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Endoscopy Equipment

Pent-up demand set to drive endoscopy market in India in 2021

Endoscopy is a non-surgical procedure performed using a long, thin tube for imaging and diagnostics or to perform minimally invasive procedures of the internal organs or tissues. There are several types of endoscopes based on applications like gastroenterology, pulmonology, and orthopedic surgery. The majority of the gastrointestinal (GI) procedures are screenings related to colon cancer or the removal of abnormalities from the GI tract. Based on the product type, the categories include flexible, rigid, and capsule endoscopes.

The Indian endoscopy market was estimated to be worth Rs 1775 crore in 2019, according to our analysis. The main drivers behind the advancement in endoscopic technologies are:

  • Natural preference for less-invasive methods of treatment to shorten the length of stay in hospitals and to decrease the complications.
  • Rising prevalence of chronic diseases.
  • Improvement in endoscopic technology.

However, several challenges are hindering the adoption of endoscope use in low and middle income countries (LMIC) like India, including:

  • Poor insurance penetration.
  • Lack of or limited reimbursements for procedures.
  • Higher cost of disinfection, maintenance, and training.
  • Lack of skilled workforce.

Frost & Sullivan’s analysis indicates that there is huge scope for growth in the market as a significant proportion of the procedures are still performed as open procedures for most conditions, except cholecystectomy (80 percent) and appendectomy (70 percent); only one out of four hysterectomies and mastectomies are done with an endoscope. The Indian endoscopy market is attractive for global companies due to the huge unmet need and greater room for expansion. Gastro-intestinal, urological, and orthopedic applications are the top segments in endoscopy. Improved patient outcomes and shortened procedure time are major determinants for market adoption, along with factors like total cost of ownership, after-sales service and maintenance, and product quality. Top companies in the market are striving to sustain or improve their position through innovations centered on improved visualization of deep tissues, easy maneuverability, and embedded decision support using AI. There is a gradual transition taking place in commercial models, where the companies are moving from capital expenditures (CapEx) model to service and procedure based business models. There is also a transition toward single-use endoscopes due to factors like rapid administration and lower infection risk.

Our analysis indicates that the Indian market has been severely impacted by COVID-19, with an estimated overall decline in revenues by about 60 percent and procedure volumes by more than 80 percent. While most of the segments, like arthroscopy, ENT, gynecology, neurology, and urology, have seen more than a 70 percent decline in revenues, the pulmonary segment, which is under-penetrated in the country, has seen a 20 percent increase in revenues. However, this has not necessarily ensured an increase in the volume of procedures, so it is considered a one-off spike. Another change observed was the reversal of revenue split between the equipment and consumables (forceps, guide wire, stent, balloon dilation device and others) in the endoscopy market, from 60:40 ( percent) in 2019 to 20:80 ( percent) in 2020.

However, Frost & Sullivan’s analysis indicates that we will witness the market rebound in Q2 2021, and established players in the market are looking to catch up on the pent-up demand from postponed procedures. Component suppliers and OEMs are vying for the huge market opportunity due to chronic diseases, increasing minimally invasive surgical volumes due to growing awareness, and rapid scaling up of healthcare infrastructures like specialty daycare surgical centers across metro and Tier-I cities in the country. 

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