Economic factors remain the greatest threat to innovation in the coming years, as healthcare providers call on manufacturers for low-cost technology. The tussle is now between enhancing clinical diagnostics and improving cost and efficiency.
Diagnostics imaging is in high demand as procedures form the basis of diagnosis and also the treatment of various medical conditions. The healthcare sector has made significant technological advancements within the country, which has in turn led to growth in the medical imaging market. The increasing awareness about preventive healthcare and the rising ability of the country's population to spend on diagnostics services has further boosted the prospects of this industry.
As per a trend analysis, large multinational companies are looking to modify their products to match the requirements of Indian healthcare facilities. GE Healthcare has launched Discovery IQ, a PET/CT molecular imaging system designed in India. Philips has introduced Allura Centron and PrimaryDiagnost radiography solutions, both developed in India. Toshiba Medical Systems has introduced Vantage Elan MRI system with optional power-saving mode and compact design. Entry of Dabur into imaging segment in Delhi/NCR region is an interesting development in this niche marketplace.
Domestic companies, with a presence in the X-ray and ECG equipment segment have much to catch up with when it comes to high-end equipment. Indian Radiological and Imaging Association (IRIA) is also promoting research on imaging modalities using various platforms. Going ahead, the diagnostics imaging market is expected to record solid growth.
The Indian MRI equipment market is estimated at Rs.1150 crore, at 230 units in 2015. The 1.5T continues to be popular with a 75 percent market share, with 3T systems constituting the balance. The 0.2T-0.5T is gradually exiting this segment. The Indian market has not yet procured any 7T systems.
The market which saw a 45 percent increase in 2014 over 2013 saw a mere 12.5 percent increase in 2015, over 2014.
GE, Philips & Siemens have a combined share of 95 percent in the Indian market; the balance is shared by Hitachi and Toshiba.
MRI equipment offering silent scan that makes the sound of an MR scan as silent as a whisper have gained popularity over the last couple of years. While providing excellent image quality, these systems ensure clinicians make a confident diagnosis.
At Radiological Society of North America (RSNA) annual meeting in November 2015, the leading brands showcased systems delivering multiple, adjustable contrast images, and quantitative data from a single scan. These systems have started to make their way into the Indian market too. Designed to lower total cost of ownership and using considerably less power than previous-generation MRI systems, they require a smaller footprint for installation. These products are built on a platform designed to help clinicians increase imaging productivity and diagnostic confidence, while addressing patient comfort and the MR experience.
The department of IT's R&D laboratory SAMEER is scheduled to launch India's first MRI machine by 2018. The R&D laboratory is in advanced stage of product development.
The global MRI equipment market is poised to reach USD 5813.6 million by 2020, with a CAGR of 4.9 percent over the period 2015 to 2020, estimates Meticulous Research. The MRI equipment market reflects a balance of cost-constrained, saturated mature market, and emerging market with a low MRI-installed base. In mature markets, the purchase of systems continues to be dictated by cost; this is not only due to austerity measures, but also because of more focus on spending in healthcare IT and the replacement of CT equipment.
Emerging regions continue to show increasing interest in advanced imaging. However, political and economic pressures are influencing a number of markets, especially Middle-East, Argentina and Brazil, leading to limited growth in healthcare spending.
In 2015, closed MRI equipment emerged as one of the most lucrative segments accounting for majority of the market. High usage of these systems amongst majority of hospital chains and advantages associated with it such as rapid and accurate diagnostic results are a few factors attributing for its large share. Budget limitations have halted a move to the widespread use of more expensive advanced functionality 3-T systems. However, encroachment on closed 1.5-T systems has been seen from the mid-field open segment, with improved technology in the latter offering a competitive alternative to value-segment closed 1.5-T systems.
Very-high-field MRI equipment are expected to grow at a lucrative rate over the forecast period of 7 years. Key application areas of MRI equipment include brain and neurological MRI, spine and musculoskeletal MRI, pelvic and abdominal MRI, vascular MRI, cardiac MRI, and breast MRI. The brain and neurological MRI system segment accounted for the largest share of MRI market. Lack of substitute imaging tool for brain and neurological diagnostics is one of the key factors for its large share.
Historically, from the discovery of X-rays by Roentgen in 1895 to the introduction of MRI by Damadian in 1969, radiological advances have revolutionized the practice of modern medicine. The last few decades have witnessed dramatic innovations and improvizations in MR imaging technology.
A new way of using MRI scanners to look for evidence of multiple sclerosis (MS) in the brain has been successfully tested by researchers at The University of Nottingham and Nottingham University Hospitals NHS Trust.
Research team at Nottingham has found a way to use clinical MRI to distinguish between MS lesions and other brain white spots, which are found in MS. The study is published in the Multiple Sclerosis Journal. They have used a clinical MRI scanner of the type all neuroscience centers have to carry out a special type of scan called a T2-weighted imaging process, which is able to reveal lesions in the brain's white matter that are centered on a vein ' a known indicator of MS. A total of 40 patients were recruited from the neurology outpatients' department of Nottingham University Hospitals NHS Trust. Within the test cohort, all patients with MS had central veins in more than 45 percent of brain lesions, while the rest had central veins visible in less than 45 percent of lesions. Then, by applying the same diagnostic rules to the second cohort, all the remaining patients were correctly categorized into MS or non-MS, by the blinded observer, taking less than two minutes per scan.
The new study is significant because currently among patients referred to MS treatment centers with suspected MS, fewer than 50 percent are found to have it. This shows that diagnosing MS in a significant minority of cases can be challenging.
The next decade will witness further sophistication of these techniques and with data available from larger studies, it is expected that imaging will continue to provide new and unique insights in neurology and neurosurgery, which should hopefully contribute to better management of patients with diseases of the central nervous system.
Key Growth Drivers
Since the beginning of this decade, a lot of importance has been given to an early diagnosis of clinical disorders, which have paved the way for many technological advancements and innovations. MRI technology is a milestone in the diagnosis of many chronic health conditions due to its ability to capture more complex soft tissue structure. This enables the physicians to diagnose the disorders in time so that the chances of cure are increased.
Early detection of chronic disorders like cancer and neurological diseases greatly increases the chance for successful treatment; with the result that the healthcare sector is now emphasizing on early detection of such diseases, rather than spending on expensive treatment later. For instance, the World Health Organization (WHO) has launched various cancer prevention programs in different countries including India, Ireland, and Korea. These programs aim to reduce the number of cancer cases and deaths by improving quality of life of the patients, through systematic and equitable implementation of evidence-based strategies for prevention, early detection, diagnosis, treatment, and palliation.
American Cancer Society has made recommendation for a guideline for screening all cancer suspects. The guidelines are issued for almost all types of cancer including breast cancer, lung cancer, colorectal cancer, skin cancer, and brain cancer. The screening includes physical examination and scanning through imaging technologies like MRI.
Similarly, government bodies have also started to realize the need for early detection of chronic disorders and save the economy from added healthcare expenditure. For instance, the Affordable Care Act passed in 2010 makes prevention and early detection services free of charge for the aged people through Medicare coverage. While in Europe, 10 nonprofit organizations have formed an unprecedented alliance that aims to raise the awareness for early diagnosis of the chronic and non-communicable disorders. Such initiatives are expected to propel the diagnosis rate of chronic diseases across the globe.
Growing geriatric population and technological advancements such as the introduction of software application in the system that in turn increases the accuracy are some other key factors attributing to the growth of MRI market. Introduction of technologically advanced products and the way the entire RF subsystem has been operated in MRI are the major drivers of this market. Moreover, increase in incidences of road accidents caused by rash driving or driving after being intoxicated and increasing prevalence of cardiovascular diseases, tumors, and other neurological disorders are also few factors propelling market growth.
Battle between Cost and Development
Despite numerous advances in MRI capabilities, economic factors remain the greatest threat to innovation in the coming years, especially as healthcare providers call on manufacturers for low-cost technology. The battle is now between enhancing clinical diagnostics and improving cost and efficiency.
Some other factors impeding market growth include high capital investment, lack of long-term data on use of MRI in patients, limited availability of venture capital, shortage of helium gas deposition, and declining reimbursement rates for MRI procedure. However, manufacturers are now more concerned about analyzing more applications and developing effective equipment with improved patient comfort, which is expected to reduce the impact of these restraining factors.
Approximately 80 million MRI scans are conducted on 24,000 MRI scanners worldwide each year. In the United States alone, more than 40 million MRI scans are conducted each year. The second largest market, Japan, enjoys the best access with the highest number of systems per million people. In the world's most populous Asia-Pacific region, the compound annual growth rate for MRI is projected at 16 percent. Although the MRI market is well established in Europe and Asia, where a number of major manufacturers are also based, it is still in its infancy in developing countries. China, for example, is spending tremendously on MRI equipment for its hospitals and developing MRI manufacturing capability. To date, improvements in MRI images have been possible primarily with more powerful, better-designed magnets, and to a lesser degree with advanced electronics and software. The industry continues to pursue even more powerful magnets and refinements based on multiple sensors and processors. However, the resulting gains are forecasted to be marginal overall with little improvement in basic operation or patient experience.
Digital superconductor electronics, proven in metrology and wireless communications, provide significant benefits for medical imaging. Digital-RF transitions MRI to fully digital MRI with reduced scan times, improved image resolution, lower cost, enhanced safety, and improved accessibility to people worldwide. Digital-RF technology can be used to both modify existing MRI systems and develop new small, portable machines that can be operated safely in any environment. These portable MRIs could be taken to the patient - in the doctor's office, emergency room, or even on the battlefield in a military field hospital.
The quality and resolution of MRI have improved in the past two decades, primarily due to more powerful magnets. Electronics and imaging software have also improved as in other imaging technologies. At present, there is little that can be done to further improve the operation of the basic MRI system while significant limitations and challenges remain. Operating costs, installation complexity, and safety concerns need to be addressed. Scan time - arguably the most important factor in operating costs and patient concerns - has not improved in any meaningful way. Healthcare professionals are in agreement that shortening scan times while preserving image quality is the biggest game-changer.