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All things Pharma

A European tour of medical devices

In the holiday season, On Target Editor Chris Ross takes an express tour of the European medical device market and looks at how medical technology is making a difference – not only to public health, but also to the economy.

In the June issue of On Target, we looked at how investment in medical technologies holds the key to wealth as well as health. This article focuses on the medical devices market in Europe, which is estimated by Eucomed to be worth €55.2 billion. This represents a 30% share of a global sector worth €184 billion. To understand why the medical devices sector is worth investing in, we need to look at what makes it special: its distinctive nature (see Figure 1), its diversity (see Figure 2) and its growing importance for public health.

The big €

Germany, France, Italy, the UK and Spain account for almost 78% of the European medical devices market, with Germany and France alone accounting for 51%. However, even the most mature markets are beset with challenges in the current environment. In Germany, the largest European market, growth is being driven by good export performance as the domestic market battles healthcare reforms, financial difficulties and cost-containment policies. Similarly in France, performance has been badly hit by poor economic growth and government cost-containing measures, driven by an almost constant deficit in its national health insurance fund. Healthcare in Italy and Spain is also in a state of flux, with both countries trying to devolve administrative and financial responsibilities to the regions in order to control spending.

What are medical devices?
The European Union Medical Devices Directive (93/42/ECC), article 1, defines medical devices as: “…any instrument, apparatus, appliance, material or other article, whether used alone or in combination, including the software necessary for its proper application intended by the manufacturer to be used for human beings for the purpose of:

  • diagnosis, prevention, monitoring, treatment or alleviation of disease;
  • diagnosis, monitoring, treatment, alleviation of or compensation for an injury or handicap;
  • investigation, replacement or modification of the anatomy or of a physiological process;
  • control of conception;

and which does not achieve its principal intended action in or on the human body by pharmacological, immunological or metabolic means, but which may be assisted in its function by such means.”

The UK is Europe’s third-ranked market for medical devices. In fact, Britain is home to the largest number of medical technology companies in Europe. However, per capita spending is relatively low compared to other Western European countries. The UK invests around 7.5% of its GDP in health, but less than 5% of this amount is spent on medical devices. This is below the European average of 6.4%. While the NHS accounts for around 80% of all healthcare expenditure, a small specialist private healthcare sector also plays a role in the market. To reduce waiting times, preferred supplier status has been given to private healthcare groups in orthopaedics, ophthalmology, general surgery, primary care services and local procurement.

On Target Quick Read
  • Global medical device market valued at €184 billion
  • Europe has 30% share of world market, at an estimated €55.2 billion
  • The top five markets in Europe are Germany, France, the UK, Italy and Spain
  • Germany and France make up 51% of the global market
  • The UK has more medical device manufacturers than any other European country, but spends a lower than average % of GDP on devices
  • The European market will grow to $77.8 billion by 2010
  • The biggest single product segments are cardiovascular, orthopaedics and surgery

Saving lives and fighting disability

According to Frost & Sullivan, the total European medical devices market will grow to $77.8 billion by 2010. Cardiovascular devices are currently the leading European single product segment for devices (19%), followed by orthopaedics and surgery. Over the next five years, Frost & Sullivan forecasts that the cardiovascular devices market will grow by around 25%.
Eucomed reflects these trends by citing the following disease areas as key challenges in which medical devices can make an impact in the coming years: cardiovascular disease, cancer, diabetes and musculoskeletal conditions. Cardiovascular disease is the leading cause of death in Europe, killing 4 million people each year – 46% of all women and 38% of all men. Eucomed points out that interventional cardiology (including coronary angiography and coronary stents), arrhythmia and stroke management all provide great examples of the contribution medical technology makes to patient care. Such innovations not only improve patients’ quality of life, but also relieve the economic burden of lengthy hospital stays.
Cancer is the second largest killer in Europe. The World Cancer Report predicts that global cancer rates could increase by 50% between now and 2020. Medical technology assists the screening, diagnosis and treatment of cancer, as well as helping to restore quality of life post-surgery. Medical science shows that cure rates in cancer improve when early detection is combined with optimal treatment – a good example of how medical devices and pharmaceuticals can work together to improve public health. Diabetes is emerging as one of Europe’s major killers. Eucomed notes that medical technology plays a vital role in diabetic patient care, and can help to reduce the healthcare bill for the disease. Devices for diabetes treatment include insulin delivery products such as syringes, pens, automatic injectors, insulin patches and external or implantable pumps. Precise blood glucose monitoring can substantially reduce the risk of developing complications and slow the progression of the disease. Effective wound care reduces the frequency and length of hospital stays and the incidence of amputation in diabetic patients.
Finally, medical devices play a significant role in improving patient outcomes in four major musculoskeletal conditions: osteoporosis, osteoarthritis, rheumatoid arthritis and lower back pain. With populations continuing to live longer, osteoarthritis is projected to become the fourth leading cause of disability in Europe by 2020. Joint replacement surgery can restore the patient’s mobility, while new developments in bone, cartilage and soft tissue regeneration based on biomaterials can speed up the healing process.

Examples of medical devices
Anaesthetic machines and monitors
Apnoea monitors
Artificial eyes
Artificial limbs
Blood transfusion and filtration devices
Breast implants
Cardiac monitors
Cardiopulmonary bypass devices
Clinical thermometers
Contact lenses and prescribable spectacles
CT scanners
Dental equipment and dentures
Dental material and restoratives
Diagnostic imaging equipment
Diagnostic kits and tests
Electrosurgery devices
Enteral and parenteral feeding systems
Equipment for disabled people
Examination gloves
Foetal monitors
Hearing aids and inserts
Heart valves
Hospital beds
Hydrocephalus shunt
Incontinence pads
Infusion pumps and controllers
Intra-uterine devices
Intravascular catheters and cannulae
Laboratory equipment
Medical lasers
Medical textiles, dressings, hosiery and surgical supports
Orthopaedic implants
Operating tables
Ostomy and incontinence appliances
Physiotherapy equipment
Prescribable footwear
Pressure sore relief devices
Radiotherapy machines
Special support seating
Suction devices
Surgical instruments and gloves
Sutures, clips and staples
Syringes and needles
Ultrasound imagers
Urinary catheters, vaginal
speculae and drainage bags
Walking aids

Source: Healthcare Industry Task Force (2004). This list is not exhaustive, and is intended to illustrate the range of products manufactured by the industry.

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