Medical Equipment Industry Overview

The point-of-care diagnostics devices and equipment market consists of sales of point-of-care (POC) diagnostics devices and equipment and related services. Point-of-care diagnostics devices and equipment are designed to aid physicians in performing medical diagnostic testing at or near the point of care, for immediate knowledge on diseases or conditions. Point-of-care diagnostics are segmented into cardio metabolic monitoring kits, infectious diseases testing kits, cardiac and cancer markers excluding blood glucose monitoring kits. The global point-of-care diagnostics devices and equipment market is expected to grow from $17.7 billion in 2019 to $21.5 billion in 2020 at a compound annual growth rate (CAGR) of 21.4%. The growth of this market is mainly due to the increased diagnostic testing in laboratories, hospitals, and other testing sites across various country to detect the pandemic COVID-19 virus. The need for rapid diagnostic testing such as molecular and RT PCR based testing to identify people infected by coronavirus is driving the in-vitro diagnostics market. The market is then expected to grow at a CAGR of 5.3% from 2021 and reach $25.2 billion in 2023. The point-of-care diagnostic devices and equipment market has been geographically segmented into North America, Western Europe, APAC, Eastern Europe, South America and Middle East & Africa. The North America is the largest market for point-of-care diagnostic devices and equipment and is expected to continue to be the largest market during the forecast period. An increase in the incidence of target diseases is driving the POC devices and equipment market globally. The rising incidence of chronic diseases, like diabetes, rheumatism, or cancer is increasing steadily worldwide due to poor lifestyle choices and increasing obesity, thus driving the growth of POC devices and equipment market. For example, according to American Heart Association cardiovascular disease is listed as the underlying cause of death for 0.84 million deaths in the US in 2016, approximately 1 of every 3 deaths. The POC diagnostics devices and equipment market is expected to slow down due to stringent regulatory policies, which increases the gestational period before the product enters market. POC devices and equipment manufacturers are required to obtain multiple FDA clearances before launching their product into the market. The entire process of approval consumes a lot of time, thereby restraining the market growth. Over-the-Counter (OTC) testing is being termed as an important trend driving the growth of point of care diagnostics market. FDA has approved OTC test kits for cholesterol, fecal occult blood, pregnancy and HIV/HCV. This method would improve the access to testing and early detection of the disease. These testing kits may generate more revenue than prescription tests over the forecast period due to ease of using the kits, increased home care and self-testing, and rise in availability and adoption rate. Point of care devices are regulated by the U.S. Food and Drug Administration (FDA) and all the diagnostic laboratory tests regulated by the clinical laboratory improvement amendments of 1988 (CLIA) that is administered by the centers for Medicare & Medicaid services (CMS). As these devices measure the biomarker levels in the body they are classified as class II (requiring 510[k] approval), or III devices (requiring the more tedious premarket approval). On the contrary, to the stringent approvals by FDA, China has a moderately lenient approval mechanism. Therefore, the top companies are using partnership approach with local vendors and distributors to expand their market share.

The cardiovascular surgery devices and equipment market consists of sales of cardiovascular surgery devices and related services. Cardiovascular surgery devices and equipment are used in cardiac surgery and other cardiovascular procedures performed to repair structural defects of the cardiovascular system of the heart and its damaged or blocked valves and vessels. Cardiovascular surgery devices are divided into perfusion disposables, beating heart surgery systems, cardiopulmonary bypass equipment and cardiac ablation devices. The global cardiovascular surgery devices and equipment market is expected to decline from $19.1 billion in 2019 to $15.6 billion in 2020 at a compound annual growth rate (CAGR) of -18.5%. The decline is mainly because of the lockdown measures due to the COVID-19 outbreak. The decrease in the demand for cardiovascular devices due to decreased number of cardiac surgeries for reasons such as re-scheduling of surgeries, cancellations and no-show by patients, coupled with the restrictions by government and health authorities to shutdown factories manufacturing these devices to contain the spread of virus and keep the staff safe, contribute to this decline. The market is then expected to recover and grow at a CAGR of 5.9% from 2021 and reach $24.3 billion in 2023. North America was the largest region in the cardiovascular surgery devices and equipment market in 2018. This region is expected to remain the largest during the next five years. The cardiovascular surgery devices and equipment market in Asia Pacific is forecasted to register the highest CAGR during 2018-2023. Rising geriatric population along with the rising deaths related to cardiovascular disorders is driving the cardiovascular surgical devices market. According to American Heart Association (AHA), in the US, approximately 43.7 million aged above 60 suffered from cardiovascular disorders. It is also reported by AHA that death related to cardiac diseases amount to 17.3 million per year and is expected to rise to more than 23.6 million by 2030, world-wide. Due to these factors, higher number of surgeries are being performed, thereby driving the market. The cardiovascular surgical devices market may be restrained due to stringent and longer approval process by the regulatory authorities. According to a researcher from Harvard Business School, innovative first-mover products such as implantable defibrillators or trans-catheter heart valves are delayed for approvals by FDA, thereby adding to the development cost to the manufacturer. For new cardiovascular devices (first-entrants), the innovator spends 7.2 months longer than the first follow-on innovator. For example, Edwards Lifesciences trans-catheter heart valve, was approved in Europe 4 years before it was approved in the USA. The study also estimated the financial loss associated with the delay in getting the approval. The delay may cost firms an average of $6.7 million to the already existing $94 million average price to introduce a new medical device to market, thereby hampering companies’ pursuit on new innovations. Companies in the cardiovascular surgery devices and equipment market are investing in second generation bioresorbable stents and as well rectifying the glitches which occurred in the earlier version of bioresorbable stents. This advancing segment is poised to garner $247 million by 2025. Due to the all-new device features such as thinner strut thicknesses, faster resorption times, and better radial force, these are expected to grow at a higher growth rate. A higher elective procedure volume due to the less-invasive nature of PCIs when compared to coronary artery bypass grafting is expected to drive bioresorbable stents adoption. For instance, Amaranth Medical has developed three medical devices with thinner strut thickness, latest bearing a magnitude of 100 microns. The U.S. Food and Drug Administration’s (FDA) Center for Devices and Radiological Health (CDRH) made public, its priority list for medical device guidance documents for the fiscal year 2017. This would allow the companies in promoting innovation and as well save them from the stringent consequences of non-approval of any product. Thus, a clearer and transparent approval method would drive the cardiovascular surgical devices market in the future.

The therapeutic dental equipment market consists of sales of therapeutic dental equipment and related services. Therapeutic dental equipment is used for the treatment of dental diseases. The key products include dental lasers, soft-tissue laser systems, diode lasers systems, CO2 lasers systems, YAG laser systems, and all-tissue (hard/soft) laser systems. The global therapeutic dental equipment market is expected to decline from $0.2 billion in 2019 to $0.1 billion in 2020 at a compound annual growth rate (CAGR) of -21.3%. The decline is mainly due to COVID-19 outbreak and the measures to contain it. Several dental care facilities in affected countries have been completely closed or have been only providing minimal treatment for emergency cases. The restrictions on non-essential medical services including dental services coupled with slowed production of dental equipment and supplies due to extended factory closures in various countries is contributing to the markable decline in the market growth. The market is then expected to recover and grow at a CAGR of 5.5% from 2021 and reach $0.2 billion in 2023. The therapeutic dental equipment market has been geographically segmented into North America, Western Europe, Asia-Pacific, Eastern Europe, South America and Middle East & Africa. The North American market is the largest market for therapeutic dental equipment and is expected to continue to be the largest segment during the forecast period. The changing lifestyles and unhealthy habits of people has increased the instances of oral disease & has increased the demand for dental and oral care. The major lifestyle changes that has stimulated periodontal diseases include smoking, inadequate oral hygiene, and unawareness about dental health. Diabetes is also one of the major reason for oral diseases. With increasing diabetic population, which is estimated to rise by 154% (415 million in 2015 to 642 million in 2040), the need for periodontal care is expected to rise. These lifestyle change along with rising diabetes prevalence are expected to increase the demand for dental care and surgeries thereby driving the therapeutic dental market. The painless procedure using dental lasers have complications that affect the tooth and the surrounding dental region. Tooth surface, dental pulp, subcutaneous and submucosal layers are some of the regions prone to adverse effects during the use of dental lasers. Necrosis of the pulp, bone resorption, hypo/hyperpigmentation, scarring among others are the complications associated with dental lasers. In addition to this, the micro-hardness of the tooth walls is also affected, resulting in surface cracks of the tooth. Due to these effects, the growth of the therapeutic dental market is expected to be restrained in the future. There have been continuous technological advancements in dental lasers that is resulting in a positive impact on the growth of the dental laser industry. For instance, UltraDent Products, Inc. in 2016 launched the first dual-wavelength soft tissue diode laser named the Gemini 810 + 980 diode laser, this tool is used in intraoral and soft tissue procedures. Development of such new technologically advanced devices will augment industry growth. In the USA, manufacturers of laser devices in the medical device industry must comply with Title 21 Code of Federal Regulations (CFR). As per the Title 21 Code of Federal Regulation, the performance standard and specific purpose of the laser product must also be mentioned along with other records on calibration that are provided to the customers. Daheng Group Inc. recalled its Diode Laser Therapy System and Dental Laser Therapy System as it failed to comply with 21 CFR 1040.11 and did not provide calibration procedures to purchasers. In the UK, institutions employing laser for dental surgeries must register with the Care Quality Commission and the National Minimum Standards and Regulations for Independent Health Care 2002 states all the standards (C1 to C32) that are a mandate to all hospitals and dental clinics that use lasers. According to the core standards, the operators must have patient guide explaining the benefits and risk of laser, statement of treatment policy, management and personnel, a complaints procedure, premises, facilities and equipment management, risk management procedure and research strategy in place.

The dental diagnostic imaging devices and equipment market consists of sales of dental diagnostic imaging devices and equipment. The dental diagnostic imaging devices use technology that creates visual representation of the inner body of tooth for clinical analysis. These devices are used for better analysis of dental problems such as tooth decay, tooth erosion and gum disease. The global dental diagnostic imaging devices and equipment market is expected to decline from $2.1 billion in 2019 to $1.7 billion in 2020 at a compound annual growth rate (CAGR) of -20%. The decline is mainly due to COVID-19 outbreak and the measures to contain it. Several dental care facilities in affected countries have been completely closed or have been only providing minimal treatment for emergency cases. The restrictions on non-essential medical services including dental services coupled with slowed production of dental equipment and supplies due to extended factory closures in various countries is contributing to the markable decline in the market growth. The market is then expected to recover and grow at a CAGR of 7.6% from 2021 and reach $2.8 billion in 2023. The dental diagnostic imaging devices and equipment market has been geographically segmented into North America, Western Europe, Asia-Pacific, Eastern Europe, South America and Middle East & Africa. The North American market is the largest market for dental diagnostic imaging devices and equipment and is expected to continue to be the largest market during the forecast period. The growing awareness on dental health care has led to demand for proper healthcare system with upgraded devices. The dental diagnostic imaging devices help to meet the oral healthcare demands of people and will drive the market growth. These imaging devices helps to reduce shorten the recovery time for a patient and also result in less pain when compared to earlier methods of diagnosing dental problems. According to Adults Oral Health & Well-being Survey, 85% Americans believe that oral health is extremely important among which only 15% were satisfied with their current oral health. This indicates that people look for better dental care now and are aware of the importance of oral healthcare. The lack consumer awareness on the available dental diagnostic imaging devices in many developing economies is restraining the dental diagnostic imaging market growth. People in many developing countries tend to neglect dental problems due to lack of awareness. This attitude affects the health and also the growth of dental diagnostic imaging device market as the use and procurement of these devices is affected negatively. For example, WHO has provided technical and financial support to the Ministry of Public Health and Education in conducting a series of workshops and campaigns on oral health for school teachers in Kabul city. The aim of these workshops is to raise awareness of oral health and prevention of negligence towards the dental problems. The need for precise diagnostic tools has given rise to innovation in dental imaging technology such as cone beam computed tomography (CBCT) and magnetic resonance imaging and others. These new techniques have helped in better examination of complex facial structures and early diagnosis of dental diseases. For example, on 19 January 2018, The All India Institute of Medical Sciences (AIIMS) started use of Cone Beam CT (CBCT) scan facility that would help dental surgeons in increasing the efficiency of their dental surgeries. These devices provide a 3D image of the patient`s jaw to get precise knowledge of the problem before the surgery is performed and helps in safe and better treatment outcome. Various government reforms and organizations are currently focusing on dental care safety and aim to reduce oral health care problems. For example, FDA`s Center for devices and radiological health is responsible for regulating firms who manufacture, repackage or import medical devices sold in the United States. Also, CDRH regulates medical devices such as radiation-emitting electronic products such as lasers, x-ray systems, and ultrasound equipment.

The dental surgical devices and equipment market consists of sales of dental surgical devices and equipment. Dental surgical devices and equipment are used for the treatment of problems related to dental caries, cavities, tooth decay, periodontitis, gingivitis, oral candidiasis, xerostomia, and other forms of oral cancers and injury. This includes examination instruments, retractors, dental hand-pieces, dental lasers and others. This market does not include therapeutic dental equipment, general dental devices and equipment and dental diagnostic imaging devices and equipment. The global dental surgical devices and equipment market is expected to decline from $5 billion in 2019 to $4 billion in 2020 at a compound annual growth rate (CAGR) of -20.3%. The decline is mainly due to COVID-19 outbreak and the measures to contain it. Several dental care facilities in affected countries have been completely closed or have been only providing minimal treatment for emergency cases. The restrictions on non-essential medical services including dental services coupled with slowed production of dental equipment and supplies due to extended factory closures in various countries is contributing to the markable decline in the market growth. The market is then expected to recover and grow at a CAGR of 7.3% from 2021 and reach $6.6 billion in 2023. The dental diagnostic surgical devices and equipment market has been geographically segmented into North America, Western Europe, Asia-Pacific, Eastern Europe, South America and Middle East & Africa. The rise in dental diseases is the driving force in the dental surgical devices Market. Oral diseases are the most common non-communicable diseases (NCDs) and affect people throughout their lifetime, causing pain, discomfort, disfigurement and even death. According to WHO, in 2016, an estimated half of the world’s population (3.58 billion people) were found to be affected with dental caries. The periodontal (gum) disease, which may result in tooth loss, was estimated to be the 11th most prevalent disease globally. All these diseases require suitable surgical procedures involving various dental surgical instruments. The rise in dental diseases coupled with the rising demand for cosmetic dentistry is expected to drive the market in the forecast period. High costs associated with dental surgical procedures such as implants, periodontal surgery, root canal, laser whitening along with less favorable reimbursement policies are the factors which may hinder the growth of dental surgical devices market. The dental implants on an average costs around $2000 to $34,000. The additional costs associated with X-ray, scans, tests and consultation fee increases the total cost of the surgical procedure. Due to these high costs, the surgical devices market may find the growth to be challenging. Increasing number of companies are investing in 3D Printing technology in dental surgical devices and Instrument market. 3D printing technology is process of making complex 3-D structures by laying down thin layers of raw material in succession. In this market, 3D Printing technology is used for the production of drill guides for dental implants, the preparation of physical models for prosthodontics, orthodontics and surgery, the production of dental, craniomaxillofacial and orthopedic implants, and the fabrication of copings and frameworks for implant and dental restorations. The major players are using 3D Printing technology to produce devices like 3D printed braces, dental crowns and implants as well. For example, ArchForm, a teeth-aligner software startup allows the orthodontists to create, design and 3D print aligners within their own offices. According to the company’s customer base, approximately 75% of orthodontists already have 3D printers with software. The US FDA regulates material that is being used in manufacturing of dental devices and instruments apart from regulating the devices in USA. The dental materials cleared by the FDA fall into one of two classes: Class I which signifies minimum to no risk, and Class II that indicates some risk. Materials in class II include alloys, ceramic and polymers, all those that take final form in the hands of a practitioner or lab. Carbon’s new 3D printable DENTCA resins have been approved by the FDA. However, the material approval process takes extra time in overall launch of the product in the market.

The cataract surgery devices and equipment market consists of sales of cataract surgery devices and equipment and related services. Cataract surgery devices and equipment include instruments used for performing cataract surgeries such as small incision cataract surgery and extra capsular surgery in the treatment of cataract, a condition in which the lens of the eye becomes progressively opaque, resulting in blurred vision. This market does not include vision care devices and equipment, refractive surgery devices and equipment and diagnostic & monitoring ophthalmic devices and equipment. Femtosecond Lasers used in cataract surgery are included in this market. The global cataract surgery devices and equipment market is expected to decline from $6 billion in 2019 to $4.7 billion in 2020 at a compound annual growth rate (CAGR) of -22%. The decline is mainly due to the COVID-19 outbreak and the measures to contain it. The restrictions on non-essential medical services including ophthalmology services coupled with slowed production of ophthalmic devices used for treating eye conditions, due to extended factory closures in various countries together have contributed to the decline in the growth rate. The market is then expected to recover and grow at a CAGR of 6.2% from 2021 and reach $7.6 billion in 2023. In 2018, North America was the largest region in the cataract surgery devices and equipment market. During the forecast period, Asia Pacific cataract surgery devices and equipment market is forecasted to register a CAGR of 5.5%. The major growth driver for this industry has been the global ageing population. The world population recorded an estimate of 962 million people aged 60 or above in the year 2017. This estimate is expected to show an upward trend and is expected to double by 2050. The cases of cataract in the geriatric population also expected to increase in the same proportion. According to World Health Organization, the number of cataract cases are expected to increase by 78% by 2050 in the U.S. alone. This presents a huge market for the cataract surgery equipment manufacturers in the near future by expanding the customer base due to the fast growing geriatric population. For instance, the population of China is getting older faster than anywhere else in the world, this presents a huge market for the cataract surgery device manufacturers in China. Major challenge that is faced by this industry is the low level of awareness about eye disorders, especially cataract. Many people do not have proper knowledge about the symptoms of cataract and do not get the treatment done. This leads to potential revenue loss for the cataract surgery device manufacturers because of low number of end users. For example, as per a study done by NCBI, out of 1552 respondents 89.9% had heard of cataract but only 42% were aware of any symptom of cataract, low awareness of cataract symptoms acts as a major restraint for the cataract surgery equipment industry. The cataract surgery devices and equipment industry has witnessed many positive changes introduced by the market players, the most prominent one being the introduction of laser technology. The laser assisted cataract surgery is used to gather information about the lens, to make the corneal incision and for the opening in the lens capsule. The advent of laser technology has caused a significant impact over this industry by bringing in new levels of safety and accuracy and advancing cataract surgery. Femtosecond laser platforms have significantly contributed to the precision of cataract surgeries being performed and may soon surpass the traditional hand-held surgeries. For example, Abbott laboratories which lacked this technology, acquired Optimedica for $250 million to enter laser cataract surgery devices market after witnessing the huge demand and benefits of laser technology. The ophthalmology and medical equipment industry is subject to numerous stringent regulations and the cataract surgery device equipment manufacturers are no exception. These manufacturers need to comply with several regulations of which the European Medical Device Directives and the U.S. Health Care Compliance are the most prominent ones. The European Medical Device Directive requires a manufacturer to meet the harmonized standards for placing their devices in the European market. Similarly the U.S. Health Care Compliance has laid down certain guidelines related to standards of business conduct to be followed by the Pharmaceutical manufacturers. The Medicines and Healthcare products Regulatory Agency (MHRA), which regulates the safety of medical devices in the UK, has issued an urgent notice to Carl Zeiss Meditec, for voluntarily recalling a small batch of its intraocular lenses (IOL). The recall was initiated after the manufacturer detected mislabeling of its IOL, Aaren Scienfific EC-3 hydrophobic lens with a wrong dioptric power. Therefore, the manufacturers need to comply strictly with correct labelling of dioptric power on the IOLs. In 2018, Carl Zeiss Meditec acquired IanTECH for an undisclosed amount. The acquisition would strengthen Carl Zeiss’ position in the cataract surgery portfolio as IanTECH focuses on technology solutions for micro-interventional cataract surgery. IanTECH is expected to complement Zeiss’ leading portfolio of equipment and consumables in cataract surgery. IanTECH specializes in endocapsular lens fragmentation and micro-interventional technology for cataract removal and eye treatment. It is headquartered in Reno, Nevada, USA.

The diagnostic and monitoring ophthalmic devices and equipment market consists of sales of diagnostic and monitoring ophthalmic devices and equipment and related services. Diagnostic and monitoring ophthalmic devices and equipment are used for the diagnosis and monitoring of diseases related to the retina and cornea by measuring affix lenses and refractive errors. These devices also help to identify the power of intra ocular lens (IOLs) and analyze the visual field. Ophthalmic diagnostic and monitoring devices include ultrasound imaging systems, optical coherence tomography scanners, ophthalmoscopes, corneal topographers, specular microscopes, slit lamps, fundus cameras, anomaloscope, haploscope, ophthalmic lens gauge, stereopsis measuring Instrument, retinoscopes, stereoscope and others. The global diagnostic and monitoring ophthalmic devices and equipment market is expected to decline from $1.4 billion in 2019 to $1.1 billion in 2020 at a compound annual growth rate (CAGR) of -22.7%. The decline is mainly due to the COVID-19 outbreak and the measures to contain it. The restrictions on non-essential medical services including ophthalmology services coupled with slowed production of ophthalmic devices used for treating eye conditions, due to extended factory closures in various countries together have contributed to the decline in the growth rate. The market is then expected to recover and grow at a CAGR of 4.7% from 2021 and reach $1.7 billion in 2023. In 2018, North America was the largest region in the diagnostic and monitoring ophthalmic devices and equipment market, followed by Europe. The diagnostic and monitoring ophthalmic devices and equipment market in Asia Pacific is forecasted to register the highest CAGR during 2018-2023. Increasing prevalence of eye diseases is expected to drive the demand for diagnostic and monitoring equipment in the ophthalmic devices industry. Rise in surgeries associated with eye disorders like cataract, diabetic retinopathy, and glaucoma have increased the demand for diagnostic and monitoring ophthalmic devices. According to a study, 4 out of 10 people have been found to have cataract disease in their early stage of life. The total number of cataract surgeries performed in 2017 was around 20 million, and this number is expected to rise to 35 million by 2025. Lack of awareness about eye diseases mostly in the developing and underdeveloped nations is expected to hinder the growth of diagnostic and monitoring ophthalmic devices and equipment market. BLack of awareness of eye disorders results in fewer patients going for a routine eye check-up or diagnosis of the disorder, impacting the demand for diagnostic and monitoring ophthalmic equipment. According to study conducted by vision impact institute, 42% of drivers in India have vision related problems leading to 59% of road accidents. According to WHO, 550 million people in the country need vision correction and to achieve this, companies should increase awareness & provide vision care to people living in rural and semi-urban areas. Advanced eye care medical devices equipped with artificial intelligence (AI) and machine learning (ML) are the new trends in the ophthalmic diagnostic and monitoring equipment market. AI and ML equipped medical devices can not only quickly interpret the eyes of the patient with better accuracy but also recommend a suitable treatment for the patient. Deepmind, a subsidiary of Alphabet Inc. has developed an AI-based system which is capable of analyzing 3D retinal OCT scans for detecting severe diseases like glaucoma, retinopathy, macular degeneration and 50 different types of eye diseases at their early stage. The increased regulatory compliance norms by the Food and Drug Administration (FDA) and the Medicines and Healthcare products Regulatory Agency (MHRA) have impacted the market making the approval/regulation process for diagnostic and monitoring ophthalmic devices strenuous. Complex and tedious premarket and postmarket submissions by FDA may increase the product release time and incur heavy costs on device development. The MHRA considers a medical device to be any equipment used for the diagnosis or treatment of disease, or for monitoring patients and recommends Yellow card reporting for ophthalmic devices and products as well. All the adverse events and the causes for any untoward incidents must be reported in the yellow card, allowing the equipment’s to be monitored thoroughly for enhanced patient safety. In March 2018, Metall Zug Group has acquired 70% of Haag-Streit for an undisclosed amount. This acquisition would strengthen Metall Zug Group’s position in the diagnostic and monitoring ophthalmic devices market as Haag-Streit specializes in production of diagnostic equipment’s in the fields of ophthalmology and surgical microscopy. Haag-Streit is involved in production and distribution of high-quality diagnostic products and services such as slit lamps, biometry, perimetry, tonometers, and workflow networking software for clinics and opticians and practice equipment. Haag-Streit holding AG was founded in 1950 and is headquartered in Köniz, Switzerland.

The X-ray devices and equipment market consists of sales of X-ray devices and equipment and related services. X-ray systems are used for the diagnosis and imaging of patients suffering from various diseases. The key product types of X-ray systems include general radiography X-ray systems, fluoroscopy X-ray systems, mammography X-ray systems, interventional X-ray systems, and mobile c-arm X-ray systems. The global x-ray devices and equipment market is expected to decline from $12.7 billion in 2019 to $10.2 billion in 2020 at a compound annual growth rate (CAGR) of -19.3%. The decline is mainly due to the COVID-19 outbreak and the measures to contain it. The governments across the countries prioritized covid-19 screening and imaging is not routinely used to screen for COVID-19. Also, most of the factories manufacturing diagnostic imaging equipment such as X-ray systems, ultrasound systems, computed tomography (CT) scanners, and MRI systems and/or their components, are currently shutdown inorder to keep the staff safe and contain the spread. The market is then expected to recover and grow at a CAGR of 5.4% from 2021 and reach $15.6 billion in 2023. North America was the largest region in the X-ray systems devices and equipment market, followed by Asia Pacific. The rising incidence of injuries occurring worldwide is driving the medical diagnostic X-ray systems, devices and equipment market. Increasing accidents, sports injuries, severe muscle damages, bone injuries and others are rising the market for diagnostic equipment, especially X-ray systems devices and equipment market. In 2017, about 2.8 million nonfatal injuries were recorded according to estimates from the Survey of Occupational Injuries and Illnesses (SOII). With the increase in injuries and accidents across the globe, number of urgent care facilities offering services such as blood tests, stitching, and X-rays also increased. For instance, according to the Urgent Care Association, the total number of urgent care centers in the USA increased from 6,400 in 2014 to 8,744 in 2018. Hazardous radiation effects and increasing health concerns hinders the X-ray systems devices and equipment market growth. Diagnostic imaging procedures use x-rays systems devices and equipment that release electromagnetic waves or particles called ionizing radiation. This radiation coming from man-made sources such as X-rays, CT scans, nuclear medicine scans and PET scans carry major health hazards. Low doses can also cause cancer in the long run. Cancer is a leading cause of death worldwide, accounting for an estimated 9.6 million deaths in 2018. When doses exceed certain levels it causes skin burns and acute radiation syndrome. According to a global survey in 2015 conducted by NCBI on radiation overexposure accidents, around 2390 people were over exposed to radiation, out of which 190 died. The X-ray systems devices and equipment market is witnessing a rise in number of mergers and acquisitions. Mergers and acquisition activity is being driven mainly by companies intending to diversify their business into the medical/diagnostic imaging and radiology businesses. In January 2018, Hitachi acquired VidiStar LLC, a digital solution provider in order to expand its clinical reporting and analytical services division for diagnostic imaging. In November 2017, Philips acquired a Baltimore-based Analytical Informatics Inc., an advanced workflow tools and applications providing company, to expand its radiology business. In January 2018, Canon Medical Systems, Europe in order to expand its product portfolio and services offered acquired DelftHold BV, a company specialized in enterprise healthcare information technology (IT) solutions, manufacturing digital X-ray systems, system integration and providing services for radiology departments. In 2017, National Council on Radiation Protection and Measurements (NCRP), in response to FDA`s initiative to reduce unnecessary radiation exposure from medical imaging devices, recommended to minimize medical radiation exposure by proposing a new radiation “vital sign” risk score. This aids quality of care and patient safety from diagnostic X-ray systems by calculating potential harm from additional exposure to medical radiation. The incorporation of vital sign into these electronic medical devices helps in taking protective measures. The Advisory Committee on X-ray and Radium Protection, of NCRP provided approaches and modalities that use less or no ionizing radiation for medically appropriate and safe patient care. In January 2019, Shimadzu Medical Systems USA acquired Core Medical Imaging, Inc for an undisclosed amount. This acquisition would strengthen Shimadzu`s healthcare business and expands its medical systems division in North America to cater to the regions demands and capitalize on the market. Core Medical Imaging, Inc., is an US-based medical equipment company offering various medical products and devices, surgical equipment, diagnostic and X-ray systems, apparatus, and other medical instruments. It was founded in 2000 and is headquartered in Washington, United States.