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Market for Respiratory Equipment and Disposables, 4th Edition, The
September 1, 2010
The market for respiratory disposables and reusable accessories is currently witnessing
dynamic changes, thus making it one of the most important device sectors. The market
factors influencing demand are the same globally. These include the aging of the
population, technological trends and government regulation and fiscal policy.
This Kalorama Information report, The World Market for Respiratory Equipment and
Disposables represents Kalorama's latest analysis of this dynamic medical device
segment. Included in this global report are market estimates and forecasts for the
following segments:
Inhalers
o Metered Dose Inhalers
o Dry Powder Inhalers
o Spacers
Nebulizers
Airway Management Devices
o Endotracheal Tubes
o Tracheostomy Tubes
o Nasopharyngeal Catheters
o Nasal Cannulae
o Emergency Airways
o Airway Masks
o Oxygen Masks
o Pulmonary Resuscitators
o Resuscitator Masks
Positive Airway Pressure Devices
o Continuous Positive Airway Pressure (CPAP) Devices
o CPAP Mask Accessories
o Bi-Level CPAP Devices
o Bi-Level Device Accessories
Mechanical Ventilators
o Critical Care Ventilators
o Portable Ventilators

2. o Disposable Ventilators
o Reusable Ventilators
o Anaesthesia Ventilator Circuits
Oxygen Systems
Humidifiers
o Heated Humidifier Disposable Reservoirs
o Heated Humidifier Reusable Reservoirs
o Disposable Heat/Moister Exchangers (HMEs) in Portable Ventilators
o Pass-Over Humidifiers
o Disposable HMEs in Anesthesia Ventilators
Respiratory Measurement Devices
o Pulse Oximetry Sensors
o Capnographs
o Spirometers
o Peak Flow Meters
Within each segment, historical unit sales and dollar volume are provided. Projections
are provided to 2015. Competitive market share is also provided by leading competitor
for the base year of 2009.
The report covers not only market estimates and forecasts in these categories and sub
categories within, but also addresses the trends affecting the market today. Variations in
product specifications, regulatory approval processes, distribution requirements and
reimbursement policies require equipment suppliers to tailor their approach.
Respiratory Market Trends
The key factors affecting the industry are:
Regulatory Changes : The Montreal protocol enacted in 2005 addressed the
effect of CFCs on the depletion of the ozone layer. The subsequent reduction in
greenhouse gases resulted in the ban of CFCs in 2008 and impacted the
demand for HFA-based inhalers after 2008. Hence CFC based inhalers were
replaced by HFAs (hydrofloro alkanes).
Increased Research and Development Efforts : New innovative products are
in the development pipeline, including combination agents that will reduce the
usage of single use and multiple dose agents and provide better patient
convenience and compliance. These new products will also reduce the volume
consumption for certain single use agents. Equipment manufacturers are now
focusing on total patient management by offering remote monitoring features to
the devices. The product differentiation primarily is focused on faster, smaller,
lighter and more user friendly devices that offer remote patient management
capabilities
Demographic Shifts: There will be an increase in number of people over 65
years. This trend will lead to greater use of home care and respiratory therapies.
Also, an increase in life expectancy will continue to increase the life time value of

3. customers for companies in the respiratory disposables industry. The respiratory
equipment and disposables industry is expected to continue to experience
favorable demographics due to the aging of the population. The number of
Americans aged 65 or older is expected to increase to 45 million by 2012, 54
million by 2020 and 70 million by 2030. All in all, the current market dynamics will
reshape the respiratory disposables and reusable accessories market
significantly.
Increased Home Care Products: Home care is expected to increase in
popularity among the Medicare eligible patient population. This development is
expected to result in increased cost savings for insurance firms and increased
demand for home based respiratory equipments. Technological advances have
made medical equipment increasingly adaptable for use in the home. Current
hospital procedures often allow for earlier patient discharge, thereby lengthening
recuperation periods outside of the traditional institutional setting. Continuing
medical advances prolong the lives of adults and children, increasing the
demand for home medical care equipment.
Health Care Cost Containment: Expenditures in the US on health care
surpassed $2.3 trillion in 2008, more than three times the $714 billion spent in
1990, and over eight times the $253 billion spent in 1980.
Distribution Channels: The home health equipment manufacturers continuously
come up with new ways of reaching their end users. The distribution network for
products has expanded to include not only specialized home health care
providers and extended care facilities, but also retail drug stores, surgical supply
houses, rental, hospital and HMO-based stores, home health agencies, mass
merchandisers, direct sales and the internet. Internet based dealers now account
for 10% of respiratory equipment sales. Products found on the internet are often
priced at a 25% to 30% discount. The internet dealer market space is expected
to continue to grow in popularity.
A Note About Methodology
The market forecast in the current report is calculated by bottom-up approach (i.e.
taking into account the number of patients in each market and multiplying the number of
patients by average unit price for each equipment). In addition, the average refill rate for
some disposable equipment is calculated based on epidemiological studies conducted
by the hospitals/clinics and researchers.The differences in the numbers in 2008 report
and the current report is that the current report has bottom-up approach versus 2008
report that had numbers derived from third-party discussions.
Table of Contents
CHAPTER ONE: EXECUTIVE SUMMARY
1.1. Size and Growth of the Market

4. o a) Market Size
o b) Market Growth
1.2. Market Trends
o 1.2.1. Regulatory Changes
o 1.2.2. Increased Research and Development Efforts
o 1.2.3. Demographic Shifts
o 1.2.4. Increased Home Care Products
o 1.2.5. Health Care Cost Containment
o 1.2.6. Increasing dominance of low cost competitors
o 1.2.7. Distribution Channels
1.3. Industry Structure and Competitiveness: Strategic Perspective
o 1.3.1. Strategic Brief
o 1.3.2. Industry Structure
1.4. Leading Industry Challenges
o 1.4.1. Early Hospital Discharge
o 1.4.2. Preferred Vendor Model
o 1.4.3. Consolidation
o 1.4.4. Reduced Reimbursements for Home Care
1.5. Scope and Methodology
1.6. Reasons for doing the study
CHAPTER TWO: RESPIRATORY DISEASES OVERVIEW
2.1 Background
2.2. Leading Respiratory Complications
o 2.2.1. Asthma
 a) What is Asthma?
 b) Causes
 c) Epidemiology
 d) Prevalence rates in Developed Countries
 e) Prevalence rates in Developing Countries:
 f) Economic Burden of Asthma
 g) Treatment
o 2.2.2. Chronic Obstructive Pulmonary Diseases (COPD)
 a) What is COPD?
 b) Causes
 c) Epidemiology
 d) Treatment
o 2.2.3. Cystic Fibrosis
 a) What is Cystic Fibrosis
 b) Epidemiology
2.3. Respiratory Diseases and Treatment Patterns
CHAPTER THREE:INHALERS
3.1. Background

5. 3.2. Inhalers: Usage Patterns
3.3. Drugs Delivered by Inhalers
3.4. Inhalers: Types
o 3.4.1. Metered Dose Inhalers
o 3.4.2. Dry Powder Inhalers
3.5. Inhalers: Product Comparison
o 3.5.1. Metered Dose Inhalers
o 3.5.2. Dry Powder Inhalers
o 3.5.3. Diskus DPI (Advair, GlaxoSmithKline)
o 3.5.4. Rotahaler (Advair, GlaxoSmithKline)
o 3.5.5. Diskhaler (Serevent, GlaxoSmithKline)
3.6. Inhaler Accessories: Spacers
3.7. Pricing
o 3.7.1. Metered Dose Inhaler
o 3.7.2. Dry Powder Inhalers
3.8. The Market
o 3.8.1. Prescribers
o 3.8.2. End Users
o 3.8.3. Channels of Distribution
o 3.8.4. Sales in Units
o 3.8.5. Sales in Dollar Volume
o 3.8.6. Leading Competitors
CHAPTER FOUR: NEBULIZERS
4.1. Background
4.2. Drugs delivered by Nebulizers
4.3. Nebulizers: Usage Patterns
o 4.3.1. Chronic Obstructive Pulmonary Disease (COPD)
o 4.3.2. Cystic Fibrosis
o 4.3.3. Other Pulmonary Deficiencies
4.4. Nebulizer Types
o 4.4.1. Jet/Pneumatic Nebulizer
o 4.4.2. Ultrasonic Nebulizers
o 4.4.3. Micropump Nebulizers
4.5. Nebulizers: Product Advantages and Disadvantages
o a) Advantages
o b) Disadvantages
4.5.1 Product Improvisations
4.6. Nebulizer Accessories
o 4.6.1. Compressors
o 4.6.2. Compressor Air Intake Filters
o 4.6.3. Outflow Filters
o 4.6.4. T-Pieces
o 4.6.5. Medication Cups
o 4.6.6. Aerosol Masks and Corrugated Plastic Hoses

6. o 4.6.7. Reservoirs
4.7. Pricing
o 4.7.1. Pricing
o 4.7.2. Medicare Reimbursement
4.8. The Market
o 4.8.1. End Users
4.8.2. Worldwide and U.S. Sales
4.8.3. Leading Competitors
CHAPTER FIVE: AIRWAY AND MASK DEVICES
5.1. Background
5.2. Airway and Mask Devices: Usage Patterns
5.3 Airway Devices: Types
o 5.3.1. Endotracheal Tubes
 a) Usage Patterns
 b) Types
o 5.3.2 Tracheostomy Tubes
o 5.3.3. Nasopharyngeal Catheters
o 5.3.4. Nasal Cannulae
o 5.3.5. Emergency Airways
Mask Devices
o 5.4.1. Oxygen Masks
o 5.4.2. Anesthesia Masks
5.5. Resuscitators
o 5.5.1. Pulmonary Resuscitators
 a) Exhaled Air Pulmonary Resuscitators
 b)Manual Pulmonary Resuscitators
 c)Gas-Powered Pulmonary Resuscitators
5.6. Airway and Mask Devices: Product Advantages and Disadvantages
o a) General Advantages
o b) General Disadvantages
5.7. Pricing
o 5.7.1. Endotracheal Tubes
o 5.7.2. Tracheostomy Tubes
o 5.7.3. Nasopharyngeal Catheters
o 5.7.4. Nasal Cannulae
o 5.7.5. Emergency Airways
o 5.7.6. Resuscitators
5.8. The Market
o 5.8.1. Market Segments
 a) Endotracheal Tubes
 b) Tracheostomy Tubes
 c) Nasopharyngeal Catheters
 d) Nasal Cannulae
 e) Emergency Airways

7.  f) Oxygen Masks and Oxygen Tubing
 g) Anesthesia Masks
 h) Pulmonary Resuscitators
o 5.8.2. Sales by Unit Volume
 a) Endotracheal Tubes
 b) Tracheostomy Tubes
 c) Nasopharyngeal Catheters
 d) Nasal Cannulae
 e) Emergency Airways
 f) Oxygen Masks and Tubing
 g) Pulmonary Resuscitators
 h) Resuscitator Masks
o 5.8.3. Sales by Dollar Volume
 a) Endotracheal Tubes
 b) Tracheostomy Tubes
 c) Nasopharyngeal Catheters
 d) Nasal Cannulae
 e) Emergency Airways
 f) Oxygen Masks and Tubing
 g) Pulmonary Resuscitators
 h) Resuscitator Masks
5.9. Leading Competitors
o a) Endotracheal Tubes
o b) Tracheostomy Tubes and Cannulae
o c) Emergency airway devices and Oxygen masks
o d) Pulmonary Resuscitators and Accessories
CHAPTER SIX: POSITIVE AIRWAY PRESSURE DEVICES
6.1. Background
6.2. Positive Airway Pressure Devices: Usage Patterns
o 6.2.1. Obstructive Sleep Apnea
o 6.2.2. Mixed Sleep Apnea
o 6.2.3. Central Sleep Apnea
6.3. Positive Airway Pressure: Product Types
o 6.3.1. Continuous Positive Airway Pressure Devices
o 6.3.2. Bi-Level Devices
6.4. Positive Airway Pressure Devices: Advantages and Disadvantages
6.5. Positive Airway Pressure devices: Product Accessories
o 6.5.1. Plastic Tubing
o 6.5.2. Gross-Particle Intake Filters
o 6.5.3. Small-Particulate Intake Filters
o 6.5.4. Headgear and masks
o 6.5.5. Humidifiers
6.6. Pricing
o 6.6.1. CPAP and Bi-Level Machines

8. o 6.6.2. Accessories
6.7. The Market
o 6.7.1. End Users
o 6.7.2. Sales by Channel
o 6.7.3. Sales by Unit Volume
 a) CPAP Devices
 b) Bi-Level Devices
 CPAP/Bi-Level Device accessories
6.7.4. Sales by Dollar Volume
6.7.5. Leading Competitors
CHAPTER SEVEN: MECHANICAL VENTILATORS
7.1. Background
7.2. Mechanical Ventilators: Usage Patterns
7.3. Mechanical Ventilators: Types
o 7.3.1. Portable Ventilators
o 7.3.2. Critical-Care Ventilators
o 7.3.3. Anesthesia Ventilators
o 7.3.4. Transport Ventilators
7.4. Pricing
o 7.4.1. Portable and Transport Ventilators
o 7.4.2. Critical-Care Ventilators
o 7.4.3. Anesthesia Ventilators
7.5. Ventilator Accessories
o 7.5.1. Heated Humidifiers and Humidifier Tubing
o 7.5.2. Heat/Moisture Exchangers
o 7.5.3. Filters
o 7.5.4. Water Traps
o 7.5.5. Positive-End Expiratory Pressure Valves
o 7.5.6. Nebulizer Supply Lines
o 7.5.7. Spirometers
o 7.5.8. Face Masks
7.6. The Market
o 7.6.1. Critical-Care, Portable, and Transport Ventilator Patients
o 7.6.2. Anesthesia Ventilator Patients
o 7.6.3. Critical-Care Ventilators
o 7.6.4. Portable and Transport Ventilators
o 7.6.5. Anesthesia Ventilators
7.7. Sales by Unit Volume
o 7.7.1. Critical-Care ventilators and Breathing Circuits
o 7.7.2. Portable and Transport ventilators and Breathing Circuits
o 7.7.3. Anesthesia ventilators and Breathing Circuits
7.8. Sales by Dollar Volume
o 7.8.1. Critical-Care Ventilator and Breathing Circuits
o 7.8.2. Portable and Transport Ventilator Circuits

9. o 7.8.3. Anesthesia Ventilators and Circuits
7.9. Leading Competitors
CHAPTER EIGHT:OXYGEN THERAPY SYSTEMS
8.1. Background
8.2. Oxygen Therapy Systems: Usage Patterns
o 8.2.1. COPD Patients
o 8.2.2. Hypoxia, Dyspnea, and Fatigue Patients
o 8.3. Oxygen Therapy Systems: Types
o 8.3.1. High-Pressure Cylinders
o 8.3.2. Oxygen Concentrators
o 8.3.3. Liquid Oxygen
8.4. Oxygen Concentrators: Product Accessories
o 8.4.1. Disposable Oxygen Tubing
o 8.4.2. Disposable Nasal Cannulae
o 8.4.3. Disposable and Reusable Filters
8.5. Pricing
8.6. The Market
o 8.6.1. End Users
o 8.6.2. Sales by Distribution Channel
o 8.6.3. Sales by Unit Volume
o 8.6.4. Sales by Dollar Volume
8.6.5. Leading Competitors
CHAPTER NINE: HUMIDIFIERS
9.1. Background
9.2. Humidifiers: Types
o 9.2.1. Heated Humidifiers
o 9.2.2. Heated-Wire Breathing Circuits
o 9.2.3. Heat/Moisture Exchangers
o 9.2.4. Pass over Humidifiers
9.3. Humidifier Accessories
o 9.3.1. Heated Humidifier Reservoirs
o 9.3.2. Corrugated Tubing for Inspiratory Limb
o 9.3.3. Pass-Over Humidifier Reservoirs
9.4. Humidifiers: Product Advantages and Disadvantages
9.5. Price
o 9.5.1. Heated Humidifier Reservoirs and Accessories
o 9.5.2. HMEs
o 9.5.3. Pass over Humidifier Reservoirs
9.6. The Market
o 9.6.1. Patients
o 9.6.2. Sales by Channel
o 9.6.3. Sales by Unit Volume

10. o 9.6.4. Sales by Dollar Volume
9.7. Leading Competitors
CHAPTER TEN: RESPIRATORY MEASUREMENT DEVICES
10.1 Background
10.2 Respiratory Measurement Devices: Types
10.2.1. Pulse Oximeters
o a) Pulse Oximetry: Usage Patterns
o b) Sensors: Types
o c) Monitors: Types
10.2.2. Capnographs
o a) Gas-Sampling Lines for Capnographs
10.2.3 Spirometers
o a.) Mechanical Volume Spirometers
o b) Automated-Flow Spirometers
10.2.4. Peak Flowmeters
10.3. Respiratory Measurement Devices: Product Advantages and
Disadvantages
o a) Advantages
o b) Disadvantages
10.4. Respiratory Measurement devices: Disposable Accessories
o 10.4.1. Pulse Oximetry
o 10.4.2. Capnography
o 10.4.3. Spirometry
o 10.4.4. Peak Flowmeters
10.5. Pricing
o 10.5.1. Pulse Oximetry
o 10.5.2. Capnography
o 10.5.3. Spirometry
o 10.5.4. Peak Flow Meters
10.6. The Market
o 10.6.1. Sales by Unit Volume
 a) Pulse Oximetry
 b) Capnography
 c) Spirometry
 d) Peak Flowmeters
o 10.6.2. Sales by Dollar Volume
 a) Pulse Oximetry
 b) Capnography
 c) Spirometry
 d) Peak Flowmeters
o 10.7. Leading competitors
LIST OF EXHIBITS

11. Exhibit 1: Worldwide Market for Respiratory Disposables, Sales Volume (Millions),
(2009-2015)
Exhibit 2: Worldwide Market for Inhalers & Accessories, Unit Volume (Millions),
(2009-2015)
Exhibit 3: Worldwide Market for Inhalers & Accessories, Sales Volume (Millions),
(2009-2015)
Exhibit 4: Worldwide Market for Nebulizer Compressors, Unit Volume (Millions),
(2009-2015)
Exhibit 5: Worldwide Market for Nebulizer Compressors, Sales Volume (Millions),
(2009-2015)
Exhibit 6: Worldwide Market for Nebules, Unit Volume (Millions), (2009-2015)
Exhibit 7: Worldwide Market for Nebules, Sales Volume (Millions), (2009-2015)
Exhibit 8: Worldwide Market for Nebule Cups, Unit Volume (Millions), (2009-2015)
Exhibit 9: Worldwide Market for Nebule Cups, Sales Volume (Millions), (2009-2015)
Exhibit 10: Worldwide Market for Airway and Mask Devices, Unit Volume (Millions),
(2009-2015)
Exhibit 11: Worldwide Market for Airway and Mask Devices, Sales Volume
(Millions), (2009-2015)
Exhibit 12: Worldwide Market for Positive Airway Pressure Devices, Unit Volume
(Millions), (2009-2015)
Exhibit 13: Worldwide Market for Positive Airway Pressure Devices, Sales Volume
(Millions), (2009-2015)
Exhibit 14: Worldwide Market for Mechanical Ventilators, Unit Volume (Millions),
(2009-2015)
Exhibit 15: Worldwide Market for Mechanical Ventilators, Sales Volume (Millions),
(2009-2015)
Exhibit 16: Worldwide Market for Portable Oxygen Concentrators, Unit Volume
(Millions), (2009-2015)
Exhibit 17: Worldwide Market for Portable Oxygen Concentrators, Sales Volume
(Millions), (2009-2015)
Exhibit 18: Worldwide Market for Hospital Oxygen Concentrators, Unit Volume
(Millions), (2009-2015)
Exhibit 19: Worldwide Market for Hospital Oxygen Concentrators, Sales Volume
(Millions), (2009-2015)
Exhibit 20: Worldwide Market for Oxygen Cylinders, Unit Volume (Millions), (2009-
2015)
Exhibit 21: Worldwide Market for Oxygen Cylinders, Sales Volume (Millions), (2009-
2015)
Exhibit 22: Worldwide Market for Liquid Oxygen Systems, Unit Volume (Millions),
(2009-2015)
Exhibit 23: Worldwide Market for Liquid Oxygen Systems, Sales Volume (Millions),
(2009-2015)
Exhibit 24: Worldwide Market for Humidifiers, Unit Volume (Millions), (2009-2015)
Exhibit 25: Worldwide Market for Humidifiers, Sales Volume (Millions), (2009-2015)
Exhibit 26: Worldwide Market for Respiratory Measurement Devices, Unit Volume
(Millions), (2009-2015)

12. Exhibit 27 Worldwide Market for Respiratory Measurement Devices, Sales Volume,
(Millions), (2009-2015)
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