June 2015

Radiotherapy The Future is Here

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With the growing cancer burden on the healthcare sector, the invention of new technologies for diagnostic and treatment will give more opportunities to the radiation oncology equipment market. Romiya Das of Elets News Networks (ENN) digs out the trends driving the radiation oncology equipment market

Growing at 15.5 per cent per annum, the Indian medical equipment market is positioned third in Asia and ranks among top 20 in the world. Over the next five years, it would be one of the world’s fastest growing markets. The rapid growth of the industry will reflect high inflation driven by increasing public and private expenditures on health.  Radiotherapy

Market Dynamics

The maximum growth of the radiation oncology equipment will be driven by the demand in developing countries, particularly in India and China. The new tech- nologies have changed the way treatments are planned and doses are delivered. In 2014, the global radiotherapy market was estimated at US$ 5.8 billion and it is expect- ed to reach US$ 8 million by 2019, growing at a CAGR of 6.7 per cent (The BCC Research Report 2015).

The radiation oncology equipment market is expect- ed to grow in the coming years owing to the increased prevalence of cancer and healthcare expenditure level of the patients. There are more than one million cancer cases diagnosed annually in the country and the numbers are expected to stretch five million over the next decade.However, stringency in the regulatory prices related to medical devices is expected to impede the growth of oncology medical equipment market.

The equipment market may be segregated into two broad segments on diagnosis and therapeutics. The therapeutics segments include chemotherapy, hormone therapy, and biotherapy and radiation therapy. The oncol-ogy diagnosis can be sub-segmented to biopsy imaging, endoscopy and blood test. Radiation therapy identifies one of the major markets. Also, chemotherapy sees a notable growth owing to a greater useable rate.

Cancer will continue to be a major challenge for public health, economics, and society in the years to come. In India presently, one in every six cancers is due to infec-tions like Human Papilloma Virus (HPV), hepatitis B, etc. According to WHO report 2015 (World Cancer Day 2015: ‘Not Beyond Us’), the overall mortality from cancer (both male and female) is expected to mount to nearly 8,45,000 in 2020 and approximately touching one million by 2025. This increased number of cancer will overburden the existing healthcare system in India, which is already struggling to cater the present needs.

According to The Report Global Radiation Therapy Market Report: 2015 Edition, the United States is one of the largest markets of radiotherapy equipment globally. The increasing incidences of cancers, replacements of older radiotherapy systems and reimbursement levels of radiotherapy are the main drivers for US market growth. The demand for radiotherapy equipment in Asia-Pacific region has also shown a significant growth, mainly driven by China.

Radiotherapy is taken as a standard procedure for on- cology treatment with the increase in cancer cases. With a prominent rise in their GDP, emerging nations act as the future growth opportunities for the global radiation oncology equipment market.

Government funding through constant reimbursement, continuous research and development applied to various applications and considering radiationtherapy as an effi- cient treatment are some of the major drivers anticipated to boost the radiation oncology equipment market in near future. Factors such as high cost of the equipment, space restrictions and lack of skilled professionals can create obstacles in the growth of the market.

Technology Trends

With the advancement of technology, the number of hospitals, diagnostic centres, clinics and research centres is making a prompt rise in the country. These healthcare facilities with technological advancements are also increasing the precision and accuracy of radiotherapy allowing treatments that minimise the impact on healthy tissue and reduce treatment-related morbidity. Also, the use of portable cancer equipment that can be utilised in mobile medical units in the rural area in India is high on demand. Looking onto the evolution and improvements in the delivery technologies the recent radiotherapy inno- vations have led to the rise in the accuracy in treatments allowing improved outcomes and reduced treatment-re- lated side effects. At present, desirable developments are seen in the areas of intensity modulated radiotherapy (IMRT), stereotactic body radiation therapy (SBRT), 4D imaging, particle therapy and nanotechnology. The imag- ing technology is enhancing the radiotherapy treatments. Radiation oncology is pepersonalized according to the patient’s particular clinical circumstances and anatomy. It is expected that with the unveiling of tumour marker system, molecular and biological imaging techniques will enhance the already personalised radiotherapy treatments.

On the basis of applications, the radiation oncology equipment market may be categorised into linear accelerators and Stereotactic Radiosurgery Systems (SRS). Earlier both the conventional radiation therapy and SRS were entirely different technologies for separate treat- ment systems. Over the past few years, the vendors have expanded system capabilities with the help of stereotac- tic add-ons and most of the conventional linear accelerators can provide at least some form of stereotactic treat- ment. These add-ons to the liner accelerators bundles mark the distinct shift towards the more multi-functional radiation treatment systems. Therefore, with the limited budget the majority treatment facilities are looking for- ward to hybrid systems that are capable of both conven- tional and stereotactic treatment measures ensuring full utilisation. Also, intensity modulated and image guidance tools have allowed the technology to move into the cutting edge as a more outcome driven solution for radiation oncology treatments.

It is seen that the service delivery and models of care are changing with a shift in focus from the delivery of isolated treatments to a multidisciplinary, coordinated approach to cancer care. The multidisciplinary patient management includes radiation, surgical and medical oncology as well as allied health services.

Major Players

Indian radiation oncology equipment market is majorly dominated by MNCs. GE Healthcare, Siemens Health- care, Philips Healthcare, Elekta Medical Systems India, Accuracy India, and Varian Medical Systems are among the major players in the radiation oncology equipment market. These companies have introduced, and are still continuing to offer, modified cancer diagnostic and monitoring equipment designed for the Indian market. Medical equipment that is easy-to-use, portable, dura- ble, cost effective is what the Indian market demands. Global manufacturers of diagnostic tests for cancer have achieved success in the Indian market. A high demand of mobile cancer screening laboratory units and portable equipment is also noticeable.

The advanced treatment options for cancer are also seen making their own space in the Indian radiation oncology equipment market. Many corporate hospitals such as Apollo, Fortis, Manipal, Healthcare Global and Max Healthcare are the important players in this par- ticular market. Apollo had announced a partnership with Belgium’s lon Beam Applications to build India’s first proton therapy centre, which is expected to be operation- al by the year 2016. Some home healthcare companies have also started offering home chemotherapy services. This assistance is giving rise to the more affordable and access to cancer care without travelling long distances to the specialised hospitals.


With the new cancer cases is doubling with every 50 years with the rising and ageing population of the world the requirement of more cancer treatment systems for medical diagnostics rises, particularly in the growing markets such as Brazil, Russia, India, China and South Africa (BRICS). Increasing demand for advance forms of radiotherapy, neurosurgery, brachytherapy and proton therapy is providing the requisite impetus to the growth of radiation oncology market. All the healthcare provid-ers and medical equipment manufacturers have a market to provide systems for the most advanced forms of radio- therapy, radiosurgery, brachytherapy and proton therapy.

Hence, with more growing cancer burden on the healthcare industry, increasing the market share of the diagnostic and treatment opens gates of opportunities for the MNCs to manufacture such products. Equipment that are simpler, portable, easy-to-use and cost-effective versions of diagnostic and cancer treatment products see success in the Indian radiation oncology equipment industry.

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