Within the wound care market, there is an increasing number of devices and drugs addressing wound healing, most recent being growth factors and gene therapy. Their goal is wound healing or treating one stage in wound healing, for example, debridement or granulation/ tissue formation or epidermisation. Yet more products are not necessarily translating into better and more cost-effective treatment. Making distinction between products is challenging, particularly as clinical evidence is not always available or robust. In recent years, there has been increasing focus on bioactives and external devices. Dressings are most widely used products, but are seen as ‘passive’ as they do not activate cells in the wound. Their core function is to absorb exudate.
There is a slow, but sure shift in focus to bioactive dressings and external devices driven not only by ongoing clinical unmet need, but also by manufacturers’ lower willingness to invest in the saturated and commoditized dressings markets, especially for mature markets in EU countries and the United States.
Key Success Factors
Defining the Role of Products in Treatment
The role of products or technologies, especially new ones, needs to be clearly defined in the treatment strategy or pathway. However, key challenges are that it is a crowded market and health care professional’s (HCP’s) ability to differentiate products is not always strong, across, or within categories.
Exhibit 1: Key Success Factors, 2016
Premium Pricing Strategy
Superior products and strong evidence to justify this are essential for a premium pricing strategy. This has been a strong success factor for Molnycke’s strong growth in Advanced Wound Care market, for example. However, the key challenge is that it does not apply for all countries due to pricing and reimbursement constraints.
Positioning New Products or Technologies
The marketing and positioning of the product need to reflect its role in treatment and optimal setting for use. Misuse or usage failures on first attempts can discourage all future use. Understanding when to start and stop using a product is key to its sustainable adoption. It is critical for manufacturers to position their products where it will have optimal benefit, supported by clinical evidence. Support is required for physicians and nurses through classes and symposia. The key challenges are providing sufficient clinical evidence to support product usage choices or allowing sufficient time for HCPs to gain experience using the product.
For new products, manufacturers need to know which markets will allow reimbursement. For new categories or innovative products manufacturers need to provide evidence of clinical and cost-benefit. However, the return on investment (ROI) holds the key, as national reimbursement environments are not very accommodating for disruptive or innovative products. Furthermore, payer education is required, as direct costs are still used by most countries to determine reimbursement status, rather than indirect cost benefit.
Due to the similarity in products it is essential to offer services along with product bundles. Value-added services include holistic training and educational services for nurses and care givers to improve relationship and product familiarity. It is essential to have a large field force on the ground to support or partnerships with contract sales organisations in place. There is a need to develop online resources for training.
Positioning and Differentiation
The top 4 leaders in the advanced wound care market offer a broad product portfolio across product categories, including moist dressings, active therapies, and external devices. Within the moist wound dressings market, for example, all key players offer the full spectrum of product categories, from foam to films, showing the importance of breadth of portfolio.
Exhibit 2: Advanced Wound Care Portfolio, 2016
A Closer Look at the Foams Category
Within the foams category, Smith & Nephew and Mölnlycke are leading companies as they offer a variety of foam products and foam product combinations. As the market is driven by reimbursement and tender processes it is important to have a complete range of foams. Whilst all companies differentiate based on foam technology and conformability, market leaders focus on foam technology & patient benefits in particular for their positioning. Mölnlycke was the first to market with its positioning around ‘pain’, and Smith & Nephew is continually focusing on new product development and improving performance. Regarding patient benefits, the focus on patient quality of life holds the key. Mölnlycke, for example, has a strong focus on reducing pain, with clinical trial evidence. Its Safetac® technology’s main focus is on minimising risk of trauma to the wound or surrounding skin. Therefore, there is less stress for patients and it helps and supports faster healing. Coloplast, as another example, has Biatain Ibu foams which release ibuprofen. Additional patient benefits include silicone adhesives, which focus on patient well-being and the ability to re-position, so there is less pain on removal. Smith & Nephew’s Gentle range for example incorporates silicone adhesives. Lohmann & Rauscher also has introduced a 3 layered wound dressing Suprasorb® P silicone.
Mölnlycke and Smith & Nephew effectively use clinical evidence to support their product claims to increase credibility, highlighting different types of wounds and specific patient categories. Molynlycke and Smith & Nephew have largest volume of clinical evidence supporting their foam products. They tend to focus on all key clinical endpoints, often with country specific examples and a focus on a specific type of wound and/or patient type.
Whilst leading companies offer a broad advanced wound care portfolio, Smith & Nephew and Mölnlycke’s success is based on their positioning and product portfolio. However, they are facing increasing pressure from companies such as ConvaTec who are focusing on innovation and technology to drive their market position. Leading companies offer differentiation through technologies, conformability, and functional and patient benefits supported by strong clinical evidence. However, communication and building relationships through a service orientated approach are also important, as product offerings in the market are similar.