BIBA Research’s fourth quarter 2008 report confirms recovery of drug-eluting stent use

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The number of percutaneous coronary transluminal angioplasty (PTCA) procedures performed in Western Europe in the time frame 1 October to 31 December 2008 was measured at 195,611 – a 1.4% decrease since the third quarter and 2.8% lower than the fourth quarter one year earlier.

This is one of the main findings of the latest report on percutaneous coronary intervention trends in Western Europe from BIBA Research. The report collected and elaborated data from a sample of approximately 250 hospitals across Western Europe.


According to the report, procedures with a stent accounted for 88.8% of the total number of PCTAs. The stent market size has increased by .7% since the previous quarter, pushing the stent-per-procedure ratio in Western Europe up to the 1:1.29 level in Q4. The stent-per-procedure ratio had been measured at 1:1.26 in the same time frame one year earlier. The overall stent market size has decreased by .6% compared to the same period one year earlier.


The report states Germany remained the Western European market with the highest procedure-per-capita ratio, followed by Italy, Sweden, Switzerland and France. At the opposite end, Spain and the UK recorded two of the lowest rates.


Drug-eluting stent penetration rate
The drug-eluting stent penetration rate was measured at 51.6% in Western Europe: this represents the fifth consecutive increase since the third quarter 2007. Cardiologists have regained confidence in drug-eluting stent-based therapies since the late-thrombosis episodes two years ago. A drop in average price, product development and new clinical trial outcomes have been the three major drivers of the drug-eluting stent penetration recovery across Western Europe in the past 14 months, the report says.


Germany and France recorded the highest over-the-quarter drug-eluting stent penetration rate increase (+1.1%), followed by The Netherlands (+1%) and the UK (+0.9%). All the other European countries remained stable or grew at a conservative rate.


The drug-eluting stent market size was measured at approximately 130,400 units in Q4 2008, meaning a >US$202 million turnover. The annual turnover figure for the drug-eluting stent market was measured at 516,000 units or US$803 million.


Germany, Italy and France were the three largest European markets for the number of procedures, stent usage and turnover.


Devices pricing
The report highlights that drug-eluting and bare metal stent prices were stable over the Q4 2008 – although the exchange rate US Dollar/Euro and US Dollar/Pound Sterling had a considerable impact on stent pricing. Spain and the UK were the two countries with the highest and the lowest average bare metal stent price, respectively, with a brand price measured within the €1,200 range. UK and Germany were the two countries with the lowest prices in the drug-eluting stent segment, whereas Spain, France and Italy have recorded some of the highest device prices. The maximum price variation within brands across Western Europe in the fourth quarter was measured at approximately €1,800.


The overall market size for coronary balloons was measured at the 254,000-unit level in Q4, meaning just a 0.9% drop over the previous quarter. Guiding catheters usage was at approximately 343,000 units in the fourth quarter 2008. Guide wires usage was stable over the previous quarter at approximately 366,000 units.


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