Summary
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Since the COVID-19 virus outbreak in December 2019, the disease has spread to almost 100 countries around the globe with the World Health Organization declaring it a public health emergency. The global impacts of the coronavirus disease 2019 (COVID-19) are already starting to be felt and will significantly affect the Extracorporeal Membrane Oxygenation (ECMO) Systems market in 2020.

COVID-19 can affect the global economy in three main ways: by directly affecting production and demand, by creating supply chain and market disruption, and by its financial impact on firms and financial markets.

The outbreak of COVID-19 has brought effects on many aspects, like flight cancellations; travel bans and quarantines; restaurants closed; all indoor events restricted; over forty countries state of emergency declared; massive slowing of the supply chain; stock market volatility; falling business confidence, growing panic among the population, and uncertainty about future.

This report also analyses the impact of Coronavirus COVID-19 on the Extracorporeal Membrane Oxygenation (ECMO) Systems industry.

ECMO is a niche product with few daily applications. In fact, ECMO is composed of a complete set of equipment system, upstream raw materials of various types, electronic components, high-end materials, etc.; while ECMO equipment manufacturers produce core membrane lungs, pumps, consumables, etc., combined with other equipment, to form a complete set of system; at present, hospitals with high medical level have the ability to manage ECMO.

Upstream raw materials, ECMO The core part of the raw material is the membrane lung, which is responsible for blood oxygen and its internal is composed of hollow microporous fibre membrane. When the system is running, the patient's blood flows outside the hollow fibre membrane, and oxygen is injected into the membrane fibre. The carbon dioxide in the blood and oxygen in the membrane fibre are replaced by differential pressure to realize the gas exchange function of the lung. This requires that the material not only has good air permeability, but also can realize long-term hydrophobicity, so as to meet the requirements of continuous operation for weeks or even months. PMP (poly-4-methyl-1-pentene) is a kind of polyolefin material with excellent performance. It has good oxygen flux, nitrogen and oxygen selectivity, low dissolution and biological safety. It is recognized as the optimal medium of "membrane lung oxygenator". At present, only Membrana of 3M can supply this material exclusively. Due to its tight production capacity, the capacity of downstream ECMO enterprises is limited; and due to its supply monopoly and price monopoly, the price remains high.

At present, the main manufacturers of ECMO in the world are Medtronic in the United States, Maquet in Germany, Sorin in Germany, etc. It is dominated by imported foreign enterprises, among which domestic Maquet and Medtronic occupy the main market.

Based on our recent survey, we have several different scenarios about the Extracorporeal Membrane Oxygenation (ECMO) Systems YoY growth rate for 2020. The probable scenario is expected to grow by a 46.1% in 2020 and the revenue will be US$ 399.67 Million in 2020 from US$ 273.56 Million in 2019. The market size of Extracorporeal Membrane Oxygenation (ECMO) Systems will reach US$ 379.01 Million in 2026, with a CAGR of -0.88% from 2020 to 2026.

[url=]Figure 1.   Global Extracorporeal Membrane Oxygenation (ECMO) Systems Market Size (Value), (US$ Million), 2015 VS 2020 VS 2026[/url]

Source: Secondary Sources, Expert Interviews and QYResearch, 2020

Figure 2.   Global Extracorporeal Membrane Oxygenation (ECMO) Systems Revenue 2015-2026 (US$ Million)

Source: Secondary Sources, Expert Interviews and QYResearch, 2020

Figure 3.   China Extracorporeal Membrane Oxygenation (ECMO) Systems Revenue 2015-2026 (US$ Million)

Source: Secondary Sources, Expert Interviews and QYResearch, 2020

At present, there is no manufacturer of ECMO in China. More than 400 ECMO Systems owned in China are imported from abroad, and only 5 major manufacturers produce ECMO in the world. There are only 1200 ECMO Systems in the world and more than 400 in China.

Some progress has been made of ECMO in China. Relying on the Sino-German joint R & D team, Shenzhen Hanover Medical Group has designed oxygenators and centrifugal pumps after 3 years of scientific research. At present, it has completed the functional prototype of the whole set of equipment including oxygenator, centrifugal pumps and system host design stereotypes.

Table 1.   Global Extracorporeal Membrane Oxygenation (ECMO) Systems Sales (Unit) by Regions (2015-2026)

(Unit)

2015

2016

2017

2018

2019

2020E

2021F

2022F

2023F

2024F

2025F

2026F

North America

431

449

468

479

488

596

495

528

559

591

623

655

Europe

365

376

389

413

426

537

456

493

502

530

553

576

China

86

91

98

103

109

406

156

168

177

188

199

209

Japan

68

71

74

75

78

90

78

80

82

84

86

88

RoW

85

87

89

90

92

103

91

93

95

97

99

101

Global

1035

1074

1118

1160

1193

1732

1276

1362

1415

1490

1560

1629

Source: Secondary Sources, Expert Interviews and QYResearch, 2020

Figure 4.   Global Extracorporeal Membrane Oxygenation (ECMO) Systems Sales Market Share by Regions (2015-2026)

Source: Secondary Sources, Expert Interviews and QYResearch, 2020

Extracorporeal Membrane Oxygenation (ECMO) Systems is a new treatment method aimed at heart and lung failure disease. ECMO transport is an effective method of transferring patients with severe ARDS. It has multiple causes, and the diagnosis should be investigated and treatment commenced during ECMO. Since ECMO is a complicated and high-risk therapy, adequate training in its performance and creation of a referring hospital network are essential. Its working principle is to drain the patient's venous blood to the outside of the body, after the membrane oxygenator (its function is similar to artificial lung, referred to as membrane lung) oxygenation and carbon dioxide removal, it is transported back to the patient's body, and undertakes the function of gas exchange and part of blood circulation.

Figure 5.   Extracorporeal Membrane Oxygenation (ECMO) Systems Product

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Source: Secondary Sources, Expert Interviews and QYResearch, 2020

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ECMO technology mainly includes VV ECMO (Veno-Venous ECMO) and VA ECMO (Veno-Arterial ECMO). In these two ways, the blood discharged from the venous system will be oxidized in vitro, VV only has the role of respiratory assistance, while VA has both the role of circulation and respiratory assistance. Accordingly, the global market size of VV ECMO and VA ECMO will reach US $ xx Million and US $ xx Million in 2020, respectively, which are increased compared to 2019 xx% and xx%. VV ECMO takes a big amount of market with xx%.

Figure 6.   Global Extracorporeal Membrane Oxygenation (ECMO) Systems Market Structure by Type in 2015 & 2020

Source: Secondary Sources, Expert Interviews and QYResearch, 2020

VV ECMO

A single catheter is placed into a vein, usually in the side of the neck. Blood is drained from this catheter into the ECMO circuit at the same time as oxygenated blood is returned through the same catheter from the ECMO circuit to the child.

VV ECMO provides lung support only and does not support the heart. A few children who start with VV ECMO will need to be changed over to VA ECMO if their heart also starts to need support.

VV ECMO takes blood from a large vein and returns oxygenated blood back to a large vein. VV ECMO does not support the circulation.

Another variant of VV ECMO is extracorporeal CO2 removal (ECCO2R). With this mode of support, oxygenation is provided by slow ventilation of the native lungs while CO2 removal is accomplished by the ECMO circuit. In all forms of ECMO, CO2 removal is more efficient than O2 addition because of the solubility and diffusion properties of CO2 relative to O2.

VA ECMO

VA ECMO takes deoxygenated blood from a central vein or the right atrium, pumps it past the oxygenator, and then returns the oxygenated blood, under pressure, to the arterial side of the circulation (typically to the aorta). This form of ECMO partially supports the cardiac output as the flow through the ECMO circuit is in addition to the normal cardiac output.

Two cannulae (tubes) are placed into your child’s blood vessels, one into a vein and the other into an artery, usually on the side of the neck. Dark blood (containing little oxygen) is drained continuously into the ECMO circuit from the tube in the vein, while the now oxygen-rich blood from the ECMO circuit is returned to the body through the tube in the artery.

This type of ECMO provides support for both the heart and the lungs and so can be used for children requiring either cardiac or respiratory ECMO support.

For the small number of children who require ECMO after open heart surgery, the cannula (tubes) may be inserted directly into the heart through the chest during the heart operation rather than into the neck vessels.

Application

From the perspective of application/end users, Extracorporeal Membrane Oxygenation (ECMO) Systems can be divided into three main categories: Neonatal, Pediatric and Adult. Accordingly, the global market size of Neonatal, Pediatric and Adult will reach US $ xx Million, US $ xx Million and US $ xx Million in 2020, respectively, which are increased compared to 2019 xx%, xx% and xx%. Among them, Neonatal takes a big amount of market with xx%. However, with the spread of COVID-19, there will be more ECMO Systems applying on adults due to the increasing number.

Figure 7.   Global Extracorporeal Membrane Oxygenation (ECMO) Systems Market Structure by Application in 2015 & 2020

Source: Secondary Sources, Expert Interviews and QYResearch, 2020

In recent years, the clinical indications of ECMO have been expanding, including cardiogenic shock, severe acute respiratory failure and severe circulatory failure.

COVID-19 broke out worldwide in an all-round way, and the demand for medical ventilator was released rapidly. COVID-19 was diagnosed in 638928 cases (except China) as of 10 March 30th, and 30672 cases died. The demand for medical equipment around ICU will continue to increase with the increase of the number of severe and critical patients, and it is in urgent need of import reserves. It is estimated that at least 1.3 million new ICU beds are urgently needed overseas, and life monitoring and respiratory support products are flexible. As a very important equipment in ICU, ECMO Systems’ demands increase day by day with the impact of COVID-19.

Figure 8.   Global Extracorporeal Membrane Oxygenation (ECMO) Systems Revenue in Adult 2015-2026 (US$ Million)

Source: Secondary Sources, Expert Interviews and QYResearch, 2020

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Major manufacturers

Table 2.   Major manufacturers and products analysis

Company

Product Type

Medtronic

VV ECMO, VA ECMO

Maquet

VV ECMO, VA ECMO

Sorin

VV ECMO, VA ECMO

Xenios AG

VV ECMO, VA ECMO

ALung   Technologies

VV ECMO, VA ECMO

Source: Secondary Sources, Expert Interviews and QYResearch, 2020

Extracorporeal Membrane Oxygenation (ECMO) Systems is a new treatment method aimed at heart and lung failure disease. ECMO transport is an effective method of transferring patients with severe ARDS. It has multiple causes, and the diagnosis should be investigated and treatment commenced during ECMO. Since ECMO is a complicated and high-risk therapy, adequate training in its performance and creation of a referring hospital network are essential.

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