Over the past several decades, energy-based tissue ablation – defined as physical or/and functional alteration of targeted tissues via directed energy transfer and deposition – has established itself as an indispensable part of the therapeutic toolkit. This spans virtually all major areas of medicine – including aesthetic surgery; cardiology; ear, nose, and throat (ENT); general surgery; gynaecology; oncology; ophthalmic surgery; and urology.
During the forecast period, cumulative worldwide tissue ablation product sales are projected to register a healthy growth, expanding 4.6% per annum between 2013 and 2020, to almost $16.8 billion (€15.3 billion) at the end of the decade.
Besides increases in established applications, this growth will also benefit from the emergence of new tissue ablation technologies and the opening up of new geographic areas. Smithers Apex’s exclusive research defines four key trends driving market development.
The greatest increase will be in electrosurgical RF ablation products
The largest absolute gains can be expected to occur in the electrosurgical radio frequency (RF) ablation product segment, thanks to a high single-digit growth in barely penetrated atrial fibrillation (AFib) ablation business.
During the forecast period, Smithers Apex forecasts that the worldwide electrosurgical RF ablation product market will grow by an average of 5.2% per annum, to $4.87 billion in the year 2020. This is driven by a strong 7.6% annual increase in the market for cardiac arrhythmia RF ablation systems, and a moderate 4.2% annual expansion in the general and specialty surgery RF ablation segment.
The cardiac arrhythmia ablation segment will register impressive expansion in both established and emerging regions – particularly, in China – from the introduction of efficacious and formally endorsed AFib RF ablation devices in previously underdeveloped markets.
Microwave and cryogenic ablation will be the new growth technologies Smithers’s research anticipates that the fastest relative advances will be in microwave ablation, and cryogenic ablation products. The former should benefit from increasing use of thermotherapy in tumour ablation at the expense of the RF techniques that currently dominate.
Microwave technology offer several advantages when compared to other thermoablative techniques. These include consistently higher intramural temperatures, larger tissue ablation volumes, faster ablation times, and an improved convection profile. An emerging and growing application of microwave ablation is it use in palliative treatment of inoperable primary and secondary cancers – metastatic malignancies – of the liver, lungs, and bones, where volumetric microwave thermotherapy is gaining increasing acceptance alongside existing RF-based ablation.
Impressive future gains in cryoablation platforms meanwhile will reflect strong expansion in the utilisation of such techniques in paroxysmal AFib caseloads. This will build upon cryogenic ablation’s existing use in electrosurgery for conditions like symptomatic supraventricular tachycardia (SVT).
The Americas will remain the largest market
In 2013, North America and South America represented the largest share of global tissue ablation product sales – nearly 41%. This was followed by the Western Europe with 28%, Asia with 24%, and the Rest of the World with 7%.
This balance will largely be maintained across the study period, principally due to opportunities in the world’s largest economy and biggest world medical device market – the US. In 2013, the US healthcare spending was estimated at $2,990 billion, approximately $9,447 per capita. For technology suppliers this compares favourably with competing First World economies, like Germany where the per capita spending on healthcare is $4,914, France where it is $4,814 per capita, or Japan where it is $3,455 per capita.
Considering the future, Brazil has great potential partially due to its aging population – as older demographic segments consume tissue ablation services more heavily than other age groups.
In Canada meanwhile, public health programmes are set to receive a fillip after the recent election of Prime Minister Justin Trudeau, with his pledge to invest in a new Health Accord for all Canadians.
The Asian market is showing the quickest growth
Asian countries are forecast to show the largest absolute increase in tissue ablation dollar volume from 2013-2020. The region will gain over $1.3 billion in system sales over the seven years, boosting its share of the global marketplace from 24% to 28% at the expense of Europe and the Americas.
Asia’s expansion will be driven mostly by continuing major investments into healthcare infrastructure by China, which is expected to emerge as the second largest medical device market by the end of the forecast period.
Growth in China will be shadowed by that in India, as the two states look to deliver modern services to their over 2.5 billion citizens, making them the two largest emerging world markets.
This will be joined by ongoing opportunities in states like Japan, which already operates a sizable, and one of the world’s most technically sophisticated, healthcare systems.
The impact these trends and other important factor will have on influencing the growth of the tissue ablation technology market are analysed in full in the Smithers Apex report, The Future of Tissue Ablation Products to 2020.