karen Haslam and Maria Sinfield of Royal Bolton Hospital with the Queen’s Award.

The UK medical device market is one of the biggest in the world, with growth relying predominantly on imports. But it is also a significant exporter of medical technologies. In the second of two articles looking at the domestic market, Medtech Business in association with Espicom takes a look at the UK medtech export market.

The UK is a significant global exporter of medical devices (including medical equipment and medical supplies) and remains among the world’s top 10. But the sector has faltered in recent years. Exports peaked in 2006 at US$7,238.5 million, but have fallen every year since then. In 2009, exports dropped to US$5,394.4 million – roughly the same level seen in 2005. The orthopaedic sector was hit especially hard in 2009. (For more details, see Figures 1–3.)

Consumables

Medical consumables were the largest individual export area in 2009, valued at $1,140.0 million,* or 21.1% of total exports. This was a fall of 3.8% compared with 2008, with a 2005–09 Compound Annual Growth Rate (CAGR) of –1.8%.

Consumables are defined as wound care products (medical dressings, sutures, sterile, surgical and dental goods), syringes, needles and catheters. Within this category, catheters and cannulae amounted to $279.7 million, virtually unchanged from 2008, but significantly lower than the 2005 level of $410.6 million. Exports of medical dressings amounted to $503.7 million, a fall of 8.3% compared with 2008.

Diagnostic imaging

Diagnostic imaging is not historically one of the UK’s stronger sectors. In 2009, UK exports of diagnostic imaging apparatus amounted to $1,131.3 million – 21.0% of the country’s total export market. In recent years, the electrodiagnostic sector has been its biggest source of growth. The 2009 total showed a fall of 0.1% compared with 2008, with a CAGR for 2005–09 of 5.4%.

Electrodiagnostic imaging exports amounted to $575.1 million, a rise of 23.4% over 2008 due largely to a big rise in MRI exports. Radiation apparatus exports were far lower at $83.4 million, although this too represented a strong increase of 28.2% on 2008 figures. Exports of imaging parts and accessories fell sharply in 2009, by 21.4% to $472.9 million.

Orthopaedic products

Exports of orthopaedic and prosthetic products saw a sharp fall in 2009. Exports totaled $1,231.5 million in 2008, but fell by 46.7% the following year to reach $656.2 million. Artificial joints fell by 67.1% to $71.5 million, while other orthopaedic/fracture appliances fell by 49.8% to $445.2 million.

As outlined in Medtech Business’s first UK market article (July 2011), imports in this sector also saw a sharp fall in 2009. Espicom suspects that much of the reduction is due to a change or relocation of multinational manufacturing and repackaging activities.

Patient aids

Exports of patient aids amounted to $1,054.5 million in 2009, a fall of 5.2% compared with 2008.

Portable aids fell by 8.0% to $762.1 million, while therapeutic appliances rose by 2.9% to $292.4 million.

Dental products

Exports of dental products reached US$148.2 million in 2009 – 2.7% of the total. This is an increase of 4.1% over 2008; the total fell sharply in 2007, but has since recovered a little.

Dental cements amounted to US$70.2 million in 2009, a rise of 17.7% over 2008.

Leading destinations

In 2009, the single leading destination for UK exports was the US, with $768.1 million (4.2%) of total exports. The largest shipments to the US were diagnostic imaging products, which amounted to $188.8 million, 16.7% of exports in this sector. This was followed by consumables, which amounted to $136.5 million, 12.0% of exports in this product area. The US also received 31.7% of dental product exports, valued at $47.0 million. (See Figures 4 and 5 for more details.)

More than half of UK exports went to the EU-27 countries. Shipments totaling $3,016.7 million (55.9% of total exports) left the UK for the EU-27. The principal recipient within the EU was Germany, accounting for 13.4% of exports, valued at $720.6 million. Almost a quarter (22.3%) of diagnostic imaging apparatus exports went to Germany. Belgium was the single biggest importer of UK consumables (18.6%) and UK orthopaedic and prosthetic products (17.2%) – in both cases outstripping the US. Other leading destinations within the EU were France, Ireland and the Netherlands.

Next month, Medtech Business will look at the medical technologies market in France.

This article is based on information from Medical Market Outlook reports published quarterly by Espicom Business Intelligence.
*All figures are in US $. For further details of the 63 markets covered, please visit www.espicom.com/outlookm1

The UK medical device market is one of the biggest in the world, but its growth is predominantly import-led. In the first of two articles looking at the domestic market, Medtech Business in association with Espicom takes a look at the past, present and future of the UK medical devices sector.

The UK has one of the largest medical device markets in the world, valued at $8.5 billion* in 2011. The domestic market vies with France to be the second largest in Europe behind Germany. The UK medical device market (including medical equipment and medical supplies) is predicted to increase by 3.5% per annum to attain a value of $10.1 billion by 2016 (see Fig. 1 below).

The growth of the UK medical device market is predominantly import-led, as many domestic manufacturers are not able to adjust rapidly to changes in demand. This led to a trade deficit for the seventh year in succession in 2008. The import market has not been immune to the recession, however. It has faltered since mid-2008, and the total was 11.8% lower in 2009 than in 2008.

The medical device market – defined for the purposes of this article as consumables, diagnostic imaging, dental products, orthopaedic and prosthetic products and patient aids – continued to struggle in 2010. Provisional imports for the year ended August 2010 were $6.9 billion, a fall of 4.8% compared with the previous twelve-month period. Consumables and dental products were hardest hit, falling by over 6%. Diagnostic imaging products did better, rising by 1.4%.

Most medical devices are imported. The UK has few large manufacturers, and those that do exist tend to concentrate on the US market. Between 85% and 90% of the market is therefore supplied by imports, a percentage which rising demand has boosted in recent years.

Fig. 1: Medical device market projections (2011–2016)

Market categories

Fig. 2 below shows an overview of market categories.

Consumables. The UK consumables market is estimated at $1,865.0 million in 2011 – 21.9% of the market as a whole. Despite its size, the sector has performed unevenly in recent years, as prices fell and cheaper sources of supply were found. The market for wound care products is estimated at $711.4 million in 2011. Around 80% is supplied via imports, with the leading supplier of basic bandage items being China. More advanced wound care products tend to be sourced from Europe or the USA. The market for syringes, needles and catheters is estimated at $1,019.7 million in 2011. Around 94% are imported, with Mexico the lead supplier country in 2009. The market for other consumable products, such as blood grouping reagents, ostomy appliances and surgical gloves, is estimated at $133.9 million in 2011. Around 86% of these are imported, principally from Denmark, China and Malaysia.

Diagnostic imaging. In 2011, the diagnostic imaging market is estimated at $1,297.0 million, 15.3% of the total market. This area experienced some of the most rapid growth in the 2002–08 period, as new facilities were built and provision of diagnostic services in the NHS updated and expanded. Tighter budgets have brought an end to this rapid growth, though demand has remained steady, with many projects still ongoing. The market for electrodiagnostic products is estimated at $631.5 million in 2011. Around 83% are imported, with the USA and Germany the principal supplier countries. The market for X-ray and other radiation apparatus is estimated at $208.6 million in 2011. This remains low by comparison with other Western countries. Over 90% of the market is supplied by imports, largely from the USA, Germany and the Netherlands. The market for imaging parts and accessories is estimated at $456.9 million in 2011. These are largely sourced from Germany, with Ireland being the leading source of contrast media.

Orthopaedic and prosthetic devices. The 2011 UK market for orthopaedic and prosthetic products is estimated at $833.0 million in 2011, equal to 9.8% of the total market. Around 85% of the market is served by imports. The UK has long-standing production capacity in this area, principally through Smith & Nephew, but products tend to be exported. The market for artificial joints is estimated at $238.1 million in 2011, with the USA and Germany the leading suppliers. Imports in this sector fell sharply in 2009.

Patient aids. The market for patient aids is estimated at $1,586.2 million in 2011 – 18.7% of the total market. Portable aids such as hearing aids and pacemakers amounted to $1,110.8 million in 2011, with therapeutic appliances accounting for $475.4 million. This area of the market – portable aids in particular – has seen strong growth in recent years. One example of this growth is the now widespread provision of new digital hearing aids on the NHS. These are generally imported from Denmark, Germany and Australia.

Dental products. The UK market for dental products is estimated at $356.2 million in 2011, equal to 4.2% of the total market. Over 90% is imported. Dental drills and X-ray apparatus is generally supplied by Germany, with Italy and Japan strong in the import of dentists’ chairs. Germany and the USA are the leading suppliers of dental instruments and supplies.

Fig. 2: UK medical device market by category, 2011 (%)

Imports

The level of UK medical device imports rose sharply from 2000 to 2006, spurred on by large boosts in public health expenditure. Performance since then has been uneven, however. 2009 saw a drop of 11.8% in imports to $7,222.4 million, the lowest figure since 2005. All major product sectors recorded a fall in 2009. Fig. 3 below lists the major importers.

Consumables were the leading individual import product area in 2009, valued at $1,653.4 million or 22.9% of the total. This was a decrease of 19.4% compared with 2008. Much of the fall has occurred within the catheters and cannulae category, where imports fell from $1,147.9 million in 2008 to $799.6 million in 2009.

Imports of diagnostic imaging apparatus were valued at $1,051.3 million in 2009 (14.6% of total imports). The sector fell by 6.6% in 2009. Imports of electrodiagnostic apparatus fell by 6.9% to $513.5 million, and radiation apparatus fell by 3.0% to $172.6 million. Parts and accessories for X-ray apparatus amounted to $365.2 million, a fall of 7.7% compared with 2008.

Orthopaedic and prosthetic imports in 2009 were worth $687.7 million (9.5% of total imports). This sector experienced the sharpest fall in 2009, of 25.0%. This was primarily due to a 40.9% fall in the value of imported artifical joints, from $369.6 million in 2008 to $218.3 million in 2009.

Imports of patient aids amounted to $1,278.0 million in 2009, equal to 17.7% of the total, while imports of dental products were valued at $312.9 million in 2009 (4.3%).

The largest single supplier to the UK in 2009 was the USA, with $1,328.1 million or 18.4% of total imports. US suppliers were strong in all areas of the market, though their share has been declining in recent years: it was 21.1% in 2008. In 2009, $4,463.7 million of imports were sourced from within the EU-27, equal to 61.8%. Germany was the leading EU supplier, with $1,092.1 million (15.1% of total imports). It was particularly strong in supply of dental and diagnostic imaging products, accounting for 34.5% and 29.0% respectively. Other main suppliers within the EU were the Netherlands with $955.7 million (13.2%), Belgium with $599.0 million, France with $505.5 million and Ireland with $473.8 million.

Next month, Medtech Business will look at UK export trends.

Fig. 3:  Top 10 suppliers to the UK market, 2009 ($000)

This article is based on information from Medical Market Outlook reports published quarterly by Espicom Business Intelligence.

For further details of the 63 markets covered, please visit www.espicom.com/outlookm1

*All figures are in US $.