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1、 StentMarket situationl 2007 sales decay because of negative clinical trial data（physicians opted only medical treatment to treat angina patients because of low cost and noninvasive (COURAGE trial)）,2008 recover. l Drug-eluting stents（DES）with a higher rate of late stent thrombosis (LST)l 2008,addit
2、ional clinical data alleviated concerns over DES and supportive evidence for PCI in novel patient population (diabetic and acute myocardial infarction (AMI)l Coronary artery disease (CAD) will contribute to growth in IC device market through 2013;average selling prices declining in response to the e
3、xpanding competitive landscape.l In 2008,market of DES and bare-metal stent (BMS) grew because of 2 new DES competitors and supporting clinical data.l Prior to 2008,2 competitors in US market : Cordis and Boston Scientific ; followed by Medtronic and Abbott.In 2008, BMS ： DES =25 ：75l Biggest issue
4、of DES ：LST ; but good for diabetic and AMIl PTCA Balloon Catheter procedure by type will reach at 900,000 procedures in 2013.l Interventional cardiology (IC) accessory market, which includes PTCA guidewires, diagnostic catheters, PTCA guiding catheters, and introducer sheaths will reach 320 million
5、 US dollars. It will decline at a compound annual growth rate of less than -1 from 2008 through 2013. l Accessory Device Market, which includes PTCA guidewires, diagnostic catheters, PTCA guiding catheters, introducer sheaths remain relatively stable. CAGR is less than 1%.l Intravascular Ultrasound
6、Catheter (IVUS) during IC procedures will increase considerably over the forecast period due to the unique imaging capabilities offered by this device. It would reach at 350,000 procedures at 2013.Only 2 competitors in IVUS market in 2008, Boston Scientific and Volcano. Competitors of US IC device m
7、arket in 2008：Abbott Vascular ev3Angio Score MedtronicArgon Medical Merit Medical SystemsArrow International St. Jude MedicalBoston Scientific Terumo MedicalC. R. Bard Vascular SolutionsCook Medical VolcanoCordisl In 2008CompanyDES MarketBMS MarketTotal MarketBoston Scientific44.825.241.7Cordis29.62
8、4.8Medtronic11.814.219.7Abbott Vascular 13.860.613.8l Boston Scientific PROMUS=Abbott Vascular XIENCE V. PROMUS is a private-label. Under the Guidant acquisition agreement, Abbott will receive 40 profit from PROMUS sales.l Boston Scientific maintained its leading position.l TAXUS Express2 Atom of Bo
9、ston Scientific is the first DES with 2.25 mm diameter approved in the US, previously used a BMS.l TAXUS Express2 specifically treats in-stent restenosis in BMS.l The numerous DES launches signaled the resolution of the FDA warning letter, which had plagued the company since 2006, after suspicions o
10、f improper review and reporting of complaints surrounding TAXUS.l PERSEUS clinical trial is evaluating Boston Scientifics third-generation TAXUS Element DES, whose platform will feature the platinum /chromium Alloy and a new balloon catheter.l Boston Scientifics BMS :Express2 :stainless steel platfo
11、rm; the Liberte with a cobalt chromium platinum.l Cordis is the first company which launched DES in the US in 2003.l Johnson &Johnson is the parent company of Cordis, and its paclitaxel-eluting stent failed to pass the COSTAR trial in 2007 and stopped production.l Cordis would rely on Cypher stent,
12、the cobalt and chromium platform and sirolimus-eluting stents.l Its revenue is further limited by lack of cobalt-chromium-based BMS, the preferred device of most physicians.l In 2007, it announced that it had signed a definitive agreement with former Boston Scientific partner Medinol to distribute M
13、edinols BMS. So Cordis will access Medinils stainless steel and cobalt-chromium BMS.l In 2008, Medtronic capture the third leading position with the February 2008 launch of Endeavor.l Finally, Medtronic won in the RX(rapid exchange) patent war against Abbott Vascular. Market share may increase becau
14、se of it.l Star products: Endeavor DES and Endeavor RESOLUTE（used for complex lesions and features a biocompatible polymer enables more precise drug release）l Abbott launch its first DES, XIENCE V in 2008.l Boston Scientific PROMUS=Abbott Vascular XIENCE V. PROMUS is a private-label. Under the Guida
15、nt acquisition agreement, Abbott will receive 40 profit from PROMUS sales.l In addition to the companys new DES, Abbott Vascular was the leading competitor in the US BMS market in 2008 with its wide range of products.l Abbott developed a new completely absorbable DES and evaluated through ABSORB cli
16、nical trial, 30 patients are implanted with the stent and it had been completely absorbed after 2 years. The technology is not expected to enter the market for at least 4 years due to the rigorous FDA approval process. The second phase of this trial began in early 2009.US Market Analysisl Coronary S
17、tent will reach 2,500 million US dollars after 2010 and its growth as follow: 6 in 2008, 5.5 in 2009, almost 0 after 2010. l Stent Procedure (by procedure type)：In total,2010 will exceed 1 million. From 2007 to 2013, the amount is 908,000 to 1,080,000. CAGR(0813) ：2.7. Growth：2010 is 2.6. From 2008
18、to 2013, the amount is 4.12.2%.PTCA-with-stent：2010 will exceed 0.78 million. From 2007 to 2013, the amount is 699,000 to 839,000. CAGR(0813) ：2.4. Growth：2010 is 2.5. From 2008 to 2013, the amount is 6.52.3%.Direct stenting：2010 will exceed 0.22 million. From 2007 to 2013, the amount is 210,000 to
19、241,000. CAGR(0813) ：3.6. Growth：2010 is 2.9. From 2008 to 2013, the amount is -3.92.0%.Stent Procedure (by segment)： Units per procedure (Average)：In total：Procedure: 2010 will exceed 1 million. From 2007 to 2013, the amount is 908,000 to 1,080,000. CAGR(0813) ：2.7. Growth：2010 is 2.6. From 2008 to
20、 2013, the amount is 4.12.2%. Units per procedure (Average)：1.43；Units：2010 will exceed 1.4 million. From 2007 to 2013, the amount is 1,263,000 to 1,563,000. CAGR(0813) ：3.0. Growth：2010 is 2.9. From 2008 to 2013, the amount is 6.82.5%.ASP(US)2010 will exceed 1,700. From 2007 to 2013, the amount is
21、1,749 to 1,620.CAGR(0813) ：-1.4. Growth：2010 is -2.0. From 2008 to 2013, the amount is -0.6-2.0%. Market Value(USM)2010 will exceed 2,400. From 2007 to 2013, the amount is 2,208 to 2,532.CAGR(0813) ：1.5. Growth：2010 is 0.8. From 2008 to 2013, the amount is 6.20.5%.DESProcedure: 2010 will exceed 0.76
22、 million. From 2007 to 2013, the amount is 607,000 to 838,000. CAGR(0813) ：4.9. Growth：2010 is 3.6. From 2008 to 2013, the amount is 8.52.6%. Units per procedure (Average)：1.45；Units：2010 will exceed 1.1 million. From 2007 to 2013, the amount is 844,000 to1,228,000. CAGR(0813) ：5.5. Growth：2010 is 4
23、.1. From 2008 to 2013, the amount is 11.63.1%.ASP(US)2010 will exceed 1,974. From 2007 to 2013, the amount is 2,142 to 1,838.CAGR(0813) ：-2.5. Growth：2010 is -2.6. From 2008 to 2013, the amount is -2.5-2.2%. Market Value(USM)2010 will exceed 2,150. From 2007 to 2013, the amount is 1,808 to 2,257.CAG
24、R(0813) ：1.5. Growth：2010 is 1.4. From 2008 to 2013, the amount is 8.80.8%.BMS：Procedure: 2010 will exceed 0.24 million. From 2007 to 2013, the amount is 301,000 to 243,000. CAGR(0813) ：-3.3. Growth：2010 is -0.5. From 2008 to 2013, the amount is -4.60.8%. Units per procedure (Average)：1.40；Units：201
25、0 will exceed 0.33 million. From 2007 to 2013, the amount is 419,000 to335,000. CAGR(0813) ：-3.8. Growth：2010 is -1.0. From 2008 to 2013, the amount is -2.90.3%.ASP(US)2010 will exceed 850. From 2007 to 2013, the amount is 956 to 820.CAGR(0813) ：-2.5. Growth：2010 is -2.6. From 2008 to 2013, the amou
26、nt is -2.9-2.2%. Market Value(USM)2010 will exceed 295. From 2007 to 2013, the amount is 400 to 274.CAGR(0813) ：-6.2. Growth：2010 is -3.6. From 2008 to 2013, the amount is -5.7-1.9%.The US coronary stent market was driven by an expanding competitive landscape in 2008, with the number of FDA approved
27、 DES more than doubling the number available in 2007.l The largest benefit of DES is seen in diabetic patients and those with more complex lesions.l DES Units, by Diameter, 20082.25mm 8,740 0.92.5mm 286,890 30.52.75mm 112,880 12.03mm 316,490 33.63.5mm 199,160 21.14mm 17,730 1.9Global DES Market size
28、 and forecast:l According to TechNavio, the global market for DES is expected to reach $8,289.1 million by 2012, from $6,140 million in 2008; thus, growing at CAGR of 7.8% .l In 2008, the Americas accounted for 3,192.8 million, 52%; accounted for $4,291.6 million in 2012 with CAGR of 7.7%. In 2008,
29、EMEA accounted for $1,657.8 million, 27%; $2,213.9 million by 2012 with CAGR of 7.5%. In 2008, APAC accounted for $1,289.4 million, 21%; accounted for $1,783.6 million by 2012 with CAGR of 8.4%.l Competitive pricing will be an important tool in maximizing market share for the companies in the DES ma
30、rket. Reimbursing institutions will also create pressure on DES prices because health care budget limitations will likely restrict the level of reimbursement for the devices in the future.l DES market growth is further supported by the application of the devices in new patients and lesion types, inc
31、luding long and complex lesions, and diabetic and AMI patients.DES developing trend : l smaller diameter, for bifurcated lesions, polymer-free DES, bioabsorbable devices.l Next-generation DES improve on the deliverability and ease-of-use, also include the cobalt-chromium platform, which is preferred
32、 because of lower profiles and increased radiopacity compared to the stainless steel platform.l For all competitors, the ability to build physician relationships and offer product bundles with a wide variety of devices will remain an important strategy in the US DES market.Major market trends of DES
33、 ：l Consolidation of the Market :Such as Guidant and Cordis cardiology divisions. Through the strategic alliance, they look forward to expand their product portfolio to provide a full range of interventional therapies to the physicians and patients. This will result in an increased competition in the DES market; raising the entry barriers in the market.l Growth in Demand for DES :The increasing acceptance leads to the growth in the demand for DES, and its fueled by the robust economic growth and a greater adoption of social securit
