Endoscopes Market

Market Overview

Endoscopes are primarily used in some surgeries such as removal of the gall bladder and taking out tumors from the digestive system. It is often used to diagnose symptoms related to inflammation, bleeding, or cancer in the digestive system. In addition to this, endoscopes can be used to view organs of several systems and can even be used to perform minor surgeries. According to Cancer Treatment Centers, in the U.S., women undergo 40 million mammograms leading to 1.6 million breast biopsies whereas men undergo 30 million PSA tests annually.

Market Dynamics

Increasing number of minimally invasive surgeries are driving the market growth. The sales of endoscopes increase with the increasing prevalence of diseases and the demand for their diagnose. It has been found that over 75 million endoscopies are performed every year in the U.S. The study suggests that the rising geriatric population is the leading contributor to the market. As per the American National Institutes of Health, the geriatric population in the U.S. is projected to increase from 617 million in 2015 to 1600 million by 2050. The investments and growth of hospitals and ambulatory surgery centers also upsurge the number of overall endoscopies.

Cost of Endoscopies: One of the Key Factors

Cost of an endoscopy depends on many factors such as type of facility in which endoscopy is performed and inpatient facilities like hospitals, which require higher running costs while outpatient facilities like the ambulatory surgery centers run at a lower cost. It also varies as per personal ability to pay and health insurance plan, which can cover complete or partial bill payment. Apart from this, the location plays an important role in determining the cost of endoscopy. For instance, the location having fewer medical facilities usually charges higher than the urban areas having many providers.

The cost of an endoscopy performed in the U.S. also varies as per area or location. The endoscopy performed in an in-patient facility like a hospital would cost approx. USD 4,350. On the other hand, an out-patient facility like an ambulatory surgery center charges around USD 2,550. In 2016, the average cost of endoscopy performed in a U.K’s private hospital was approx. USD 3528.3, which was way higher than the U.K’s public hospital, where it was USD 516.3. To obtain low-cost healthcare, many patients from the U.S and the U.K travel to countries like Poland, Korea, and India to get their endoscopies. This has further upsurged medical tourism. The number of medical tourists has reached 50 million and the number is poised increase by 10% till 2028.

Endoscopes Market:Challenges 

There are several instances where hospitals using endoscopes have not been able to clean, sterilize, and disinfect. Endoscopes have multiple small parts, which are more prone to harbor infection. For instance, in April 2018, the U.S. Centers for Disease Control and Prevention conducted a study and found that current reprocessing methods are leading to contamination. To tackle this issue, end users are looking for disposable endoscopes. In 2017, Ambu acquired Invendo to develop single-use disposable endoscopes, which come with the risk of zero contamination and reprocessing, and require minimal training.

Segmental Analysis

By applications, the market is segmented into the gastrointestinal tract, respiratory tract, reproductive system, and others

1. Gastrointestinal

This is performed to view the inside lining of an organ such as the esophagus, stomach, duodenum, small and large intestines (colon), rectum, and anus. In 2015, about 11 million colonoscopy and 6.1 million upper endoscopies were performed and more than USD 135,900 million spent on the treatment of various GI diseases. From the last few years, the overall prevalence of GI disease has gone up because of changing eating habits, more consumption of junk foods, and the rising prevalence of gastrointestinal infections.

2. Respiratory Tract

Respiratory tract endoscopy is to be performed to view the nose and lower respiratory tract. In 2016, 652,572 deaths were reported due to lower respiratory tract infections. The prevalence of this infection is found to be higher in low- and middle-income economies and it is more dominant in children below 5 years and adults above 70 years. Every year, the infection affects around 18.75 million children in South Asia; more than 50% of these children are diagnosed with a bacterial infection.

3. Urinary Tract

Cystoscopy is performed to view the lining of the urinary tract through the urethra, which advances into the bladder. This is performed in patients suffering from urinary tract infection but is most common in women. According to the National Institute of Diabetes and Kidney Diseases, 40%–60% of women in the U.S. fall prey to urinary tract infection at least once in their  lifetime.

Types of Endoscopes

1. Rigid endoscopes are used only for a few minimally invasive procedures such as laparoscopy, rhinoscopy, and cystoscopy for viewing the abdomen, nose, and urinary bladder. They are ideal for performing procedures in small animals. However, the endoscopes are available in a wide range of diameters from 1 to 12mm. Rigid endoscopes are generally used for therapeutic purposes instead of diagnostic purposes.
2. Flexible endoscopes have a similar use, but their construction is slightly different which increases their efficacy. These kinds of endoscopes are lighter and quicker and can be controlled easily, but they produce images with low resolutions because of flexible fibers. Fibreoptic endoscopy and videoscope are the two types of a flexible endoscope. A fibreoptic endoscope is made of very thin size fiber, thinner than a hair. On the other hand, the videoscope is equipped with a video chip at its distal end, which sends images directly to monitor.
3. Capsule endoscope is equipped with a miniature camera. Due to its size, it can be swallowed. The capsule passes through the digestive tract and sends visuals. It is primarily used to view small bowel and colonic mucosa and to detect gross blood in the esophagus, duodenum, and stomach. The capsule endoscopes market is still in its nascent stage as a handful of companies, including Medtronic, Olympus, Jinshan and CapsoVision, have been able to meet the regulatory standards. These companies are still trying to make advances in the capsule endoscopy to improve overall output. For instance, the capsule when swallowed cannot be orientated, but it can be corrected by Magnetically Guided Capsule Endoscopy (MGCE). It uses an extracorporeal magnetic field to operate, guide, and orient the capsule and its mechanisms.

Regional Analysis

Every year, North America has been witnessing significant growth in the number of overall endoscopies being performed. This is mainly attributed to the growing prevalence of various types cancer, rising penetration of insurance,  strengthening network of hospitals and ambulatory centers, and increasing investment in research and development activities.  Children below 5 years are more prone to GI and respiratory tract infections. In 2018, the U.S. was housing about 23.8 million children. Every year, more than 200,000 people are hospitalized and 3–5 million people visit outpatient because of GI and respiratory tract infection. Ambu, one of the leading players in the region, is expecting  that its annual sales by the end of 2019 would reach 900,000 units.

The U.K is also going through a similar situation where more than 20% of children aged between 0-4 years are reporting such issues. The United European Gastroenterology reported that colorectal, gastric, pancreatic, liver, and esophagus cancer causes 590,000 deaths every year in the region. These cancers require endoscopies and biopsies for accurate screening and diagnosis.

Some of the leading countries in APAC, such as Japan, Korea, and China, are experiencing growth in the prevalence of stomach cancer. Urbanization, intake of junk food, and genetics issues are found be to the primary factor behind this rise. This, in turn, has increased the demand for minimally invasive surgeries as well as procedures like endoscopies. Olympus has already started investing in regions having a higher population and faster economic growth. For instance, it has set up a plant in Vietnam and facilities in China and India to tap the upcoming opportunity. Urinary tract infections are also on the rise in Singapore. UTI requires endoscopes for screening. According to HealthHub, 4% of young females are likely to have UTI infection and the number is expected to go north to 7% in females above 50.

Every year, 5.8 million people die due to acute lower respiratory infections (ALRI), out of which  50% of the victims are from sub-Saharan Africa. Peptic ulcer disease and liver cirrhosis are most prevalent in Africa.

Recent Developments

There have been many advancements in endoscope technology. This has benefited the doctors in understanding infections, inflammations and bleeding inside the GI tract, respiratory tract and the reproductive tract easily.

1. Currently, the rigid, flexible, and capsule endoscopes available in the market are facing several challenges. For instance, the tip mounted video camera cannot look behind due to haustral folds. Robot-assisted endoscopes have been developed which can bend 180^° backward to have a view behind the folds. Also, the use of robotics has improved the effectiveness and safety and enhanced the therapeutic capabilities of the endoscope.
2. Endoscopes are being used for surgical procedures such as cardiac surgery (mitral valve surgery and atrial ablation). For instance, Medtronic has announced that its RAS (Robot-Assisted Surgery) technology would partner with Karl Storz’s 3D Vision System and visualization tools to develop a robot-assisted platform. The use of robot-assisted surgery will make a paradigm shift in surgical procedures and it is projected to make an impact on the development of endoscopes.
3. Endoscopes are also introduced for thyroidectomy. In a transoral robotic thyroidectomy, thyroid tumor is partially or wholly removed by passing an endoscope through a small incision.
4. Experts at Friedrich-Alexander-Universität Erlangen-Nürnberg have developed a new kind of endoscope that uses microscopic imaging by exciting the molecules of a body to illuminate without needing synthetic agents.
5. Researchers from the University of Leeds have been able to develop an endoscope whose cost of manufacturing is USD 52 (£40) instead of USD 102,850 (£80,000). This will significantly improve cancer screenings in low and middle-income countries. It will lower sedation than before.

Endoscopes Market Segmentation

By Type

• Rigid Endoscopes
• Flexible Endoscopes
• Capsule Endoscopes
• Others

By End User

• Hospitals and Clinics
• Diagnostic Centers
• Others