Eye Care Needs Rising Quickly in Asia

By Ames Gross
November 28, 2016


• Categories: Business Analysis, Market Access

Recent medtech growth trends emerging from the Asian countries are providing opportunities for Western medical device companies to expand their businesses. While North America provides the largest market for global ophthalmic devices, studies indicate that Asia has the fastest growing consumer base. Recent changes in environmental and lifestyle factors such as air pollution, an aging population, rising levels of obesity, and increased utilization of phones and computers contribute to driving the demand for ophthalmic diagnostic and treatment devices. Common eye diseases include cataracts, blindness, glaucoma and myopia. In addition, a lack of quality locally made ophthalmic devices furthers this need. The combination of these factors presents a tremendous opportunity for foreign eye care device companies in Asia.

Rising Prevalence and Incidence of Eye Diseases

Numerous studies highlight the rapid growth of ophthalmic diseases in Asia. According to a case study conducted by the International Finance Corporation, blindness in China is increasing at a rate of 6% each year, making China home to almost one-fifth of the world’s blind population. Increasing levels of obesity and diabetes are also growing quickly in Asian countries. Glaucoma, a condition often diagnosed in obese and diabetic patients, has become 10 times more prevalent in China over the past 30 years. Even in a small Asian country like Malaysia, the rate of diabetes among adult populations is 17.9%, which ranks 14 highest in the world, according to data from The World Bank. The sharp increase of aging populations also contributes to the development of eye diseases. Conditions such as cataracts and glaucoma are significantly higher in populations over 60.

Myopia, or nearsightedness, is a common condition that causes nearby objects to appear clear, and far away objects to appear blurry. Cited by CNN as an epidemic, rates of myopia have doubled, and even tripled in some Asian countries in the last 40 years. Up from 18% in 1955, the rate of myopia among 20 year olds in South Korea in 2012 was more than 95%. In Hong Kong, Taiwan and Singapore, estimated rates of myopia are approximately 80%. This stands in sharp contrast to the current U.S. myopia prevalence rate of 40%. Many individuals with myopia feel that the condition is not a severe detriment to their health because relatively simple treatments such as glasses, contact lenses or LASIK surgery are widely available. However, experts consider such high rates of myopia a serious issue because individuals who develop the condition at a young age in life are at an increased risk for developing more severe eye diseases as they age.

Despite these alarming rates of ophthalmic disease incidence in Asia, there is generally still a widespread lack of diagnostic and treatment options across Asian eye care markets. Screening procedures to identify common conditions such as cataracts and myopia are sparse in many Asian countries. Often, both patients and doctors are not knowledgeable about prevention and treatment options until the diseases have progressed significantly. In addition, qualified ophthalmologists and doctors needed to perform more serious surgical procedures are in short supply. These issues are further exemplified in poorer Southeast Asian countries, where even fewer resources are available for patients and doctors. One exception to these trends, however, is seen in Japan, which already has a very developed eye care device market.

Ophthalmology Practices in China

One example of such treatment discrepancies can be seen in China. Hospitals in China are classified into a three-tier system. Class I hospitals are typically township hospitals, providing minimum healthcare services. Class II hospitals provide more comprehensive health services in medium-sized cities, while class III hospitals often serve as major hubs providing services to the larger cities. Routine eye care examinations and general diagnostic procedures occur in all three hospital classes in China. However, advanced treatment is more concentrated in class III hospitals because they have the infrastructure and ophthalmologists who have the technical skills to meet international standards. Class III hospitals have sufficient financial resources to invest in pricey imported technologies rather than locally made products. It is estimated that 85% of the sophisticated ophthalmic instruments used in Chinese hospitals are imported.

Even though Chinese class III hospitals have sophisticated ophthalmic diagnostic and treatment devices, there has been little change in the standardization of ophthalmology and clinical practices. The lack of standardization is attributed to low awareness of standard practices among Chinese doctors, low local drive for establishing such guidelines, and lack of basic training. Thus, in the ophthalmic market today, there is a wide range of practice protocols among different Chinese hospitals. This often leads to discrepancies in diagnosing and treating patients with eye diseases. Therefore, there is a need for more advanced Western ophthalmic devices, along with increased training and awareness programs when using such devices.

In general, Chinese ophthalmologists seek new devices that provide the most convenience and practicality in treating patients. They prefer instruments that are durable, quick to clean and easy to master without the support of other medical teams. The key to a foreign ophthalmology company’s increased product sales in China is directly correlated to training and educating physicians about how these sophisticated ophthalmology devices work to improve diagnosis and treatment.

Opportunities for Western Ophthalmic Device Companies

Numerous Western companies have already taken advantage of the need for a growing ophthalmic device market in Asia. Companies including Carl Zeiss Meditec, Ellex, and STAAR Surgical have established a presence in multiple Asian markets and are hoping to continue expanding throughout the region.

Carl Zeiss Meditec is located in Jena, Germany and is a multinational supplier of ophthalmological diagnostic tools, including screening devices, retina imaging devices, and slit lamps. During the first three quarters of their 2015-16 fiscal year, sales increased by almost 20% in the Asia-Pacific region. Overall, the company has seen almost 10% sales growth worldwide, despite experiencing no growth in North American, European and African regions. Carl Zeiss Meditec is currently undergoing a business reorganization to further extend business opportunities.

STAAR Surgical, located in Monrovia, California, is a designer and developer of implantable lenses intended to provide more freedom from using glasses or traditional contact lenses. In 2006, STAAR announced its first successful surgical implant of Visian implantable collamer lenses (ICLs), after gaining approval from the China Food and Drug Administration (CFDA). The lenses are inserted behind the iris through a small surgical incision and have significantly improved vision in patients with extreme myopia or astigmatism. After expanding business to other Asian countries such as Korea, STAAR experienced nearly a 20% increase in ICL sales during fiscal year 2015. The APAC region is a driving force behind total ICL sales and growth for the company.

Ellex Medical Lasers (based in Adelaide, Australia) is a medical leader in lasers and devices utilized in eye care. In 2016, the CFDA granted Ellex regulatory approval for its lasers used for treating glaucoma, vitreous floaters and secondary cataracts. The company’s sales in Asia grew by more than 50% during the second half of 2015. In light of the CFDA approval of its new laser devices, the company expects to see significantly higher growth in Asia in upcoming years. For companies like Carl Zeiss Meditec, Ellex Medical Lasers and STAAR Surgical, making specialized high-tech equipment is a tremendous opportunity in Asia because these countries often lack such products in their markets.

A variety of changing environmental and social factors are contributing to the rise of various ophthalmic diseases throughout Asia. In countries such as China, there is a need for more advanced technologies, which requires stricter training procedures and guidelines to ensure ease and uniformity in treatment. Western ophthalmic device companies with strong products and training procedures should take advantage of these necessities in order to rapidly expand their businesses to the Asian market.