2021 in the Spine market is being a year of growth after the impact generated by COVID in 2020. Today we are going to analyze (with the Q1 and Q2 already published), the changes in market shares and which companies are recovering faster after the pandemic.
As you will see, we have included all the data for the first semester of 2021 compared to those of 2020 for the main companies that represent 80% of the global market.
However, obtaining this information is an increasingly complicated task. For example, Medtronic Spine results are presented together with those of Brain or Cranial and in the case of Zimmer, together with those of Dental or CMF. All this means that we have to work with estimates and not with real data. In any case, we will explain to you how we have obtained these estimated data.
Which is our Estimate for 2021?
According to Research and Markets, the global market for the Spine in 2019 was USD 9662 million. If we take into account the average growth of the main companies and the estimates made by most of the consulting firms, we can think that the market growth in 2021 is 23.9% compared to the same period 2020 and 3.5 compared to 2019.
Our market estimate for 2021 is USD 9,951 million, which represents a growth of 21% compared to 2020 and 3% compared to 2019.The 9 key spine companies have seen an average of 24% in the first half of 2021.
Which is Our Market Share Estimate for the End of 2021?
Considering the data from the Q1 and Q2 result of this year, we have made an estimate of how 2021 could end and therefore how the market shares could remain.
1.- Medtronic
First of all, note that the data used are estimates since Brain and Spine appear together in the published results. We have considered according to various analyzes and histories that the column represents over 45% and Brain 55%. Of course, our forecast may be wrong and therefore should be taken as an estimate.
On the other hand, also consider that the quarter results are not the same as the rest since their year is fiscal. Therefore, Q1 is Medtronic´s Q4 and Q2 is Q1 of the following year.
Medtronic’s sales in Q1+Q2 2021 have been USD 1.156 MM with a growth of 8% compared to the same period 2020.
Comments: We think that at the end of the year their sales will account for USD 2.216 MM (+8%) keeping the Leadership with a 22% market share. They are trying to maximize their growth by launching new products and pushing hard with the Mazor Spinal robot. It could not be a surprise if their final growth is higher than our 8% estimation. They have recently announced their latest additions to its minimally invasive spine surgery ecosystem.
The New additions to the Medtronic MIS+ portfolio include:
- Catalyft™ PL and PL40, the first releases in the new Catalyft™ Expandable Interbody System. Catalyft™ PL and PL40 feature a unique design for anterior rim engagement, a beveled tip for ease of insertion, seamless integration with StealthStation™ Navigation, simplified bone graft delivery, and active expansion at the precise angle and lift that surgeons need for minimally invasive, patient-specific solutions to meet sagittal alignment goals.
- The Space-D™ Access System, which enables pedicle-screw-based distraction, retraction and compression, compatible with Medtronic’s leading MIS screw system, CD Horizon™ Solera™ Voyager™, enabling simpler, all-in-one access for surgeons, making procedures more efficient and reproducible.
- Accelerate™ Graft Delivery System with Grafton™ DBF.
2.- Johnson&Johnson
It is also difficult to obtain exact spine sales figures since J&J publishes them together with Sport and others. Therefore, we make an estimate considering that the Spine represents about 44-45% of the total sales of the segment.
Johnson&Johnson’s sales in Q1+Q2 2021 have been USD 657,63 MM with a growth of 23% compared to the same period 2020.
Comments: Spine sales have grown in 2021 primarily driven by the benefit of market recovery from COVID-19 impacts and the associated deferral of medical procedures in the prior year.
3.- Stryker
Stryker’s spine sales in these first six months of 2021 have been USD 585 MM with a 34% growth compared to the results of the same period of 2020 (USD 438 MM).
Comments: This growth is mainly due to the activation of the market after COVID with delayed surgeries as well as the launch of some new products including their MIS and Enabling Technologies offerings (Airo, Niagara Lateral Retractor System, Canyon Port Minimally Invasive Retractor System…). Our estimate is that it will end the year with sales of USD 1121 MM representing 11.3% of the market share. Without a doubt, the acquisition of K2M has established STRYKER as the third market player already ahead of Nuvasive.
4.- Nuvasive
Their spine sales in these first six months of 2021 have been USD 566 MM with a 22% growth compared to the results of the same period of 2020 (USD 463,48 MM).
Comments: Nuvasive, has based its growth mainly on the launch of its Pulse platform alongside the NuVasive ACP, Simplify Cervical Disc, Cohere TLIF-A, Cohere TLIF-O and Modulus ALIF.The Pulse Platform is clearly an strategic launch that will certainly increase their spine sales because it allows surgeons to easily access multiple technologies from a condensed footprint and address some of the most common surgical challenges. It is currently the only enabling technology platform with the ability for utilization in 100% of spine procedures (See Image).Our estimate is that it will end the year with sales of USD 1100 MM representing 11% of the market share.
5.- Globus Medical
Worldwide net sales were $478 million in the the first six months of 2021, an increase of 41% as compared to the first and second quarters of 2020. This strong growth comes from robotics; contributions from new product introductions; a resurgence in their biologics business; and competitive recruiting according to Globus Medical.
Comments: According to their recent publication, the Company Guidance full year 2021 net sales are from $925 million to $950 million. We agree with their first figure that would lead to a market share of 9,2%-9,3%. They are doing a great job launching continuously new products and with the strong support of their Robot Excelsius GPS that has had an important role in their sales growth.
6.- Zimmer Biomet (ZimVie?)
Weeks ago, Zimmer Biomet said ZimVie would be the name of its spine and dental business it plans to spin-off. As we’ve seen before with Medtronic or Johnson & Johnson, spine-only sales are hard to find. In this case, they come together with the dental ones. Our estimate is that the Spine business represents 59% and dental 41%. Their spine sales in these first six months of 2021 have been USD 300,6 MM (our estimate) with a 37% growth compared to the results of the same period of 2020 (USD 219,3 MM).
Comments: This growth is mainly driven by the benefit of market recovery from COVID-19. Our estimate for the end of the year is USD 600 MM representing 6% of the market share. This growth according to the Company is led by the Key Product Brands: Mobi-C, The Tether and, their Spine robot ROSA ONE.
7.- OrthoFix
The sales of Orthofix included in this document are only those known as Global Spine, thus excluding those of Global Orthopedics. Worldwide net sales (Global Spine) were $176,99 million in the the first six months of 2021, an increase of 26% as compared to the first and second quarters of 2020 (USD140,39 MM). Growth drivers are the M6-C artificial cervical disc, and the recently bolstered 3D-printed titanium spinal interbody portfolio.
Comments: Our estimate is that it will end the year with sales of USD 339,23 MM representing 3,4% of the market share. Into the back half of the year, the growth drivers -as before- will be the M6-C artificial cervical disc and the 3D-printed titanium spinal interbody portfolio but also, the expansion of their biologics portfolio with products like the recently-launched fiberFUSE™ Strip, and the development of innovative new bone growth therapy products for spine and orthopedics.
8.- Alphatec Spine (ATEC)
Alphatec’s sales in Q1+Q2 2021 have been USD 106,370 MM with a growth of 78% compared to the same period 2020 (USD 59,744 MM). This sales are driven by the following issues:
- Expanded contribution from new products to 84% of revenue, up from 61% in Q2 2020;
- Continued elevation of the sales team, delivering 106% year-over-year revenue growth from strategic distribution;
- Closed acquisition of EOS imaging, S.A. (“EOS”), and commenced integration to advance ATEC clinical prowess with improved information from diagnosis to follow-up.
Comments: Great Job done by the Alphatec team! The Company now expects total revenue for the fiscal year ended December 31, 2021, to approximate $238 million, reflecting growth of approximately 64% compared to the prior full year. This includes an organic revenue contribution of approximately $212 million, or 50% growth compared to the prior full year. The Company anticipates about $25 million of revenue related to EOS imaging. Total revenue guidance for the full year 2021 also includes a $1 million contribution from the Company’s international supply agreement, which will terminate on August 31, 2021.
9.- Seaspine
Seaspine’s spine sales in these first six months of 2021 have been USD 89,5 MM with a 38% growth compared to the results of the same period of 2020 (USD 64,7 MM). The increase in U.S. revenue was driven by both the spinal implants and orthobiologics portfolios. Sales of new and recently launched products increased to 74% and 41% of U.S. spinal implants and U.S.
SeaSpine expects full-year 2021 total revenue to be in the range of $201 million to $205 million, reflecting growth of 30% to 33% over full-year 2020 revenue and 26% to 29% over full-year 2019 revenue. Growth drivers will be the limited commercial launches of the WaveForm Lateral and WaveForm Anterior 3D-Printed Interbody Implant Systems and the 7D Surgical Percutaneous Spine Module for minimally invasive surgery. Our estimate is that it will end the year with sales of USD 201 MM representing 2,0% of the market share.