Canada Cardiac Resynchronization Therapy Market

Canada Cardiac Resynchronization Therapy Market Executive Summary

Canada Cardiac Resynchronization Therapy Market valued at $384 Mn in 2022, projected to reach $567 Mn by 2030 with a 5% CAGR.

Cardiac resynchronization therapy (CRT) involves the use of a pacemaker to restore the proper rhythm of the heart through a minor surgical procedure. Implanted under the skin, the CRT pacemaker coordinates the timing between the upper (atria) and lower (ventricles) heart chambers, as well as the synchronization between the left and right sides of the heart. This intervention is particularly crucial in cases of heart failure, where inadequate pumping leads to fluid accumulation in the lungs and legs due to the desynchronized beating of the two lower chambers (ventricles). Additionally, if serious heart rhythm issues are identified, an implantable cardioverter defibrillator (ICD) may be recommended by the doctor and can be combined with CRT therapy. Connecting wires from the pacemaker to both sides of the heart, the CRT device employs biventricular pacing, sending electrical signals to the ventricles to ensure coordinated contractions and optimize overall heart function.

As of 2023, 750,000 Canadians, constituting 3.4% of the adult population, are living with heart failure, touching the lives of approximately 1 in 3 Canadians. Annually, over 100,000 new cases of heart failure are diagnosed, making it a prevalent health concern. Notably, heart failure stands as the primary reason for hospitalization among adults over 65 and is a leading cause of readmission within 30 days of discharge. The associated healthcare costs exceed $2.8 Bn annually and are expected to rise. The aging population significantly contributes to the increased risk of heart failure, while prevalent risk factors such as high blood pressure, diabetes, obesity, and lifestyle choices like smoking and physical inactivity contribute to its development. Advances in medical care have led to improved survival rates, resulting in a larger population living with heart failure.

Abbott's Amplatze Impella RP, which was equipped with SmartAssist pump technology, received approval from Health Canada in 2023, marking a noteworthy milestone. To sustain patients facing severe heart failure during high-risk medical procedures, this temporary heart pump is essential. Abbott also carried out a notable clinical experiment in Canada to evaluate how well the CardioMEMS HF System worked for patients undergoing remote cardiac failure monitoring.

Similarly, in 2023, Medtronic achieved a significant milestone when Health Canada approved the Micra AVTM pacemaker, which is known for being the smallest pacemaker in the world. Patients with heart conditions can now benefit from novel remedies thanks to pacemaker technological advancements. The Everest Cardiac Resynchronization Therapy System was also released by Medtronic into the Canadian market. With its improved lead technology and smaller device design, this system distinguishes and contributes even more to the progress of cardiac care.

Market Dynamics

Market Growth Drivers

Rising Prevalence of Heart Failure: Heart failure is a major public health concern in Canada, affecting around 750,000 individuals and being the main cause of hospitalization rates and healthcare costs. The probability of heart failure is expected to rise with an aging population and an increase in risk factors including obesity and diabetes, which will lead to a larger potential patient base for cardiac resynchronization therapy (CRT).

Technological Advancements: The appeal of CRT is growing among patients and physicians due to advancements in technology, which include smaller, more energy-efficient devices with extended battery life and advanced features. Patient management benefits from features like remote monitoring and telemedicine capabilities, contributing to improved post-implantation outcomes. Promising prospects for CRT advancements are seen in emerging technologies such as leadless pacemakers and algorithms powered by artificial intelligence.

Increased Awareness and Education: Healthcare organizations and patient advocacy groups are working to raise public knowledge about heart failure and treatment options like CRT using public health campaigns and educational initiatives. Improved patient understanding and knowledge may lead to early diagnosis, prompt therapies, and even superior overall results.

Market Restraints

High Device Cost: Cardiac Resynchronization Therapy (CRT) devices come with a substantial price tag, varying from tens of thousands to hundreds of thousands of dollars. This considerable expense may pose a hindrance for patients, particularly those facing financial constraints or insufficient coverage through insurance.

Insufficient Data Regarding Long-Term Advantages: Although there is evidence endorsing the immediate advantages of CRT in certain patients, a more comprehensive understanding of its cost-effectiveness and influence on mortality rates in the Canadian context requires additional long-term data.

Limited Access to Specialists: CRT device implantation requires specialized knowledge and instruction. In certain parts of Canada, access to therapy may be impeded by the limited availability of electrophysiologists and other professionals with the necessary training.

Notable Recent Updates

• February 2020, Abbott announced it had received CE Mark for the new Gallant implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRT-D) devices.
• March 2019, BIOTRONIK announced the European market release of the world’s smallest ICD and CRT-D devices that are approved for 3 Tesla (3T) full-body MRI scans.

Healthcare Policies and Regulatory Landscape

In Canada, multiple authorities are tasked with regulating and supervising the administration of therapeutic drugs. Health Canada, operating through its Pharmaceutical Drugs Directorate and Health Products and Food Branch, holds a crucial role in overseeing pre-approval and approval procedures for new pharmaceuticals, as well as post-market safety monitoring and pre-market evaluations. Independently, the Patented Medicine Prices Review Board regulates the market to ensure fair pricing of patented medications. The Canadian Agency for Drugs and Technologies in Health supplies evidence-based information regarding medication effectiveness and cost-efficiency. Additionally, each province and territory maintains its drug formulary, making choices based on factors like cost-effectiveness, safety, and efficacy to prevent excessive pricing of patented medications.

Competitive Landscape

Key Players

• Abbott
• Biotronik
• Boston Scientific
• Medtronic
• St. Jude Medical
• Sorin Group
• Siemens Healthineers
• Philips Healthcare
• GE Healthcare
• Esaote