The spa market - France (2024)

1.2 A fast-growing global market

The spa and mineral cures market represents sales of $**.* billion in ****, up *% on **** but still below its pre-covid level (***).

Worldwide spa and thalassotherapy market size World, ****-*****, in billions of dollars Source: GWI * projections

Europe, followed by Asia , dominate this market - Asia will overtake Europe by ****. These two continents account for **% of revenues and **% of establishments in the sector.

Spa and thalassotherapy sales World, ****, US$ billion Source: ****

China, Japan and Germany are the main countries accounting for a large share of market sales. France will onlyrank **th in ****. However, France was ranked **th before the health crisis.

Main countries generating spa and thalassotherapy market sales World, ****, US$ million Source: ****

Most spa and thalassotherapy establishments also have a spa, which is more focused on customer well-being. Establishments offering both services account for around two-thirds of revenues generated by the sector.

In Europe, depending on the legislation in force in each country, spa treatments may be partially or fully reimbursed. This is the case in France, Italy, Germany and Iceland. [***]

1.3 Domestic market

The following graph shows the evolution of spa consumption.

In ****, the spa treatment market was worth *** million euros, up **% on ****, but still below its pre-crisis level (***).

Consumption of spa treatments France, **** - ****, in millions of euros Source: ****

However, taking into account direct (***) expenditure, sales in the spa sector can be estimated at *.** billion euros in ****[***]

According to the Fédération Thermale, indirect spending by spa visitors will amount to *** million euros in ****, and spending induced by direct and indirect spending to *.* billion euros. On-site spending by spa visitors includes treatments included in the spa cure, accommodation (***), food and complementary care, which is more a matter of well-being than prescribed medical care.

As of January ****, there are *** spa establishments and ** health resorts in France. [***].

2.1 Number of curists

The graph above shows that the number of curists has increased since ****, rising from around ***,*** to almost ***,*** in ****. A peak seems to have been reached in ****, however, with over ***,*** curists. Nevertheless, the number of curists fell considerably in **** due to the health crisis (***).

trends in the number of spa visitors France, **** - ****, thousands Source: ****

Moreover, in ****, over ** million days of treatment were dispensed in French spa resorts, for the ***,*** curists.

In addition, daily spending by spa visitors (***) is estimated at €**/day for spa visitors and €**/day for accompanying persons. [***]

2.2 Spa visitors by therapeutic orientation

Thermal baths have a therapeutic purpose, aiming to treat dysfunctions using certain properties of thermal water. [***]

Thermal establishments do not generally offer all cures, which partly explains their diversity across the region (***). The graph below shows the proportion of spa visitors by therapeutic orientation.

number of spa visitors by therapeutic orientation France, **** - ****, thousands Source: ****

rheumatological

trend in the number of spa visitors for rheumatology treatments France, **** - ****, thousands Source: ****

2.3 Guest profile

the vast majority of spa guests (***) are women:

Curists by gender France, ****, in Source: ****

The over-**s account for **.*% of the clientele. Demand is particularly strong among those aged ** and over.

Distribution of spa visitors by age group France, ****, in Source: ****

With the majority of customers aged over **, the most common professional status of curists is retirement. Working people account for **% of curists.

Professional status of spa visitors France, ****, in Source: ****

medium-sized resorts appear to be more attractive to active spa visitors. They attract proportionally more visitors under ** than other categories of resorts (***)

2.4 Guest behavior

According to a Nomadeis survey dating from ****, the format most followed by curists is that of an annual cure (***).

Answer to the question: How often do you carry out your cures? France, ****, in Source: ****

What's more, nearly * curists out of * (***) come accompanied during their stay, including nearly **% with their spouse.

Answer to the question: FOR THIS STAY, ARE YOU ACCOMPANIED? France, ****, in Source : Nomadeis It's often the doctor's prescription that defines the spa where the curiste will undergo treatment. However, word-of-mouth, loyalty and tourist interest in a spa are also key selection criteria for curists.

Criteria for choosing a spa France, ****, in Source: ****

When it comes to accommodation, almost half of spa visitors opt for a gîte or furnished apartment. Next come tourist residences (***).

Main type of accommodation France, ****, in Source: ****

In the majority of cases, curists stay in the resort (***)

To occupy their free time, spa visitors mainly enjoy hiking, cultural activities and relaxation:

Leisure time activities France, ****, in Source: ****

2.5 Demographic factors

Demand in the spa market is driven by senior citizens (***), and is therefore closely linked to the country's demographics.

In ****, France will have a population of **.* million. People over ** account for **.*% of the French population, or around **.* million people.

Breakdown of French population by age category France, ****, in Source: ****

The aging of the population is a growth driver for the sector. Indeed, between **** and ****, the proportion of the population aged over ** rose by * points to **.*%. According to INSEE forecasts, the proportion of the population aged ** and over is set to continue rising over the coming decades, as shown in the graph below.

Percentage of French population aged ** and over France, **** - *****, as % of total population Source: ****

For spa operators, this represents a broader target clientele, which should increase spa visits. On the other hand, this aging of the population could be followed by health insurance reforms, which could result in partial or total delisting of spa stays.

2.6 French people's overall image of spa medicine

In ****, Toluna - Harris Interactive carried out a survey on behalf of the Conseil National des Etablissements Thermaux, involving a sample of *,*** French people aged ** and over, to assess French people's opinion of spa medicine.

The French identify the sector well, especially for the oldest and wealthiest among them

Three quarters of French people surveyed said they had already heard of spa treatments, and **% had a precise idea. **% of respondents who had already heard of spa treatments were aged ** or over, and **% were from the highest socio-professional groups.

Answer to the question: Would you say that you are a curist ... ? France, ****, in % Source: ****

Overall, spa treatments are considered effective for most pathologies.

After an explanation of what spa treatment is, over **% of respondents consider that it can treat problems related to bones, muscles and joints, respiratory tract disorders and psychosomatic ailments. However, only ~**% consider that it can treat post-covid disorders, gynaecological diseases and child development disorders.

Answer to the question: Have you taken several spa treatments in the same resort? France, ****, in Source: ****

An experience judged highly satisfactory by those who have tried it out

Over **% of people who have visited a spa say they are satisfied: we note that the ...

3.1 A market dominated by a hundred or so players

According to the CNETh (***), there are ** active spa resorts and *** spa establishments in France as of January ****.

The table below lists the main players in the sector (***). The national market leader is the Chaîne Thermale du Soleil, with a total of ** establishments across the country

Source: ****

In addition, new players have entered the spa market through the acquisition of several thermal baths. These players are relatively diverse, with L'Oréal, for example, buying the Saint-Gervais spa, and La Caisse des Dépôts investing alongside BO Resort to revive the Châtel Guyon spa. [***]

In addition to these external investments, it's the spa's own investments that are driving change. *** million euros of investment have been made between **** and ****.[***]

These funds have made it possible to:

Develop infrastructures (***) Diversify the offer with additional services Invest in research and development

3.2 Resorts depend on mineral water sources

Regulations require spa resorts to exploit natural mineral water from uncontaminated springs.

Boreholes must be drilled to reach this water, which is then used by spa facilities (***) and thermoludism and wellness facilities.

There are *** natural mineral springs in France. This represents **% of Europe's thermal capital, making France Europe's #* hydromineral heritage country.

Other services offered by spa resorts include accommodation and food.

3.3 Mainly rheumatology referrals

Geographically, most spa resorts are located in south-west and south-east France, corresponding to the areas where the mineral springs are found.

Distribution of spa resorts (***)

Source: ****

Next, establishments can be segmented according to their therapeutic orientation. However, the same establishment can adopt several orientations, for example, it may decide to treat rheumatological and respiratory disorders (***).

Spas treating rheumatological disorders and respiratory tra ct disorders are the most numerous, with ** and ** establishments respectively.

Number of establishments by orientation France, **** Source: ****

3.4 Employment in the sector

According toCNETh, the spa sector generates ***,*** direct, indirect and induced jobs.

Among these ***,*** jobs, the breakdown is as follows:

*,*** direct jobs (***) **,*** indirectand dependent jobs(***) **,*** induced jobs (***)

In addition,there are *** spa doctors practicing in spa resorts

According to the CNETh, **% of spa establishments are located in towns with fewer than **,*** inhabitants, with **% in towns with fewer than *,*** inhabitants.

3.5 The importance of social security reimbursements for the sector

**% of spa revenues come from reimbursed cures. Reimbursement of spa treatments is therefore vital to this sector. Below is a breakdown of reimbursements by the French health insurance system. it should be noted that some mutual health insurance companies may reimburse all or part of the remaining costs. The Assurance Maladie will only pay for cures underwritten by the attending physician (***) for one of the following conditions or pathologies:[***]

Diseases of the bucco-lingual mucosa Digestive disorders Psychosomatic disorders Urinary disorders Dermatology Gynecology Cardio-arterial disease Neurology Phlebology Rheumatology Developmental disorders in children Respiratory disorders

To be reimbursed, the cure must include ** days of effective treatment (***). Medical expenses are covered as described below:

Medical surveillance package (***) Complementary medical practices, if required, reimbursed at **% of the standard rate Spa package (***), reimbursed at **% of the standard rate

Accommodation and transport costs may also be reimbursed, depending on the curist's resources and family situation, as detailed in the following table:

In this case, transport costs are reimbursed at **%. Subsistence costs are reimbursed at **% on the basis of a fixed rate of €***.**, i.e. €**.**.

4.1 A wide range of derivative services

Thermal spas are legally obliged to treat patients for ** days (***) if they wish to be reimbursed. Thermal spas have therefore developed a range of facilities designed to treat a variety of pathologies and ailments.

To diversify their clientele and boost revenues, spas have also developed spa and thermoludism services. These services are not covered by the French health insurance system, but are greatly appreciated by spa visitors.

The spa facilities are not totally separate from the spa and thermoludism activities. As a result, customers can take advantage of the spa's baths and pools without any therapeutic purpose in mind.

However, spas are also defined as a set of services offered to spa-goers to accompany their stay. Accommodation, catering and entertainment are sometimes complementary expenses, partly captured by the spas themselves (***)

In Gréoux-les-Bains, for example, the Chaîne Thermale du Soleil offers guests accommodation in one of its residences, ranging from *-star to *-star. [***]

4.2 Spa prices

The table below shows the prices of the most popular spa treatments (***).

The price of spa treatments can be broken down into the TFR (***), which is the amount remaining to be paid in full by the patient and/or his/her mutual insurance company.

Source: ****

**% of the cost of accommodation is reimbursed on the basis of the standard rate of €***.**. Below is a breakdown of accommodation prices by hotel quality at Chaîne Thermale du Soleil, for your information.

Source: ****

*Prices "from

4.3 Upmarket and local

The investments made by players inside and outside the sector are aimed at improving spa facilities. One of the primary objectives is to enable establishments to move upmarket. [***] During this decade, the sector has invested heavily: between **** and ****, €*** million was invested in modernizing, enlarging, creating or reopening centers such as Saint-Jean-d'Angély and Nancy. Between **** and ****, these investments were expected to reach €*** million, but this figure could be revised downwards due to the health crisis.

Resorts are proving to be a particularly popular model with investors, combining care, accommodation, catering and various activities.

BO Resort residences, for example, offer a range of activities that are both independent of the thermal baths (***). The aim is to capture a larger share of the sector's revenues. [***]

Proximity is also becoming a highly prized aspect for curists, who prefer human-sized spas, like Vernet-les-Bains, which has seen attendance rise by more than **% since ****.[***]

The activities developed by spa resorts are turned towards local territories (***) which offer curists a more relaxing environment.

In July ****, a **-year loan of ** million euros was granted to France Thermes Group, the group that acquired Compagnie de Vichy in ****. This loan will be used to finance the €** million works plan for the ...

5.1 Spa regulations

It may be important to note certain regulatory aspects that have marked a breakthrough in the sector. Cures at thalassotherapy centers have no longer been reimbursed by Social Security since ****. Thermal cures, on the other hand, are reimbursed under certain conditions:

The spa cure must be prescribed by a health professional and concern an ailment or pathology that appears on the list of ** therapeutic orientations covered by the Assurance Maladie. The spa must be accredited and approved by the Assurance Maladie, the duration of treatment is fixed at ** days, and the cure can only be reimbursed once a year.

This represents a real disadvantage for thalassotherapy centers, which have had to adapt in terms of price and target clientele.

The centers have adapted, however, and have askedAFNOR (***) to introduce standards prohibiting thalassotherapy centers that do not use seawater.

5.2 The quality of the water used is paramount

The process of opening an establishment is a slow and tedious one, involving numerous administrative stages. In particular, approval must be obtained from the Prefecture and the Regional Health Agency. When an establishment wants to set up near a mineral water source or extend its therapeutic orientations, it must forward its request to the French National Academy of Medicine. [***]

The water used for therapeutic purposes in a spa must be natural mineral water, which is subject to national regulations. To preserve its original purity, groundwater must be protected from any risk of contamination.

It is precisely its purity and the stability of its physico-chemical elements (***) that define its quality as mineral water suitable for therapeutic use.

In ****, a decree added further controls to be carried out on mineral water sources (***).[***]

Regular checks on the quality of thermal waters are carried out by the Regional Health Agency, which are responsible for complying with the limits imposed by law, the terms of which are set out in the decree of October **, ****.[***]

5.3 Coverage of spa treatment costs

Assurance Maladie covers all or part of the costs of a spa treatment (***). [***] To qualify, * conditions must be met:

The cure must be prescribed by the patient's attending physician The cure must correspond to an ailment or pathology covered by the regulations (***) The spa must be accredited or approved by the Assurance Maladie The cure must last exactly ** days (***) and cannot be repeated for the same ailment during the same calendar year

After certain administrative formalities, it is possible to receive reimbursement of medical, transport and accommodation expenses, as well as a daily allowance.

The medical surveillance package is reimbursed at **%, while the conventional spa package is *** euros, and is reimbursed at **% If your income is less than **,*** euros in the year preceding the cure, you will be entitled to **% reimbursement of transport and accommodation costs, based on a flat-rate amount (***).

6.1 Segmentation

• Chaîne Thermale du Soleil
• Valvital – Cie Européenne des Bains
• EuroThermes
• Arenadour
• Thermes de Balaruc les Bains
• Station Thermale de Bagnols les Bains
• Station Thermale de Brides-les-Bains
• France Thermes
• Thermes de Vals-les-Bains
• Barrière Groupe
• Compagnie Lebon
• Caisse des Dépots
• Les Thermes de Vittel
• Caliceo (Duval groupe)
• Thermes des Fumades