It is all about getting functional information out of the same scan without additional expense or radiation to the patient.
The evolution of CT scanners has progressed to the point where the number of slices per rotation is no longer the benchmark for performance. Market leaders in the higher-slice segments have proven superior image quality. They are under pressure to prove that they can incorporate effective dose-reduction techniques while maintaining the image quality. High-end imaging modalities require advanced image management and archival systems. The diagnostic outcome of molecular imaging has been made available to clinicians, and healthcare IT and molecular imaging are exploiting the advantage of systems.
Manufacturers are working on providing effective distribution of images to clinicians and integrating CT systems with electronic medical records. With the addition of high-speed multi-slice CT scanners, healthcare providers are thinking differently about imaging, diagnosis, and treatment of patients, as new pathways for clinical applications in areas such as trauma, pediatric, vascular, and cardiac imaging open up.
Indian Market Dynamics
The Indian CT scanners market was valued at 900 crore in 2015-16, a 13 percent increase in value terms over 2014-15. The smaller machines, <16-slice category, continue to gain popularity, and account for 40 percent of the market in value terms. The 16-slice machines, giving value for money contribute 25 percent to the market. The discerning customer continues to prefer the 64- and larger-slice machines. The three brands, GE, Philips, and Siemens, dominate the market, albeit the Revolution ACT by GE has gained ground.
The pre-owned (refurbished) CT scanners are primarily sold in the <16-slice category, with Siemens being the most popular brand. Some GE systems are also sold. About 30 units were also sold in the 16-slice category, at an average unit price of 1 crore and a couple of systems in the 16- to 28-slice category, at an average unit price of 2.5 crore. The leading vendors in this category are Cura, Sanrad, Ives Medical, Soma Technology, and some regional freelancers.
The recently announced AERP regulation that systems older than 7 years cannot be refurbished and sold has changed the dynamics of this market. At the outset, freelancers who currently sell about 100 systems annually will perhaps get marginalized over this year, after which the pre-owned segment market is expected to shrink.
CT Technology – What Is Next?
Today's CT scanners include technological developments that enable users to better manage patient care, including lung cancer screening, dose guidance and regulation, spectral and multi-energy imaging, and expansion of cardiac and brain imaging. These scanners and solutions also provide new levels of information to help clinicians make a more confident diagnosis at low dose, without increasing complexity in their routines.
Global CT trends continue to focus on addressing the increasing burden for diagnosing complex patients while ensuring optimal dose management, efficient system utilization, and standardization of protocol practice. Health systems are seeking CT systems that can improve the efficiency of handling complex workflows and broad case mixes for settings like outpatient or emergency, from polytrauma to light headaches, or improving clinical excellence in specialties such as detecting small liver lesions or establishing lung screening practices. Optimizing dose as well as greater standardization of protocols also continues as health systems improve operational efficiency and ensure patient satisfaction as well. Traditional installed CT systems are unable to address these dynamic challenges.
The CT scanners market has shown consistent growth over the last 3 years, driven by a number of factors. The conversion to a value-based payment healthcare system has changed what hospitals look for in return on investment, cost-effectiveness, efficiency, and increasing patient safety. Hospitals need to operate more efficiently and productively, meaning a shift toward more value-oriented products. Similarly, a quality-shift has occurred with patients, who are now more proactively involved in their care.
Trends from this shift to value-based care include data integration (big data) and population health management. An influx of data combined with advancements in imaging helps leverage this data to not only bring further value but also apply it to broader populations.
The buzzwords for 2017, when it comes to CT, are dual energy and spectral imaging. It is all about getting functional information out of the same CT without additional expense or radiation to the patient, while providing valuable functional information. Examples include detecting lesions earlier in the disease process and customizing future treatments. Structural heart imaging is also on the rise, a trend believed to continue.
The latest advancements in CT technology focus on the information derived from CT solutions, looking at how else this information can be used and integrated to bring further value. Some of the notable advancements include:
- lThe ability to extract clinical information from CT studies, which enables a more confident diagnosis – potentially resulting in reduced follow-up testing and improved disease management.
- lThe ability to extract clinical information at lower radiation doses, which allows a broader use of CT for high-risk populations and earlier disease detection (lung cancer screening).
- lThe ability to integrate information across different diagnostic tools, creating opportunities to optimize information across the continuum of patient care.
Spectral CT is a relatively new concept in diagnostic imaging, allowing physicians to use CT scanning to assess the material composition of the target area. This makes CT more definitive and cost effective, by reducing the need for downstream tests, especially in cancer, vascular diseases, and kidney stones. Another trend that is likely to continue to gain prominence is the transition of 3-D printing from toy to tool.
Many aspects, including equipment, will continue to evolve, but none more so than applications and cloud computing. Considering the enormous amounts of data generated by a CT scan, there is a tremendous amount of data to capture and optimize. CT technology will continue to see advancements that quantify and make sense of these data – using it to bring value back to the radiologist, the provider, and the patient.
Indian Market Dynamics is based on market research conducted by Medical Buyer in September 2016.