The ventilator segment is poised to see a steady growth of 10 percent, over the next 5 years with the imported brands continuing to dominate the market.

The World Health Organization reports that more than five million deaths are reported every year owing to chronic respiratory diseases. The deteriorating quality of air, particularly in countries where the economy is largely dependent on pollution-intensive industries, is one of the chief causes of the alarming spike in the prevalence of respiratory diseases, especially chronic obstructive pulmonary disease (COPD). This translates into an increased demand for medical devices, one of which is mechanical ventilators.

In contrast, the shrinking profit margins of manufacturers, intensive competitive rivalry, budgetary constraints faced by small healthcare facilities, and injuries associated with the prolonged use of ventilators threaten the growth of the global mechanical ventilators market.

Indian Market Dynamics

ventilators

ventilatorsThe Indian ventilator market has exhibited a steady growth of 10 percent over the last couple of years. The market in 2015-16 was estimated at 6450 machines, valued at 335 crore. The imported equipment continues to dominate the market with a 58 percent volume share and a 73 percent share in value terms. Within the segment, there are premium and super premium, both with an equal share. The very-high-end machines have a 5 percent share.

The ambulatory or transports have seen traction, with the turbine-driven ventilators gaining popularity. Refurbished ventilators are available in a higher price range now, as the basic model is no longer available for refurbishing. The indigenous players continue to command a niche share as some medical facilities, with limited budgets, prefer a low-end model, and some just to ensure that they meet the formality of offering a ventilator.

Global Market

The global market for mechanical ventilators was worth USD 1.1 billion in 2015-16 and is poised to reach a value of USD 1.8 billion by 2024, registering a 4.8 percent CAGR therein. In terms of volume, the mechanical ventilators market is projected to expand at a CAGR of
5.5 percent in the period 2015–2024.

The global mechanical ventilators market is characterized by the strong presence of a number of local and regional players. These companies are just as capable as global players in efficiently catering to the changing consumer needs and entering neighboring markets. However, regulatory requirements differing from country to country tend to restrict the entry of these players in several national markets. Nevertheless, large multinational players are entering into strategic partnerships or acquiring small start-up companies in order to match the competition in local markets for mechanical ventilators.

The global market witnessed a significant growth over the past two decades, and it has been characterized by technological innovation and increasing preference for portable and homecare ventilators.

ventilatorsCritical care mechanical ventilators contributed the most toward the global market. In terms of percentage share contribution, the segment is anticipated to account for a 48.2 percent share by 2024. The portable mechanical ventilators segment is expected to exhibit the strongest CAGR of 7.6 percent from 2016 to 2024 by value.

Based on mode, invasive mechanical ventilators presently form the leading segment of the global market. However, registering a rapid growth rate through 2024, the non-invasive mode segment is expected to reflect a gain in market share by the end of the forecast period. On the basis of end use, hospitals account for the major share in the global mechanical ventilators market in terms of revenue. Home healthcare, on the other hand, is forecast to register the highest growth rate by 2024.

The Road Ahead

Despite the strides made, especially with the advent of complex algorithms in the latest ventilators on the market, expert knowledge is still crucial to successful outcomes. The major challenge seen in the ventilator market is due to the manufacturers having no restrictions on the definitions of respiratory support modes, which are confusing for the end user. In many cases, an algorithm or ventilation mode proposed by a manufacturer as being exclusive for its equipment is based on almost the same concept, but with a different registered trademark name than the option proposed by another manufacturer. Another challenge in the market is related to size of ventilators. Infant-to-adult ventilators seem attractive because they offer single user interface for staff to become familiar with, and also make maintenance easier, but one-size machines definitely do not fit all.

Eric Noronha,Sr. Manager-Operations, TBS India Telematic and Biomedical Services Pvt. Ltd., Bangalore
Second Opinion
Cellular Phone Interference

The cellular phone with computer control and operating at 828.750 MHz analog modulation will be operated at 16, 40, 100, 250, and 600 mW, 30 cm from the floor and 30, 15, and <3 cm from all sides of each ventilator. Six of the 14 ventilators tested malfunctioned when a cellular phone at maximum power output was placed 15 cm from the device. None of these responses were considered immediately life-threatening except for the response of alarm, which may stop ventilating when the cellular phone at the maximum power output was placed 30 cm from the ventilator

One ventilator doubled the ventilatory rate and another increased the displayed tidal volume from 350 to 1033 mL. One of the infant ventilators displayed tidal volume increased from 21 to 100 mL. In another ventilator, the high respiratory rate alarm sounded but the rate did not change.

Conclusions: In a controlled laboratory setting, cellular phones placed in close proximity to some commercially available intensive care ventilators can cause malfunctions, including irrecoverable cessation of ventilation. This is most likely to occur if the cellular phone is <30 cm from the device and ringing. Based on universal historic data and the available literature, we believe it is reasonably safe to permit the use of cellular phones in the intensive care unit, as long as they are kept 3 feet from all medical devices. The current electromagnetic compatibility standards for mechanical ventilators are inadequate to prevent malfunction. Manufacturers should ensure that their products are not affected by wireless technology even when placed immediately next to the device.

Eric Noronha
Sr. Manager-Operations
TBS India Telematic and Biomedical Services Pvt. Ltd., Bangalore

 

Customers that typically have low awareness and purchasing power are trusting local companies to provide better after-sales support, which might compel MNCs to scale down prices. This may offer huge opportunities for engineering service providers and OEMs. Devices suitable for providing more comfortable and clinically effective ventilator support by specific inspiratory ramps, cycle triggering, expiratory facilitation, leak correction, and real-time ventilator support are the current needs in the marketplace. A large number of exciting opportunities are waiting for the manufacturers of ventilators in the market.

Indian Market Dynamics is based on market research conducted by Medical Buyer in July 2016.


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