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Global HA Viscosupplementation Market Will Continue to Grow Through 2017

Hyaluronic acid (HA) viscosupplementation represents the largest segment of the total European orthopedic biomaterials market. After a decrease in 2011, this segment will see continuous market growth through 2017. HA viscosupplementation therapy was introduced first in the early 1980s as a treatment for osteoarthritic pain and since has been increasingly recognized as an effective alternative to traditional painkillers and a useful technique in delaying total knee arthroplasty. The immediate short-term benefit mainly appears to be pain relief, more so than actual healing, however the procedure does allow for long-term improvements in mobility.


The HA viscosupplementation products existing in the European market today are single-injection, three-cycle injection and five-cycle injection. In each case, the number of injection cycles corresponds to the number of HA viscosupplementation injections the patient requires to complete a full treatment. Driving this market is an increasing elderly European population. Price-sensitivity continued to vary across regions due to reimbursement and incentive differences between countries and brands. In 2010, Fidia Farmaceutici S.p.A. and Genzyme Corp. maintained a significant share of the viscosupplementation market.


Aging Population Drives Growth


While Europe has seen steady growth in recent years, new changes to reimbursement for HA viscosupplementation products may create challenges to overall market growth during 2011. France, in particular, passed a new law in 2010, limiting reimbursement of single- and three-injection cycle products to 100 euros (approximately $140). Additionally, the public price of three-injection cycle products was restricted to a maximum of 100 euros, reducing the average selling price by nearly 50 percent in just one year. France’s changes to reimbursement also have affected other European countries, as many are required to be within a particular price range of their neighbors. Despite the expected decline in price, after 2011 a quick recovery for the HA viscosupplementation market is expected.


The total number of injections has seen a stable increase in recent years, growing at the rate of the aging population. The incidence of knee osteoarthritis increases with age and with the amount of physical activity. As a result, the total number of HA viscosupplementation injections in Europe is expected to continue rising at a compound annual growth rate of more than 9 percent through 2017.

HA Market Price Sensitivity


Single-injection products are the newest products in the HA viscosupplementation market and have generated a buzz within the orthopedic biomaterials industry. Despite their anticipated introduction, single-injection products were less popular in regions where there is relative parity in the average selling price per injection.


Three-cycle products remained more popular than single-injection, with results from iData Research’s global physician survey indicating that orthopedic surgeons prefer three-cycle HA viscosupplementation treatment in Europe, the United States and Latin America. Clinical efficacy and safety were rated as the most important factors in choosing a hyaluronic acid brand worldwide, while pricing and reimbursement were more important in Asia and Latin America than in the United States or Europe. Within Europe, three-injection cycle products were most favored in France, Benelux, Greece and the Scandinavian countries.


Meanwhile, five-cycle products were most popular in Germany, Austria, Switzerland and Italy. The common feature in these countries was a desire from doctors to increase the number of patient visits; as a result, higher injection cycle products were particularly attractive to them. Five-cycle products were less common in Portugal, Spain, Greece and the Scandinavian countries and were not even part of the market in some other countries.


European Market Leaders


Several small European companies are selling HA viscosupplementation products at exceptionally low prices and, in some cases, even are providing them complimentary with the purchase of other products. This is making market penetration difficult and increases competition for current providers. Companies offering higher-end products are attempting to remain competitive through price matching to lower-end products, despite higher manufacturing costs. The countries most affected by this reduced pricing are Germany, Austria, France and the Benelux region, due to the high number of competitors.


Despite increased pricing pressures, a number of companies have managed to maintain substantial market share. Fidia’sthree- and five-injection cycle products Hyalubrix and Hyalgan held a large share of the HA viscosupplementation market in 2010. Fidia remained the leading competitor in its home country of Italy, and also was a leader in Germany. Relatively new brands in the five-cycle market also included Jointex by Documedica S.A. (a Swiss firm), which increased its market presence in 2010, particularly in Italy and Switzerland. Cambridge, Mass.-based Genzyme was another strong competitor in the HA viscosupplementation market in 2010. The company’s single-injection SynviscOne product led the market in the United Kingdom and also had a substantial share in Spain and Portugal. Genzyme’s new single/double-injection product Jonexa has been on the market since 2009 and also is emerging as a popular brand in some countries.

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The information in this article was taken from a 2011 global physician survey on HA viscosupplementation published by iData Research and three additional reports.

Kamran Zamanian, Ph.D., president and CEO of iData Research Inc., has spent more than 20 years working in the market research industry. Zamanian is a founding partner of iData Research. He received his Bachelor of Science in engineering from the University of Dundee, and received his Master of Science and doctoral degrees from the University of Manchester in market research and technology. Lucie Semenec has experience as a lead analyst conducting market intelligence investigations for the orthopedic biomaterials, arthroscopy and soft tissue repair markets. She received her Bachelor of Science degree from the University of British Columbia, as well as a Master of Science from Simon Fraser University. Semenec also worked in the biotech industry for several years prior to joining the iData Research team. iDataResearch is an international market research and consulting firm focused on providing market intelligence for the medical device, dental and pharmaceutical industries.