Traditional Chinese Medicine

Traditional Chinese medicineTraditional Chinese medicine (TCM) is a 2,500-year-old system of diagnosis and treatment that emphasizes the prevention of diseases. TCM medicines are tailored to each individual and may need to be altered from time to time, therefore, patients are encouraged to see their TCM doctor frequently. After the fall of the Qing dynasty in 1911, TCM was regarded as superstition but in recent years the practice has seen an increase in popularity. An interest in preventative medicine as a way to avoid costly trips to the hospital as well as President Xi Jinping’s endorsement of it, calling it “the gem of Chinese traditional science,” have contributed to its popularity. In 2015 there were 452,000 licensed practitioners in China, an increase of 50% from four years prior. One-third of China’s pharmaceutical market consists of TCM medicines approved by the government.

Today’s market size shows the number of hospitals in China that offered TCM either alone or in conjunction with modern medicine in 2003 and 2015.

Geographic reference: China
Year: 2003 and 2015
Market size: 2,500 and 4,000 respectively
Source: “Health Care With Chinese Characteristics,” The Economist, September 2-8, 2017, pages 37-38.
Image source: mac8739, “chinese-medicine-donguibogam-2178253,” Pixabay, April 2017 available online here.

Smart Wearable Healthcare Market

fitbit-imgThe market for smart wearable healthcare devices is one part of the larger smart wearables market as a whole. The term wearables is used to refer to any electronic device, usually small, that can be worn relatively easily during the normal activities of life. Examples include wristbands such as the Fitbit, smart watches, clip on devices like pedometers and even clothing into which sensors have been sewn.

Smart wearable healthcare devices are those that are specifically designed to help a person monitor his or her own health—activity level, hours of sleep, heart rate, temperature, blood pressure, etc.—as well as devices designed to communicate remotely with medical providers so that they may monitor a patient from afar.

Geographic reference: United States
Year: 2014 and forecasted for 2020
Market size: $2 billion and $41 billion respectively
Source: “Healthy Beats — With Health Being the ‘Great Motivator,’ Wearables Are Gaining Popularity,” Corp! Sept./Oct. 2016, pages 36-39.
Original source: Soreon Research

Training Doctors

The education and training of a doctor is a long and costly endeavor. First comes the classroom education, the cost of which is picked up, for the most part for those not fortunate enough to get a scholarship, by the future doctor him or herself. Then comes a final on-the-job training period in which doctors with new diplomas spend four or more years working in a residency program.

During this residency, doctors in training see and treat patients under the supervision of more seasoned physicians. Most of these residency programs are carried out in teaching hospitals, which account for approximately 20% of the nation’s hospitals. Residency programs are arduous. Residents are expected to routinely work 80 hours a week and they are paid half or far less of what they will receive for much the same work after the residency. This training is expensive for the system as a whole and has been, for all practical purposes, nationalized.

The U.S. federal government pays for most of this training with money from the Medicare and Medicaid systems. Our market size today is the money spent by the federal government annually to support this graduate medical education.

Geographic reference: United States
Year: 2012
Market size: $11.5 billion of U.S. government funds are used to support residency slots in training hospitals, approximately 115,000 in 2012
Source: Catherine Dower, “Graduate Medical Education,” a health policy brief published in Health Affairs, on August 31, 2012 and available online here.
Original source: U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services
Posted on January 22, 2014

Home Health Care Services

With an aging population it will come as no surprise to most people that the home health care services industry has seen steady growth over the last decades and is forecast to see continued growth well into the next decade.

Today’s market size post is the revenue earned in 2002 and 2012 by all firms with employees in the business of providing home health care services in the United States. This industry [NAICS 6216] is defined as follows by the Census Bureau: “This industry comprises establishments primarily engaged in providing skilled nursing services in the home, along with a range of the following: personal care services; homemaker and companion services; physical therapy; medical social services; medications; medical equipment and supplies; counseling; 24-hour home care; occupation and vocational therapy; dietary and nutritional services; speech therapy; audiology; and high-tech care, such as intravenous therapy.”

Geographic reference: United States
Year: 2002 and 2012
Market size: $30.39 billion and $66.07 billion respectively
Sources: (1) “Table 8.1. Health Care and Social Assistance (NAICS 62)—Estimated Revenue for Employer Firms: 2002 Through 2010,” Service Annual Survey 2010, February 2012, page 151, available online here. (2) “Table 1 – Selected Services Estimated Quarterly Revenue for Employer Firms Fourth Quarter 2003 Through Fourth Quarter 2012,” Annual Benchmark Report for Services through 2012, a link to which is available on the U.S. Census Bureau’s website, here.
Original source: U.S. Department of Commerce, Bureau of the Census
Posted on November 13, 2013

Pharmacy Benefit Managers

The cost of prescription drugs in the United States is a subject about which there is much controversy. As the Affordable Care Act—or, Obamacare—gets off to a rocky start across the nation, we decided to look at just one small part of the prescription drug distribution network, about which most people are not particularly conscious. That is the segment made up of Pharmacy Benefit Managers (PBMs), middlemen who stand in a central position in the prescription drug supply chain and who, it turns out, have carved out for themselves a rather lucrative business. The three largest PBMs—Express Scripts, CVS Caremark, and OptumRx—together control about 70% of all prescriptions filled in the United States.

PBMs are firms that provide an administrative service to insurance companies, large self-insured employers, and government benefit providers. They develop and maintain drug formularies—lists of specific drugs to be covered and the prices for each—for their insurance providing customers. They also negotiate with pharmaceutical companies for preferred pricing on the drugs covered in those formularies and they negotiate with retailers to accept those terms and participate in the PBM’s network of preferred pharmacies.

According to an article in Fortune magazine, “PBMs started as paper pushers: They began hand-processing medical claims in the 1970s and evolved into middlemen who touted their ability to use corporate customers’ combined purchasing power to negotiate huge discounts from pharmaceutical companies. Today the top PBMs are as big as or bigger than their clients.” The United States has a unique health care delivery system, one which is significantly fuller of lucrative middleman-businesses than the systems present in other industrialized nations.

Today’s market size is the total estimated revenue earned by Pharmacy Benefit Managers in the United States in 2012.

Geographic reference: United States
Year: 2012
Market size: $250 billion
Source: Katherine Eban, “Painful Prescription,” Fortune, October 28, 2013, pages 202-207.
Original source: J.P. Morgan analysts
Posted on November 4, 2013

Dentistry

Dentists

The practice of dentistry is a part of the overall health care industry and recent trends in this segment of the health care industry show a pattern similar to that of the industry as a whole. Steady growth. The graph shows estimated revenue taken in by Offices of Dentists annually from 1998 through 2012. While the rate of increase slowed a bit after the recession and financial crisis that hit in 2007 and 2008, growth in revenue continued. The growth in revenue for dentist offices between 1998 and 2012 exceeded inflation by 61.6% (dentistry’s 102.6% increase versus inflation which grew 41%).

Factors influencing that rate of growth for dentists are many of the same factors driving the overall health care industry, primarily among them, demographics and technology. As we age, we need more health care services of all sorts, including dental care. Technological advances are a driver in the field because they make available services that simply did not exist before and improve the ones that did. According to the American Dental Trade Association in the early 2000s nearly half of dentists’ revenues were being generated from procedures and treatments that were not available 20 years earlier.

Today’s market size is the total estimated revenue earned by offices of dentists in the United States in 2000 and in 2012.

Geographic reference: United States
Year: 2000 and 2012
Market size: $58.8 billion and $104.3 billion respectively
Sources: “Table 8.1. Health Care and Social Assistance (NAICS 62)–Estimated Revenue for Employer Firms: 2002 Through 2010,” Service Annual Survey 2010, U.S. Census Bureau, February 2012, page 171, a link to which is offered here. Data for years before 2002 come from the Service Annual Survey 2003, available from the same website. The data from 2011 and 2012 come from the “Estimated Quarterly Revenue for Employer Firms, Fourth Quarter 2003 Through Fourth Quarter 2012,” part of the same Annual and Quarterly Services tracking done by the Census Bureau in preparing their annual report. The quarterly data are available here. Jeffrey R. Lavers, “Market Trends in Dentistry,” Dental Economics, available online here.
Original source: U.S. Department of Commerce, Bureau of the Census
Posted on October 24, 2013

High-Deductible Health Insurance Plans

High-deductible health insurance plans are insurance policies in which consumers pay lower monthly premiums but incur higher out-of-pocket costs when visiting doctors and hospitals. In the past decade, high-deductible health plans have become more common. Some believe that these insurance policies will reduce overall health spending, especially on discretionary services, and thereby keep premiums affordable. But some studies show that while trips to the emergency room are reduced, especially for minor ailments, many consumers are also forgoing getting treatment for more serious conditions such as kidney stones or heart trouble. And, when treatment is sought, the cost of treatment is higher due to the increased severity of the illness.

Today’s market size is the number of consumers in the United States with high-deductible health insurance plans as of early 2013, a three-fold increase since 2006.

Geographic reference: United States
Year: 2013
Market size: 13.5 million
Source: Ashley Griffin, “Men Put Off Health Care When It Costs More,” Lansing State Journal, July 21, 2013, pages 1C, 4C
Posted on August 2, 2013

Hospitals in the United States

Hospitals2

Today we update an earlier post on a part of the huge health services industry, namely, hospitals. The graph shows the total annual revenues of all U.S. hospitals as they are defined by the Census Bureau, below, over a fifteen year period. Annual revenues for this industry appear to rise, regardless of economic conditions, recessions, financial crisis, or business cycles.

This industry is identified within the industry coding system, NAICS, with the code 622 and is defined by the Census Bureau as including hospitals whose primary business is to “provide medical, diagnostic, and treatment services that include physician, nursing, and other health services to inpatients and the specialized accommodation services required by inpatients. Hospitals may also provide outpatient services as a secondary activity. Establishments in the Hospitals subsector provide inpatient health services, many of which can only be provided using the specialized facilities and equipment that form a significant and integral part of the production process.”

Geographic reference: United States
Year: 2005 and 2012
Market size: $620.85 billion and $904.47 billion respectively
Source: “Table 1 – Selected Services, Estimated Quarterly Revenue for Employer Firms,” Annual Benchmark Report for Services through 2012, a series of reports put out by the Census Bureau in conjunction with their Service Annual Survey, published every non-Economic Census year. The Service Annual Survey reports are accessible on the Census web site here.
Original source: U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau
Posted on July 10, 2013

Plastic Surgery

Procedures that fall under the umbrella of plastic or cosmetic surgery include minimally intrusive procedures such as laser hair removal and injections of Botulinum toxin or collagen. They also include more extensive, often reconstructive procedures that are necessary to restore a person after an accident, animal bite, or surgery to remove a tumor, for example.

Today’s market size is the number of, and estimated total spent on, cosmetic surgical procedures performed in the United States in 2012. This includes all surgical procedures but does not include the minimally-intrusive procedures such as chemical peels, laser hair removal nor soft tissue filling procedures. In terms of spending, cosmetic surgeries make up 55.6% of the total spent on all cosmetic procedures and in terms of number of procedures, surgeries account for 10.9% of all procedures.

Geographic reference: United States
Year: 2012
Market size: 1,594,526 surgeries valued at $6.12 billion
Source: 2012 Plastic Surgery Statistics Report, “2012 Average Surgeon/Physician Fees,” American Society of Plastic Surgeons, 2013, page 20, available online here.
Posted on May 3, 2013

Psychiatric Hospitals

A great deal of attention is paid to the health care industry and its remarkable rates of growth. However, one segment of that industry has not experienced growth, has in fact shrunk. That segment is psychiatric hospitals. Because of changing policies and attitudes about how the mentally ill should be treated, psychiatric hospitals have been on a steady decline for many decades in the United States. The number of beds available in psychiatric hospitals in 1955 was equal to 1 bed for every 300 people in the general population. In 2005, that number had fallen to 1 bed for every 3,000 people.

Yet the rate of serious mental illness in the society has not changed during the fifty years between these two measures. This means that many, many mentally ill people end up incarcerated and/or, when they reach a breaking point, in the emergency rooms of general hospitals. According to a 2007 report from the National Health Policy Forum, there were nearly 2 million admissions to general hospitals in 2004 of patients suffering from mental health problems. Clearly, demand for some important things is not met through the mechanisms of a free market.

Today’s market size is the number of beds available in psychiatric hospitals in the United States in 2005.

Geographic reference: United States
Year: 2005
Market size: 99,800
Source: “More Mentally Ill Persons Are in Jail and Prison Than Hospitals: A Survey of the States,” a report published by the National Sheriffs Association and the Treatment Advocacy Center, May 2010, available online here. Eileen Salinshy and Christopher Loftis, PhD, “Shrinking Inpatient Psychiatric Capacity: Cause for Celebration or Concern?” National Health Policy Forum, August 1, 2007.
Posted on April 30, 2013

Nutritional Supplements Market

The market we’re presenting today is one that includes a large range of ingestible products, from vitamins and calcium pills to protein shakes, diet pills and energy drinks. The market is also referred to by various names, among them: nutritional supplements, dietary supplements, and simply, supplements. By whatever the name, this is a lucrative market and one that many people feel is less regulated than would be prudent. The federal guidelines regulating the ingredients used in the production of nutritional supplements are far less restrictive than those imposed on food and drink makers. Worth noting is the fact that federal requirements of pharmaceutical companies are even more restrictive than those regulating the food and drink industry. Nutritional supplements are not bound by the regulations for either of these industries—food and drink nor pharmaceuticals.

The supplements market has been growing steadily since the turn of the century and is expected to continue growing. Driving the growth are a number of factors. An older population looking to supplements to minimize the effects of aging is one such driver. The young, too, are using supplements heavily. Having grown up in a society that appears to approve of the use of chemicals to augment human capacities of all sorts, they turn to supplements to help build muscle, lose weight, and stay awake.

Geographic reference: United States
Year: 2011
Market size: $30 billion
Source: Natasha Singer and Peter Lattman, “Is the Seller to Blame,” The New York Times, March 17, 2013, page B1, available online here. Brittany McNamara, “Monster Energy Switches from Supplement to Beverage,” Nutrition Business Journal, February 14, 2013, available online here.
Original source: Nutrition Business Journal
Posted on March 20, 2013

The Sleep Business

In 2012, approximately three-fourths of internet users searched online for health information. Half of them searched specifically for sleep remedies. According to the National Sleep Foundation, only 56% of Americans report getting a “good night’s sleep” on a typical night. Some sleep studies have found a link between insufficient sleep and hypertension, depression, diabetes, and other illnesses. Spending related to sleep has increased 8.8% yearly since 2008. Spending on over-the-counter sleep aids increased 31% from 2006 to 2011, with the biggest increase being spending on natural and homeopathic products.

Today’s market size is the estimated amount spent in the United States, in 2012, on things designed to aid sleep, from pills and medical devices to sleep consultants who work with hospitals and deluxe mattresses made with tension-relieving foams.

Wishing all our readers a sound night’s sleep!

Geographic reference: United States
Year: 2012
Market size: $32 billion
Source: Kit Yarrow, “The Sleep Industry: Why We’re Paying Big Bucks for Something That’s Free,” Time, January 28, 2013, available online here.
Posted on March 1, 2013

Face-Lift Market

Some people choose to undergo cosmetic surgery because of perceived economic benefits to being more attractive. Some simply feel that they will be happier if they are more attractive according to society’s standards of beauty. Today’s market size shows the amount Americans spent on face-lifts in 2010.

Geographic reference: United States
Year: 2010
Market Size: $845 million
Source: Abigail Tucker, “How Much is Being Attractive Worth?” Smithsonian, November 2012, page 18, also available online here.
Posted on January 4, 2013

Medicare Enrollment

Medicare Enrollment Stats

Today is the 70th anniversary of the attack on Pearl Harbor. Today is also the final day of the Medicare annual enrollment period. Only one of these topics lends itself to a market size post. Worth noting—and by way of tying these two things together a little—is the fact that anyone (now an American citizen) who was around on the day that Pearl Harbor was attacked, is now eligible for Medicare.

Today’s market size is the number of people enrolled in the Medicare health insurance system in the United States in 2010. The graphic provides data on enrollment from 1970 to 2010 and shows how this population relates to the total U.S. population over this period.

Geographic reference: United States
Year: 2010
Market size: 47.2 million
Source: “Table I.1 Medicare Enrollment Trends,” part of the statistical offerings on the Federal Government’s CMS website here.
Original source: Center for Medicare and Medicaid Services, U.S. Department of Human Health and Services
Posted on November 7, 2011

Veterans Enrolled in the VA

Today’s post is about veterans since it is the holiday we have designated for remembering our veterans of foreign wars. The Department of Veterans Affairs has since 1999 done an annual survey to help track the number of veterans who are enrolled to receive health benefits through the Veterans Administration (VA). It may surprise some people to discover that a veteran of the U.S. military would even need to enroll in anything to receive VA benefits but things are more complicated as it turns out.

Here is an explanation from the VA on the need to enroll annually for some veterans. “Enrollments are renewed annually and many veterans will stay enrolled each year without any action on their part. Most veterans who are not receiving monthly compensation or pension checks from VA, however, must complete an annual financial statement known as a Means Test. Completing a Means Test allows the VA to place you in the correct Priority Group for determination of copayments. It also ensures that your local VA receives reimbursement from VA for the health care provided to you.”
Link to quoted source.

The market size listed below is the number of U.S. veterans enrolled to receive VA benefits in 2002 and in 2010.

Geographic reference: United States
Year: 2002 and 2010
Market size: 6.2 million (approximately 25% of the veteran population in 2002) and 7.8 million (approximately 35% of the veteran population in 2010)
Source: “Table 7.1—Perceived Health Status by Year,” 2010 Survey of Veteran
Enrollees’ Health and Reliance Upon VA,
July 2011, page 74, available in a PDF format here.
Original source: U.S. Department of Veterans Affairs
Posted on 11/11/11

Cancer Diagnoses

Today’s market size is one based on a medical diagnosis and thus is really the size of the “customer” base for cancer treatment. Specifically, it is the number of people who were diagnosed with cancer of any type, anywhere in the world, in 2008.

Geographic reference: World
Year: 2008
Market size: 13 million
Source: “Death Rates are Down in the U.S. But Globally the Disease is Rising,” National Geographic, October 2011, page 28.
Original source: Globocan, International Agency for Research on Cancer
Posted on October 14, 2011

Hospitals

Most of us are well aware of the rising costs of health care. It will not come as a surprise to see that revenues for hospitals in the United States have seen steady increases year-over-year, despite recessions, slowdowns, housing bubbles, financial melt-downs, or any other events that disrupt the economy. This is not to suggest that individual hospitals may not have struggled during our most recent recession, however, as a whole, the hospital industry has seen nothing but rising revenues for well over a decade.

Today’s market size is the revenue earned by hospitals in the United States in 2005 and 2010. Revenues increased over this period by 30.4%, more than twice the rate of inflation during over the same period which was 12.8%. To your health!

Geographic reference: United States
Year: 2005 and 2010
Market size: $620.85 billion and $809.47 billion respectively
Source:  “Table 1 – Selected Services, Estimated Quarterly Revenue for Employer Firms,” Annual Benchmark Report for Services through 2010, page 9, a series of reports put out by the Census Bureau in conjunction with their Service Annual Survey, published every non-Economic Census year. The table from which today’s market size is taken is available online here.
Original source: U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau
Posted on September 20, 2011

MHealth

The term “mHealth” is one being used to help define a category of medical services and devices and a growing part of the healthcare industry. It stands most simply for mobile health care, more fully “emerging mobile communications and network technology for healthcare.”

This market encompasses the use of mobile technology in the service of providing health care. It includes all those applications which combine body sensors with mobile or static devices designed to monitor a patient’s vital signs or some specific bodily function. The infrastructure behind these devices is also part of the category. An example of such a device is an electrode patch which may be worn by a patient and automatically sends the monitoring center information about the patient while he or she is on-the-go. The information is sent by a tiny radio transmitter built into the epidermal electronic device.

Today’s market size is the estimated size of the market for mHealth products in 2010 and a forecast for the size in 2014. Please note, however, that this market has yet to be well defined and as a result various research firms have come up with widely disparate projections of its size. The source listed below provides a link to an article explaining this problem more fully, titled “mHealth predictions: $1.9B, $4.4B, $4.6B?” Defining the market is key!

Geographic reference: United States
Year: 2010 and a forecast for 2014
Market size: $1.5 and $4.6 billion respectively
Source: “Market Size Projections for mHealth and Wireless Health,” Wireless Health Strategies, March 19, 2010, available online here.
Original source: CSMG, a division of TMBG Global
Posted on September 06, 2011

Veterinary Services

A sleepy looking Katie the Beagle

The downturn in the U.S. economy has not spared many but there is always some variation in how such a sharp economic slowdown hits some industries versus others. Veterinarians are among those who often see their base business less impacted than others. While dealing with declining revenues in 2009, veterinary service providers saw a decline of only 0.6% between 2008 and 2009. Of the 27 5-digit NAICS (North American Industrial Classification System) industries in the professional services sector, the veterinary services industry was one of four that saw revenues decline by 0.6% or less between 2008 and 2009. Many other professional service providers saw revenues decline by 15% or more.

Today’s market share is based on the estimated revenues earned by veterinary service providers in the United States in 2009.

Geographic reference: United States
Year: 2009
Market size: $25.64 billion
Source: “Table 6.1. Professional, Scientific, and Technical Services (NAICS 54) – Estimated Revenue for Taxable Firms: 2001 Through 2009,” page 1 and 2 of an extract from Service Annual Survey: 2009, available online here.
Original source: U.S. Bureau of the Census
Posted on August 30, 2011

High-Deductible Health Insurance Plans

High-deductible health insurance plans have lower premiums than traditional coverage but the insured pays quite a bit more out-of-pocket before any coverage starts. If the deductibles in such plans are at least $1,200 for individuals and $2,400 for families, the plans can be paired with Health Savings Accounts (HSAs). HSAs allow employees to deposit pre-tax income to pay for medical expenses. In many cases, employers also contribute to their employees’ HSAs.

Today’s market size shows enrollment for high-deductible health insurance plans with health savings accounts as of January of that year. In 2011, this represented 7% of all health insurance enrollment for people younger than 65.

Geographic reference: United States
Year: 2008 and 2011
Market size: 6.1 million and 11.4 million respectively
Source: Tom Murphy, “More Are Enrolling in High-Deductible Plans,” Lansing State Journal, June 19, 2011, page 3E
Original source: America’s Health Insurance Plans