The medical imaging market - France (2024)

1.2 Global market

In ****, the global medical imaging market was valued at $**.** billion. Two years later, in ****, the global market size is estimated at $**.** billion, an increase of **% over the previous year. The market is expected to continue to grow at a CAGR of *.*%, reaching $**.** billion in **** .

Evolution of global medical imaging market size World, **** - ****, in billions of USD Source: ****

On a global scale, the growth drivers for this market are: an aging population, an increase in the number of chronic diseases, technological innovations, and the reorganization and growing investment in healthcare systems, particularly in emerging countries such as India and China.[***]

The World Bank has released in **** a *st procurement guide entitled"How to select and contract a Medical Diagnostic Imaging (***) specialist consultant".

The aim being to establish a panel of independent consultants specialized in MDI (***) equipment, themselves available to assist and support borrowers and the Bank in the procurement of Bank-financed equipment and services.

This guide therefore provides several pieces of information on the breakdown of the global IDM market, but has not been updated since ****. However, the breakdown of the global market has not changed significantly between **** and ****.

The majority of market share is captured by North America (***). The other ...

1.3 Balance of trade

In order to analyze French foreign trade in medical imaging equipment, we will use the following CN* codes, which cover all such equipment:

********: electrocardiographs, ********: ultrasonic scanning diagnostic equipment (***), ********: magnetic resonance imaging diagnostic equipment, ********: scintigraphy equipment, ********: electrodiagnostic equipment for simultaneous monitoring of two or more physiological parameters, ********: other electrodiagnostic equipment for functional exploration or monitoring of physiological parameters, ********: ultraviolet or infrared medical devices.

Between **** and August **** importsof medical imaging equipment increased significantly increase, from***,*million to ***.* million. At the same time, exports exports also increased, from ***.* million in **** to ****,* million in ****. As a result, the trade balance remains negative throughout this period, increasing from -***.* million euros in **** to -***.* million euros in **** .

Exports and imports of medical imaging equipment France, ****-****, in millions of euros Source: ****

The following chart shows exports by type of imaging equipment. Scanners and MRIs export the most. However, we can see that scanners export less in **** than in ****. Only MRI and scintigraphy equipment saw a significant increase in exports between **** and ****, of **% and ***% respectively.

Exports of medical imaging equipment by type France, **** - ****, in millions of euros Source: ****

The following chart shows imports by type of imaging equipment. Scanners and MRIs are also the most ...

1.4 The French market

The French medical imaging equipment manufacturing business is listed under NAF nomenclature code **.**Z: "Manufacture of medical irradiation equipment, electromedical and electrotherapeutic equipment"

This code includes :

The manufacture of irradiation equipment and tubes (***), i.e. X-ray equipment and equipment using alpha, beta or gamma radiation, manufacture of computer tomographs, the manufacture of positron emission tomography (***) scanners, manufacture of magnetic resonance imaging (***), manufacture of medical ultrasound equipment, manufacture of electrocardiographs and electroencephalographs, manufacture of electromedical equipment for endoscopic techniques, manufacture of laser medical devices, manufacture of pacemakers, manufacture of hearing aids.

INSEE gives this market size for ****: it amounted to *.*** billion euros. This figure can be used to estimate the size of the medical imaging market in France in ****, by multiplying it by the annualized sales index for ****, also provided by INSEE, then dividing it by the sales index for ****.

This formula gives: *.*** billion euros * ***.**/*** = *.*** billion euros for ****. The same applies to other years:

Size of the French market for the manufacture of medical irradiation, electromedical and electrotherapeutic equipment France, **** - ****, in billions of euros Source: ****

Although this market size for the manufacture of medical irradiation, electromedical and electrotherapeutic equipmentlectrotherapeutic equipment encompasses more than just the medical imaging market, it does provide ...

2.1 Overview of the French hospital sector

In **** (***), there were *,*** healthcare establishments in France providing diagnosis, monitoring and treatment of patients, with a capacity of ***,*** full hospitalization beds and **,*** partial hospitalization places, compared with ***,*** and **,*** respectively in ****. These facilities differ in terms of legal status, size and mission. There are three types of legal status: public, private non-profit and private for-profit. The total number of establishments fell by *** entities between **** and ****. The public sector lost ** establishments between **** and ****, the private non-profit sector only ** and the private for-profit sector **.

We can therefore see a downward trend in the number of healthcare facilities, particularly public hospitals.

Breakdown of healthcare facilities by sector France, ****, in units Source: ****

**%

**%

**%

Source: ****

Abbreviations: CHR: center hospitalier régional; CHU: center hospitalier universitaire; CH: center hospitalier; CLCC: center de lutte contre le cancer; SSR: soins de suite et de réadaptation; SCD: soins de courte durée.

2.2 Imaging equipment in healthcare establishments

Imaging equipment is a major component of healthcare facilities. Technical advances and the cost of new, more efficient equipment have led to a concentration and sharing of facilities. By ****, there will be *.* scanners per ***,*** inhabitants. However, there are significant geographical disparities, with the ratio ranging from *.* in Mayotte to *.Z in the Hautes-Pyrénées. For MRI, the ratio is *.* units per ***,*** inhabitants (***). [***]

Public and private non-profit establishments

In ****, a total of *,*** conventional X-ray rooms were available in *** public and private not-for-profit healthcare establishments. In detail, *** public or private not-for-profit establishments declared at least one scanner, for a total of *** machines, *** of which were operated by the establishment itself. The other scanners are installed on the site of a healthcare establishment, but are owned and operated by private practices. As for MRIs, *** public or private not-for-profit establishments declare at least one device, for a total of *** MRIs, of which *** are operated by the establishment itself. The following graph shows the equipment for the different types of medical imaging devices.

Public and private non-profit establishments France, ****, in units Source: ****

Private for-profit establishments

Private for-profit clinics also have medical imaging equipment. However, their census is not exhaustive, and the figures presented by DREES ...

2.3 Focus on MRI demand

French consultancy and research firm Cemka, specializing in Public Health, Health Economics and Epidemiology, released a study in ****, an extract of which focuses on MRI and its waiting times. There have been no new reports since, but this data gives an idea of the evolutions and challenges of MRI.

Between **** and ****, the number of MRI scanners installed in France increased more than *-fold, from *** in **** to *** in ****, representing a ***% increase in ** years .

number of MRI units installed France, **** - ****, in number of MRI units installed Source: ****

The number of MRI scanners per million inhabitants has risen steadily since ****, from *.* scanners per * million inhabitants in **** to **.* MRI scanners per million inhabitants in ****.

number of MRI scanners per million inhabitants France, ****, in number of MRI scanners per million inhabitants Source: ****

There are, however, geographical disparities in the number of MRI facilities in the regions, as the following map and table show. Indeed, while the rate of MRI scanners per million inhabitants is **.* in Pays de la Loire and **.* in Occitanie, it is ** in Centre Val de Loire and **.* in Île-de-France .

average waiting time

**.* days

Moreover, there are major disparities between regions in terms of waiting time, linked to the number of MRI ...

2.4 Socio-demographic factors driving market growth

Older people are the most likely to benefit from healthcare devices, and therefore from medical imaging devices. It is therefore interesting to look at the current and future demographics of the French population.

An aging population: already a reality...

Proportion of the French population aged ** or over France, ****-****, in % Source: ****

...which will continue to be a growth driver for the future of the sector

Population projections to **** in millions of inhabitants, France, ****-****, % Source: CNSA (***) Source: CNSA (***) based on INSEE The aging of the French population is real, as this graph shows. While those aged ** and over willrepresent only *.*% of the population in ****, their weight in the French population will double to **.*% in ****. This aging is linked to longer life expectancy and the arrival of the baby-boom generation at retirement age: * factors favoring the number of potential consumers for medical imaging devices.

The following graph shows the number of patients managed by pathology, chronic treatment or care episode, by age group and gender. The majority of ailments presented may require the use of medical imaging devices in patient care. This is the case, for example, when treating cancer, degenerative diseases or inflammatory diseases.

Number of patients treated, by pathology ...

3.1 Value chain

Below is a simplified value chain for the medical imaging sector:

Source: ****

The medical imaging equipment manufacturing market in France is held by a handful of international players (***). For example, in ****, General Electric controlled **% of the medical imaging equipment supply market. [***]. Indeed, with very high R&D costs, as well as significant production costs, barriers to market entry are high and represent a brake on the arrival of new players. it's worth noting that France once had a French giant on the market: Compagnie Générale de Radiologie. This company was bought by General Electric in ****.

In addition to selling equipment, these medical imaging "giants" sign contracts for installation, maintenance and servicing. However, maintenance and servicing can also be carried out by other players who are not the manufacturers of the medical imaging equipment (***). This practice offers customers the advantage of having a single point of contact for all the maintenance of their medical imaging devices. This is the case, for example, withAlthea, which specializes in the management and maintenance of medical technologies.

While the development and production of devices is a highly concentrated sector, the market for additional services, in particular data processing and analysis software, is a more ...

3.2 French players

Although France has no medical imaging giants, a number of French players are making their mark on the market, at all levels of the value chain presented in the previous section. The following table presents some of these French companies:

The French ecosystem is essentially made up of SMEs.GE Healthcare, world leader in the medical imaging market, also has astrong presence in France. The company has * sites in France, including its worldwide R&D center for ultrasound in Sophia Antipolis, its worldwide R&D center for interventional imaging, mammography and software, and its European headquarters in Buc.

Guerbet, which specializes in contrast products for medical imaging, is one of the four main players in this niche sub-segment of medical imaging, along with Italy's Bracco, Germany's Bayer and the USA's General Electric. This sub-segment is valued at $*.* billion in **** and should reach $*.* billion in ****.[***]

3.3 The emergence of new distribution and operating models

There are many different models for distributing and operating medical imaging equipment. According to a study by Transverse and strategy consultancy Frost & Sullivan, two business models stand out[***]:

The MES model (***): this model is based on the sale of equipment, followed by a range of related services, such as management, procurement, financing, maintenance, renewal, installation, training, consulting, etc. [***].these include management, procurement, financing, maintenance, renewal, installation, training, consulting and other professional services, including the provision of human resources, medical equipment and associated consumables.

The MVS model (***) : service contracts are negotiated outside the equipment sales contract. This model is based on the provision of maintenance services for a fleet of medical imaging equipment made up of devices from different brands. This service can be provided by the manufacturer or by an external company. The advantage of this model for the customer is that a single service provider handles all the services for his or her fleet of devices. This is the case, for example, with Althea, which specializes in the management and maintenance of medical technologies.

Although these two models are not yet the norm in the medical imaging landscape, they are set to grow strongly in the years to come.velopment, ...

4.1 Diversity of medical imaging equipment

There are many different types of medical imaging technology, for a wide range of applications, the main ones of which are listed in the following table:

Source: ****

Below is a non-exhaustive list of the main types of medical imaging equipment:

Conventional and digital radiography Fluoroscopy CTscanner / Tomodensitometry / Scanography

MRI (***) Functional MRI

Positron emission tomography (***) or PET scan / PET-CT PET-MRI Ultrasound Doppler High-intensity focused ultrasound (***) Endoscopy Bioluminescence imaging Fluorescence imaging

Finally, medical imaging equipment is associated with PACS (***), depending on the customer's needs.

4.2 Pricing of medical imaging equipment and procedures

Equipment prices

Prices for medical imaging equipment can vary widely, depending on the brand, features and modifications modifications made to the equipment, as well as the customer'scustomer requirements. However, SNITEM provides a price range for top-of-the-range equipment:

In addition to the cost of the equipment, there are installation costs. According to the FNMR, installation costs range from €***,*** to €***,*** depending on the manufacturer (***), with maintenance costs of around €**,*** per year.

Prices for medical imaging procedures/examinations

The CNAM (***) sets the agreed tariffs for medical procedures. Patients are reimbursed according to these rates, up to a maximumof **% for imaging examinations, with the exception of third-trimester ultrasound, the only imaging procedure reimbursed at ***%. The remaining **% is paid by the patient and/or his/her complementary health insurance.

Doctors can decide whether or not to follow the agreed tariffs, in which case they charge extra fees which are payable by the patient. In addition, the CNAM has recently lowered the conventional rates for medical imaging. [***]

The following table lists the conventional rates for medical imaging:

Source: ****

For MRI and CT scans, the examination is broken down into two costs: the technical package and the associated medical fees. The technical fee is reimbursed by Social Security ...

4.3 Supply trends

The world of medical imaging is undergoing major changes as equipment technology improves and artificial intelligence develops.

Technological innovations by modality

Numerous technical advances are being made in each modality, notably in the finesse of equipment, which produces images that are increasingly precise, faster and less stressful for the patient.

All modalities are evolving:

MRI scanners are becoming increasingly powerful (***), and use less helium[***], Scanners now incorporate spectral imaging (for example, Philips' IQon Spectral CT[***], New ultrasound scanners are also ultraportable (***)[***], Remote imaging : faced with the lack of medical services in France, a number of projects are aimed at developing remote medical imaging.dical imaging (***)[***]. This telemedicine allows doctors to analyze images collected on their screens, from a distance. AdEchoTech offers a remote ultrasound scanner.

Multimodal imaging

Increasingly, the equipment used in medical imaging is complementary: data collected during an examination can be used to illuminate other imaging results. This trend is driving imaging towards greater multimodality.

Images may be superimposed on one another (***), all in the course of a single examination.

This can be achieved either by wedging two images together - which can present problems of different positioning between examinations - or by taking the same image, which implies ...

5.1 Regulations for manufacturers and healthcare professionals

International Data Management Standard (***)

DICOM is an international standard governing the communication and management of medical imaging and related information. It governs the format of images, enabling them to be exchanged without loss of data. This standard applies to almost all medical imaging equipment, and was created in ****. [***]

European regulations

on a European scale, new rules were passed in **** and have been applied since **** for medical imaging equipment.[***]

These new regulations:

Reinforces controls on high-risk devices via the establishment of an expert committee verifying the risks of a device before it is placed on the market. Improves transparency in the sector by setting up a European database to enable equipment traceability. Reinforces the monitoring that manufacturers must carry out on their own machines after they have been placed on the market. Reinforces rules on clinical evidence, enabling clinical testing throughout Europe.

Regulations for healthcare facilities and professionals

Prior to installation, healthcare establishments must :

Receive prior authorization from the ARS (***) for interventional radiology activities. Declare their radiology equipmentto the ASN (***), and obtain authorization from the ARS for MRI, PET-MRI or PET-CT.

Regular quality controls are carried out by the ASN or ARS to ensure compliance with operating regulations.

Patents

Manufacturers of equipment ...

5.2 Future regulations

In the near future, particularly with the growing presence of AI in this sector (***), medical imaging could also be governed by :

ePrivacy Regulation, a European Union project aimed at strengthening citizens' online privacy by "governing all electronic communications on publicly available services and networks originating from individuals within the European Union"[***]. This regulation was supposed to come into force in May **** at the same time as the GDPR (***), but has generated so much debate that in **** it still has no effective date.

"Intelligence Artificial Act" : draft regulations aimed at framing artificial intelligence, announced by the European Commission in April ****. This project breaks down artificial intelligence into * uses , which are: unacceptable risk, high risk, acceptable risk, use that does not pose a problem. [***]

6. Segmentation

• Siemens Healthineers
• Supersonic Imagine
• Eos Imaging
• Mauna Kea
• NGI Group
• CHU de Toulouse
• CHU de Bordeaux
• Clinique d’Arcachon
• Polyclinique Montréal Elsan
• Incepto Medical
• AZmed
• Guerbet
• Diagnostic Medical System DMS Groupe
• Philips
• Gleamer
• Deeplink Medical
• VIMS Video Interventionnelle Medicale