MediPoint: Hernia Repair - EU Analysis and Market Forecasts

Summary

Dramatic improvements in access to and quality of healthcare in the Asia Pacific region, concurrent with the introduction of next-generation biologic and composite meshes in developed countries and adoption of laparoscopic techniques worldwide, will drive hernia repair market growth in the US, Europe and Asia Pacific. Saturated with numerous players and a library of different products, the fiercely-competitive hernia mesh industry has experienced notable improvements recently in device quality and affordability, as companies strive for increased physician adoption in established markets and strategize entry into new regions.

The report provides a comprehensive evaluation of the global hernia market, including development and sales of inguinal, incisional and umbilical hernia repair products. Included within is an analysis of the drivers, opportunities and barriers impacting growth in the mesh market worldwide, with in-depth breakdown by surgical technique to highlight the fast adoption of laparoscopic methods. The report identifies and evaluates key trends and unmet needs shaping the global market through 2019, emphasizing testimonials from top physicians around the world who are implanting the devices.

GlobalData estimates the overall hernia repair market in the major European markets of France, Germany, Italy, Spain, and United Kingdom in 2012 to be $239 million.

GlobalData built this report using data and information sourced from secondary sources, as well as primary research interviews with leading Herniologists and General Surgeons around the world, and in-house analysis conducted by GlobalData’s team of industry experts.

Scope

- An overview of hernia, which includes epidemiology, etiology, symptoms, diagnosis, pathology and treatment guidelines.
- Annualized EU hernia repair market revenue and future forecasts from 2009 to 2011, forecast for 7 years to 2018.
- Investigation of current and future market competition for hernia repair
- Insightful review of the key industry drivers, restraints and challenges as well as predicted impact of key events.
- Competitor assessment including device approval analysis and device sales forecasts.
- Marketed and pipeline product profiles covering efficiency, safety, clinical study details, device approvals, product positioning and device sales forecast.
- Analysis of unmet needs within the market and opportunities for future players.
- Technology trends evaluation to assess strength of pipeline.
- An overview of all devices in development including clinical study details, design and material selection considerations, efficacy reports, and device approval timelines.
- Company profiles including business description, financial overview and SWOT analysis.
- Coverage of key market players.
- Strategic assessment of the hernia repair sector through market impact analysis, future market scenario and company analysis.
- Direct quotes from Key Opinion Leaders (KOL) as well as herniologists

Reasons to buy

- Understand the trends shaping and driving the EU hernia repair Market.
- Realize device preferences of physicians who have performed the tests already.
- Access market sizing, forecasts and quantified growth opportunities in the EU hernia repair market through 2018.
- Quantify candidate patient populations to better design product pricing & launch plans.
- Drive revenues, formulate effective sales and marketing strategies and gain in-depth understanding of the competitive landscape.
- Perform benchmarking analysis of growth opportunities against currently marketed products.
- Assess competitiveness of products in market by understanding the strengths and weaknesses of current competition.
- Take a comprehensive look at the market’s device pipeline and identify promising, paradigm-shifting products.
- Create an effective counter-strategy to gain a competitive advantage against those currently in the market.
- Organize your sales and marketing efforts by identifying the market categories and segments that present the best opportunities for growth.
- What’s the next big thing in EU hernia repair market landscape? Identify, understand and capitalize.

Table Of Contents

1 Table of Contents
1 Table of Contents 6


2 Introduction 21
2.1 Catalyst 22
3 Disease Overview 23
3.1 Anatomy and Physiology 23
3.1.1 Inguinal Hernias 23
3.1.2 Incisional Hernias 25
3.1.3 Umbilical Hernias 26
3.2 Pathophysiology 27
3.2.1 Inguinal Hernia 27
3.2.2 Incisional Hernia 29
3.2.3 Umbilical Hernia 29
3.3 Clinical Presentation 30
3.3.1 Symptoms 30
3.3.2 Diagnosis 31
3.3.3 Clinical Outcomes 32
3.4 Epidemiology 37
3.4.1 Inguinal Hernias 37
3.4.2 Incisional Hernias 40
3.4.3 Umbilical Hernias 43
3.5 Economic Impact 45
3.5.1 Open versus Laparoscopic Repair 45
3.5.2 Watchful Waiting 46
3.5.3 European Union 47
4 Competitive Assessment 49
4.1 Overview 49
4.2 Large Pore Meshes 49
4.2.1 Overview 49
4.2.2 Angimesh R2 (Angiologica) 53
4.2.3 Assumesh (Assut Europe) 54
4.2.4 Cristalene (Abiss Analytical Biosurgical Systems) 55
4.2.5 Hexapro Mesh (Agency for Medical Innovation) 56
4.2.6 Optilene Mesh (B. Braun) 57
4.2.7 Omyra Mesh (B. Braun) 61
4.2.8 ProLite Ultra Mesh (Atrium Medical) 63
4.2.9 Surgimesh 1 and 2 and XLIGHT (Aspide Medical) 64
4.2.10 Surgimesh PET 2D (Aspide Medical) 66
4.2.11 Surgimesh WN (Aspide Medical) 67
4.2.12 Vypro Mesh (Ethicon) 69
4.3 Small Pore Meshes 71
4.3.1 Overview 71
4.3.2 Premilene Mesh (B. Braun) 73
4.3.3 Prolene Mesh (Ethicon) 75
4.3.4 ProLite Mesh (Atrium Medical) 77
4.3.5 Repol Angimesh (Angiologica) 78
4.4 Composite Meshes 80
4.4.1 Overview 80
4.4.2 4DDome (Cousin Biotech) 82
4.4.3 B-Foil (Assut Europe) 84
4.4.4 Biomesh CA.B.S Air Composite (Cousin Biotech) 85
4.4.5 C-QUR Mesh (Atrium Medical) 86
4.4.6 C-QUR TacShield (Atrium Medical) 87
4.4.7 C-QUR V-Patch (Atrium Medical) 89
4.4.8 C-QUR CentriFX (Atrium Medical) 90
4.4.9 C-QUR FX Mesh (Atrium Medical) 91
4.4.10 Parietex Composite (Covidien) 92
4.4.11 Parietex ProGrip Self Fixating Mesh (Covidien) 94
4.4.12 Sorbimesh (Assut Europe) 95
4.4.13 Surgimesh Cible (Aspide Medical) 96
4.4.14 Surgimesh Diablo (Aspide Medical) 98
4.4.15 Surgimesh M.O.P.P. (Aspide Medical) 99
4.4.16 Surgimesh XB (Aspide Medical) 101
4.4.17 Ultrapro Mesh (Ethicon) 103
4.5 3D Meshes 104
4.5.1 Overview 104
4.5.2 3DMax Mesh (C.R. Bard) 107
4.5.3 Bio-A Hernia Plug (W. L. Gore and Associates) 108
4.5.4 Laparomesh (Assut Europe) 110
4.5.5 Perfix Plug (C.R. Bard) 111
4.5.6 ProLoop Mesh (Atrium Medical) 113
4.5.7 Surgimesh Easyplug (Aspide Medical) 114
4.5.8 Surgimesh PET 3D (Aspide Medical) 116
4.5.9 Surgimesh XD (Aspide Medical) 118
4.5.10 Repol Plug Cap (Angiologica) 119
4.6 Biologic Hernia Meshes 120
4.6.1 Overview 120
4.6.2 AlloDerm Regenerative Tissue Matrix (LifeCell) 123
4.6.3 Allomax Surgical Graft (Davol) 126
4.6.4 Biodesign Hernia Graft (Cook Medical) 128
4.6.5 Permacol Surgical Implant (Covidien) 131
4.6.6 Strattice (LifeCell) 133
5 Unmet Needs 134
5.1 Overview 134
5.2 Specialized Laparoscopic Clinics 134
5.3 Increased investigation of TAPP versus TEP procedures 135
5.4 Competitive Pricing for Premium Hernia Meshes 136
5.5 Economic and Financial Impact of Laparoscopic Techniques 137
5.6 Research and Development of Self-Fixating Meshes 138
5.7 Registry for Laparoscopic Hernia Repair 139
6 Pipeline Products 141
6.1 Overview 141
6.2 Clinical Trial Analysis 142
6.2.1 Overview 142
6.2.2 Trials to Watch 142
7 Industry Overview 144
7.1 Procedure Trends 144
7.1.1 France 144
7.1.2 Germany 145
7.1.3 Italy 146
7.1.4 Spain 147
7.1.5 UK 148
7.2 Market Access 149
7.2.1 Cost Concerns 149
7.2.2 Group Purchasing Organizations 150
7.2.3 Distribution Networks 150
7.2.4 Access to Healthcare 151
7.3 Reimbursement Trends 151
7.3.1 Overview 151
7.3.2 5EU 152
7.4 Regulatory Issues/Recalls 152
7.5 Added Indications 153
7.6 Mergers and Acquisitions/Key Partnerships 153
7.6.1 Baxter Acquires Synovis Life Technologies 153
7.6.2 Covidien Acquires Tissue Science Laboratories 153
8 Current and Future Players 154
8.1 Trends in Corporate Strategy 154
8.2 Company Profiles 155
8.2.1 Abiss Analytic Biosurgical Solutions 155
8.2.2 AMI: Agency for Medical Innovation 156
8.2.3 Angiologica 157
8.2.4 Aspide Medical 158
8.2.5 Assut Europe 160
8.2.6 Atrium Medical 161
8.2.7 B. Braun Surgical 162
8.2.8 Cook Medical 164
8.2.9 Cousin Biotech 166
8.2.10 Covidien 167
8.2.11 C.R. Bard 168
8.2.12 Ethicon 170
8.2.13 FEG Textiltechnik mbH 172
8.2.14 Proxy Biomedical 173
8.2.15 TEI Biosciences 174
8.2.16 W. L. Gore and Associates 175
9 Market Drivers and Opportunities 178
9.1 Market Drivers 178
9.1.1 Consistent Hernia Prevalence 178
9.1.2 Transition from Open Hernia Repair to Laparoscopic Hernia Repair 178
9.1.3 Fall of Watchful Waiting 180
9.1.4 Residents Being Trained on Laparoscopic Technique 182
9.2 Opportunities 184
9.2.1 Invest in Composite Meshes Designed Specifically for Laparoscopic Repair 184
9.2.2 Market Meshes to Specialized Centers 185
9.2.3 Focus on Countries Experiencing Increasing Composite Mesh Adoption 186
9.2.4 Develop Business Relationships with Robotic Surgery Equipment Manufacturers 187
9.3 Market Barriers 188
9.3.1 Group Purchasing Organizations 188
9.3.2 Reimbursement 189
9.3.3 Cost 190
9.3.4 Self-Gripping Technology 190
9.3.5 Mosquito Net Mesh 192
10 Country Outlooks and Forecasts 194
10.1 France 194
10.1.1 Overall Hernia Repair Market 194
10.1.2 Overall Inguinal Hernia Repair Market 195
10.1.3 Overall Incisional Hernia Repair Market 196
10.1.4 Overall Umbilical Hernia Repair Market 196
10.2 Germany 197
10.2.1 Overall Hernia Repair Market 197
10.2.2 Overall Inguinal Hernia Repair Market 198
10.2.3 Overall Incisional Hernia Repair Market 199
10.2.4 Overall Umbilical Hernia Repair Market 199
10.3 Italy 200
10.3.1 Overall Hernia Repair Market 200
10.3.2 Overall Inguinal Hernia Repair Market 202
10.3.3 Overall Incisional Hernia Repair Market 202
10.3.4 Overall Umbilical Hernia Repair Market 202
10.4 Spain 203
10.4.1 Overall Hernia Repair Market 203
10.4.2 Overall Inguinal Hernia Repair Market 204
10.4.3 Overall Incisional Hernia Repair Market 205
10.4.4 Overall Umbilical Hernia Repair Market 205
10.5 UK 206
10.5.1 Overall Hernia Repair Market 206
10.5.2 Overall Inguinal Hernia Repair Market 207
10.5.3 Overall Incisional Hernia Repair Market 208
10.5.4 Overall Umbilical Hernia Repair Market 208
11 Appendix 209
11.1 Bibliography 209
11.2 Abbreviations 224
11.3 Report Methodology 225
11.3.1 Overview 225
11.3.2 Coverage 225
11.3.3 Primary Research 225
11.3.4 Secondary Research 226
11.3.5 Forecasting Methodology 227
11.4 General Surgeons and Herniologists Included in this Study 227
11.5 About the Authors 229
11.5.1 Joseph A. Gregory, Analyst, Surgical Devices 229
11.5.2 Derek Archila, MBA, Director of Research and Analysis, Medical Devices 229
11.6 Global Head of Healthcare 230
11.6.1 Bonnie Bain, Ph.D., Global Head of Healthcare 230
11.7 About MediPoint 231
11.8 About GlobalData 231
11.9 Disclaimer 231

1.1 List of Tables
Table 1: Layers of the Abdominal Wall 23
Table 2: Distribution by Sex in the Major Markets, 2012 37
Table 3: Inguinal Hernia, Distribution by Age in the Major Markets, 2012 38
Table 4: Hernia Mesh Classifications 49
Table 5: Large Pore SWOT Analysis, 2013 51
Table 6: Product Profile - Angimesh R2 53
Table 7: Product Profile - Assumesh 55
Table 8: Product Profile - Cristalene 56
Table 9: Product Profile - Hexapro Mesh 57
Table 10: Product Profile - Optilene Mesh 58
Table 11: Product Profile - Optilene Mesh LP 59
Table 12: Product Profile - Optilene Mesh Elastic 60
Table 13: Product Profile - Omyra Mesh 62
Table 14: Product Profile - ProLite Ultra Mesh 63
Table 15: Product Profile - Surgimesh 1 and 2 and XLIGHT 65
Table 16: Product Profile - Surgimesh PET 2D 66
Table 17: Product Profile - Surgimesh WN 68
Table 18: Product Profile - Vypro Mesh 70
Table 19: Small Pore SWOT Analysis, 2013 72
Table 20: Product Profile - Premilene Mesh 73
Table 21: Product Profile - Premilene Mesh Plug 74
Table 22: Product Profile - Prolene Mesh 76
Table 23: Product Profile - ProLite Mesh 77
Table 24: Product Profile - Repol Angimesh 79
Table 25: Composite Meshes SWOT Analysis, 2013 80
Table 26: Product Profile - 4DDome 83
Table 27: Product Profile - B-Foil 84
Table 28: Product Profile - Biomesh CA.B.S. Air Composite 85
Table 29: Product Profile - C-QUR Mesh 87
Table 30: Product Profile - C-QUR TacShield 88
Table 31: Product Profile - C-QUR V-Patch 89
Table 32: Product Profile - C-QUR CentriFX 90
Table 33: Product Profile - C-QUR FX Mesh 92
Table 34: Product Profile - Parietex Composite 93
Table 35: Product Profile - Parietex ProGrip Self Fixating Mesh 94
Table 36: Product Profile - Sorbimesh 96
Table 37: Product Profile - Surgimesh Cible 97
Table 38: Product Profile - Surgimesh Diablo 99
Table 39: Product Profile - Surgimesh M.O.P.P. 100
Table 40: Product Profile - Surgimesh XB 102
Table 41: Product Profile - Ultrapro Mesh 103
Table 42: 3D Meshes SWOT Analysis, 2013 105
Table 43: Product Profile - 3DMax Mesh 107
Table 44: Product Profile - Bio-A Hernia Plug 109
Table 45: Product Profile - Laparomesh 111
Table 46: Product Profile - Perfix Plug 112
Table 47: Product Profile - ProLoop FX Mesh 113
Table 48: Product Profile - Easyplug 115
Table 49: Product Profile - Surgimesh PET 3D 117
Table 50: Product Profile - Surgimesh XD 119
Table 51: Product Profile - Repol Plug Cap 120
Table 52: Biological Meshes SWOT Analysis, 2013 122
Table 53: Product Profile - AlloDerm Regenerative Tissue Matrix 125
Table 54: Product Profile - Allomax Surgical Graft 127
Table 55: Product Profile - Biodesign Hernia Graft 129
Table 56: Product Profile - Permacol Surgical Implant 132
Table 57: Product Profile - Strattice 133
Table 58: Overall Unmet Needs - Current Level of Attainment and Importance 134
Table 59: Company Portfolio - Abyss Analytic Biosurgical Solutions 155
Table 60: Abyss Analytic Biosurgical Solutions SWOT Analysis, 2013 156
Table 61: Company Portfolio - AMI: Agency for Medical Innovation 156
Table 62: AMI: Agency for Medical Innovation SWOT Analysis, 2013 157
Table 63: Company Portfolio - Angiologica 157
Table 64: Angiologica SWOT Analysis, 2012 158
Table 65: Company Portfolio - Aspide Medical 159
Table 66: Aspide Medical SWOT Analysis, 2013 159
Table 67: Company Portfolio - Assut Europe 160
Table 68: Assut Europe SWOT Analysis, 2013 160
Table 69: Company Portfolio - Atrium Medical 161
Table 70: Atrium Medical SWOT Analysis, 2013 162
Table 71: Company Portfolio - B. Braun 163
Table 72: B. Braun SWOT Analysis, 2012 164
Table 73: Company Portfolio - Cook Medical 165
Table 74: Cook Medical SWOT Analysis, 2013 165
Table 75: Company Portfolio - Cousin Biotech 166
Table 76: Cousin Biotech SWOT Analysis, 2013 166
Table 77: Company Portfolio - Covidien 167
Table 78: Covidien SWOT Analysis, 2013 168
Table 79: Company Portfolio - C. R. Bard 169
Table 80: C. R. Bard SWOT Analysis, 2013 170
Table 81: Company Portfolio - Ethicon 170
Table 82: Ethicon SWOT Analysis, 2013 171
Table 83: Company Portfolio - FEG Textiltechnik 172
Table 84: FEG Textiltechnik SWOT Analysis, 2013 172
Table 85: Company Portfolio - Proxy Biomedical 173
Table 86: Proxy Biomedical SWOT Analysis, 2013 173
Table 87: Company Portfolio - TEI Biosciences 174
Table 88: TEI Biosciences SWOT Analysis, 2013 174
Table 89: Company Portfolio - W. L. Gore and Associates 176
Table 90: W. L. Gore and Associates SWOT Analysis, 2012 177
Table 91: Laparoscopic Adoption Across the Major Markets, 2012 and 2019 179
Table 92: Composite Mesh Adoption in Inguinal Hernia Repair across Major Markets, 2012 and 2019 186
Table 93: Composite Mesh Adoption in Incisional Hernia Repair across Major Markets, 2012 and 2019 187
Table 94: France Hernia Mesh Repair Sales ($m) Forecast, 2010-2019 194
Table 95: Germany Hernia Mesh Repair Sales ($m) Forecast, 2010-2019 197
Table 96: Italy Hernia Mesh Repair Sales ($m) Forecast, 2010-2019 201
Table 97: Spain Hernia Mesh Repair Sales ($m) Forecast, 2010-2019 203
Table 98: UK Hernia Mesh Repair Sales ($m) Forecast, 2010-2019 206

1.2 List of Figures
Figure 1: Inguinal Hernia 24
Figure 2: Layers of the Abdominal Wall 25
Figure 3: Anatomy of an Umbilical Hernia 26
Figure 4: Indirect Inguinal Hernia 27
Figure 5: Direct Inguinal Hernia 28
Figure 6: Entrance Points for Laparoscopic Inguinal Hernia Repair 35
Figure 7: Prevalence of Total Inguinal Hernias in the 5EU, 2010-2019 40
Figure 8: Prevalence of Total Incisional Hernias in the 5EU, 2010-2019 42
Figure 9: Prevalence of Total Umbilical Hernias in the 5EU, 2010-2019 44
Figure 10: Global Company Market Share, Large Pore Meshes, 2012 52
Figure 11: Structure of Angimesh R2 53
Figure 12: Structure of Assumesh 54
Figure 13: Structure of Cristalene 55
Figure 14: Structure of Hexapro Mesh 56
Figure 15: Structure of Optilene Mesh 58
Figure 16: Structure of Optilene Mesh LP 59
Figure 17: Structure of Optilene Mesh Elastic 60
Figure 18: Structure of Omyra Mesh 61
Figure 19: Structure of ProLite Ultra Mesh 63
Figure 20: Structure of Surgimesh 1 and 2 and XLIGHT 64
Figure 21: Structure of Surgimesh PET 2D 66
Figure 22: Structure of Surgimesh WN 67
Figure 23: Structure of Vypro Mesh 69
Figure 24: Global Company Market Share, Small Pore Meshes, 2012 72
Figure 25: Structure of Premilene Mesh 73
Figure 26: Structure of Premilene Mesh Plug 74
Figure 27: Structure of Prolene Mesh 75
Figure 28: Structure of ProLite Mesh 77
Figure 29: Structure of Repol Angimesh 78
Figure 30: Global Company Market Share, Composite Meshes, 2012 81
Figure 31: Structure of the 4DDome 82
Figure 32: Structure of B-Foil 84
Figure 33: Structure of the Biomesh CA.B.S. Air Composite 85
Figure 34: Structure of C-QUR Mesh 86
Figure 35: Structure of C-QUR TacShield 87
Figure 36: Structure of C-QUR V-Patch 89
Figure 37: Structure of C-QUR CentriFX 90
Figure 38: Structure of C-QUR FX Mesh 91
Figure 39: Structure of Parietex Composite 92
Figure 40: Structure of Parietex ProGrip Self Fixating Mesh 94
Figure 41: Structure of Sorbimesh 95
Figure 42: Structure of Surgimesh Cible 96
Figure 43: Structure of Surgimesh Diablo 98
Figure 44: Structure of Surgimesh M.O.P.P. 99
Figure 45: Structure of Surgimesh XB 101
Figure 46: Structure of Ultrapro Mesh 103
Figure 47: Global Company Market Share, Composite Meshes, 2012 106
Figure 48: Structure of the 3DMax Mesh 107
Figure 49: Structure of the Bio-A Hernia Plug 108
Figure 50: Structure of Laparomesh 110
Figure 51: Structure of Perfix Plug 111
Figure 52: Structure of ProLoop Mesh 113
Figure 53: Structure of Surgimesh Easyplug Standard 114
Figure 54: Structure of Surgimesh WN Easyplug 114
Figure 55: Structure of Surgimesh WN Easyplug No Touch 115
Figure 56: Structure of Surgimesh PET 3D 116
Figure 57: Structure of Surgimesh XD 118
Figure 58: Structure of Repol Plug Cap 119
Figure 59: Global Company Market Share, Biological Meshes, 2012 123
Figure 60: Structure of the AlloDerm Regenerative Tissue Matrix 124
Figure 61: Structure of the Allomax Surgical Graft 126
Figure 62: Structure of the Biodesign Hernia Graft 129
Figure 63: Structure of the Permacol Surgical Implant 131
Figure 64: Open versus Laparoscopic Procedure Volumes, France, 2010-2019 144
Figure 65: Open versus Laparoscopic Procedure Volumes, Germany, 2010-2019 145
Figure 66: Open versus Laparoscopic Procedure Volumes, Italy, 2010-2019 146
Figure 67: Open versus Laparoscopic Procedure Volumes, Spain, 2010-2019 147
Figure 68: Open versus Laparoscopic Procedure Volumes, UK, 2010-2019 148
Figure 69: France Hernia Mesh Repair Sales ($m) Forecast, 2010-2019 195
Figure 70: Germany Hernia Mesh Repair Sales ($m) Forecast, 2010-2019 198
Figure 71: Italy Hernia Mesh Repair Sales ($m) Forecast, 2010-2019 201
Figure 72: Spain Hernia Mesh Repair Sales ($m) Forecast, 2010-2019 204
Figure 73: UK Hernia Mesh Repair Sales ($m) Forecast, 2010-2019 207

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