Automated Endoscope Reprocessors (AER) Market Growth Opportunities, 2021

Breakthrough Technologies and Strategic Collaborations Drive Growth Strategies

While the entire healthcare industry adapts to changes induced by the COVID-19 pandemic, the endoscope reprocessing industry undergoes a major technology transformation. The rise in multiple infection outbreaks from contaminated endoscopes due to faulty endoscope reprocessing and manual errors in cleaning presents huge growth potential for automated endoscope reprocessors (AER), which offer high-level disinfection (HLD) in endoscope reprocessing.

However, the complex design and faulty reprocessing of reusable endoscopes, specifically duodenoscopes which pose the highest risk of patient cross-contamination, have led to a gradual shift toward single-use or disposable endoscopes that require no reprocessing. Following the pandemic, governments are increasingly recommending endoscope manufacturers to simplify endoscope design or shift to disposable ones, especially in the United States. The shift to disposable endoscopes is further supported by the Centers for Medicare and Medicaid granting reimbursement for such endoscopes. Single-use duodenoscopes are preferred in endoscopic retrograde cholangiopancreatography (ERCP) procedures as they offer zero cross-contamination risk and zero reprocessing, repair and maintenance, and labor costs. Leading participants Boston Scientific and Ambu have already introduced single-use endoscopes. These pose a major threat to endoscope reprocessing stakeholders, specifically AER manufacturers, as AERs could become obsolete. AER manufacturers are seeking ways to retain or strengthen their market share in the endoscope reprocessing market.

More and more endoscopic procedures are being conducted outside hospital premises in ambulatory surgery centers (ASC), ambulatory endoscopy centers (AEC), physicians’ own clinics, specialty gastrointestinal clinics, and diagnostic centers. Unlike hospitals that have in-house central sterile supply departments (CSSD) or reprocessing departments, these endoscopy facilities usually engage off-site reprocessing centers for endoscope HLD. Off-site reprocessing facilities have captured a substantial share of the end-user market for AERs, which can be classified into two major segments: single-chamber AERs and dual/multi-chamber AERs. While dual/multi-chambers AERs remain the preference of hospitals and large-scale reprocessing facilities, single-chamber AERs are increasingly being installed in AECs and physicians’ clinics.

The global competitive landscape comprises about 15 AER manufacturers that offer single-chamber and dual/multi-chamber AERs. Apart from Olympus which reprocesses its own brand of endoscopes, the majority of manufacturers offer AERs that can reprocess all types and models of endoscopes. The latest features in AERs, such as track-and-trace and networking capabilities, asynchronous operation, and printer-integrated for cycle display, boost the adoption of advanced AERs. As such, software solution providers could potentially enter the AER market to upgrade AERs with innovative software capabilities. Automating the reprocessing workflow using robots in CSSDs and large-scale reprocessing facilities is another growth opportunity in the market.

This research service provides an overview of the global AER market and AER models. The North American and European markets are saturated with AERs from different makers with distinct specifications. The European market has more AER replacement sales but fewer new AER installations, while the market in the United States gradually transitions to single-use endoscopes. On the other hand, markets outside these regions offer untapped growth opportunities to AER manufacturers. The study also compares endoscope reprocessing and single-use endoscopes in terms of cost, efficiency, infection rate, and facility volume.

Potential strategies and business models for AER manufacturers to grow in the industry are listed in the study, including effective collaborations with endoscope manufacturers, software solution providers, reprocessing stakeholders, third-party service vendors, and off-site reprocessing facilities. AER manufacturers can work with reprocessing stakeholders to offer bundle or reduced pricing for AERs to expand AER installation, while partnerships with endoscope makers can lead to improved endoscope designs and additional disposable components. As regional AER participants dominate the market in developing nations with low-cost, relatively effective AERs, leading global participants could pursue regional collaborations for geographical expansion and technology improvement.