World Market for Cardiac-Rhythm Management

In 2003, total market revenues were $7.25 billion.

The expanding patient pool and increasingly sophisticated technologic innovations make it imperative to impart training and to improve awareness about the technology and clinical trial results among primary care doctors. Several clinical trials have helped to identify more patients, and there is a significant move toward increased awareness of CRM technology among electrophysiologists. However, the key challenge lies at the primary care physician level, since general practitioners are usually the first points of reference for patients.

"In the United States, a large percentage of the population is unable to access the right treatment due to a lack of awareness among general practitioners,” says Frost & Sullivan analyst Vaishnavi Ananthanarayanan. "Therefore, it is imperative to train both primary care physicians and electrophysiologists on the technology and to update them when new products enter the market.”

Some companies are now using this strategy globally. While countries such as Germany and France have a higher percentage of trained doctors than the United States, the lack of awareness and penetration in countries such as Spain lowers the total European average.

The emerging remote monitoring system is likely to remedy the issue of limited presence of CRM devices and difficulty in regional coverage. This system monitors patients in the comfort of their homes and thereby encourages compliance. Electrophysiologists and doctors involved with a remote monitoring facility need to be extremely well trained since their awareness of the technology can help improve patient uptake of CRM. Technologies that are making rapid strides in the European market are pacemakers and implantable cardioverter defibrillators (ICDs).

Germany is the largest market for CRM in Europe, mainly because it is the most populous and is highly advanced in cardiology. France is also a very influential country and is a strong market for pacemakers. The success of CRM devices in Germany and France may be attributed to the fact that they are financed through labor parties and insurance companies. Healthcare organizations have realized the importance of improving reimbursement as a way to provide more cost-competitive options to patients.

"Italy, Spain, Belgium, and the Netherlands have several autonomous health authorities that help in funding,” notes Mr. Ananthanarayanan. "Although these regions have a good market for CRM, they show less revenue due to their small population.”

The market scope of CRM equipment is likely to increase further, the analysis concludes, especially with heart failures having an annual worldwide incidence of nearly 1.5 million.




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