Cardiac Rhythm Management Market Outlook to 2024
Global CRM market was valued at $10bn in 2015, with two main product categories ICD accounted for an estimated $6.0bn (60%) in sales and the pacemaker the reaming $4.0bn (40%) of the total market. The global CRM market is expected to grow at a modest 5.4% CAGR between 2015 and 2024, culminating in 2024 global sales of $16.8bn.
Cardiac Rhythm management (CRM) represents the largest segment of the cardiovascular devices market. Heart rhythm disorders are fairly common, with millions of people experiencing arrhythmias, or irregular heartbeats, at some point over their lives. Cardiac rhythm management (CRM) accounts for nearly 30% of worldwide death caused by cardiovascular disease. Nearly 7 million deaths occur in Germany, Italy, France, UK, & Spain annually due to sudden cardiac arrest (SCA).
In the early 2000s, the ICD market was a growth market driven by the launch of new products, positive clinical trial results, and indication expansions. However, after several recalls, government investigations, and journal articles raising the issue of overuse, the market slowed and has since become a mature market. The pacemaker market has been a more mature market for some time though in recent years has come under some more pressure amid a deteriorating pricing environment.
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Cardiac Rhythm Management Market: By Device Segment 2015-2024
An increasing number of M&A, rise in the number of collaborations and partnerships, and new product launches are some of the latest trends in the global cardiac rhythm management market which is going to boost the performance in the sector during forecast period.
The regulatory environment is more favorable now than before. The December 2015 decision on medical device excise tax suspension for 2016-2017 looks affirmative for the sector. M&A deals already touching $34 billion for 2016 with few months still to go, makes the year third busiest since 2008, which is again sign of progress.
“Drivers and Restraints”
Overall, the CRM market has stabilized and has recovered from market pressures experienced in 2011 & 2012 following JAMA article on overutilization and DoJ investigation. However, the CRM market remains intensely competitive. Product introductions promise to keep the CRM space interesting and MRI compatibility, competitive and innovative product launches could lead to more CRM shifts. Broadly, within CRM space, improving volume & moderating pricing pressure support stabilization and set the stage for mid-single digit growth through 2024.
" Medtronic, St. Jude Medical (pending acquisition by Abbott), Boston scientific are some of the key players in the CRM market"
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The market sales in CRM are driven from the three principal players—Medtronic, Boston Scientific, and St. Jude Medical (pending acquisition by Abbott). Together they represent roughly 90% of the global CRM market. Smaller, more regional players include Biotronik (private) and Sorin. R&D commitment by the players and the technology differentiation keeps market shares fluid.
The Cardiac Rhythm Management (CRM) landscape is shifting. Medtronic has benefitted from being the only manufacturer on the market with MRI-safe products, and momentum should continue as it expands it MRI-labeling to 3T scans in the U.S. Boston Scientific launched in its own MRI safe pacemaker and the MRI-safe Emblem S-ICD, with expectations for its MRI-safe ICD products 2017.
Medtronic continues to hold a dominant position today, with more than 40% share of both the pacemaker and ICD segments. Over the past 2-3 years, Medtronic has managed to gain share due to its first-mover advantage in MRI compatibility and new products like its Reveal Linq implantable cardiac monitor. Medtronic should continue to offer competitive edge driven by the roll out of novel technologies such as Micra leadless pacemaker and extravascular ICD (E-ICD). However, going forward, Medtronic’s share is expected to stabilize as St. Jude and Boston Scientific close the MRI gap through new product launches.
Although a relatively small player in U.S. CRM, privately-held Biotronik has an FDA approved MRI ICD product. The broader clinician enthusiasm around MRI compatible implantable devices offers the company the commercial and competitive advantage.
The Cardiac Rhythm Management (CRM) landscape is shifting. The CRM portfolio of leading companies continue to gain traction through differentiated product offering and companies investing to develop and launch new MRI compatible products. An increasingly competitive market will likely pressure ASP going forward though continued technology innovation should help offset this.
Despite the challenges in CRM, this market continues to be an important area of investment for the players given the large market size for ICD and pacemaker where even small share shift can make meaningful difference in operating profits and margin. The result of continued R&D commitment in CRM will be steady innovation, with new product mix resulting in some absorption of price pressure.
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