Global Spine Market Report

--------------------------------2012

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Executive Summary

The spine market is by far the largest segment within the global orthopedic market. Over the last few years, the market has

witnessed significant growth majorly on the back of economic recovery and aging population. The US is the largest market for

spinal surgeries and the country has significant growth opportunity in the coming years also. However, in 2011, the overall

revenue of the spine market in the US has declined due to pricing pressures on manufacturers and declining insurance

coverage.

Within the global spine market, the thoracolumber segment is the highest revenue generating segment, whereas, in the US

spine market, spinal fusion segment recorded higher revenues as well as higher procedural volumes compared to the other

segments. The spinal fusion and disc replacement segments in the US have shown significant volume growth. However, the

revenue from these segments grew marginally as the average selling prices of spine equipments have declined as a result of

pricing pressure on manufacturers and higher competition in the market.

It is expected that new innovations in the minimally invasive surgeries domain will continue to have a positive impact on the

market as the new and improved surgical tool will make complicated spine surgeries easier than before. However, shortage of

skilled healthcare workers, doubtful medical reimbursements, and growing cost of advanced surgeries will continue to

challenge the growth of the market.

Medtronic led both the worldwide and the US spine market in 2011, followed by JNJ Depuy, Synthes, and Stryker. However,

the market share of Medtronic has witnessed significant decline in recent past due to strong performance of few new entrants

(including NuVasive and Globus Medical) in the market. Recently, JNJ Depuy acquired Synthes and the combined entity is

expected to become the major competitor of Medtronic.

The report provides an analysis of the global spine market. It discusses major market trends, growth drivers, and challenges.

It presents the competitive structure of the industry and profiles major players in the spine market with a discussion of their

key business strategies.

By combining SPSS Inc.’s data integration and analysis capabilities with our relevant findings, we have predicted the future

growth of the global spine market. We employed various significant variables that have an impact on this industry and created

regression models with SPSS Base to determine the future direction of the industry. Before deploying the regression model,

the relationship between several independent or predictor variables and the dependent variable was analyzed using standard

SPSS output, including charts, tables and tests.

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Promising Growth Opportunity

The worldwide spine market has recorded ……growth

over the last …….. on the back of ………………and

decreased ……………….. In 2010, the worldwide spine

market was valued at US$..............billion, which recorded

a Y-O-Y growth of ……………% reaching US$.............

billion in 2011. The market is expected to experience

major ………. in near future, which will decrease the

…………… on …………... As a result, increasing

………………… coupled with moderate ……………….. will

drive the future market growth.

The ………segment which includes orthopedic surgeries

related to …………………..of the spinal column was the

major segment of the global spine market and the

particular segment accounted for about ……% of the

overall market in 2011. The ………segment which includes

……………………………………….. has accounted for

about …..% of the worldwide spine market in the

mentioned year. The ……..segment is gaining popularity

rapidly and in 2011, the segment has accounted for ……%

of the aforesaid market. The other segments within the

global spine market include ………………………..,

…………………, and …………………….

Revenue of Worldwide Spine Market, 2007-2011

Worldwide Spine Market by Segments, 2011

2007 2008 2009 2010 2011

US

$ B

illion

Biologics Cervical

Interventional MIS

Motion Preservation Thoracolumbar

The outlook for spine market in the US remains positive on the back of strong growth prospects of spinal fusion surgeries in the near future…

The quarterly performance of the US spine market has shown that the

market has witnessed ……………….and …. during the …. in … as the

quarterly sales of the market ….. compared to the sales ….. year. It is

estimated that in 4Q11, the sales of the market have ….US$.... billion

compared to US$..... billion in 4Q10, showing a marginal …. of …..%.

The spinal procedures in the US can be segmented into ….segments.

The spinal fusions accounted for approximately …..% of the market by

value in 2011. The …..segment and …..segment accounted for ….%

and …….% of the market respectively. On a … basis, the US spinal

surgeons expect …….. in the …. market in 2012. In 2013, the US

spinal surgeons expect …….. However, it is obvious from surgeon

responses that they expect …. over the next several years.

The overall revenue from the US ….. procedures is expected to have

reached US$.... in 2011 compared to US$.... in 2009. It is estimated

that, during 2011-2014, the US market for cervical procedures will

grow at a CAGR of …% to reach US$.... in 2014.

Revenue of the US Spinal Fusion Market, 2009A-2014F

The US Spinal Procedures Market by Segment, 2011

Quarterly Revenue Spine Market in the US, 1Q10A-4Q11E

1Q10A 2Q10A 3Q10A 4Q10A 1Q11A 2Q11A 3Q11A 4Q11E

US

$ B

illion

82.28%

2.82%

14.9%

Spinal Fusions Spinal Disc Replacements

Kypho/Vertebroplasties

2009A 2010A 2011E 2012F 2013F 2014F

US

$ M

illio

n

Cervical Curvature/Cancer Lumbar

Global Spine Market to Show Moderate Growth

There has been a significant growth in the worldwide spine market in the past few years, and this growth is projected to continue at

a ………….rate in the years ahead. In 2011, the overall revenue of global spine market was approximately US$........ billion, which

is expected to grow up to US$................ billion by the end of 2015. The worldwide revenue of spine products is estimated to grow

at a CAGR of ……..% during 2011-15. The major reasons for the growth of global spine market would be increasing ……………,

improving ………………….., increasing …………….. rates, and …………………… products.

Global Revenue Forecast of Spine Market, 2011A-2015E

2011A 2012E 2013E 2014E 2015E

US

$ B

illion

Table of Contents

1. Spine Market Overview

1.1 Regions of the Spine

1.2 Spinal Products

1.3 Disorders Affecting the Spine

2. Market Size

2.1 Global Orthopedic Market

Market Value

Market Segments

Regional Breakdown

2.2 Worldwide Spine Market

Market Value

Market Segments

Regional Breakdown

Spinal Implant Market

2.3 Spine Market in the US

Market Value

Market Segments

Spinal Fusion

Disc Replacement

Vertebroplasties

Product Segmentation

3. Key Trends

3.1 Growth Potential of New Spinal Procedures

3.2 Growth of Minimally Invasive Spine Surgery

3.3. Higher Success Rates due to Improved Surgical Tools

List of Charts

Worldwide Orthopedics Market, 2009-2015E

World Orthopedics Market Share by Segments, 2011

Worldwide Orthopedics Market by Geography, 2009-2010

Revenue of Worldwide spine Market, 2007-2011

Quarterly Revenue of Worldwide Spine Market, 1Q10A-4Q11E

Worldwide Spinal Market Sales by Geography, 2011

Worldwide Spine Market by Segments, 2011

Worldwide Spinal Implant Market, 2009A-2013E

Spine Market in the US, 2007-2011

Quarterly Revenue Spine Market in the US, 1Q10A-4Q11E

Spinal Procedures in the US by Volume, 2008-2011

The US Spinal Procedures Market by Segment, 2011

Monthly Growth of Spinal Fusion Procedure in the US, Jan 2011-Jan

2012

Spinal Fusion Procedures by Volume in the US, 2008-2011

Disc Replacement Procedures by Volume in the US, 2008-2011

Vertebroplasties Procedures by Volume in the US, 2008-2011

Revenue of the US Spinal Fusion Market, 2009A-2014F

Revenue of the US Spinal Disc Replacement Market, 2009A-2014F

Spine Curvature/Cancer Cases & Revenue per Case in the US, 2009A-

2016E

Spinal Market Sales in the US by Product Type, 2011

Region of Spinal Fusion in the US by Procedural Volume, 2011

Spinal Market Procedural Volume by Indication in the US, 2011

Growth of Global Aging Population (60 years and above), 2005-2012E

Worldwide Gross National Income per Capita, 2005-2011

Global Life Expectancy at Birth, 2005-2010

Worldwide Orthopedic Market Share by Company, 2011

Market Share of Manufacturers in the Worldwide Spine Market, 2011

Market Share of Top Five Players in the Worldwide Spine Market, 2006-

2010

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Table of Contents

4. Growth Drivers

4.1 Global Ageing Population

4.2 Improving Worldwide Economy

4.3 Increasing Life Expectancy Rates

5. Significant Developments

5.1 New Power Technology for Reconstructive Spine Surgery by

Medtronic

5.2 New System for Neuromuscular Scoliosis by JNJ Depuy

5.3 Launch of iVAS Inflatable Vertebral Augmentation System by

Stryker

5.4 Launch of First Minimally Invasive System by JNJ Depuy

6. Challenges

6.1 Shortage of Healthcare Workers and High Wages

6.2 Lower Reimbursements for Spine Surgery

6.3 Growing Cost of Innovation in the Spine Market

7. Spine Market - Competitive landscape

7.1 Competitive Landscape in the Global Spine Market

Market Share

Major Players – Growth Comparison

7.2 Competitive Landscape in the US

Overall Market Share

Share in Key Segments

8. Company Profiles

8.1 Medtronic

Business Description

Key Financials

Business Strategies

List of Charts

Market Share of Top 5 Players in the Global Spinal Implant Market,

2009A-2013E

Y-O-Y Growth of 5 Major Players in the Global Spinal Implant Market,

2009A-2013E

Market Share of Major Players in the US Spinal Implant Market, 2011

Share of Major Players in the US Interbody Fusion Market, 2011

Share of Major Players in the US Lumbar Metal Market, 2011

Share of Major Players in the US Cervical Plates and Screws Market,

2011

Medtronic Sales by Product Categories, 2012

Medtronic’s Total Sales and Net Income, 2009-2012

Sales of Johnson & Johnson’s by Business Segments, 2011

Net Sales and Net Earnings of Johnson & Johnson, 2006-2011

Stryker’s Revenue Contribution by Business Segments, 2011

Net sales & Net Earnings of Stryker, 2008-2011

Share of Net Sales by Reportable Segments, 2011

Net sales & Net Earnings of Zimmer, 2007-2011

Global Revenue of Spine Market, 2011A-2015E

List of Tables

Product Overview

Average Selling Prices of Spinal Components, 2008-2011

Quarterly Growth of Major Players in the Worldwide Spine Market,

Q110A- Q112E

Quarterly Market Share of Major Players in Worldwide Spine Market,

2010A-2011E

Market Share of Major Players in US Spine Market, 2010A-2011E

Dependent & Independent Variables, 2007–2011

Correlation Matrix

Model Summary – Coefficient of Determination

Regression Coefficients Output

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Table of Contents

Distribution Strategy

Focus on R&D Efforts

8.2 Johnson & Johnson

Business Description

Key Financials

Business Strategies

Financial Risk Minimization

Focused Growth Strategy

8.3 Stryker

Business Description

Key Financials

Business Strategies

Novel Product Innovation

Strategic Acquisitions

8.4 Zimmer

Business Description

Key Financials

Business Strategies

Organizational Discipline

Achieving Financial Commitments

9. Market Outlook

9.1 Market Forecast

9.2 Forecast Methodology

9.2.1 Dependent and Independent Variables

9.2.2 Correlation Analysis

9.2.3 Regression Analysis

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Vikas Gupta

BD Manager

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