Wound Management Forecast 2016 to 2026

The global annual market for products used in wound management is currently a behemoth of $20.2 billion. The wound management forecast to 2026 shows the global market hitting $38 billion as it grows in response to strong wound care demand.

The market is driven by inescapable demographics — an aging population, with dramatically increasing prevalence of obesity and diabetes leading to growth in the most expensive types of wounds, chronic wounds. The market is also growing as a result of advanced wound technologies that improving in their ability to shorten healing time, costs, or both.

Chronic wound remain a big focus, for good reasons. From our press release:

“Our recent research shows that chronic wounds, which have long been no secret to clinicians, epidemiologists, and product manufacturers as a growing health problem, are actually even more prevalent and costly than has been previously reported.”

Care of chronic wounds is a significant, global burden on healthcare systems. In the USA alone, it is estimated that at least 6.7 million people suffer with chronic wounds, requiring treatment in excess of $20-50 billion per year .

With many, many active companies in an industry that started hundreds of years ago, an almost continuous spectrum of products exists from low tech (gauze) to high tech (bioengineered skin):

      • traditional adhesive
      • traditional gauze
      • non-adherent
      • film
      • foam
      • hydrogel
      • hydrocolloid
      • alginate
      • antimicrobial
      • collagen
      • negative pressure wound therapy (NPWT)
      • bioengineered skin & skin substitution
      • growth factors

Growth in sales varies, with the lowest rates for traditional products and the highest rates generally for the advanced products. We say generally because, depending upon the product and the geographic location, sales growth rates can be considerable. The end result is that the makeup of the wound market will change from 2016 to 2026. See below:

Source: MedMarket Diligence, LLC; Report S254.

Put another way, some segments will gain share of the total wound market at the expense of others:

Source: MedMarket Diligence, LLC; Report #S254.

 

And considering geography, the wound care industry recognizes the major impact of China on future demand, eventually eclipsing U.S. sales:

USA vs. Asia/Pacific Wound Sales

Source: MedMarket Diligence, LLC; Report S254.

Companies

The wound care industry remains quite fragmented, with about eight companies holding leading market shares, but with possibly thousands of small cap companies around the world that are also manufacturing and marketing various wound care products. The Traditional Wound Care space remains attractive, in part since gauze dressings are relatively easy to manufacture and are also still the most commonly-used wound dressing.

2017 Worldwide Wound Management Market Shares

Source: MedMarket Diligence, LLC; Report S254.


The MedMarket Diligence Report #S254 is described in detail at link.

Separate size, growth and competitor data are presented for the U.S., rest of North America, Latin America, leading western European countries (specifically, United Kingdom, Germany, France, Italy, Spain), rest of Europe, Japan, Korea, rest of Asia/Pacific, and the Rest of World category. The report’s company profiles assess 92 leading and key emerging companies regarding current/projected products, technologies and positions in the advanced wound care market.

 

 

Chronic wounds drive product development

To the person with a chronic wound, the condition represents pain, social and psychological debilitation and usually a financial load. To society, wound care—and especially the treatment of difficult-to-heal wounds—may represent great human suffering, social discomfort, days lost from work, mental health problems, recurrent infections and great economic burden and the human burden of wound care. Having a chronic wound not only necessitates physical care of the wound, including cleaning, disinfecting, irrigating, and changing dressings; it also impacts the emotional and psychological health of the patient. Depression can set in due to a lower quality of life and dependence on others for care of the wound, as well as for overall assistance, both physical and financial. Wounds may cause odors or may have visible drainage, staining clothing and triggering feelings of embarrassment and shame. These in turn may lead to isolation due to decreased mobility and the fear of being a burden on family and friends. To make things worse, increased stress can slow the progress of wound healing.  For all of these reasons, chronic wounds drive product development.

Growth and trends in the global prevalence of wounds
Prevalence by wound type, 2016-2026

Source: MedMarket Diligence, LLC; Report S254.

In caring for a chronic wound, the dressing costs are only part of the picture; the less visible costs include such items as nursing care, medications for pain and infections, and hospitalization. Hospitalization is a leading cost driver for wound care, accounting for at least 50% of the global economic burden. Nursing time to properly care for the patient with a chronic wound can be lengthy, and this is time that could be spent with other patients. In a new report published in the December 2017 online version of the International Society for Pharmacoeconomics and Outcomes Research’s (ISPOR) Value in Health journal (An Economic Evaluation of the Impact, Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds. Nussbaum, Samuel R. et al. Value in Health, Volume 21 , Issue 1 , 27 – 32) (see the study), the researchers found that the costs related to wound care in the Medicare population (USA) were much higher than originally estimated, and that care took place primarily in outpatient settings. For the calendar year 2014, there is considerable variation in the estimates originating from different sources:

“Total Medicare spending estimates for all wound types ranged from $28.1 to $96.8 billion. Including infection costs, the most expensive estimates were for surgical wounds ($11.7, $13.1, and $38.3 billion), followed by diabetic foot ulcers ($6.2, $6.9, and $18.7 billion,). The highest cost estimates in regard to site of service were for hospital outpatients ($9.9–$35.8 billion), followed by hospital inpatients ($5.0–$24.3 billion).”

The development of advanced wound care dressings, devices and biologics is helping to change this situation. Although these advanced products may seem (or may be) expensive, they end up saving money for health care systems by healing wounds more rapidly.

Industry Structure

The wound care industry remains quite fragmented, with about eight companies holding leading market shares, but with possibly thousands of small cap companies around the world that are also manufacturing and marketing various wound care products. The Traditional Wound Care space remains attractive, in part since gauze dressings are relatively easy to manufacture and are also still the most commonly-used wound dressing. Even a small company can invent a novel twist to a dressing and experience a rise in profits and inroads into the market.

Low to medium industry concentration. As the traditional and advanced market shares diagrams below demonstrate, there are five to eight major players in Traditional and Advanced Wound Care Markets.

Traditional Wound Care Market Shares, 2017

Source: Report S254, “Wound Management to 2026”.

While these firms account for about 79% and 73% of the total markets, respectively, a significant portion of these markets are covered by hundreds or thousands of Other companies. This low to medium level of concentration means that smaller companies, or large companies looking to break into Wound Care, are able to do so more easily than if, say, three companies controlled 95% of the market.

Johnson & Johnson is estimated to be the Traditional Wound Care market leader with about 26% share, followed by Smith & Nephew, 3M Health Care and Hartmann. Medline Industries is estimated to account for about 8%, while Others account for about 21% of this market.

Breaking into the Advanced Wound Care markets presents a somewhat greater challenge. Here, the leading companies have invested heavily in R&D to gain strategic competitive advantage, as well as to create improved products for patients. Smith & Nephew is holds an estimated 21% of this market, followed by Acelity and Johnson & Johnson with 11% each, and Mölnlycke, 3M Health Care, Hartmann, Cardinal Health and ConvaTec accounting for smaller shares. Here again, Others accounts for at least 27% of this market.

Advanced Wound Care Market Shares, 2017

Source: Report S254. 

Opportunities exist in both Traditional and Advanced Wound Care, especially if a company is in the position of acquiring part or all of an existing wound care company, and if the company can then invest in the development of its new products. If points of distribution overlap, then so much the better.

Relatively low barriers to entry. Good news for companies wishing to break into wound care: barriers to entry into the traditional wound dressing segments (Adherents, Gauze and Non-Adherent Dressings) are relatively low, while demand remains strong. Typically, once a company is established in a traditional segment, it may either plow revenues into research and development, or it may acquire companies to more easily break into new product segments and markets. Many companies in wound care have followed just this path to gain market share and make an impact in the industry.


From, “Wound Management to 2026”; Report S254. Excerpts available.

Bioengineered skin and skin substitutes in wound management

Bioengineered skin was developed because of the need to cover extensive burn injuries in patients who no longer had enough skin for grafting. Not so long ago, a patient with third degree burns over 50% of his body surface usually died from his injuries. That is no longer the case. Today, even someone with 90% total body surface area burn has a good chance of surviving. With the array of bioengineered skin and skin substitutes available today, such products are also finding use for chronic wounds, in order to prevent infection, speed healing and provide improved cosmetic results.

Estimated Worldwide Wound Prevalence by Etiology, 2015

Source: MedMarket Diligence, LLC; Report #S251, “Wound Management to 2024.” (See pending Report #S254.)

Skin used in wound care may be autograft (from the patient’s own body, as is often the case with burn patients), allograft (cadaver skin), xenogeneic (from animals such as pigs or cows), or a combination of these. Bioengineered skin substitutes are synthetic, although they, too, may be combined with other products. It consists of an outer epidermal layer and (depending on the product) a dermal layer, which are embedded into an acellular support matrix. This product may be autogenic, or from other sources. Currently most commercial bioengineered skin is sheets of cells derived from neonatal allogenic foreskin. This source is chosen for several reasons: because the cells come from healthy newborns undergoing circumcision, and therefore the tissue would have been discarded anyway; foreskin tissue is high in epidermal keratinocyte stem cells, which grow vigorously; and because allergic reactions to this tissue is uncommon.

Bioengineered skin and skin substitutes are on the market and in development by LifeCell (Acelity), Organogenesis, Smith & Nephew, Organogenesis, Vericel Corporation (formerly Aastrom Biosciences), Mölnlycke Health Care, Integra LifeSciences, Smith & Nephew, Stratatech Corporation, A-Skin, University Children’s Hospital, Zurich; EuroSkinGraft.

The market may become more crowded as growth in the adoption of these products draws more competitors. Bioengineered skin and skin substitutes will drive more revenue than any other segment of the broader wound management market.

Growth in Advanced Wound Market Segments, 2014 to 2024

Source: MedMarket Diligence, LLC; Report #S251, “Wound Management to 2024.” (See pending Report #S254.)

Competitors’ positions in bioengineered skin are variable based on their geographic presence. See shares in the U.S., the UK, and Germany for bioengineered skin & skin substitutes.

Source: MedMarket Diligence, LLC; Report #S251, “Wound Management to 2024.”

Source: MedMarket Diligence, LLC; Report #S251, “Wound Management to 2024.” (See pending Report #S254.)

Source: MedMarket Diligence, LLC; Report #S251, “Wound Management to 2024.” (See pending Report #S254.)