Global interventional cardiology market 2017-2022 sample report

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Global Interventional Cardiology Market (2014-2022)

December, 2017

Sample pages

Chapter 1: Executive Summary

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3

Market Scope and Segmentation

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Product Types

Stents

Catheters

Others

Application

Angioplasty

Valvuloplasty

Region

North America

Europe

Latin America

Middle East and Africa

Asia Pacific

4

Key Questions Answered in This Study

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What is the history of interventional cardiology and how has it evolved?

What is the global market revenue of the Interventional Cardiology market?

What is the future of the Interventional Cardiology market?

What are the factors instrumental in changing the market scenario?

What are the drivers, restraints and trends in the market?

What is the competitive scenario of the global Interventional Cardiology market?

What are the strategies of the key market players?

How have competitors performed in 2016?

What are the different types of devices and application areas in the Interventional

Cardiology market?

What are the respective market shares and the opportunities associated with Interventional

Cardiology products in various regions around the world?

What are the regions with maximum opportunity for the growth of the Interventional

Cardiology market? Which are the countries in those regions with maximum opportunities?

What are the factors that affect the global Interventional Cardiology market?

What are the investment opportunities for the Interventional Cardiology market?

5

Executive Summary

Def

init

ion

Competition

XX.XXXX.XX

XX.XX

2014 2017 2022

$ bn

• Interventional cardiology is the catheter-based treatment of heart diseases. Interventional cardiologists are certified cardiologists performing

Interventional Cardiology procedures, mostly in specialized catheterization laboratories in hospitals.

• Interventional Cardiology procedures are minimally invasive in nature.

• During the process, the catheter is directed towards the area affected by using real-time X-ray.

• Stents account for a significant share of the market owing to its ease of use, low cost, and technological advancements - advent of

bioabsorbable stents and bioabsorbable vascular scaffold.

• Catheters segment is likely to grow at a considerable pace owing to their varied application areas.

• By application, angioplasty segment held the maximum market share due to the growing prevalence of cardiovascular diseases

and rising adoption of angioplasty procedures around the world. However, blood clotting or thrombosis has been observed in

some cases of angioplasty procedures. This might restrain the growth of the market to some extent.

• The development of transcatheter aortic valve replacement (TAVR) is likely to drive the growth of the valvuloplasty application

segment in the coming years.

• In the global Interventional Cardiology market, Medtronic PLC held the maximum share of the market followed by Abbott

Laboratories. These two players occupied half of the total market share in the global market.

• Boston Scientific, in the third place, lost its position to Abbott after the latter acquired St. Jude. Medical. Edwards Lifesciences and

Johnson and Johnson Pvt. Ltd. held significant market shares in the global Interventional Cardiology market as well.

• North America held the maximum share in the global interventional cardiology market followed by Asia Pacific.

• Asia Pacific is expected to grow at a considerable rate over the forecast period owing to surge in population, increase in health

spends, and growing number of people having cardiovascular diseases.

• Other regions covered in the report are Europe, Latin America, and Middle East and Africa.

Chapter 2: Introduction - Interventional Cardiology Market

6

7

• Prototype

• Process

Development

• Regulatory

Approval

• Product

Engineering

Components Manufacturing

DistributionMarketing and Sales

Value Chain Analysis

Post Sales Services

Input Suppliers Buyers

• Software

Development

• Precision Metal

Works

• Plastics Extrusion,

Moulding

• Assembly

• Packaging

• Sterilization

Final Products

• Interventional

Cardiology

Devices

• Surgical

Instruments

• Others

• Training

• Consulting

• Maintenance,

Repair

Wholesalers

Hospitals

Doctors and Nurses

Individual Patients

MetalsChemicals

Research and Product Development

Companies operating in the global Interventional Cardiology market are expanding their product portfolios to keep up with the rapidly changing market demand and increasing product life cycles. For instance,emerging economies demand more economical products. Compliance issues are on the rise as products are going through more complex and strict regulatory scrutiny. The sector could decrease its production leadtimes, while manufacturers, hospitals, pharmacies and distributors could hold significantly smaller inventories. This would improve the healthcare supply chain and help millions of patients around the world bypassing on benefits to consumers.

Some companies in the Interventional Cardiology devices field are trying to reduce costs in order to improve their margin. In emerging as well as established markets, device makers are turning to third-party supplychain partners. This initiative, in turn, helps to simplify the complexities of the international logistics landscape. Additionally, it delivers products more quickly, inexpensively and efficiently to patients and healthcareprofessionals who need them.

Market Segments

• Cardiovascular

(Stents,

Catheters)

• Orthopaedics

• Others

Assembly

Chapter 4: Interventional Cardiology Market Overview

9

Global - Market Overview

XX.X

XX.X

XX.X

2014 2015 2016

XX.X XX.XXX.X

XX.XXX.X

XX.X

2017 2018 2019 2020 2021 2022

Key MarketDrivers

Fig 1: Global historical market revenue (US$ bn) Fig 2: Global forecasted market revenue (US$ bn)

CAGR (2014-2017): X.X% CAGR (2018-2022): X.X%

The higher incidence of CVD (cardiovascular disease) is because of an increase in familiar risk factors such as hypertension, dyslipidemia (high cholesterol), smoking, obesity, diabetes, andsedentary lifestyle. These factors give rise to cardiovascular ailments, including devastating heart attacks. The increase in the number of cardiovascular diseases is expected to drive the growth ofthe Interventional Cardiology market over the forecasted period.

• Minimally invasive procedures are operational

processes in which the surgeon operates

between the ribs of the patient through small

incisions (rather than cut through the

breastbone).

• Some of the advantages of this procedure are

reduced post-operative discomfort, less blood

loss, lowered risk of infections and faster healing

times. They eliminate the possibility of deep

sternal wound infections as well.

• The development of advanced minimally-invasive

procedures and an increase in its adoption in

interventional cardiology is likely to drive the

global market in the future.

• Clotting in a blood vessel is known as thrombosis. Drug-eluting stents may result in thrombosis. Moreover, in situations of procedural complexities,

bioabsorbable stents have not been as effective as initial projections. Other problems include. varying rates of degradation and uneven release of the drug in

the patient’s body

• The global Interventional Cardiology market is very dynamic. The intensity of competition among the market players is relatively high. Additionally, the price

cuts offered by small and medium players on their devices is compelling the established companies to reduce their profit margins. These factors have led to the

inhibition of the research and development efforts owing to lack of funds.

• Some of the other restraining factors include limited insurance coverage (especially in the developing countries), and some cases of death(.1%), hematoma (1-

3%), infection (0.2%), blood clot, and bleeding.

Market Challenges

Global - Market Drivers

ImpactHigh Medium Low

Number of Patients

• Globally, the number of patients with cardiovascular disease is increasing at a fast pace.

• According to WHO, almost 23.3 million deaths are expected to occur by 2030 on account of cardiovascular diseases.

• This increase is primarily due to the following factors: increasing percentage of the geriatric population and the

growing obesity epidemic, especially in developed nations. Both these factors are responsible for the rising number

of heart diseases in the world at present.

3Hybrid Procedures

• The rising popularity of hybrid procedures will drive the growth of

the global Interventional Cardiology market over the forecast

period. Hybrid processes/procedures are a combination of

catheter-based and surgical intervention to the heart for the

treatment of cardiovascular diseases.

• According to industry experts, one of the major factors

responsible for the rising inclination for hybrid procedures is their

ability to obliterate plaque from the blood vessels. It offers long-

term benefits to the patients as well.

Procedural Efficiency

• In the current scenario, the advancements in the field of cardiology

have made Interventional Cardiology procedures uncomplicated,

undemanding and unchallenging.

• These procedures cause less pain than the conventional cardiology

procedures, the risk of infection is low, and large scars are avoided.

Moreover, in many cases, patients remain awake during the process.

• These factors have increased the confidence of the patients towards

Interventional Cardiology procedures. The percentage of cardiac

patients undergoing surgery has grown in the past years and is likely to

develop considerably in the years to come, thereby increasing the

overall growth of the Interventional Cardiology market.

1

2

10

Global - Market Trends

ImpactHigh Medium Low

Technology

• Latest technological advancements such as 3D printing, nanotechnology, and total artificial heart are likely to have a positive impact on

the global Interventional Cardiology market.

• In the field of structural heart disease, TAVR or transcatheter aortic valve replacement and the MitraClip and Watchman devices are

being tested to integrate them into more routine care. Their real-world performance is going to be monitored for safety and efficacy.

The next possible area that is explored is non-operative mitral valve replacement. It is likely to encourage more and more patients to

undergo interventional surgeries, increasing the demand for Interventional Cardiology procedures.

Bioabsorbable stent

• The bioabsorbable stent has become the preferred choice of

interventional cardiologists in the treatment of cardiovascular

diseases. It has become the prevalent type of drug-eluting stent

used in the treatment of cardiovascular diseases.

• Present-day stents have transformed the practice of

interventional cardiology. The cost of these stents has recently

been standardized, which has led to an increase in the adoption of

these stents.

• Bioabsorbable stents have acquired a significant place in the

treatment armamentarium of interventional cardiology.

Health Promotion

• Health promotion, a concept that focuses on understanding general

health from various perspectives, is a significant trend that is emerging

and is likely to grow. Moreover, to manage health and disease, mobile

technology and digital health are likely to evolve in the coming years.

• Investment for the expansion of mobile interfaces in the field of

cardiac health will boost accountability among patients with regard to

their health. Eventually, more patients will opt for interventional

cardiology treatments.

• Currently, these interfaces are used to transmit heart rhythms in

arrhythmia patients.

1

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Chapter 5: Regional Overview

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North America - Market Overview

Précis

North America

XX.X XX.X 5.35 XX.X XX.X XX.X XX.X XX.XXX.X

2014 2015 2016 2017 2018 2019 2020 2021 2022

CAGR (2017-2022): X.X%

Fig 4: North America Market revenue (US$ bn)

Market Drivers

Major Trends

Increase in the cardiovascular patient pool

• North America and Europe exhibit a high consumption

rate of premium-priced Interventional Cardiology

devices. Moreover, these regions continue to drive

innovations in medical devices that have given them an

advantage over the other regions.

• Cardiovascular disease (CVD) takes lives of around

800,000 people in the United States (one in three

deaths). In this region, an average of one person dies

due to CVD every 40 seconds.

• The majority of CVD deaths takes place in patients with

coronary heart disease (CHD) followed by stroke and

heart failure.

• Expenses associated with cardiovascular diseases are likely to

soar in the future and exceed medical cost estimates for

other diseases such as diabetes and Alzheimer’s.

• North America held the maximum market share in the global

Interventional Cardiology market in 2016. Presence of a large

number of people with cardiovascular diseases along with the

presence of a significant number of manufacturers is some of

the factors responsible for the leading position in this region.

PFO (Patent Foramen Ovale) closure procedures are

expected to pick up in 2017. PFO closure efficacy has

been studied in the RESPECT trial and has beaten

medical management in secondary stroke prevention.

TAVR (Transcatheter Aortic Valve Replacement) is likely

to supersede SAVR (Surgical Aortic Valve Replacement)

as the standard of care for all patients suffering from

severe aortic stenosis, thereby driving the overall

Interventional Cardiology market.

The major risk factors affecting the North American population are smoking, physical

inactivity or sedentary lifestyle, overweight/obesity, hypertension, and dyslipidemia.

The United States of America, North America: About 610,000 people die of heart disease in the United States every year–that’s 1 in every four deaths. Availability of advanced healthcare, high adoption rate of interventional cardiology, large patient pool, and presence of many established players in the field of interventional cardiology are some of the factors for this region’s dominance.

European Union, Europe: Data available from across the EU states that, more than a million coronaryangioplasty were conducted in 2015 alone. The next most common procedure was heart bypass surgery.As the number of procedures for heart-related diseases is likely to rise, so will the number of coronaryangioplasty procedures in this region, of which a significant percentage will be performed viaintervention cardiology.

Leading Countries(contd.)-Interventional Cardiology Market

.14

Japan, Asia Pacific: Japan has always been regarded asone of the largest markets for cardiovascular devices inthe world, second only to the United States, due to itsadvanced health-care system and high pricing.

Asia Pacific: Most device companies regard Japan,China, and India as their chief targets, the former dueto its wealth and pricing structure, and the othersdue to their economic growth and vast population.Many devices are made available in other parts ofAsia as well, notably Hong Kong and Singapore.

Brazil, Latin America: Latin America’s two largest economies, Brazil,and Argentina, are growing at a steady economic rate since morenumber of people are gaining access to healthcare services andpeople can spend more on medical services currently. It isestimated that 13.8% and 33.7% of the total population in Brazil willreach the highest life expectancy by 2020 and 2060, respectively.

Saudi Arabia, Middle East: The prevalence of risk factors for HF isincreasing in this region. For example, 26% of the Saudi population isaffected by hypertension, and approximately 24% is affected by diabetesmellitus. Patients with diabetes are at a higher risk for developing HF;the Framingham study showed that the risk of HF was 2-fold higheramong men and 5-fold higher among women with diabetes.

South Africa, Africa: Due to the high prevalence of ischemicheart disease and rheumatic heart disease, coronaryangiography, PTCA, intracoronary stenting, and balloonvalvuloplasty has become established cardiology proceduresin South Africa.

Chapter 6: Segmentation Overview-By Product Type

16

Global product overview – Stents

NorthAmerica

Asia Pacific

Europe

LatinAmerica

Middle Eastand Africa

2016 US$ XX.XX

bn

North America

Asia Pacific

Europe

Latin America

Middle East andAfrica

2022 US$XX.XX

bn

Revenue contribution – Stents

Stents-Analysis

Stenting has various advantages such as improving blood flow and preventing further damage

to heart cells. Moreover, stenting is much less invasive than other cardiac surgeries.

The price of stents is decreasing, owing to technological developments, and various government initiatives, thereby resulting in a higher adoption rate. For instance, the

National Pharmaceutical Pricing Authority (NPPA) of India issued a notification in February 2017. It capped the price of stents (drug-eluting stent at around US$ 460, former

price range: US$ 620 - US$ 3065; bare-metal stents at just US$ 113, former price range: US$ 465 - US$ 1160). The stent segment in the Asia Pacific is likely to grow at a

significant pace during the forecast period owing to many factors such as increase in geriatric population, favorable government initiatives, and increasing patient awareness.

Top

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Medtronic PLC.

Boston Scientific Corporation

Abbott Laboratories, S.A.

Livanova, PLC

Microport Medical Apparatus(Shanghai) Co. Ltd.

Logo

Logo

Logo

Revenue: US$28.83 bnFY 2016


Revenue: US$20.85bnFY 2016



Chapter 7: Segmentation Overview-By Application

17

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Global application overview – Angioplasty

Revenue contribution – Angioplasty

Angioplasty-Analysis

More than 15 million Americans are affected by CAD (Coronary Artery Disease) each year. Angioplasty is the procedure in which

cardiologists open narrowed arteries to treat various CADs. With an increase in the number of old patients, the number of

angioplasties will also rise in the Interventional Cardiology market.

The development of DES and DEB is likely to drive the growth of angioplasty in the forecast period. As the restenosis rate decrease owing

to technological advancements such as laser coronary angioplasty. Laser angioplasty is expected to control the coronary stenosis by

ablation of atherosclerotic plaque. Thus, the future of coronary angioplasty seems promising.

Another futuristic procedure currently under study is the application of adult stem cells at the time of an angioplasty procedure to stop a

heart attack in progress. Scientists are hoping that the outcome of this procedure may be the generation of new heart tissues that might

improve the long-term heart functioning. This procedure will give an immense boost to the angioplasty procedures in the coming years.

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Medtronic PLC.

Boston Scientific Corporation

Terumo Corporation

Livanova, PLC

Logo

Logo

Revenue: US$ 28.83 bnFY 2016


Revenue: US$ 4.83bnFY 2016


Microport Medical Apparatus(Shanghai) Co. Ltd.Revenue: US$ 0.40 bnFY 2016

NorthAmerica

Asia Pacific

Europe

LatinAmerica

Middle East& Africa

2016 US$ XX.XX

bn

North America

Asia Pacific

Europe

Latin America

Middle East andAfrica

2022 US$XX.XX

bn

Chapter 8: Company Profiles

MICHAEL J. COYLE

EVP and President, Cardiac and Vascular Group

MIKE GENAU

SVP and President, Americas Region

HOOMAN HAKAMI

EVP and President, Diabetes Group

BRYAN HANSON

EVP and President, Minimally Invasive Therapies Group

Management Team: Medtronic Public Limited Company

SCOTT OSTRANDER

IT Director - Identity & Access Management

JEFF WYSOCKIBusiness Unit CIO / IT

Leader

MICHAEL HEDGESVP & Chief

Information Officer

20

21

Company Overview: Medtronic Public Limited Company

Company snapshot

Products/Services

• Year of establishment: 1949

• Headquarters: Dublin, Ireland

• Key People: Omar Ishrak, Chairman and CEO

• Employee Strength (2016): 88,000

• Industry: Medical Devices

• Ticker: NYSE: MDT

• Website: www.medtronic.com

Strategy and Initiatives

Key numbers (2016)

• Net Income: US$ 3,538 mn

• Profit Margin (%): 12.3%

• Gross Margin (%): 68.3%

• Return on Assets (ROA)(%): 3.5%

• Return on Equity (ROE)(%): 55.4%

• Quick Ratio: 1.18x

• Current Ratio: 3.29x

• PE Ratio: 31.85x

• The company focuses on therapy innovation, globalization and creation of

economic value for customers. To pursue that, in June 2014, Medtronic announced

its acquisition of Covidien, PLC of Ireland, after which it moved its headquarters to

low-tax Ireland. Moreover, in October 2017, Medtronic PLC announced that it had

treated the first patient in the landmark transcatheter mitral valve replacement

(TMVR) pivotal trial.

• Medtronic PLC also emphasizes on mergers and acquisitions for obtaining a wide

variety of technologies, products, and capabilities. In February 2016, the company

planned to acquire Bellco to venture into a newly created renal care solutions

division. Furthermore, in June 2016, Medtronic PLC pronounced its acquisition of

HeartWare International Inc. for US$1.1 billion to expand its heart failure portfolio.

• The company’s sales and marketing strategy are concentrated on the rapid and

cost-effective delivery of quality products to different groups of customers

worldwide, including hospitals, physicians, and other medical institutions. In May

2017, Medtronic launched resolute Onyx(TM) Drug-Eluting Stent in the United

States. It became the first DES available in 4.5 mm and 5 mm sizes. Additionally, in

February 2017, Medtronic PLC’s New Solitaire(TM) Stent Retriever Study validated

the outcomes from four pivotal randomized controlled trials (SWIFT PRIME,

ESCAPE, EXTEND IA, REVASCAT), establishing the benefits of mechanical

thrombectomy in patients who suffer from AIS or acute ischemic stroke.

Revenue (2016)US$ 28,833 Mn

Cardiac and Vascular Group

Restorative Therapies Group

Minimally Invasive Therapies Group

Diabetes Group

28%

12%

35%

33%

25%

07%

Revenue Contribution

Locations

• Americas

• Europe, the Middle East

and Africa

• Greater China

• Asia Pacific

Appendix

22

Appendix

Table 11: Latin America Segments by Type (2014 – 2022) value in US$ bn

23

2014 2015 2016 2017 2018 2019 2020 2021 2022CAGR(2017-

2022)

Stents XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX X.X%

Catherers XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX X.X%

Others XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX X.X%

Total XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX X.X%

List of Tables

Table 12: Latin America Segments by Application(2014 – 2022) value in US$ BN

2014 2015 2016 2017 2018 2019 2020 2021 2022CAGR(2017-

2022)

Angioplasty XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX X.X%

Valvuloplasty XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX X.X%

Total XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX XX.XX X.X%

Appendix

24

Research Methodology

The study begins with identifying the right research question(s). The question depends on what we are going to achieve by conducting the research or what we wantto convey to the prospective customers through this research. Next, we identify the logical steps to arrive needed to arrive at the answers to the question(s). Theselogical steps form our research objectives. The research objectives provide us a guideline regarding what information we need to conduct analysis. We stronglybelieve that well-defined objectives will lead to clear results about the given market

The next stage of the research is conducted utilizing the secondary sources of information, using a process called desk/secondary research. Netscribes Inc. has aconsiderable volume of information in both quantitative and qualitative forms, across all major industries and its sectors. Also, we conduct an in-depth study of themarket, understanding its key stakeholders, drivers, trends, challenges and global opportunities covering major regions such as North America, Latin America, Europe,Asia Pacific, and Middle East & Africa. The key sources referred to for this research includes (but not limited to) the following: Financial reports published by the key market players Government and other official sources including the National Statistics National and International trade associations Paid databases Other reliable sources

Primary research complements the secondary research as it helps us gain insights from the industries directly by communicating with the senior executives, keyopinion leaders and independent consultants who are experts in their industries or specific industry sectors. Such interviews are conducted across the value chain ofthe market in question. A survey questionnaire is usually prepared for conducting any primary interview or survey. The questionnaire is developed with utmost care tofulfil the key research objectives and also to validate the assumptions about the market. This supplements the information otherwise unaddressed via secondaryresearch. The primary data collection is done by expert interviewers who have specific industry knowledge. Linguists are hired to conduct interviews in therespondent’s native language. Only paid interviews are conducted to incentivize the respondents and ensure that there is no shift of focus. Some of the primaryresearch methods applied at Netscribes include the following: In-depth Interviews Executive Interviews Expert Panels

The qualitative and quantitative findings from the above stages are brought together by specialists to perform a rigorous analysis. The regional market trends, drivers,and opportunities obtained during the analysis is compared with regional economic indicators, sector growth rates, population index, etc. to ensure data consistency.After ensuring the consistency, these historical and present indicators help us to understand how the market will perform in future. Our proprietary forecasting modelfactors in all these indicators to predict the future market accurately.

Appendix

25

Assumptions

A number of demographic factors such as prevalence of cardiovascular diseases,

population growth, rise in geriatric population, increase in the prevalence of diabetes, etc.

have been taken into consideration.

For calculating various ratios pertaining to companies, the share price of September 7,

2017 was taken into consideration.

No significant new competition has been considered while forecasting the market.

No unexpected changes in the external factors have been considered that could change

the global scenario of the market in the future.

No major technological development has been taken into consideration that may replace

Interventional Cardiology procedures in the coming years.

The inflation rate has not been taken into consideration while forecasting the revenue.

Appendix

26

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