Regulatory Framework And Reimbursement Landscape In The Europe Endoscopy Equipment Market

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The endoscopy equipment market is segmented into four major regions, namely, North America, Europe, Asia Pacific, and the Rest of the World.
The report "Endoscopy Equipment Market by Product (Endoscope (Flexible, Rigid, Capsule, Robot-assisted, Disposable), Visualization Systems (Video Converters, Recorders, Processors), Other endoscopic, Accessories), Application, End User - Global Forecast to 2027", is projected to reach USD 40.6 billion by 2027 from USD 28.9 billion in 2022, at a CAGR of 7.0%. The growth in this market is driven by Surging requirement for endoscopy to diagnose and treat target diseases, increasing investments, funds, and grants by governments and other organizations worldwide to improve healthcare infrastructure and research areas of endoscopy and Increasing preference for minimally invasive surgeries.
In 2021, North America accounted for the largest market share, followed by Europe and the Asia Pacific. The Asia Pacific market, on the other hand, is projected to register a CAGR during the forecast period. Factors such as the growing number of hospitals, improving healthcare infrastructure, increasing ...
... healthcare expenditure, growing patient population, surging demand for minimally invasive surgeries, as well as favorable government policies for single-use endoscopy devices, boost the growth of the endoscopy equipment market in the Asia Pacific.
Europe Endoscopy Equipment Market
Europe accounted for the second-largest share of the endoscopy equipment market in 2021.
Major factors driving the growth of the endoscopy equipment market in Europe include the rising investments by governments, increasing availability of funds to support medical innovations in the UK, the rising incidence of cancer in the UK, and the significant presence of key players in Germany.
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Endoscopy Equipment Market - GERMANY
Germany to account for largest share of European market during forecast period.
Germany’s large share can be attributed to its robust healthcare spending compared to other European regions. According to Statistisches Bundesamt (Destatis), in 2020, health expenditure in Germany amounted to EUR 440.6 billion; the total health expenditure rose by EUR 26.8 billion or 6.5% compared with 2019. Healthcare in Germany is funded by a statutory contribution system, which ensures free care through health insurance funds. Also, Statutory Health Insurance is mandatory for all individuals who earn less than USD 62,244 (EUR 56,250) per year. Insurance payments are based on the income of the individual. As a result of the favorable insurance system, expensive procedures are reimbursed, which considerably reduces the burden on patients, allowing them to opt for the most effective treatments. The favorable reimbursement scenario in the country will lead to the recommendation of endoscopy surgeries, which, in turn, will augment the demand for endoscopy devices.
The rise in the aging population in Germany is leading to an increasing number of patients suffering from chronic diseases. The rising incidence of cancer is further adding to the burden on the healthcare system, resulting in an increasing demand for technological innovations and minimally invasive surgical procedures, new skills, and new responsibilities in the health workforce. In 2020, Germany reported 538,140 people who had cancer (Source: World Cancer Research Fund International, WCRF), and it is estimated that around 289,396 men and 248,744 women in the country developed cancer in 2020. Many cancers have a high chance of being cured if detected early and treated adequately, but many patients are diagnosed in late or advanced stages. It is, therefore, important to improve cancer diagnostic methods in early or even pre-syndrome stages, which highlights the need for diagnostic technologies such as endoscopy.
Additionally, various organizations such as Deutsche Forschung Gemeinschaft/German Research Foundation (DFG), German Cancer Research Center (DKFZ), German Cancer Aid, Helmholtz-Association, and Max-Planck-Gesellschaft/Max Planck Society (MPG) are funding research projects for the development of technologies and therapies for the prevention and treatment of cancer.
Germany is home to some major endoscopy equipment manufacturers, such as KARL STORZ, Richard Wolf GmbH, Maxer Medizintechnik GmbH, Xion GmbH, and Tekno-Medical Optik-Chirurgie GmbH. These players ensure the continuous supply of products, including the launch of new and innovative products, in the region. The significant number of endoscopy equipment manufacturers, along with continuous research pertaining to technical advancement in the country, signifies the strong potential for the endoscopy equipment market in Germany.
Endoscopy Equipment Market - FRANCE
High-quality healthcare system to offer coverage to all citizens
Over the years, France has introduced various regulations and initiatives to improve its healthcare infrastructure. France invests around 11.1% of its GDP in healthcare, which is the second highest amongst EU countries (Source: OECD). This has aided the growth of the healthcare sector in the country.
In 2018, health expenditure per capita in France was USD 4,690. The healthcare system in the country is largely financed by the government's national health insurance. According to the WHO, France’s healthcare services are ranked among the best in the world. Its significant share in the global endoscopy equipment market can be attributed to the presence of a significantly large base of the aging population. According to the US Census Bureau, in 2020, the total population of France was 65.3 million, with around 21% of the population aged 65 years and above. This figure is expected to reach nearly 23.4% by 2030. The rapid growth in the aging population is leading to high demand for age-related surgical treatments in the country, which is further driving the growth of the market of endoscopy equipment. Additionally, cancer prevalence and therapeutic surgeries are on the rise in France, which is expected to play a key role in the growth of the endoscopy equipment market in the country.
Moreover, France’s government uses a statutory health insurance system (SHI), which is mandatory for all individuals. Under the SHI, a major amount is financed by the employer and employee payroll taxes. The cost of insurance for non-eligible citizens, such as long-term unemployed citizens, is covered by the state. This favorable insurance system in France reduces the healthcare cost spent by patients, which is expected to drive the adoption of advanced and effective minimally invasive treatments in the country.
Endoscopy Equipment Market - UK
Investments by hospitals in new and advanced endoscopy equipment to propel market
The demand for minimally invasive surgeries such as endoscopy in the UK has increased due to the growing aging population, the rising cases of cancer, as well as the implementation of the National Bowel Cancer Screening Program by the National Health Survey. According to Cancer Research UK, there are more than 367,000 new cancer cases in the UK every year. Each year, more than one-third (36%) of all cancer cases in the UK are diagnosed with the elderly population (above 75 years). Treating cancer through minimally invasive surgeries in an elderly patient offers various advantages, such as minimal postoperative complications and faster recovery compared to open surgeries. The incidence rates for all cancers combined are projected to rise by 2% in the UK between 2014 and 2035.
These factors have spurred investments in new endoscopy equipment or the expansion of existing endoscopy units by many UK hospitals. Some recent investments by hospitals are as follows:
• In May 2021, The United Lincolnshire Hospitals NHS Trust, UK, invested GBP 1.4 million to improve patients’ access to diagnostic imaging techniques, such as endoscopy.
• In July 2020, the Scottish government funded GBP 1.35 million to Raigmore Hospital Inverness, UK, to allow NHS Highland to place a temporary unit dedicated solely to endoscopy services and pay for additional staff to carry out the work.
• In December 2018, Norfolk and Norwich University Hospital (NNUH, UK) moved its gastroenterology department to the Quadram Institute and expanded its endoscopy services.
As UK hospitals continue to invest in purchasing new endoscopy equipment, the market in this country is expected to grow during the forecast period. Governmental initiatives for developing innovative and minimally invasive techniques for the diagnosis of cancer will accelerate the growth of the endoscopy equipment market in the UK
Endoscopy Equipment Market - ITALY
Receptivity of high-quality and technologically advanced diagnostic and therapeutic equipment to foster market
Italy is a mature market for medical equipment, and its high per capita income and sophisticated healthcare system translate into demand for a broad range of cutting-edge medical equipment. Italy is the fourth-largest market for medical equipment and supplies in Europe after Germany, France, and the UK, with about 3,957 companies (including 42% distributors, 53% producers, and 5% service providers) and a workforce of 76,400. The COVID-19 pandemic has negatively affected the medical devices market in Italy.
According to the International Trade Administration, public hospitals account for over 75% of medical device sales, with the remaining 25% of sales to the private sector. Despite having a considerable local manufacturing industry, the domestic market for medical equipment is highly dependent on imports. Major suppliers are from the Netherlands, Germany, Belgium, France, and the US, which had a 5.4% share of Italian imports, estimated at USD 6,503 million in 2021. Major US medical device imports to Italy include diagnostic imaging, dental, and patient aids. At the beginning of 2020, the Italian government allocated EUR 235 million to purchase basic diagnostic devices as a part of the Italian healthcare plan to improve local assistance to patients and therefore reduce dependence on emergency rooms. The Italian market is receptive to high-quality and technologically advanced diagnostic and therapeutic equipment and products, such as endoscopes.
Endoscopy Equipment Market - SPAIN
Prevalence of cardiovascular diseases to stimulate market
According to the Spanish Ministry of Health, Consumer Affairs and Social Services, total (public and private) healthcare expenditure in Spain in 2019 was USD 117.5 billion, representing 9% of the country’s GDP. The average per capita expenditure (public and private) was USD 2,524 (USD 1,904 –public, USD 741 – private). Each of the 17 regional governments administers its respective healthcare budget authorized by the central government. Spain’s healthcare spending will reach over 10.83 billion Euros between 2018 and 2030.
According to an article published by Héctor Bueno, Beatriz Pérez-Gómez in the journal Circulation, 2019 edition, cardiovascular disease is the number one cause of death in Spain, leading to 120,000 deaths every year. According to IS Global research, ischemic heart disease was the leading cause of death in Spain in 2018, accounting for 14.6% of all deaths. Thus, with the rising prevalence of cardiac diseases and the use of endoscopy in several surgeries, such as coronary artery bypass surgery, left ventricular cardio-endoscopic surgery, and aortic valve replacement, the Spanish market is expected to grow during the forecast period.
Endoscopy Equipment Market - REST OF EUROPE
The market in Rest of Europe is primarily studied for Russia, Finland, Sweden, Switzerland, Turkey, the Czech Republic, the Netherlands, Norway, Poland, Portugal, Romania, Denmark, Estonia, Austria, and Belgium.
According to the US Census Bureau, Greece, Portugal, Finland, Bulgaria, Sweden, and Denmark had high percentages of the aging population (to the total population), contributing to the prevalence of age-related disorders in these countries in the coming years.
Factors such as the increasing investments for the improvement and expansion of healthcare infrastructure in several Rest of European countries are driving the growth of the endoscopy equipment market in Rest of Europe. A number of initiatives have been taken to expand and improve healthcare infrastructure in the region. For example, in Russia, the government develops and uses innovative medical equipment with the rising need for replacing outdated devices and the limited supply of new devices. Such initiatives are expected to aid the growth of the overall endoscopy equipment market in Russia.
The pricing of endoscopic devices and accessories is a key factor across all European countries. Taking into consideration the global economic crisis and competitive intensity prevailing in the European market, endoscopy device manufacturers are being pressured to lower their prices and offer discounted product bundles to win tendered contracts from cost-constrained hospitals. In countries such as Italy and Spain, price competition is a primary factor restricting revenue growth. In addition, brand loyalty is an important factor in Europe; global players need to build strong customer relations to establish themselves in the region.
A number of premium-priced products—particularly in the video endoscopes and endoscopic retrograde cholangiopancreatography devices markets, which often include technological improvements—will be increasingly adopted as these devices positively affect overall patient care as well as the quality of life and, in certain cases, can even reduce overall healthcare costs. Further, there has been a shift from reusable to disposable devices, which will fuel market growth because disposable devices are associated with higher per-procedure costs. This shift will be driven by concerns over the need for proper device sterilization and the desire to eliminate the risk of infections and potential sample contamination during biopsies.
Although the European market is flooded with cheaper Asian imports, most European companies do not view these imports as major threats owing to their relatively poor quality. Aftersales services and product quality are two important parameters that European customers look for. Successful and well-established endoscope-providing companies offer a wide range of aftersales services to customers, including instrument repair and replacement, instrument loans, maintenance contracts, training, and technical support.
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