COVID-19 Pandemic and the ventilator market

Ventilators are support devices for people who are not able to breathe on their own due to various conditions or disorders associated with respiratory system (mainly asthma and pneumonia), patients who have met with accidents, problems of central nervous system that depress the drive to breathe such as stroke, neuromuscular problems where failure of the peripheral nerve and muscles that aid respiration, musculoskeletal and pleural dysfunction, and recently COVID-19. Ventilators are mainly used in operation theaters during surgery, patients who are admitted to ICU, emergency departments of hospitals, aircrafts, military and homecare centers.
 
The emergence of coronavirus disease 2019 (COVID-19) and subsequent declaration as a global pandemic by World Health Organization (WHO) led to skyrocketing demand for ventilators. According to WHO, Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illnesses. Approximately 6.0% of people who are infected with the coronavirus may need ventilators to help them breathe. Before the COVID-19 pandemic there was demand for about 70,000 to 80,000 ventilator units annually, however, due to the pandemic, demand has increased to 800,000 to 900,000 ventilator units in 2020.
 
The regular manufacturers of ventilators were overwhelmed by the huge demand for ventilators as governments started to place orders for large number of units to treat COVID-19 infected patients. To ease the pressure on manufacturers and considering the extraordinary situation of pandemic, regulatory bodies introduced new guidelines for ventilator manufacturers, for instance, In March 2020, FDA issued an umbrella EUA that allowed the emergency use of certain ventilators, anesthesia gas machines modified for use as ventilators, positive pressure breathing devices modified for use as ventilators, ventilator tubing connectors, and ventilator accessories that the FDA determines meet specified criteria for safety, performance, and labeling. Approximately 79 ventilators and 11 ventilator’s accessories received EUA authorization in 2020.
 
Similarly, India’s Central Drug Standard Control Organization (CDSCO), published several notices since mid-March 2020 where new measures to expedite access to devices intended to prevent shortage of devices to treat COVID-19 patients. As there was no Indian standard for ventilators, first time in India, the technical expert committee at the Union Health Ministry created prescribed minimum essential specifications for “Make in India Ventilators” to be used in COVID-19 ICU. The Chinese government announced on April 2020, China’s customs administration would conduct inspections of medical equipment, including ventilators exported from China. Starting from April 2020, exports of medical products including ventilators were required to provide extra documentation to get customs clearance. Exporters were needed to declare in the document, in either print or digital form, that the products were officially registered in China and met the quality-control standards of respective export destinations.
 
The non-ventilators manufacturers also stepped in to provide ventilator to the healthcare professionals. For instance, Dyson, a famous vacuum cleaner company designed a new ventilator in just ten days and received an order for 10,000 ventilators from the U.K. government. General Motors partnered with Ventec Life Systems to build ventilators. Some of the ventilator manufacturers including GE Healthcare, Medtronic, ResMed and other privately held companies ramped-up ventilator production in anticipation of demand, Zoll Medical increased its manufacturing capacity to 10,000 ventilators per month. In March 2020, Ford Motor Company joined with firms including 3M and GE Healthcare, lend its manufacturing and engineering expertise to quickly expand production of urgently needed medical equipment and supplies for healthcare workers, first responders and patients fighting coronavirus.
 
To overcome the shortage of ventilators, companies and research institutes developed low-cost ventilators, for instance, a team called Massachusetts Institute of Technology (MIT) E-Vent (for emergency ventilator) designed and developed a device that would cost $400 to $500 whereas regulator ventilator would cost $30,000. In June 2020, HP Inc partnered with Redington 3D in India to produce 0.12 million ventilator parts for AgVa Healthcare. As part of the initiative, 12 categories of parts were 3D printed to manufacture 10,000 ventilators.
 
Globally, all countries have been affected by the COVID-19 pandemic, some of the countries such as the United States, Canada, India, South Korea, Australia and others are witnessing the second and third wave of coronavirus, European countries already faced the second wave of coronavirus, WHO has warned Europe of the third wave of disease in early 2021. According to WHO, Europe accounts for 28.0% of global COVID-19 cases and 26.0% of deaths, Italy, the U.K. and France are the countries in Europe that are most affected with COVID-19.
 
According to IQ4I analysis, in 2020, the ASP of all ventilator types saw a sharp increase due to a sudden surge in demand, but still, a large number of units were purchased to meet the healthcare emergency. In coming years due to the glut in the market, the ASP is projected to decrease till 2025 and the demand is expected to moderate to 2019 level by 2027. The number of ventilator units sold in 2020 is estimated based on the number of hospital and ICU beds. The global number of hospitals is estimated to be 123,794 and 17,177,029 hospital beds, among these 555,158 beds are for intensive care units. Based on this estimation, ventilator units have been calculated globally, the total number of ventilator sold in 2020 is 482,996, among these, 116,474 units are ICU ventilator, 361,001 units are Emergency and transport ventilator and 5,521 units are other ventilators.
 
Major players in Ventilators global market are Koninklijke Philips N.V. (Netherlands), GE Healthcare (U.S.), Medtronic Plc (Ireland), ResMed Inc. (U.S.), Ventec Life Systems (U.S.), Vyaire Medical Inc. (U.S.), Hamilton Medical Corporation (Switzerland), Asahi Kasei Group Company (Zoll Medical Corporation) (Japan), Getinge AB (Sweden), Air Liquide Medical System SA (France), and Shenzhen Mindray Bio-Medical Electrics Co., Ltd. (China).

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