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NEW industry forecasts for 2011 & 2016

Implantable Medical Devices
Study # 2255 October 2007 $4500

US demand to grow 7.7% drug therapies and external fixation
annually through 2011 US Implantable Cardiac
Medical Device Implants
The Freedonia Group projects demand Neurological stimulators,
for implantable medical devices increas- Demand,
ing 7.7 percent annually to $40.2 billion 2006 eye implants among other
in 2011. An expanding prevalence of leading prospects
heart, orthopedic, neurological, visual Other implantable medical devices will
and urinary disorders, coupled with post demand of $4.9 billion in 2011, up
ongoing improvements in the safety and over 13 percent annually from 2006.
effectiveness of products, will promote Implants Products leading growth will consist of
gains. Additionally, the rising popularity 45% neurological stimulators for treating
of cosmetic surgery will boost growth epilepsy, Parkinson’s disease and other
opportunities for breast, dermal and central nervous system disorders; phakic
tissue implants. Less favorably, linkage to intraocular lenses for correcting near-
potentially fatal complications, along sightedness; retinal implants for treating
with advances in alternative drug macular degeneration; brachytherapy for
therapies, will weaken the market for a cancer indications; and cochlear devices
number of implantable medical devices, Other Implants
($27.8 billion) 10% for restoring hearing loss. These products
especially drug-eluting coronary stents. offer significant performance and
outcome advantages over alternative
CRT devices to propel their risk of disease complications, such treatments. Among other implantable
slowing cardiac segment as atrial fibrillation. medical devices, dermal and tissue
Eroding sales of drug-eluting coronary implants and silicone breast implants will
stents will moderate overall growth Orthopedic implants offer fare the best in the marketplace reflecting
opportunities for cardiac implants. Total an increasingly appearance-conscious
best growth opportunities population.
demand posted by this product group is
projected to increase 5.2 percent annually Demand for orthopedic implants will
to $16.2 billion in 2011. Discontinued reach $19.1 billion in 2011, up 8.8 Study coverage
usage among high risk cardiac patients percent annually from 2006. Tissue and This new Freedonia industry study,
will cause the market for coronary drug- spinal implants, along with hip and shoul- Implantable Medical Devices, is priced
eluting stents to decline by $750 million der replacement products, will see the at $4500. It presents historical demand
in the 2006-2011 period. However, in fastest sales gains as advances in fusion, data for the years 1996, 2001 and 2006
spite of this decrease, total demand for fixation and neurological stimulating and forecasts for 2011 and 2016 by
cardiac implants will continue to rise due technologies improve the success rate and implant material (e.g., microelectronics,
largely to the widening use of cardiac cost-effectiveness of related surgical specialty metals, polymers, elastomers,
resynchronization therapy (CRT) devices procedures. Demand for knee reconstruc- ceramics) and type (e.g., cardiac,
in the treatment of congestive heart tive implants and trauma fixation orthopedic). The study also considers
failure (CHF). CRT devices are more products will expand at a more moderate market environment factors, details
effective than alternative drug therapies pace, benefitting from an increasing industry structure, evaluates company
in restoring the blood pumping capabili- prevalence of deteriorated joint condi- market share and profiles leading industry
ties of CHF patients along with reducing tions and fracture injuries, but adversely competitors.
affected by improvements in alternative

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2006 International Markets Other Formulations Tissue Implants PRODUCT OVERVIEW Cultured Cells CARDIAC IMPLANTS 1 Implantable Medical Device Demand Product Overview Allografts & Other Tissue Implants by Product Group Implantable Cardioverter Defibrillators (ICDs) Cht Implantable Medical Device Demand ICD Technology OTHER IMPLANTABLE by Product Group.NEW US I ndustry Study with Forecasts for 2011 & 2016 Implantable Medical Devices Cardiac Stents Breast Implants Table of Contents Drug-Eluting Coronary Stents Saline Implants Peripheral Stents Silicone Implants Carotid Stents Drug Implants Introduction Bare Metal Coronary Stents Drug Inserts Other Cardiac Stents Brachytherapy Implants Executive Summary Pacemakers & Accessories Implantable Drug Pumps Dual Chamber Pacemakers Urological Implants Market Environment Single Chamber Pacemakers Penile Implants Economic Factors Pacemaker Leads Biliary Stents Demographic Patterns Pacemaker Batteries Other Urological Implants Health Care Trends Heart-Related Grafts Cochlear Implants Health Insurance Vascular & Endovascular Grafts Technology Acute Conditions Vascular Grafts Products Chronic Conditions Endovascular Grafts Dermal Implants Cardiovascular Conditions Peripheral Grafts Collagen-Based Products Orthopedic Conditions Arterial-to-Venous (AV) Grafts Other Dermal Implants Neurological Conditions Heart Valves All Other Implantable Medical Devices Other Selected Chronic Conditions Tissue Valves Airway & Esophageal Stents National Health Expenditures Mechanical Valves Gastric Bands Medical Providers Valve Repair Products & Accessories Miscellaneous Implants Hospitals Vena Cava Filters Outpatient Facilities Ventricular-Assist Devices INDUSTRY STRUCTURE Skilled Nursing Homes Implantable Heart Monitors Market Share Physicians Competitive Strategies Patient Activity ORTHOPEDIC IMPLANTS Mergers & Acquisitions Hospital Activity Product Overview Licensing & Related Agreements Outpatient Episodes Reconstructive Implants Research & Development Surgical Procedures Knee Implants Marketing & Distribution Total Procedures Demand Patterns Manufacturing Activities Implant Procedures Products & Producers Company Profiles Heart-Related Implant Procedures Hip Implants Orthopedic Implant Procedures Demand Patterns Other Implant Procedures Products & Producers List of Tables & Charts Medical Product Markets Shoulder Implants Pharmaceuticals & Biologicals Demand Patterns Surgical Appliances & Supplies Products & Producers Executive Summary Surgical & Medical Instruments Other Reconstructive Implants 1 Summary Table Electromedical Equipment Elbow Implants Other Medical Products Ankle Implants Market Environment All Other Reconstructive Implants 1 Macroeconomic Indicators IMPLANT MATERIALS & COMPONENTS Spinal Implants 2 Population by Age Group Microelectronic Components Internal Spinal Fixation Devices 3 Acute Conditions Specialty Metals Bone Grafts & Substitutes 4 Selected Chronic Conditions Polymers Natural Bone 5 National Health Expenditures Elastomers Intravertebral Spacers 6 Selected Medical Providers by Type Ceramics Bone Substitutes 7 Selected Patient Activity by Type Other Materials & Components Fusion Cages 8 Selected Implant Procedures by Type Implantable Spinal Cord Stimulators 9 Medical Product Demand by Type PRODUCT OVERVIEW Trauma Fixation Implants Market Outlook Internal Fixation Devices IMPLANT MATERIALS & COMPONENTS Historical Demand Patterns Bone Grafts & Substitutes 1 Implantable Medical Device Material Regulatory Considerations Craniomaxillofacial Implants & Component Demand by Type Pricing Trends Bone Cement Cht Implantable Medical Device Material & US Trade Acrylate Formulations Component Demand by Type. 1996-2006 ICD Leads Ophthalmic Implants 3 US Trade in Implantable Medical Devices ICD Batteries Intraocular Lenses 4 World Implantable Medical Device Retinal & Other Ophthalmic Implants Demand by Region .Demand Conventional ICD Devices Neurological Stimulators Patterns. 2006 Cardiac Resynchronization Therapy Devices MEDICAL DEVICES 2 Implantable Medical Devices .

These implants serve to stimulate new bone growth. Demand for these implants is projected to reach 3 Cardiac Stent Demand by Type $4. Jude intended to hold joined vertebrae together and enable new bone to grow between Medical.2 2 Selected Acquisitions & Divestitures SaMPLE TExT billion in 2009. autogenous bone Profiles for 26 US competitors in tables and charts grafts. screws and wires. CRT devices resynchronize 8 Trauma Fixation Implant Demand by Type contractions of the heart’s ventricles by sending tiny electrical impulses to the 9 Bone Cement Demand by Formulation heart muscles.7 9. up nearly 20 percent annually from 2006. 9 Implantable Heart Monitor Demand data and forecasts Congestive heart failure is a degenerative chronic condition characterized ORTHOPEDIC IMPLaNTS by a gradual loss in the heart’s blood pumping ability. 2006 surgical techniques and rising numbers of injuries and chronic back conditions Cht Implantable Medical Device will create strong growth opportunities for spinal implants. will post the largest Data illustrated share of demand and best growth opportunities. MEDICaL DEvICES taBle Vi-7 1 Other Implantable Medical Device Demand by Product Group spinal implant demand BY tYpe © Copyright by The Freedonia Group. The other. referred to as a cardiac Demand by Type resynchronization therapy defibrillator (CRT-D). 4 Hip Implant Demand by Type Two types of CRT devices are available for the treatment of congestive 5 Shoulder Implant Demand By Type heart failure. WL Gore and Zimmer . DECISION-MAKERS CaRDIaC IMPLaNTS 1 Cardiac Implant Demand by Product Group cardiac implants Cht Cardiac Implant Demand by Product Group. are by Product Group not effective in restoring this function. Implants used in spinal fusion surgery. A more Cht Orthopedic Implant Demand promising treatment is offered by specially designed. Spinal fusion surgery is the with the aid of preferred treatment for most spinal cord injuries and abnormalities as it provides for a faster and more complete patient recovery than alternative drug and physi- COMPaNy PROFILES more than 50 cal therapy regimens. In many procedures. CRT-D devices add the capability to terminate abnormally fast heartbeats quickly. 2006 cardiac resynchronization therapy (crt) devices 2 Implantable Cardioverter Defibrillator Continuing shortcomings in available pharmaceuticals that treat conges- Demand by Type tive heart failure will underlie a rapidly growing market for cardiac resynchroni- zation therapy (CRT) devices. especially in the repair 3 Selected Cooperative Agreements of vertebrae and treatment of degenerative disk conditions. rods. These devices are Smith & Nephew.8 37. 849 2001 1400 and 2310 3780 8 Dermal Implant Demand by Type Fusion Cages -- 238 550 1050 1970 Implantable Stimulators 135 2006 183 as240 well310 as 400 8 All Other Implantable Medical Device Demand by Type % spinal implants Freedonia 27. known as cardiac resynchronization therapy (CRT) 2 Reconstructive Implant Demand devices. Boston Scientific. 2006 cardioverter defibrillators. STRATEGISTS. Many patients with moderate to severe heart failure condi. including angiotensin-converting enzyme (ACE) inhibitors. Available since 2001. In the basic spinal fusion technique. but only slow its progression. plates. Congestive heart 4 Pacemaker & Accessory Demand by Type failure is a widely prevalent health problem in the US. fixation devices. One type is a specially designed pacemaker known as a cardiac re- 6 Other Reconstructive Implant synchronization therapy pacemaker (CRT-P). Available drug therapies 1 Orthopedic Implant Demand for the disease. between adjacent vertebrae.4 TaBLE 10.3 forecasts 34. tri-chamber implantable by Product Group. advances in less invasive Sales by Company. such as hooks. The market for Market Share. indUStry StUdieS ■ cUStom reSearch ■ FocUS reportS INDUSTRY MARKET RESEARCH: BUSINESS INTELLIGENCE FOR BUSINESS LEADERS.8 7. additional vertebrae fusion is achieved through the use of Johnson & Johnson. bone allografts or substitute bone materials are implanted to form a bridge such as Biomet.9 12. Most congestive heart failure patients die 8 Ventricular-Assist Device Demand support each table’s within eight years of initial onset. afflicting over five million 5 Heart-Related Graft Demand by Type SaMPLE PaGE individuals in total and striking more than 550. These impulses help the heart pump blood throughout the body 10 Tissue Implant Demand by Type more efficiently. St.1 30.6 5 Drug Implant Demand by Type 6 Urological Implant Demand by Type Spinal Implant Demand Internal Fixation Devices Historical data for 1300 2430 4360 7180 657 1160 2170 3510 5550 11700 7 Cochlear Implant Demand Bone Grafts & Substitutes 508 1996.orthopedic implants OTHER IMPLaNTaBLE tions are vulnerable to life-threatening tachyarrhythmias. is the same device with added 7 Spinal Implant Demand by Type anti-tachycardia pacing and defibrillation features. Stryker. Medtronic.2 billion in 2011.000 new victims each year. 2006 these devices is projected to increase more than ten percent annually to $7. Inc. (million dollars) Cht Other Implantable Medical Device Demand by Product Group. The 6 Heart Valve Demand by Type 7 Vena Cava Filter Demand Explanations that disease is responsible for more than one million hospital admissions and $45 billion in health care costs annually. CRT devices serve as broad-based pacing systems by Product Group that terminate fast ventricular tachycardia episodes as well as other heart rhythm 3 Knee Implant Demand by Type disorders such as atrial fibrillation.6 40.8 Orthopedic Implant Demand 4790 8030 12540 19100 28700 INDUSTRy STRUCTURE for 2011 and 2016 spinal implants 1 Implantable Medical Device Ongoing improvements in available produces. 2006 2 Implantable Neurological Stimulator Demand Item 1996 2001 2006 2011 2016 3 Ophthalmic Implant Demand by Type Spinal Fusion Procedures (000) 192 317 465 660 925 4 Breast Implant Demand by Type 000$ implants/procedure SaMPLE 6.