Europe ICU ventilators market is expected to register a healthy CAGR in the forecast period 2019 to 2026. The new market report contains data for historic years 2017, the base year of calculation is 2018 and the forecast period is 2019 to 2026.

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Drivers:

High prevalence of chronic respiratory diseases:

Ventilators are used for the life support treatments for chronic diseases such as hypercapnic respiratory failure, restrictive lung disease, dyspnea on exertion, asthma, orthopnea, chronic obstructive pulmonary disease (COPD), chronic interstitial lung diseases (ILDs), pneumonia, cardiogenic pulmonary edema, neurologic disease and bronchial asthma. There is an increase in the chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD), asthma, occupational lung diseases and pulmonary hypertension.

There are two types of acute and chronic respiratory failure, hypoxemic and hypercapnic. Hypoxemic respiratory failure includes the deficiency of the oxygen in blood with normal carbon dioxide whereas hypercapnic respiratory failure includes higher carbon dioxide in the blood with normal or less oxygen. These chronic respiratory failures are treated with the mechanical ventilation or breathing machine, which pumps oxygen through the mouth or nose of patients.

• According to the American Thoracic Society, in 2017, around 16 million people in the U.S. have been diagnosed with COPD and even this disease is the 3^rd leading cause of death in the U.S. after heart diseases.
• According to a research study conducted by imperial college London, Asthma is the most common chronic respiratory disease worldwide in 2015, with double the number of cases of COPD. COPD deaths were eight times more common than asthma deaths.
• According to Lancet global health journal published in 2018, in India 18% of global population suffers with COPD. This article deals with theburden of chronic disease and asthma on world’s population in 1990-2016. The increase in the prevalence and incidence of COPD and asthma in any country indicates the poor management of disease in that country.
• In India, 4.2% of crude prevalence of COPD is observed in 2016. Significantly, this prevalence has increased from 1990 to 2016. The cases of COPD in India has been increased from 28·1 million in 1990 to 55·3 million in 2016.

Worldwide statistics related to COPD & Asthma in 2015

The high prevalence of chronic respiratory diseases is increasing the death rate which ultimately helps in the demand of ICU ventilators in the hospital for critical care patients to save their life. Rising number of chronic diseases and companies initiatives towards the awareness of the COPD, pneumonia and different ventilation systems offered by the various companies like Drägerwerk AG & Co. KGaA (Germany), Medtronic (Ireland) etc will stimulate the growth of the market in the forecast period of 2019 to 2026.

Increasing government expenditures on healthcare

Government plays a vital role in improving the healthcare sector providing some health benefits to individuals with the help of some health insurance program, medicare and other facilities. Government helps in healthcare by increase in per capita of country based on its economy. Due to the increase in the mortality rate in the ICU departments government has increased the healthcare expenditure. As per an article published in Tax policy center, Federal Government has expended around USD 1.1 trillion on health care in the year of 2018.

• TABLE 1 Federal spending and Tax expenditure for healthcare in 2018

The cost and use of federal government subsidies for health insurance for people under age 65, the government invested USD 685 billion in 2018 on such subsidies helping 89.0% of the 273 million people under age 65 in the United States get health insurance.

• TABLE 2 Composition of Federal spending on Healthcare in the U.S.

Hence, we can observe that the government is increasing healthcare expenditure to save the patient’s life where ventilator has its importance in saving every breath of patient in the hospital.

Increasing number of ICU bed

The demand for ICU beds for critical care patients is increasing day by day and the resources expended on critical care continues to rise. Many initiatives have been taken to increase the use of existing ICU beds by shifting the admission of low-intensity patients and end-of-life care to other departments of the hospital.

The rising number of chronic diseases such as COPD, ventilator associated pneumonia and other disorders can enhance the occupancy ofthe beds of the ICU’s with mechanical ventilation. The paediatric and neonatal ICUs are from major teaching hospitals, and partly from some private sector hospitals.

• TABLE 3 ICU Patients admitted in respective departments, U.S.

• TABLE 4 Number of ICU patients by ventilation status, Canada, 2011–2014

Hence it is observed that there is an increase in the demand of ICU beds which ultimately affects the increase in the market value of ventilators for both invasive as well as non-invasive ventilators.

Rising number of geriatric population and pre-term birth

According to the World Health Organization (WHO), geriatric population is the elderly population aged 65 and over, and the preterm birth is a premature birth which happens before the 37th week of pregnancy.

• Every year approximately 15 million babies are born preterm which is rising every year which has its own complications leading to death of children where this death ratio is approximately 1 million per year. This death ratio is increasing due to the lack in warmth, lack of feasible, cost-effective care, basic care for infections, breastfeeding support and breathing difficulties.
• Across 184 countries, the preterm birth rate is between 5% to 18% rise.
• Birth of premature babies is the leading to the death of children under the age of 5 years.

TABLE 5 Pre- term births of few countries in 2018

• FIGURE 1 Geriatric populations of few countries in 2014, 2015, and 2016

A rising number of geriatric population and pre-term birth is increasing day by day which leads to an increase in the number of ICU patients which requires invasive ventilator for their survival.

Restraint:

High cost of invasive ventilators:

The invasive ventilators are majorly used for critical care patients which are used in the bigger hospitals who can afford this device and able to use it on their patients whenever required. This device is expensive as it is a lifesaving machine which can be used by skilled professional. The small hospitals and clinics cannot purchase this product due to its high cost and maintenance.

As per an article published by WHO, the cost of the Intensive care ventilators is ranging from 9,000 - 60,000 USD where this pricing varies with the customer requirements in the device and its mode.

Hence, the high cost of the ventilators system, less affordability amongst the poor population and less investment of the low economic countries in the ventilation system can hamper the growth of the market in the coming year.

Opportunity:

Technological innovation, portability, and design:

Many technologically advanced, portable, and design oriented ventilators are available in the market, following are few examples of the technologically advanced products:

• In September 2018, Medtronic (Ireland) took corrective action for the PB980 ventilator series, Medtronic Issues Software update for same to address customer feedback. FDA has classified this action as a Class I recall. A mechanical ventilator manufactured by Medtronic (Ireland) named as Puritan Bennett 980 ventilator () is used to support patient's breathing, operated by trained professionals in an acute or critical care clinical setting for neonatal, adult and pediatric patients.
• In October 2018, new software with IntelliSync+ for HAMILTON-G5/S1 is introduced by Hamilton Medical (Switzerland) which is helping in the growth of the ventilator market. The waveform shapes are analysed by the expert’s eye due to the IntelliSync+ option which may help in the better results and the patient efforts can be observed.
• In June 2017, Savina 300 Select which is a product of Drägerwerk AG & Co. KGaA (Germany). It is a device for all ventilation phases. This product has 8 years warranty for Savina 300 Select turbine which will help the end users to treat patients.
• In May 2017, Oxylog VE300, which is manufactured by Drägerwerk AG & Co. KGaA (Germany). It is a sturdy life saver ventilator which can be used for responding the emergency patients and it is a compact ventilator which can be used in emergency service to benefit patient’s health.
• In September 2015, Koninklijke Philips N.V. (Netherlands) has launched Respironics V680 ventilator, new two-in-one life support ventilator in Canada. It is designed for a smooth transition from ventilation to natural breathing which may help to increase patient care.

Challenge:

Side-effects of Invasive ventilator:

A long term application of mechanical ventilation can create a risk to treated patients such as Pneumothorax. Pneumothorax is a condition in which air leaks out from lung into the space between lung and chest, which can lead the lungs to collapse or damage. This can be caused due to the pumping of excess airflow or oxygen from the ventilator. According to the National Center for Biotechnology Information (NCBI), Pneumothorax, bronchopleural fistula, and the development of nosocomial pneumonia are the most common medical complications of invasive ventilators.

The examples of equipment-related complications are a failure of the ventilator to the cycle of proper functioning of safety alarms, and of inspired gas to be properly heated or humidified. The challenge for a professional is when to intubate, what setting the ventilator should be set at and troubleshooting the ventilator.

Ventilator associated pneumonia (VAP) is a lung infection for which patients require treatment in ICUs and in VAP process pneumonia occurs⩾48 hrs after incubation with the start of mechanical ventilation which can cause a high risk of gastric bleeding in the patients with ventilation.

Increasing treatments of the ventilator associated pneumonia (VAP) is the major challenge for the ventilator market for instance, according to the Centers for Disease Control and Prevention (CDC), in 2011, in the U.S. around 157,000 healthcare-associated pneumonias occurred in acute care hospitals in the U.S in which 39.0% of the pneumonia was ventilator associated.

Hence, increasing number of the cases with the chronic diseases such as respiratory issues, ventilator associated pneumonia, lung infections and rising requirement of the mechanical ventilation amongst the population can fuel the growth of the market whereas major risk associated with the mechanical ventilation can hamper the growth of the market.

Market Trends:

• On the basis of product type, the market is segmented into High-End ICU Ventilators, Basic ICU Ventilators and Mid-End ICU Ventilators. The High-End ICU Ventilators segment is projected to lead with the shares 39.3% and growing at the highest CAGR of 7.9% in the forecast period of 2019 to 2026.
• On the basis of type, the market is segmented into adult ventilators, neonatal ventilators, and pediatric ventilators. In 2018, adult ventilators segment is projected to lead with the shares 37.9% and growing at the highest CAGR of 7.8% in the forecast period of 2019 to 2026.
• On the basis of mode, the market is segmented into combined-mode ventilation, volume-mode ventilation, pressure-mode ventilation and other. In 2018, combined-mode ventilation segment is projected to lead with the shares 42.7% growing at the highest CAGR of 7.8% in the forecast period of 2019 to 2026.
• On the basis of end-users, the market is segmented into hospitals, specialty clinics, long term care centres, ambulatory, surgery center and rehabilitation centres. Hospitals are sub-segmented into ICU and PICU. In 2018, hospitals segment is projected to lead with the shares 53.0% growing at the highest CAGR of 7.7% in the forecast period of 2019 to 2026.

Major Players: Europe ICU Ventilators Market

Some of the prominent players operating in this market are Dragerwerk AG & Co. KGaA(Germany), Koninklijke Philips N.V.(Netherlands), Medtronic(Ireland), Hamilton Medical(Switzerland), Lowenstein Medical(Germany), Heyer Medical AG(Germany), Getinge AB.(Sweden), VYAIRE(U.S.) and many others.