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Summary of our market study
The global market for medical biology laboratories has been experiencing significant growth, which was further accelerated by the health crisis in 2020 due to the COVID-19 pandemic. In Spain, this market saw an increase of 33% in 2021, with the market size estimated at 4.8 billion euros. The pandemic resulted in an unprecedented demand for COVID tests, contributing to a substantial portion of sales for many laboratories, such as Unilabs reporting 40% of sales from COVID tests in 2020. The market in Spain, however, remains highly fragmented with the top two companies accounting for just 8.6% of the market share. COVID-19 tests were found to be expensive in Spain, with PCRs costing between 75 and 150 euros without a prescription. Despite this upsurge, the market is expected to return to slightly above pre-crisis levels in 2022. The demand for medical laboratory services is driven by the need for routine care, with clinical biochemistry and hematology comprising 93% of total analyses. Environmental management and digital transformation, including automation and Big Data, are current trends shaping the future of medical biology laboratories
Analyzing the Demand for Medical Laboratory Services in Spain
The demand for medical biology laboratories in Spain paints a picture of a steadfast industry where demand trends have exhibited stability with a modest upward tick. Over a period stretching, the number of analyses conducted per year displayed an increase of approximately 1%. An average of between 10 and 15 analyses accompanied each request, indicating a consistent need and application for laboratory services across the country. Most sought-after services within the sector emerged to be clinical biochemistry, hematology, immunology, and microbiology and parasitology. Combined, these specializations covered an overwhelming majority of the analyses, indicating both the health needs of the Spanish population and the areas of focus for medical labs. The geographical distribution of service requests varied, with specialized outpatient care and primary care forming the lion's share, indicating that the majority of laboratory referrals are rooted in routine healthcare and emergency services. While the health crisis of the early 2020s caused a substantial surge in demand for certain tests—specifically, those related to COVID-19—Spain's laboratories managed to quickly respond, with COVID tests comprising a notable percentage of sales for leading companies in the marketplace.
This unexpected boom in test demand illustrated the sector's resilience and ability to adapt under pressure. Environmental management and waste protocols also indicated a strong trend towards sustainable practices, showcasing an industry that is not only focused on human health but also on environmental stewardship. This reflects a broader, global trend where consumers and businesses alike are more aware of and concerned with their environmental impact. The interest in medical laboratory services, as reflected by online searches, however, presented a complex picture. Regions like Murcia, Aragón, and Castilla la Mancha led in terms of Google search volume, a metric that contradicts the physical presence of laboratories, underscoring a potential gap between laboratory accessibility and demand. Moreover, the digital transformation with the incorporation of technologies like Big data and automation is shaping the future of the industry. Approximately 90% of labs have adopted environmental programs, and almost total adherence to waste management protocols reflects this trend. In conclusion, the Spanish medical laboratory market is marked by stable demand with specialized services at the core. The adaptability shown during the health crisis and the progressive stride towards sustainable practices and digitalization augur well for the future of the industry. The market remains pivotal as it adapts to the scientific advancements and societal changes, maintaining its crucial role in public health.
Profiling the Major Contenders in Spain's Medical Biology Laboratories Scene
As we delve into the landscape of medical biology laboratories in Spain, several names emerge as the pillars of the industry, each bringing its unique strengths and strategic operations to the forefront. These laboratories have not only been instrumental in addressing routine medical needs but have also played a crucial role in responding to the heightened demand for diagnostic testing during health crises such as the Covid-19 pandemic.
- Eurofins Megalab - A Foremost Leader in Diagnostic Solutions With a workforce that ranges between 5,000 to 10,000 employees, Eurofins Megalab stands tall as one of the leading entities in the sector. Known for its comprehensive suite of diagnostic services and an established network that ensures accessibility and reach, Megalab has been a crucial player, especially noted for its rapid response during the pandemic by providing a significant number of Covid-19 tests.
- Synlab - A Global Giant with Local Impact Synlab, a group employing over 10,000 individuals, is another behemoth with an indelible mark on the Spanish medical landscape. Its extensive array of services, which extend beyond the borders of Spain, have not only provided invaluable medical insights but also positioned Synlab as a critical stakeholder in public health initiatives.
- Unilabs - Specialized Services Meeting Diverse Needs The Madrid subsidiary of Unilabs, with its cohort of 1,000 to 5,000 employees, emphasizes specialized analyses and has shone particularly in the backdrop of the global health crisis by attributing a significant portion of sales to Covid-19 related tests. Their tailored approach in diagnostic services has undoubtedly affirmed their reputation and indispensability in the market.
- Laboratorios Echevarn - A Stalwart with a Historic Legacy Laboratorios Echevarne, with around 800 employees, exemplifies a blend of tradition and modernity. With decades of experience under their belt, Echevarne has continually evolved, providing a range of diagnostic services that align with current technological and medical advancements while retaining the trust accrued over generations.
- Ribera Salud (Cialab) and Cerba International are also notable mentions, each bringing their unique flavor to the mix. Ribera Salud's strong foothold, courtesy of its 900 employees, is paralleled by Cerba's 100-employee strong operations, which, while comparatively smaller in scale, punch above their weight in service provision.
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Summary and extracts
1 Market overview
1.1 Definition and presentation
Medical biology laboratories are places where medical analyses and monitoring are carried out on the basis of fluid samples. These diagnoses are essential for treatment and medical decision-making, as well as for the prevention of various diseases.
Worldwide, the market for medical biology laboratories is growing steadily. Per capita healthcare expenditure is rising all over the world, particularly in Asia, where economic growth has led to the development of local laboratories. In Europe, healthcare expenditure per GDP is highest in France (11.3%), Germany (11.25%) and Sweden (10.3%).
In Spain, the medical biology laboratory market is growing strongly. Private laboratories are gaining ground, while in-house laboratories are losing ground. Outsourcing and external growth strategies have driven the market in recent years. The market is set to grow by 33% in 2021, and the multiplication of coronavirus diagnostic tests from the second half of 2020 has multiplied revenues in the sector. The market remains extremely fragmented, with the top two laboratories holding just 8.6% of the market, but concentration is gradually taking hold.
1.2 Healthcare expenditure in the European Union.
Europe presents a rather broad panorama of medical biology laboratories. There are many differences between countries. These differences are reflected in the healthcare systems and the divergences in healthcare expenditure by European country.
An article in EM consulte provides a typology of healthcare systems in Europe:
The Bismarckian wage-based system; The tax-financed Beveridgian system; Mixed models; Private, legalized systems.
Healthcare expenditure as a percentage of GDP:
The touteleurope. eu website presents Eurostat data on the healthcare systems of European Union countries.
Healthcare expenditure in EU countries Europe, ****, as % of country GDP Source: ****
France and Germany are the biggest spenders, devoting **.*% and **.**% of GDP respectively to their healthcare systems in February ****. France's and Germany's figures are the highest in the European Union. In France, spending is close to *** billion euros, with Spain ranking *th in the Union in terms of share of healthcare expenditure.
Medical laboratory expenditure in Europe :
Average amount spent per capita per country per year Europe, ****, in euros Source: ****
in Spain, spending on biological analysis laboratories amounted to ** euros per person in ****, just behind Germany and France. This is higher than in the UK, for example.
1.3 The Spanish medical laboratories market
Spanish market size:
In ****, the market size of medical laboratories in Spain is estimated at *.* billion euros, representing an increase of **% between **** and ****. In ****, it is forecast to return to a slightly higher pre-crisis level (***). [***]
The market was particularly buoyed by the health crisis and the explosion in the number of Covid tests, particularly in Spain. Many analysis laboratories therefore saw the health crisis as a great opportunity, and saw their sales soar.
Market size in the clinical analysis sector Spain, ****-****, in billions of euros Source: ****
Characteristics of the Spanish market:
There is a strong public-private dominance in terms of clinical analysis market share, with many hospitals having their own in-house laboratories.
Public-private analysis laboratory breakdown Spain, ****, in Source: ****
The Spanish market is also highly fragmented, with the top two companies accounting for *.*% of total market value, compared with **.*% for the top five in ****.
Furthermore, clinical analyses play a very important role in medical decisions: **% of clinical decisions depend on the results of medical biology laboratory analyses. The SEQC (***) is therefore campaigning for the sector to be upgraded and investment increased.
2 Demand analysis
2.1 Strong demand
Demand trends:
In ****, *** million analyses were delivered, for ** million requests for analyses in Spain.
Number of analyses per year Spain, ****-****, in millions Source: ****
The number of analyses is very stable over the ****-**** period, increasing by *% over the whole period. On average, there are ** analyses per request in Spain.
Most requested analyses :
The analyses most in demand in medical biology laboratories are clinical biochemistry, hematology, immunology and microbiology and parasitology.
Analysis requests by specialization Spain, ****, in Source: ****
The number of analyses is highest in clinical biochemistry (***). These two specializations account for **% of analyses. Breakdown of analyses by specialization Spain, ****, in Source: ****
Origin of requests : Breakdown of analyses by origin Spain, ****, in Source: SEQC The majority of analysis requests come from specialized outpatient care (***). A large proportion also come from hospitalizations and emergencies.
2.2 Web analysis of demand
Geographical distribution of searches :
The Google Trends index is used to evaluate the intensity and interest of a Google search. We have studied the results of the search "Laboratorio clínico" in Spain.
We can see that the regions with the highest number of searches are Murcia, Aragón and Castilla la Mancha. This does not correspond to the regions with the greatest number of medical biology laboratories; on the contrary , it seems logical: people doing this search want to know where to find a laboratory. The northern regions of Spain have the lowest Google Trends index, i.e. the lowest number of searches.
As for the evolution of the number of searches in recent years, this has remained stable.
On the other hand, no clear pattern can be observed over the course of a year.
Increase in the number of searches due to the health crisis:
It is interesting to study the impact of the health crisis on Google searches. To do this, we focused on the search "prueba laboratorio", which means "laboratory test" in Spain. Unsurprisingly, there is a sharp increase in searches over the period ****-****, which can be explained by the high demand for Covid tests during ...
2.3 Laboratories in high demand in 2020 due to the health crisis
Comparisons of Covid test use by country :
Total number of covid tests per million inhabitants in the countries most affected by the health crisis World, ****, in millions of tests Source: ****
We can see that Spaniards are major Covid test users, with Spain ranking second in terms of Covid tests per capita, with an average of **.* tests per person, well ahead of France (***).
An opportunity for medical laboratories:
In ****, Covid tests will account for **% of the sales and **% in **** of Unilabs, one of the leading companies in the Spanish medical laboratory market. [***] These tests have been a real godsend for analysis laboratories, with sales up **% in ****. In ****, the situation should return to normal, slightly up on the pre-crisis situation.
By way of information, Spain is one of the countries where PCR tests are the most expensive in Europe. Without a prescription, a PCR test costs between ** and *** euros, while an antigen test costs between ** and ** euros. [***]
3 Market structure
3.1 Geographical distribution and number of laboratories in Spain
Geographical distribution of medical laboratories in Spain :
Medical laboratories are unevenly distributed across Spain. The Madrid region, Catalonia and Valencia share the majority of laboratories, followed by Seville and Malaga. Some regions are deserts in terms of medical analysis laboratories.
The ** regions with the most biological laboratories Spain, ****, by number Source: ****
Trend in the number of laboratories :
The number of laboratories has remained fairly stable between **** and ****, according to DBK, dropping slightly from *,*** to *,***. Number of medical biology laboratories Spain, ****-****, in units Source: ****
3.2 The main laboratories
Laboratories of various sizes:
Number of centers per laboratory Spain, ****, as % of total Source: ****
**% of laboratories have just one center. Only *% of laboratories have four or more centers. This means that the market is made up of multiple players of limited size , and that large groups do not represent the majority of medical biology laboratories in Spain.
The two main types of laboratory:
There are two main types of laboratory in the market:
Routine biology laboratories
These are the non-specialized laboratories with the strongest presence in Spain. Their role is to meet a standard demand for medical analysis. These laboratories are often grouped around technical platforms. This is where equipment shared by several healthcare institutions is brought together.
Specialized biology laboratories
These laboratories carry out more specific analyses. Their customers are hospitals and other laboratories. They specialize in confidential, rare and highly technical services. They require expensive, state-of-the-art equipment.
The largest laboratories in Spain :
3.3 Salary structure
The different employees of a medical biology laboratory:
The different types of contract Spain, ****, in Source: ****
the majority of employees' contracts are permanent and temporary.
Breakdown of employees by type of qualification Spain, ****, in Source: SEQC The workforce in medical biology laboratories is mainly made up of pharmacists and doctors (***). They are followed by chemists, biologists and biochemists. The challenge of training :
Training in medical laboratories Spain, ****, in % of laboratories Source: ****
**% of Spanish medical laboratories have a structured training plan with rotation, but **% do not. Training has become a very important issue for Spanish medical laboratories. Indeed, many Spanish graduates are leaving to work abroad in search of better working conditions and higher incomes. [***]
4 Offer analysis
4.1 Breakdown of medical biology expenditure by pathology: a range of diagnostics
Points de repère - issue ** (***) presents medical biology expenditure by pathology.
Breakdown of medical biology expenditure by pathology France, ****, in * or analgesic or anti-inflammatory treatment ** : with or without pathologies, treatments or maternity *** : chronic respiratory diseases (***). Source: ****
Nearly **% of laboratory expenditure is fairly generalist and not linked to a specific pathology. They include routine care, analgesic treatments, occasional hospitalizations, etc. For the remainder, cardio-eurovascular diseases and cancers are the most important items, accounting for *.*% and *.*% of total expenditure respectively.
These observations are logical, since the core of our activity is the establishment of diagnoses, so it is normal that the majority of analyses are not attached to a particular pathology.
4.2 The different specializations
how many specializations are offered by each laboratory?
Number of specializations per laboratory Spain, ****, as % of total Source: ****
The majority of laboratories (***) offer between * and * specializations. Only *% have * or more, and **% specialize in just one type of analysis.
Services offered :
Laboratory size Clinical biochemistry Hematology Immunology Microbiology and Parasitology Genetics Pharmacology Andrology and reproduction Small (***) ** - *** % ** - ** % ** - ** % ** - ** % * - ** % * - ** % * - ** % Medium (***) ** - *** % ** - *** % ** - ** % ** - *** % * - ** % ** - ** % ** - ** % Large (***) ** - *** % ** - *** % ** - ** % ** - *** % ** - ** % ** - ** % ** - ** % Total ** - *** % ** - *** % ** - ** % ** - *** % ** - ** % ** - ** % ** - ** % Source: SEQC Smaller laboratories are less specialized than larger ones. Some analyses are less available, and only in large laboratories; this is the case for genetic, pharmacological, andrological and reproductive analyses.
4.3 Price list
In Spain as a whole, the price of healthcare services and products has risen slightly in recent years, with an increase of *.*% over * years between **** and ****. Below is the consumer price index for the healthcare sector:
Healthcare consumer price index Source: ****
For information, the price of an STD test is around *** euros (***). A test for monkeypox costs *** euros. Tests are often sold in packs. [***]
4.4 Current and future trends
Automation:
Spanish medical laboratories have worked hard to integrate digital technologies and automation into their business models. Today, many centers are equipped with these new technologies.
Integrating digitization and automation into operations has many advantages, such as increasing productivity and becoming more competitive. What's more, adopting new digital technologies and automating tasks means you can focus on other areas of value creation, both for the center and the patient.
Environmental issues:
Environmental commitment is becoming increasingly important in laboratories. In Spain, around **% of medical biology laboratories have an environmental management program, and **% have a waste management protocol.
The use of data:
The use of Big data and artificial intelligence in clinical laboratories will be useful for, among other things, establishing reference values, quality assurance, clinical decision support and population health monitoring.
There are currently many initiatives in the field of artificial intelligence, including the automated analysis of urine sediments, the prediction of diseases or results from routine laboratory tests, and the interpretation of biological data. In clinical microbiology, for example, it enables the detection and identification of clinically relevant microorganisms and the detection of antimicrobial resistance.
Other trends :
Direct access to DTC (***) diagnostic tests, which gained momentum with the Covid-** crisis, ...
5 Regulations
5.1 Spanish and European regulations
Regulations :
Clinical laboratories are subject to specific regulations, and the fundamental rules are set at European level. In ****, the In Vitro Diagnostic Regulation (***) ****/*** was published.
As far as Spain is concerned, Law **/****, of May **, on the cohesion and quality of the national health system (***) is the reference standard governing clinical laboratories in Spain. This standard establishes the general basis for the authorization procedure of health centers, services and establishments by the autonomous communities.
There are other laws and regulations concerning clinical laboratories:
● Law **/****, of April **, General Health.
● The Convention for the Protection of Human Rights and Dignity of the Human Being with regard to the Application of Biology and Medicine (***), adopted by the Committee of Ministers of the Council of Europe on November **, ****.
● Law */**** of May **, ****, regulating informed consent and patient clinical history.
● Law **/****, of November **, Basic Law regulating patient autonomy and rights and obligations with regard to information and clinical documentation.
● Law **/****, of November **, on the organization of health professions.
● Organic Law */****, of December *, on the protection of personal data and the guarantee of digital rights.
Quality control:
The main quality standard for the clinical laboratory sector is UNE-EN ISO ***** on special requirements for ...
5.2 Autonomous community regulations
6 Positioning the players
6.1 Player segmentation
- Synlab Groupe
- Eurofins Groupe
- Cerba Healthcare
- Laboratorios Echevarne
- Unilabs (Madrid)
- Salud Savia
- Ribera Lab
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