According to Millennium Research Group (MRG), the global authority on medical technology market intelligence, many segments of the European neurosurgical and neurovascular device market face significant challenges from competing treatments, and as a result the overall market will grow only slowly through 2016.
Hydrocephalus shunts, for example face increasing competition from a surgical procedure, endoscopic third ventriculostomy (ETV). Hydrocephalus shunts often experience a variety of malfunctions and require surgical revision. While newer models, including programmable shunts, show fewer failures, the problems have spurred interest in ETV as a treatment of hydrocephalus. The new procedure is being adopted particularly quickly in Germany, where physicians generally favor endoscopic procedures. Not all patients are eligible for ETV, so shunting will remain the primary treatment for hydrocephalus through 2016.
The neurovascular stent market will also face negative pressures, following the negative results from the United-States-based Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study, which tested angioplasty plus stenting using Stryker’s Wingspan stent in the treatment of intracranial atherosclerotic disease (ICAD). Though a United States study, it will strongly affect the European market. Unit sales of ICAD stents saw a dramatic decline of 45% from 2011 to 2012 in the wake of the SAMMPRIS trial.
Those negative results will also affect the European neurovascular balloon market, because balloons are typically used in conjunction with stents in the treatment of ICAD.
“Despite the bad news, there will be some market growth as the result of the adoption of premium-priced devices,” says MRG analyst Louise Murphy. “For example, programmable shunts will be increasingly adopted at the expense of lower-priced fixed-pressure stents. Programmable shunts will grow to nearly 50% of the total European hydrocephalus stent market by 2016.”
Most competitors in the neurosurgical and neurovascular device markets are large, with broad portfolios that allow for bundling and strong pricing competition. The dominant companies in this market are Stryker, Covidien, Codman & Shurtleff, and Balt Extrusion.