World Market for Dialysis Equipment and Services

Report Summary

This report looks at both the equipment and service aspects of the dialysis industry. The industry enjoys a unique place in the healthcare sector. The industry encompasses two very lucrative segments -- the medical device industry (dialysis products and supplies segment) and the healthcare services industry (dialysis services segment).

The dialysis industry remains a robust, multi-billion dollar business that has managed to fuel its growth engine in the past 5 years. What makes this market more interesting and challenging is its relatively small customer base - a bit under two million dialysis patients form its entire universe. It is the high value of these customers that make this a competitive industry.

Key Data and Analysis in this report includes:

• Detailed Forecasts to 2015
• In-Depth Profiles of the Competitive Companies in Dialysis Treatment, Equipment and Supplies.
• Scores of Figures and Tables featuring useful data, demographic and market trends that can be used to supplement internal memos or presentation.
• Detailed World Dialysis Market Review including specific reviews of the dialysis service, equipment and supplies market in the United States, Japan, UK, Italy, India, China and Australia and Canada.
• Market Share of Major Care and Equipment Providers.
• The Changing Regulatory Environment.
• Detailed Patient Demographics Current Data, Forecasts and Trends.

Kalorama's trusted information-gathering process provides most accurate study of the kidney dialysis market available today. Information and analysis presented in this report is based on extensive interviews with senior management of top companies and in the kidney dialysis and equipment industry. While major research literature and government information is culled, key market insights originate from interviews with industry leaders.

There are several key issues and trends impacting the future of the dialysis market. Demographics, insurance and reimbursement issues, and consolidation in the industry will continue to influence the outcome of the market in the future.

Issues and trends explored in this study include:

• Prevalence of Diabetes in Developing Regions
• Increasing Life Expectancy Worldwide
• Hospital Admissions for Infection
• Insurance and Reimbursement Issues
• Access to Care for Native Populations
• Kidney Transplantation
• Product Development and Innovation
• Consolidation and Joint Ventures in the Industry
• Home Dialysis
• Heat Disinfection for Water Quality
• Dialysis Treatment Comfort
• National Salt Reduction Initiative

Product managers, marketing managers, business development executives, advertising agency executives and information and research center librarians are among the individuals who will find this round-up of the kidney dialysis and dialysis equipment market essential.

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Additional Information

Rapid Consolidation Reshaping World Dialysis Market

The dialysis industry is consolidating at a rapid pace as the top players attempt to expand their networks across the globe. A robust $67.5 billion business, the dialysis market has managed to fuel its growth engine with 5% to 6% growth per year in the past 5 years, according to Kalorama Information. In its new report, World Market for Dialysis Equipment and Services, the healthcare market research publisher finds the bulk of these revenues are for dialysis care services, which has led global dialysis equipment providers to enter the services segment through acquisitions of smaller regional players.

Dialysis patients are high-value customers, costing an estimated $34,000 per year on average. They are a relatively stable customer base which explains how the dialysis industry is noncyclical in nature and is only minimally affected by the vagaries of economic downturns. And despite a relatively small customer base of just over 2 million patients worldwide, the industry has attracted a large number of players, especially in the highly fragmented services segment, which is made up of mostly regional companies.

Four global players account for about a third of the total market and the rest is occupied by regional companies, said Bruce Carlson, publisher of Kalorama Information. The industry is consolidating rapidly, with the top players expanding their network across the world in terms of dialysis services offerings.

According to the report, Fresenius is the leader in the dialysis market and will continue to dominate the scene owing to its vast product line and vertical integration into the lucrative dialysis care segment. Fresenius is followed by DaVita, Baxter and Gambro. The rest of the market is primarily in the hands of regional players.

Consolidation has become a recurring theme in the dialysis sector. Between 2005 and 2011, several structural changes occurred in the industry. Gambro exited the North American dialysis care market by selling its dialysis care division to DaVita, Inc. and Fresenius bought Renal Advantage Inc. to maintain its leadership in North American dialysis care. The company also acquired Hema Metrics Crit-Line system business in early 2011. In 2009, Baxter acquired Edwards CRRT a provider of continuous renal replacement therapy.

Table Of Contents

CHAPTER ONE: EXECUTIVE SUMMARY
Background
Scope and Methodology
Size and Growth of the Market
Key Issues and Trends Affecting the Market
Leading Competitors

CHAPTER TWO: INTRODUCTION
Overview of the Kidney
Kidney Diseases
Treatment Options
Dialysis
Kidney Transplant
The Artificial Kidney
Comparison of Treatment Options
In-Center Hemodialysis
Home Hemodialysis
CAPD (Continuous ambulatory peritoneal dialysis)
CCPD (Continuous Cycler Peritoneal Dialysis)
IPD (Intermittent Peritoneal Dialysis)
Kidney Transplantation
Epidemiology and Demographic Patterns
ESRD Trends
Dialysis Treatment Demand
Dialysis Treatment Preferences: Major Countries

CHAPTER THREE: ISSUES AND TRENDS AFFECTING THE MARKET
Overview
World Demographics
Prevalence of Diabetes in China and India
Hospital Admissions for Infection
Increasing Life Expectancy Worldwide
Insurance and Reimbursement Issues
Reimbursement in the United States
Access to Care for Native Populations Around the Globe
Trends in Kidney Transplantation
Product Development and Innovation
Dialyzers
Nephera Ltd
Prismaflex System Software
XCorporeal, Inc.
Implantable Artificial Kidney
Consolidation and Joint Ventures in the Industry
Home Dialysis
Heat Disinfection for Water Quality
Dialysis Treatment and Comfort
Dialysis on Cruise Ships
Company Commitments to the National Salt Reduction Initiative

CHAPTER FOUR: DIALYSIS EQUIPMENT AND SUPPLIES MARKET
Overview
Hemodialysis Products and Supplies
HD Machines
Blood Line
Dialyzer Market
Hemodialysis Access Products Market
Peritoneal Dialysis Products and Supplies
Peritoneal Dialysis—A Part of Integrated Care
Peritoneal Dialysis Transfer Sets
Peritoneal Dialysis Catheters
Peritoneal Dialysis Machines
Factors Affecting Demand
Innovative Products
Fresenius Medical Care
Baxter International
Gambro
Market Overview by Region
United States
Japan
Germany
France
United Kingdom
Italy
Canada
India
China
Australia
Market Analysis
Market Analysis by Country
Competitive Summary

CHAPTER FIVE: DIALYSIS SERVICES MARKET
Overview
Dialysis Service Centers
Leading Suppliers and Services
Fresenius Medical Care
DaVita
Market Overview by Region
Regional Variation of Dialysis Cost
United States
Japan
Germany
France
United Kingdom
Italy
Canada
India
China
Australia
Market Analysis
Market Analysis by Country
Competitive Summary

CHATPER SIX: MARKET AND COMPETITOR ANALYSIS
Market Overview
Market Analysis by Country
Leading Competitors

CHAPTER SEVEN: LEADING MANUFACTURERS
Overview
Asahi Kasai Kuraray Medical
B.Braun AG
Baxter Healthcare
Bellco
DaVita
Diaverum
Fresenius Medical Care
Gambro AB
Kawasumi Laboratories Inc.
Medionics International
Nikkiso Europe GmbH

CHATPER EIGHT: LIST OF MAJOR COMPANIES

List Of Exibits

CHAPTER ONE: EXECUTIVE SUMMARY
Table 1-1: The Worldwide Dialysis Market, 2005-2015
Figure 1-1: The Worldwide Dialysis Market, 2005-2015
CHAPTER TWO: INTRODUCTION
Table 2-1: Composition of Plasma, Nephric Filtrate, and Urine
Figure 2-1: Incidence of ESRD vs. Transplants in United States
Table 2-2: Kidney Transplant Rates by Country (20 Countries), 2004-2008
Table 2-3: Number of ESRD Patients by Geographical Market (United States, France, United Kingdom, Japan, Canada, ROW) 2005-2008
Table 2-4: ESRD Prevalence by Country (31 Countries), 2005-2008
Figure 2-2: ESRD Prevalence by Country (31 Countries) 2008
Table 2-5: Number of Dialysis Patients by Geographical Market (North America, Asia-Pacific, EAME, Latin America) 2010
Table 2-6: Dialysis Modality Preference (Hemodialysis, Home Hemodialysis, or Peritoneal Dialysis) in 33 Selected Countries, 2007-2008
Figure 2-3: Dialysis Modality Preference (Hemodialysis, Home Hemodialysis, or Peritoneal Dialysis) in 32 Selected Countries, 2008
CHAPTER THREE: ISSUES AND TRENDS AFFECTING THE MARKET
Table 3-1: World Population by Selected Geographical Region, 2010 - 2050
Figure 3-1: World Population by Selected Geographical Region, 2010-2050
Table 3-2: Percent Population Over 65 by Year and Region, 2010-2050
Figure 3-2: Estimated World Population by Age, 2010 and 2050
Table 3-3: Diabetes Statistics
Table 3-4: Average Life Expectancy in Years by Country 1980 and 2011
Figure 3-3: Average Life Expectancy in Years by Country 1980 and 2011
Figure 3-5: Medicare Total ESRD Expenditures (in USD Billions), 2006-2008
Figure 3-6: Annual Cost of Dialysis Care in the United States by Type of Expense (Composite Treatment Rate, Hospitalization, Epogen/Other Drugs, Physician Costs, Other) in Dollars and Percentage Share
Table 3-7: Comparison Between New Bundled and Composite Medicare Reimbursement Program (1983-2010 and 2011+)

CHAPTER FOUR: DIALYSIS EQUIPMENT AND SUPPLIES MARKET

Figure 4-1: Hemodialysis Patients by Selected Country (15 countries) Percentage of Total Dialysis Patients
Figure 4-2: Worldwide Hemodialysis Machine Demand (Installed Capacity Units), 2005-2015
Figure 4-3: Worldwide Market for Home-Use Hemodialysis Machines, (Installed Capacity in Units), 2005-2015
Figure 4-4: Worldwide Blood Lines Market, Units in Millions, 2005-2015
Figure 4-5: Worldwide Dialyzer Market, Modules in Millions, 2005-2015
Table 4-1: Differences in Source of Access by Region (North America, Europe, Asia, Latin America/Africa) and Type (AV Graft, AV Fistula, Catheter), Percentage of Patients
Figure 4-6: Worldwide Fistula Needles Market, Units in Millions, 2005-2015
Figure 4-7: Worldwide Hemodialysis Catheter Market, Units, 2005-2015
Figure 4-8: Worldwide AV Graft Market, Patients, 2005-2015
Figure 4-10: Peritoneal Dialysis Patients by Selected Country (15 countries) Percentage of Total Dialysis Patients
Figure 4-11: Worldwide Peritoneal Transfer Set Market, Units, 2005-2015
Figure 4-12: Peritoneal Dialysis Machines Market, Units, 2005-2015
Table 4-2: Leading Providers of Dialysis Equipment and Supplies, 2010
Figure 4-13: Leading Providers of Dialysis Equipment and Supplies, 2010
Table 4-3: Access Preferences in the United States Percentage of Patients by Access Type (AV Grafts, AV Fistula, Catheter)
Table 4-4: Access Preferences in Japan Percentage of Patients
Table 4-5: Access Preferences in Germany, Percentage of Patients
Table 4-6: Access Preferences in France Percentage of Patients
Table 4-7: Access Preferences in the U.K. Percentage of Patients
Table 4-8: Access Preferences in Italy Percentage of Patients
Table 4-9: Access Preferences in Canada, Percentage of Patients
Table 4-12: Access Preferences in Australia Percentage of Patients
Table 4-13: The Worldwide Market for Dialysis Products by Dialysis Type, 2005-2015
Figure 4-14: The Worldwide Market for Dialysis Products by Dialysis Type, 2005-2015
Table 4-14: Dialysis Product Market, Dollar Volume by Region, 2010
Figure 4-15: Dialysis Product Market, Market Share by Region, 2010
Table 4-15: Worldwide Hemodialysis Products Competitor Analysis, 2010
Figure 4-16: Worldwide Hemodialysis Products Market Share, 2010 (% Market Share)
Table 4-16: Worldwide Peritoneal Dialysis Products Competitor Analysis, 2010
Figure 4-17: Worldwide Peritoneal Dialysis Products Market Share, 2010 (% Market Share)
CHAPTER FIVE: DIALYSIS SERVICES MARKET
Figure 5-1: Worldwide Dialysis Centers (Number of Facilities), 2001-2010
Table 5-1: Leading Providers of Dialysis Services, 2010
Figure 5-2: Leading Providers of Dialysis Services, 2010
Figure 5-3: U.S. Dialysis Facilities (Number of Clinics), 1991-2006
Figure 5-4: U.S. Dialysis Patients at Years End, 1991-2010
Table 5-4: The Worldwide Market for Dialysis Services, 2005-2015
Figure 5-5: The Worldwide Market for Dialysis Services, 2005-2015
Table 5-5: Dialysis Service Market, Dollar Volume by Region, 2010
Figure 5-6: Dialysis Service Market, Market Share by Region, 2010
Table 5-6: Worldwide Dialysis Service Market, Competitor Analysis, 2010
Figure 5-7: Worldwide Dialysis Service Market Share, 2010 (% Market Share)
CHAPTER SIX: MARKET AND COMPETITOR ANALYSIS
Table 6-1: The Worldwide Dialysis Market by Type, 2005-2015
Figure 6-1: The Worldwide Dialysis Market by Type, 2005-2015
Figure 6-2: Dialysis Industry: Proportion Products vs Services, 2010
Table 6-2: Dialysis Products and Services Market, Dollar Volume by Region, 2015
Figure 6-3: Dialysis Products and Services Market, Dollar Volume by Region, 2010
Table 6-3: Worldwide Dialysis Product and Service Market, Dollar Volume by Competitor, 2006, 2008 and 2010
Figure 6-1: Worldwide Dialysis Product and Service Market by Company Performance, 2006-2010
Figure 6-4: Worldwide Dialysis Product and Service Market Share, 2010 (% Market Share)