Drivers: Europe Negative Pressure Wound Therapy Devices Market
RISING AGEING AND GERIATRIC POPULATION
With increase in ageing population the incidences of chronic diseases such as diabetes, peripheral vascular disease is increasing. Skin breakdown with ulcer and chronic wound formation is a frequent consequence of these diseases. Negative pressure wound therapy devices (NPWT) products have been developed for treating wound due to the various types of ulcers such as pressure ulcers, vascular ulcers, and neuropathic ulcers.
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According to Pfiedler, It has been estimated that more than USD 25.0 billion is spent each year on the treatment of chronic wounds, this burden is growing rapidly due to increasing health care costs and an aging population.
According to Angiology Open Access, it has been estimated that the number of amputations in the US is rising due to the increased incidence of diabetes and Peripheral Vascular Disease (PVD) in an aging population.
Thus, rising ageing population has led to increased incidences of chronic diseases in geriatric population thus increasing the usage of NPWT for treatment of the wound caused due to the chronic diseases such as diabetes, and peripheral vascular disease. NPWT systems are widely used with rising incidence of diabetes and obese population who are prone to chronic wounds. The complexities and risks associated with the development of chronic lower extremity wounds has resulted in increased demand of NPWT systems.
TECHNOLOGICAL ADVANCEMENT IN NEGATIVE PRESSURE WOUND THERAPY DEVICES
The key players are emphasizing developing innovative NPWT products with high properties of non-adherent, antimicrobial, non-cytogenic and porous. The new developments have led to a shift from simple dressings to more advanced devices and products.
The technological advancements taken place in single-use NPWT systems provide the benefits of NPWT for treating patients in hospital and community settings, with the expansion of treatment options, improving outcomes, and potentially reducing costs of care.
The demand for efficient and cost-effective use of resources to optimize wound care is rising as governments in the countries race to cut costs, while maintaining quality of care and improving treatment outcomes.
For instance, in 2016, Convatec Group (U.K) launched the Avelle System in the disposable NPWT segment, which makes their entry into this fast-growing segment of the advanced wound care dressings market.
- In 2011, Smith & Nephew(U.K.) launched PICO-the Single Use NPWT System in negative pressure wound therapy devices (NPWT)
- In 2013, Molnlycke Health Care(Sweden) launched Avance Solo that strengthened its negative pressure wound therapy devices (NPWT) offering by launching, a single patient-use, true NPWT system with variable pressure settings, initially across the United Kingdom.
These developments and advanced products launches are giving opportunities for better implementation of the products and its efficient uses. Due the advancements in the technology, NPWT systems are widely accepted for the management of surgical wounds which require healing by secondary intention. The key players are marketing their technologically advanced products for various types of wounds such as open abdominal incisions, dehisced surgical wounds, burns, preparation for skin graft sites, and traumatic wounds among others.
INCREASED NUMBER OF SURGICAL PROCEDURES
Negative pressure wound therapy devices (NPWT) is the well-recognized technology for the management of open wounds and has recently been applied to closed surgical incisions.
NPWT when compared with standard postoperative dressings significantly reduced the rate of wound infection and seroma when applied to closed surgical wounds. There has been increasing interest to use this technique on closed incisions after surgery to prevent possibly severe surgical site infections and other wound complications in high-risk patients. Negative pressure wound therapy devices devices with the help of negative pressure unit and specific dressings holds the incision edges together, redistribute lateral tension, reduce edema, stimulate perfusion, and protect the surgical site from external infectious sources.
According to wound care Germany, accidents occurring frequently, causing different injuries such as burns, grazes and cuts, consumers are looking for products which protect their wounds from external influences and support healing. Amidst a backdrop of growing health awareness, consumers are showing a stronger preference for high quality products which can help minimize the risk of infection or scar formation.
- In 2010, the European Union performed 39 inpatient surgical procedures every 100 admissions per 100.000 inhabitants. The highest value of inpatient surgical procedures per 100.000 was registered in Austria (14.333), where the number of inpatient care admission was 27.560. Adversely, in Slovakia there were 408 inpatient surgical procedures against 18.610 Inpatient care admissions per 100.000 inhabitants.
Thus, increased number of surgical procedures has increased the usage of negative pressure wound therapy devices.
GOVERNMENT SUPPORT FOR PROMOTING NEGAT IVE PRESSURE WOUNDTHERAPY DEVICES
According to European Wound Management Association (EWMA), aims to advocate for the rights of people with wounds and to promote best practice in wound management, to receive the best possible care in a timely manner that meet the needs of the individual and the health service. The document Home Care-Wound Care (HCWC) was developed by a group of experts within The European Wound Management Association and supported by representatives of organizations in Germany and UK, to provide a set of recommendations on wound care at the European level. FDA is creating awareness regarding the usage of NPWT devices. The regulatory framework issued recommendations for the hospitals and caregivers regarding the safety compliance to be considered while handling NPWT devices, patient selection, and monitoring. FDA is also conducting programs for educating the patients and caregivers regarding the safe use of NPWT devices in homecare settings.
The government initiatives in order to promote negative pressure wound therapy devices have led to increase the awareness and usage of the products thus acting as a driver for the market.
RISING INCIDENCE OF DIABETES
Diabetic ulcers are complex chronic wounds, which have a long-term impact on the morbidity, mortality and quality of patients’ lives. Individuals who develop diabetic ulcers are at greater risk of premature death, myocardial infarction and fatal stroke than those without a history of diabetes.
Diabetic foot ulcers have a considerable negative impact on patients’ lives, and are highly susceptible to infection that all too often leads to amputation. It is essential that diabetic foot ulcers receive the best possible wound management.
In 2017, According to National Center for Biotechnology Information, randomized controlled trials took place with 1,044 patients which were selected from 691 identified studies. When compared with standard dressing, NPWT had a higher rate of complete healing of diabetic ulcers, shorter healing time, and greater reduction in ulcer area, greater reduction in ulcer depth, fewer amputations, and no adverse effects after the treatment.
Meanwhile, it was also showed that the NPWT was more cost-effective than standard dressings.
In 2017,According to National Center for Biotechnology Information, Approximately 15.0% of all people with diabetes will be affected by a foot ulcer during their lifetime.
- In 2015, According to, National Center for Biotechnology Information, In Europe the annual amputation rate for people with diabetes has been cited as 0.5%-0.8% and in the US it has been reported that around 85.0% of lower-extremity amputations due to diabetes begin with foot ulceration.
Thus, increasing incidences of diabetes and related diseases such as diabetic ulcers, foot ulcers may act as the major driver in the growth of negative pressure wound therapy devices market.
Restraint: Europe Negative Pressure Wound Therapy Devices Market
HIGH COST OF PRODUCTS
In a typical hospital setting today, between 25.0% and 40.0% of beds will be occupied by patients suffering from various types of wounds. In the community healthcare, management of wounds takes up over half of all resources used in management of wounds. Diseases such as diabetes have a high association with wounds.
According to the wounds international, the cost of a hospital stay is estimated to be USD 535.3 per day.
- According to, National Center for Biotechnology Information, The equivalent cost has been estimated to be USD 10,604.0 million for the treatment of diabetic foot ulcers.
Cost of treatment increases with the healing time and incidence of higher complications. The high cost of the negative pressure wound therapy devices products hinders the usage as it subsequently increases the cost of the treatment.
- According to the wounds international, it has been estimated that the National Health Service treated 278,000 leg ulcers in 2012-2013 at a cost per patient of between USD 929.2 and USD 5273.1 to manage the wound and associated morbidities
Wound management is expensive: for instance, in Europe the average cost per episode is 36,650 for leg ulcers and 310,000 for foot ulcers, which accounts for 2.0%–4.0% of health-care budgets.
There is an urgent need to review wound strategies and treatments in order to reduce the burden of care in an efficient and cost-effective way.
AVAILABILITY OF SUBSTITUTE PRODUCTS
Mainly used equipment for negative-pressure wound therapy devices (NPWT) is expensive. In the present healthcare climate, there has been a huge demand to frequently highlighting cost control, importance in developing more cost-effective alternatives.
- According to National Center for Biotechnology Information, in 2012, the amount of US health care reached $2.8 trillion, with hospital care spending reaching up to USD 882.3 billion.
- According to Ostomy Wound Management, a hydro conductive dressing was introduced to the wound care market that may act as the substitute of NPWT as it helps to control and decrease edema, reducing the substances that cause bio-film formation as well as cytokines that are known to be harmful to wound healing.
Because these actions are similar to those shown to influence NPWT effectiveness, a hydro conductive dressing potentially could be used as an alternative to NPWT in selected cases.
- According to National Center for Biotechnology Information, An alternative method of NPWT called Gauze-Suction (GSUC) therapy devices has been introduced because of its cost-effectiveness and is universally available.
Gauze-Suction was developed at the UCMC and has been utilized since 2006. Gauze-Suction is simple to use and was initially developed to provide temporary replacement therapy devices when other therapy devices such as VAC was not readily available around the hospital. With the ease and convenience of application from the use Gauze-Suction (GSUC)therapy devices in any health care facilities, its use expanded naturally.
- According to National Center for Biotechnology Information, dermal substitute may act as the substitute of NPWT as it is cost effective and make wound healing during the treatment of diabetic foot ulcers faster, decreases hospital stay and prevents major amputations.
- According to National Center for Biotechnology Information, Dermal substitutes such as cellular and tissue products, when applied to a wound they act like an autologous skin graft and provide the functions of normal skin. Dermal substitutes are available with more than 70 products available in the market. According to Medicare, private health insurance providers like UnitedHealth and Aetna currently regard only the treatment of venous leg ulcers (VLU) and diabetic foot ulcers (DFU).
Dermal substitutes also emerge as key research strategies to develop adequate support for stem cells, tissue engineering and regenerative medicine applications to obtain long-lasting and scar less artificial skin. Dermal substitutes improve functional and cosmetic results long-term and thus increase quality of life.
The availability of substituent technologies for treatment of wound will hamper the growth of negative pressure wound therapy devices market as they are cost effective and are technologically advanced.
OPPORTUNITIES FOR AUTOMATIC LUBRICATION SYSTEM MANUFACTURES DUE TO PRODUCT INNOVATIONS
Various adverse effects have been reported with the usage of NPWT systems such as pain, retention of foreign bodies after dressing, death due to excessive bleeding, infection. Due to the various complications associated with the usage of NPWT systems, in 2011, Food and Drug Administration (FDA) issued safety compliance with respect to the use of the systems. Incidences of infections, severe bleeding leading to morbidity and mortality has been reported with the use of NPWT systems in homecare settings. To monitor the adverse effects, FDA has issued a recommendation for the clinicians regarding the selection of the patient, monitoring, contraindications, risk factors and the measures to be taken to manage the risk factors.
The adverse effects caused to the patients during the use of NPWT systems acts as a restraint for the market.
OPPORTUNITIES:
FAVORABLE REIMBURSEMENT SCENARIO
In addition, having secured reimbursement coverage to 65.0% of Medicare beneficiaries since launch of Tissue Regenix, it is now able to expand into the bigger outpatient chronic wound care market from its initial acute care focus.
In China, India and Brazil, new directives are implemented to harmonize their regulatory frameworks and update their reimbursement pathways to ease the market entry of international players who are seeking to access an ever growing number of customers.
- According to Home Health Agencies, in January, 2017, it has been recognized that disposable NPWT may offer cost or clinical advantages over durable NPWT for wound patients and that innovation may drive the replacement of other durable medical equipment with disposable options in the future.
The reimbursement applies only when the entirely new, complete therapy device (cartridge/pump/canister) and dressing is provided with the wound assessment and application of therapy devices.
Due to such favorable reimbursement scenario, patients may easily get operated as it will not be affecting them financially because of the easy reimbursement policy.
MERGERS AND ACQUISIT ION BY KEY PLAYERS
Companies dealing in NPWT devices have been investing in mergers and acquisition, internal R&D and new partnership to expand their business in other regions globally, especially in emerging market such as Asia- Pacific to increase their presence in advance wound care dressings market.
- In February, 2016, Molnlycke a world-leading provider of high-quality healthcare solutions announced the acquisition of Sundance Solutions, a leader in developing innovative solutions for the safe positioning and turning of patients to help prevent pressure ulcers.
- In January, Convatec Inc. a leading global medical technology company announces the acquisition of
EuroTecBeheer B.V. (“EuroTec”), a Netherlands-based manufacturer of ostomy appliances for a purchase price of USD 29,488.5 The acquisition also includes EuroTec’s production facilities in Roosendaal, Netherlands. In January, Derma Sciences, Inc. a tissue regeneration company focused on advanced wound and burn care, announced that it has signed a definitive agreement whereby Derma Sciences will be acquired by Integra Life Sciences Holdings Corporation.
CHALLENGES:
LACK OF SKILLED PROFESSIONALS
Negative-pressure wound therapy devices (NPWT) is a healing technique that uses using vacuum dressing in order to promote healing in acute or chronic wounds and enhances healing of second and third degree burns. The proper usage of the NPWT requires expertise with relevant experience and knowledge. Improper usage of NPWT products may lead to incontinence when the wound dressing is insecure or the medical adhesive is not moisture-resistant. Improper preparation of wound beds, inadequate observation, and in-sufficient irrigation are some of the severe complications. This make it very important to choose approved NPWT products and requires skilled professionals for using the negative pressure wound therapy devices products.
The shortage of skilled professionals is the segment which will hamper the growth of negative pressure wound therapy devices market.
Market Trends:
On the basis of product type, the market is segmented into Stand-Alone Negative Pressure Wound Therapy Devices, Portable Negative Pressure Wound Therapy Devices, and Disposable Negative Pressure Woundtherapy Devices.
On the basis of wound type, the market is segmented into Surgical Wound, Diabetic Ulcers, Burns, Pressure Ulcers, Venous Ulcers, Others.
On the basis of end user, the market is segmented into Hospitals, Wound Care Center, Ambulatory Centers, Home Healthcare, Clinics, and Community Healthcare.
On the basis of device channel the market is segmented into Direct Tenders, Retail.
Major Players: Europe Negative Pressure Wound Therapy Devices Market
Some of the major players operating in this market are Some of the major players operating in this market are Acelity L.p. Inc., smith and nephew, Molnlycke Healthcare, Convatec inc., Cardinal Health, among others.
