Cardiovascular disease is common in Asia, where it is a leading cause of death in countries from Japan to India to China. Of the 17.3 million deaths caused by cardiovascular disease each year, nearly 60 percent occur in Asia, according to the World Health Organization (WHO). These numbers are likely to rise in the near future: as Asians become wealthier, they are exercising less, consuming more “Western style” fast food and smoking more. All of these activities are risk factors for cardiovascular diseases.
But a growing focus on the prevention, treatment and diagnosis of cardiovascular disease in Asia has led to a growing demand for cardiovascular medical devices. The Asian market for cardiovascular medical devices was worth more than $11 billion in 2012, with 12 percent annual growth. By 2021, Asia’s share of the global cardiovascular device market is expected to increase from 30 percent to 40 percent.
Cardiac rhythm management devices (like pacemakers) and cardiovascular monitoring and diagnostic equipment are the two main divisions of devices in Asia. The more sophisticated the cardiovascular device, the more likely it is to be imported from the US or Europe. Foreign medical device companies supply three-fourths of the high end medical device market in Asia. Medtronic, St. Jude and Boston Scientific have all been selling their products to the Asian market — especially China — since the 1990s.
Many foreign companies are also setting up manufacturing sites, R&D facilities and technology centers in Asia. For example, St. Jude recently established an advanced technology center in Beijing, to train Chinese doctors in the use of their cardiovascular medical devices.
RAPIDLY GROWING DEMAND
Demand for cardiovascular devices is skyrocketing in countries like India and China. China’s rapidly aging population of 1.3 billion is a case in point: more than 20 million patients there currently have coronary artery disease.
To treat this and other serious cardiovascular diseases, physicians are increasingly turning to sophisticated interventional cardiovascular devices rather than surgery. Many local Chinese medical device companies have started manufacturing Class III cardiology products to keep up with demand. Some of these companies have their own R&D facilities, while others have partnered with Western medical device manufacturers in technological joint ventures. Noteworthy domestic manufacturers include MicroPort and Lepu.
India’s cardiovascular devices market is considerably smaller than China’s. Lower healthcare standards and fewer public facilities for treating cardiovascular diseases mean fewer people seeking treatment. However, demand is high in the private sector. Nearly 30 percent of India’s $3 billion medical device market is in cardiovascular devices.
Growth areas there include devices that treat rheumatic heart disease and devices that treat congenital heart disease in infants. Additionally, private hospitals continue to demand the latest in cardiovascular monitoring and treatment systems.
Apart from China and India, Japan is also suffering from high rates of cardiovascular disease. The country’s rapidly aging population and rising numbers of diabetics and youth smokers have all led to a high demand for cardiovascular devices. Japan has high healthcare standards and a generous government allocation for retirees. This has been fundamental to growth in Japan’s interventional cardiology device market. As more Japanese senior citizens opt for diagnostic angiography procedures, demand for diagnostic catheters is also rising.
Each country in Asia has different medical device regulations and classifications, usually based on the level of risk to the patient.
One good example is implantable cardiac pacemakers. In China, which organizes medical devices into three classes, they are considered Class III. But in Hong Kong, they are considered Class IV devices. The difference lies in the definition each region uses. China considers Class III devices to be those that are “implanted into human [bodies] or used for life support or sustenance.” Hong Kong considers Class IV devices to be those that have “direct contact with [the patient’s] heart of central circulatory system.”
In India, many cardiovascular devices are classified as drugs, in the absence of a full-fledged medical device regulatory system. More comprehensive guidelines are on the table, but real change will take time. A Medical Device Act pending before the Indian Parliament has been in the works for more than seven years.
Asia’s market for cardiovascular devices is expanding rapidly. It will continue to do so as more Asian governments implement national healthcare policies and reforms that address cardiovascular health. Singapore’s government in particular provides incentives, like tax breaks, to manufacturers who produce sophisticated cardiovascular devices there. Many foreign medical device companies have taken advantage of this, including Medtronic. In January 2011, Medtronic launched a new plant for manufacturing cardiac devices in Singapore. The office will serve as Medtronic’s Asian headquarters and as its regional distribution center for cardiac rhythm disease management products. Similarly, Sandvik AB has started manufacturing some of its cardiovascular device components (like pacemaker leads) in India, in order to lower production cost.
International cardiovascular device companies that understand these health and regulatory trends in Asia stand to realize the market’s potential.