Under a series of interlocking provincial and territorial medical insurance plans imposed by Canada’s Health Act, all Canadians benefit access to medical care regardless of their ability to pay. To maintain this enviable privilege Canada’s universal health care system is under pressure to use the most advanced and cost efficient medical technologies, including imaging.
The Canadian market for new medical imaging equipment is estimated to be US $1.6 billion. Demand has grown at an average annual rate of 7 percent over the past five years. It is expected to grow between 5 and 10 percent through 2010. Each year, Canadian hospitals spend an estimated US $2.3 billion on the operation and maintenance of medical imaging equipment as well as services, including payments to physicians. Due to Canada’s aging population and new technological advances that allow for more early diagnoses, medical imaging has become a highly valuable resource for saving and prolonging Canadian lives.
Indeed, the benefits of medical imaging technology utilized in Canada are numerous: medical imaging increases the healthcare system’s efficiency by fostering greater savings through early detection. It allows a range of less invasive medical therapies that provide patients with better care, and most importantly, detects critical diseases at their most curable stage.
Digital radiography equipment and position emission tomography (PET) are foreseen to be among the top market performers in the coming five years. Demand for what is now more conventional medical imaging devices such as CT, MRI, and ultrasound scanners, should continue to experience moderate growth. Increased demand for these technologies in Canada will create further opportunities for U.S. manufacturers seeking to export their medical imaging equipment and products North of the border.
Canadian regulations applicable to imaging technology are stringent but not unreasonable when compared with Europeans CE-Mark requirements. It guarantees that only top quality and most advanced medical equipment enters the Canadian market and competition with low-coast and lesser quality equipment is excluded.
This report seeks to shed light on the current medical imaging situation in Canada and discusses opportunities for U.S. firms.
Under Canada's Health Act, all 33 million Canadians are entitled to physician and hospital services deemed necessary to maintain a good state of health independent of their capacity to pay. This includes diagnostic and other necessary medical interventions requiring the use of imaging technology. These medical services are largely provided within the hospital settings or in affiliated for-profit and not-for-profit medical imaging clinics having an arrangement with public health authorities in their respective province or territory. Medical imaging technology is therefore widely available to Canadians.
Canadians can see a doctor whenever they feel the need. They see their doctors 6.2 times a year on average while Americans visit theirs 3.6 times. This explains in part as a result the higher number per capita of MRI and CT scanner exams conducted in Canada. Canadians on average live two years longer than Americans.
Nonetheless, a relative shortage of diagnostic equipment still prevails in Canada when compared with the United-States. For example, Canada has reached the level of 6 MRI scanners per million people in 2006 compared with about 9 in the United States.
Therefore, a strong and steady demand for performing medical imaging equipment coming from Canadian health care system facilities should prevail in the foreseeable future. In fact, based on the number of exams per scanner, the per capita use of equipment in service in Canada for MRI and CT are respectively 37 percent and 46 percent higher than in the United States. This should translate into higher demand for repair and maintenance and possibly shorter cycles of service out of the equipment used.
One of the most important factors in the growth of utilization of imaging technologies is an increasing incidence of patient procedures requiring medical imaging. This is to some extent the result of an aging population and the increase of non-invasive procedures requiring the assistance of imaging technology.
Diagnostic imaging is most widely used for head and chest problems, accidents and injuries, pregnancy-related problems, and abdominal problems. In a preventative context, medical imaging is performed for a variety of reasons, such as screening patients at risk for disease, helping patients with decisions about care choices if diagnosed with specific health conditions, and guiding surgery or other interventions.
In Canada, high demand exists for certain types of medical imaging equipment: for instance, 20 percent of market demand value is for X-rays, 18 percent for MRI technology, 18 percent for ultrasound, 17 percent for computed tomography, and 26 percent for PET and nuclear medicine. However, demand for X-rays is expected to decline through 2010 as computer and digital tomography procedures replace traditional X-ray tests.
Many different types of medical imaging equipment are utilized in Canada. Their general use is to diagnose medical conditions ranging from breast cancer to coronary artery disease. Mammography, coronary angiography, and Computed Tomography (CT) are some of the most common diagnostic-imaging devices in use.
Mammography, an X-ray specially designed for high-resolution breast imaging, can diagnose breast cancer in asymptomatic female patients. This imaging technology is a powerful tool for increasing the chance of survival in breast cancer patients. In fact, research by the WHO’s International Agency for Research on Cancer concluded that the mortality rate for women age 50 to 69 years old who chose to participate in screening programs was reduced by 35 percent. Thanks to universal access to health care, these statistics hold true in Canada. The Canadian Cancer Society recommends that all women aged 50 to 69 go for mammograms every two years.
Coronary angiography, which is used to find and treat abnormalities in the blood vessels, is an important tool in detecting obstructions and determining whether further interventions are necessary. This type of medical imaging is recognized to prevent heart disease and its use is on the rise in Canada, although the savings it generates are still difficult to measure.
CT scanning is used to locate head injury, chest trauma and musculoskeletal fractures by creating three-dimensional images of the body’s structures. It has become widely available in Canadian health care facilities since its inception in 1973. In fact, since 1990, the number of CT scanners has grown by 91 percent to 378 scanners, and approximately 4.3 percent of Canadians aged 15 and older have had a non-emergency CT scan in the past year. Many market strategists predict that CT scanners will lead in the growth of the medical imaging market as health facilities substitute earlier machines with new multi-slice models.
Within the next few years, demand for Positron Emission Tomography (PET) is expected to increase due to the need for technologically advanced systems. New hybrid PET/CT models with dual anatomical and metabolic scanning technologies will trigger PET technology growth on popularity throughout 2010. This increase in demand also stems from rising numbers of nuclear medicine professionals preference for equipment that enhances image resolution and detail.
Within the medical imaging market, demand for medical imaging consumables is expected to grow between 3 and 5 percent annually to well exceed US$500 million annually by 2010. Research in the U.S. by the Freedonia Group indicates that radiopharmaceuticals will provide the best growth opportunities based on an increase in the prevalence of nuclear medicine and PET procedures. Canada is expected to follow this trend.
During the same period, the market for contrast agents is expected to grow moderately. This can be attributed to upward trends in scans on body regions where the targeted organ requires visual enhancement to be fully analyzed.
Investment Announcements and Programs by Province
Ontario: In March 2007, the Province of Ontario government announced that it would invest over $23 million to support the Robarts Research Institute, one of the leading medical imaging centers in Canada, in collaboration with the University of Western Ontario.
British Columbia: A variety of investment initiatives are underway with the provincial government in B.C. Authorities recently announced that they would soon develop a new $15 million radiopharmaceutical laboratory facility at the BC Cancer Agency utilizing PET/CT technology. Also, in 2007, the new Abbotsford Regional Hospital was to receive $30 million from the provincial government to buy a new MRI machine, two 64-slice CT scanners and two digital mammography units.
Manitoba: Manitoba’s government announced plans to invest $35 million in 2007 for the Siemens Institute for Advanced Medicine, which will focus on advancements in neurosciences and advanced medical imaging.
Saskatchewan: The government of Saskatchewan is pursuing the development of a new radiology information system that will improve diagnostic imaging services for residents of province. The total cost for implementing this system is estimated at $35 million upon completion.
Alberta: Provincial health authorities recently announced a $2 million investment toward the Shared Remote Diagnostic Imaging Project, an Albertan initiative to develop the necessary infrastructure to improve local access to imaging services.
New Brunswick: The provincial government of New Brunswick has set aside a budget of $10 million to acquire new medical equipment including some imaging technology to support different hospitals throughout the province. The Moncton hospital already received $725,000 for medical imaging equipment.
Nova Scotia: The Nova Scotia Department of health has recently announced investments of over $800,000 for new digital diagnostic-imaging equipment compatible with the Picture Archive and Communications System (PACS) expansion project.
Quebec: The Quebec Health Ministry has announced a multimillion-dollar investment in PET diagnostic technology to accommodate and increasing number of patients and to provide timely access. Quebec is expected to increase its number of PET scanners in the province within the next few years. Although there are currently 4 PET scanners in Quebec, a significant improvement since 2003, three other machines should be added.
By Pierre Richer