Understanding future needs will guarantee the competitive advantage for manufacturers.

Neonatal care equipment manufacturers' interest in offering high-end, technology-integrated, home-based infant care and neonatal solutions mirrors the healthcare industry's shift toward value-based care. Keeping the patient-physician point-of-care (PoC) continuum requires solutions that feature information technology (IT) integration, wireless monitoring, and telehealth, among other capabilities. With the global neonatal care equipment market expected to reach USD 317.3 million by 2020, competition will intensify. New companies offering attractive pricing and technology features will compel market majors to innovate and expand to meet user needs.

More than 75 percent of healthcare organizations globally are forecast to be ready to invest in connected healthcare systems by 2020. This will fuel collaborations with neonatal care equipment companies in order to garner the best value for money. With 30 percent of patients expected to opt for alternate care by 2020, manufacturers offering quality home treatment options to infants in need of acute care, disease management, and help with other preterm birth issues will reap rich benefits.

It is getting tougher for multinational corporations to maintain their market shares in the preterm neonatal arena, especially in developing regions, as there are more than 50 domestic vendors competing primarily on price. Market leaders are creating a portfolio that is cost-effective, maintains the hospital-to-home PoC continuum, provides special attention to infants with preterm birth issues, and incorporates value-added services.

To increase market share, participants will need to collaborate with local players in fragmented domestic businesses. Intensive consumer engagement initiatives and focus on user wellness as well as disease prevention will build awareness and brand recall. In addition, the market needs affordable technologies that can conveniently reach and cater to customers in the low-income settings and assist in disease monitoring through diagnostic applications on mobile phones.

Indian Scenario

India is seen as a potential global hub for affordable health technologies, including biomedical devices and equipment. It has a vibrant industry that meets local needs to a significant extent. In addition, a plethora of foreign companies have had a marketing base here for long. Others are keen on entering the research and development space, with or without partnerships with Indian companies, to generate products at affordable cost to meet the growing demand of users here and in other countries.

The developments of the last two decades suggest that Indian products are likely to occupy a significant place in the global biomedical equipment market in the future. Neonatal care in India has changed greatly since the 1980s and 1990s. There is a widespread awareness about neonatal care equipment. Education and government initiatives have played a role, as has the spirit of technological innovation. An increasing number of manufacturers are moving to better quality. Recognizing this, international players (including Stanford University) and foreign companies are looking toward India to develop products for the global market.

Notwithstanding recent successes, Indian manufacturers and healthcare stakeholders have challenges to address. Respiratory problems are a major neonatal affliction to be tackled. Indian incubators and CPAP devices and ventilators are still undergoing the transition to international quality and standards, whereas radiant warmers and phototherapy units have gained international (Conformit Europene and Food and Drugs Administration) approvals.

Some of the teething problems faced by Indian companies have been overcome. India today is in a position to cater to the health of the world's neonates through affordable technologies. The Make in India initiative may make India a manufacturing hub.

A number of organizations and government agencies are striking partnerships with Indian industry. The Department of Biotechnology has introduced a number of initiatives in which it encourages industry and innovators to participate. The Confederation of Indian Industry and the Federation of Indian Chambers of Commerce and Industry have submitted several proposals to the government to improve Indian neonatal healthcare. Innovations are actively being supported at AIIMS and Indian Institute of Technology Delhi in association with Indian companies.

India is at the threshold of a neonatal survival revolution, with an abiding policy commitment to newborn health and a promising strategy for maternal and neonatal health, well supported by the commitment of the states. It is interesting to imagine whether the same situation would have prevailed, had the message of the AIIMS conference in 1990 been delivered just some years later and the foreign manufacturers had already entered India. And, it is also interesting to imagine what the story would have been if Indian industry had not responded to the message as it did.

Technology Trends

According to the World Health Organization, around 15 million babies are born prematurely (earlier than 37 weeks of gestation) each year, and this number is only expected to rise. Preterm birth commonly results in health issues such as low body temperature and difficulty in breastfeeding. Without proper medical assistance, many premature infants die from these complications.

This growing international need for better neonatal intensive care has galvanized healthcare companies and researchers into developing new ways of helping preterm infants. In recent years, this work has come to fruition in the form of several innovative NICU advancements.

Heart Rate Observation System (HeRO). Premature infants face numerous health challenges during their first week of life. If left untreated for too long, simple problems such as infections can become life-threatening. Recognizing the need for better NICU patient monitoring, the Medical Predictive Science Corporation (MPSC) unveiled its HeRO system. Extending beyond the capabilities of traditional monitoring systems, HeRO can detect even the smallest alterations in infants' heartbeats and provide accurate feedback on developing health problems. The machine provides feedback on a scale of zero to seven. If an infant receives a score higher than two, it indicates to hospital staff a potential health problem. In addition, HeRO can alert caregivers to issues up to two days earlier than conventional tests. With this information, nurses and doctors are able to act earlier than ever before and deliver life-saving treatment to their tiny patients.

The HeRO system is available in three forms, each of which comes with different capabilities. HeRO ES, the most basic of the three, is a standalone device that can monitor one patient at a time. For hospitals seeking a more comprehensive system, MPSC also offers the HeRO Symphony, which can accommodate all the beds in an NICU unit. In addition, this version boasts such unique features as remote technical support and one year of patient data storage.

Pea Pod. One of the challenges that premature infants must overcome before they can leave the hospital is low weight. In an effort to help these infants gain weight, Cosmed leveraged air displacement plethysmography technology to create the advanced Pea Pod system. To use the device, hospital staff places the infant inside a warmed incubator, which looks somewhat akin to an MRI machine. By analyzing the air displacement and pressure inside the capsule, the Pea Pod measures the infant's body fat percentage, total body volume, and fat-free mass. This data helps hospital staff understand exactly how much of an infant's body is fat and how much is muscle, and enables them to develop nutrition plans accordingly.

Before the creation of the device, hospital staff could only track changes in an infant's body fat by testing him or her with four different devices over the course of several hours. However, the Pea Pod can provide the same accurate results within a time span of just two minutes.

NTrainer System. For many premature infants, the simple task of feeding is difficult without the implementation of a feeding tube. These babies often spend more time in the NICU as they cultivate their non-nutritive suck (NNS) skills, a term that describes the way infants must simultaneously suckle, swallow, and breathe while feeding. The NTrainer System analyzes an infant's NNS capabilities and allows caregivers to administer safe and effective treatment. Those who require assistance with feeding can receive therapy via the NTrainer device, which delivers steady pulses to a handheld pacifier attachment. When placed in the infant's mouth, the pacifier facilitates neuromuscular training that enhances his or her ability to feed.

Caregivers typically provide NTrainer therapy three times per day for up to
20 minutes at a time. One of the most effective techniques for accelerating the treatment is to conduct therapy sessions at the same time as feedings occur, as this will help infants associate suckling with a full stomach. The NTrainer System better prepares premature infants to independently feed from the bottle or breast. This can not only reduce their time spent in the NICU, but can also support healthy neurodevelopment into early childhood.

Embrace Warmer. Infants born before term do not possess the amount of body fat needed to effectively regulate their body temperature. Most NICUs place these babies in incubators to keep their temperature steady. However, there are numerous families and medical centers across the globe that lack access to modern incubators due to power constraints, insufficient funding, and crowded hospitals. In an effort to overcome these challenges and save lives, a group of graduate students at Stanford University established Embrace in 2007. A non-profit organization, it has created a personal temperature-regulating device for premature infants. Designed like a sleeping bag, Embrace utilizes a specialized phase-change material that can remain at a temperature of 98.6F (37°C) for 6 hours at a time. Parents and caregivers can heat the bag using either the provided portable heater, or by immersing it in boiling water.

Embrace is not only effective at helping infants retain body heat, but it is also portable, which makes it perfect for use during transportation, and costs only a fraction of the price of standard technologies.

Global Market

The global fetal and neonatal care equipment market size was valued at USD 6.7 billion in 2016 and is projected to grow at a CAGR of
7.6 percent over the next 9 years. Some of the factors responsible for market growth are the high birth rate in developing countries, rising prevalence of preterm births, and efforts by the government to increase survival rates in such cases. In addition, increasing prevalence of neonatal hospital-acquired infections and rising awareness about neonatal health and care equipment is expected to contribute to the growth.

According to the UN Foundation, maternal and infant care is a global priority, since around 800 women die every day from preventable causes associated with pregnancy or childbirth. This has led to increased demand for neonatal and fetal care equipment. Furthermore, HAIs are primarily a concern for premature and infants with medical disorders requiring prolonged hospitalization. The WHO data states that 2.7 million stillbirths and 3.1 million neonatal deaths occur worldwide annually. Furthermore, preterm and low weight birth babies are susceptible to many heath risks and require specialized care. Hence, demand for neonatal equipment is expected to grow exponentially.

Neonatal equipment has been observed to have increasing demand in middle-income countries, as birth rates in these countries are higher, and the priority for improved fetal and neonatal care is high in these countries. As a result, sales of the equipment are expected to flourish at a rapid rate.

Fetal Care Equipment Insights. In 2016, ultrasound devices held the largest share owing to their increasing application to view the fetus during pregnancy. In addition, rising awareness, technological advancements, and ease in utility have further triggered the usage of portable and do-it-yourself ultrasound devices for home use. Fetal monitors are anticipated to witness the fastest growth rate during the period 2016 to 2025, owing to their utility in determining the baby's heart rate during pregnancy and labor.

Neonatal Care Equipment Insights. Monitoring device segment held the largest share in the year 2016, owing to factors such as constant technological advancements in neonatal monitors including improvements in connectivity and ease-of-use in home settings. On the other hand, respiratory devices are expected to exhibit fastest growth rate owing to increasing demand for respiratory care in neonatal in order to reduce the length of hospital stay and risk of long-term disability. Nearly all newborns are prone to respiratory difficulties at birth, and neonate respiratory devices ease the process ensuring better health of the baby.

Competitive Insights. The major players in the global market include Becton, Dickinson and Company, GE Healthcare, Philips, Draeger, and Medtronic. This industry is expected to be concentrated, which is evident from the presence of a large number of public players occupying a high market concentration ratio.

These players are collaborating with leading child care provider networks, to ensure better recognition and push product sales. For instance, Boston Children's Hospital and GE Healthcare have collaborated for the treatment and diagnosis of pediatric brain disorders by using smart imaging technology.

Way Ahead

The fetal and neonatal care equipmentmarket will continue to be shaped by the regional and local trends in the annual live births and infrastructure market. The industry is undergoing changes in regards to regulatory protocols, preventive care, reimbursement models, healthcare digitization, patient interests, physician preferences, and executive priorities. Stakeholders need to be aware of the challenges posed by the industry and anticipate new ways to innovate business models and capitalize on market transformation.


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