Nuclear sales shine in a declining market

December 15, 1993

Nuclear medicine equipment vendors are having the last laugh overcritics who predicted in the 1980s the eventual demise of thegamma camera market. As 1993 comes to a close, it appears thatnuclear medicine will be the fastest growing segment of the

Nuclear medicine equipment vendors are having the last laugh overcritics who predicted in the 1980s the eventual demise of thegamma camera market. As 1993 comes to a close, it appears thatnuclear medicine will be the fastest growing segment of the U.S.imaging equipment market this year.

Sales of new gamma cameras and computers are forecast at $395million for 1993, up 6.2% from 1992, according to Nuclear Medicine:Market Trends and Clinical Practice in the U.S., a technologyreport prepared by the editors of Diagnostic Imaging (see graph).For more information contact Sharon Cauchi, project manager, at415/905-2550.

Prospects for more growth in 1994 look good, according to MarkLamp, vice-president of sales and marketing for nuclear medicinevendor ADAC Laboratories of Milpitas, CA.

"Health-care reform has not slowed things down. Our purchasingsurveys projecting sales for next year indicate that the marketwill continue to hold strong," he said.

The nuclear medicine market is growing as the demand for othermodalities levels off, in part because facilities did not replaceexisting gamma cameras when their capital budgets were divertedto MRI, ultrasound and other high-technology imaging equipment.The typical single-head camera retired in 1993 was at least 10years old. About 85 of every 100 new gamma cameras installed in1993 replaced older existing equipment.

Technological change has also encouraged health-care facilityadministrators to shift a larger share of their capital budgetsto nuclear medicine. Multihead SPECT cameras are driving marketdemand.

Expectations of patient throughput gains using additional detectorsmotivates the popularity of multihead SPECT cameras. Multipledetector systems are also better suited for cardiac proceduresthan single-head cameras. While triple-head systems are also suitablefor neurology and cardiology studies, the dual-head systems aremore attractively priced and have larger detector fields-of-view.

Recent design research and development has led to new variable-anglegantries that configure the detectors to the optimal positionsfor heart, brain, bone or whole-body work. Sales of these systemsare expected to further erode the demand for triple-head systems.

Though it is too early to predict how the market will respondto new all-digital gamma cameras, many industry leaders believedigital imaging is the wave of the future for nuclear medicine.

"Anything in this business that can go digital will godigital," said Cary Nolan, chief executive officer of PickerInternational.

RADIOPHARMACEUTICAL COMPANIES will generate an estimated $340million in revenue from U.S. sales in 1993, according to GregFreiherr, publisher of Tech Assessment Imaging in St. Cloud, WI.Sales growth will trail off to a 4.9% rate this year, comparedto double-digit annual growth between 1989 and 1992.

Nuclear cardiology has propelled radiopharmaceutical salesgrowth for the past five years and is expected to continue toexpand.

Du Pont was the primary beneficiary among drug companies ofthe surge in cardiology applications of nuclear medicine. Demandrose for Du Pont's thallium-201 product, while its technetium-99m-labeledCardiolite and pharmacologic stressor Persantine have continuedto perform well since their introduction about three years ago.

Mertiatide (Tc-99m-MAG3) may be the single most evolutionaryradiopharmaceutical introduced in the last 10 years, accordingto Dr. Hirsch Handmaker, vice-chair of nuclear medicine at CaliforniaPacific Medical Center in San Francisco. Mallinckrodt Medical,the developer of Tc-99m-MAG3, received relatively prompt regulatoryapproval from the FDA in 1992; market acceptance has been equallyquick.

Peptides are the wave of the future, according to many sources.Research suggests that Mallinckrodt's OctreoScan, an indium-111-labeledsomatostatin peptide agent (SCAN 6/30/93), is superior to otherradiopharmaceuticals for characterizing small-cell carcinoma ofthe lung and neuroendocrine tumors. Images are easier to interpretthan gallium-67 or labeled antibody studies. The specificity ishigher, and costs and patient radiation dose are lower with OctreoScanthan with other agents.

Syncor is the undisputed powerhouse among U.S. radiopharmacycompanies. It controls 65% of the market; company revenue hasgrown 22% annually over the last four years. It operates 108 nuclearpharmacies in 34 states. Services include four oncology servicepharmacies and two PET centers. In all, Syncor provides radiopharmaceuticalsto about 6000 hospitals, clinics and physicians' offices.

ADAC TOPS THE U.S. MARKET for nuclear medicine equipment. Thevendor increased its market share lead in integrated gamma camera-computerunit sales in the first nine months of 1993. ADAC controlled a24% share, covering all product categories. Siemens ranked secondin unit sales with a 16% share, and GE was a close third with14%.

Market shares for other companies were as follows: Picker,10%; Elscint, 8%; Trionix, 8%; Hitachi-Summit, 7%; Sopha, 7%;and Toshiba, 5%.

Lamp predicted in mid-1993 that ADAC would become the marketleader in every segment in the U.S. single and dual gamma cameramarkets this year. ADAC has a lock on sales leadership in theincreasingly important fixed and variable-angle, dual-head segments.These sectors will account for up to 35% of total U.S. unit demandin 1993, according to some sources.

Siemens was the market leader in the far smaller single-headcircular-head camera market in 1992. Whether ADAC overcomes Siemens'lead in 1993 depends on fourth-quarter results, Lamp said.

ADAC faces stiff competition from Sopha for leadership in thedual-head market. Recent product introductions by GE, Toshiba,Siemens and Elscint are taking a toll on the price of dual-headsystems.

The average price of a dual-head system with computer droppedabout 10% to $390,000 in the second quarter of 1993, accordingto analyst Marvin Burns, president of Bio-Tech Systems in LasVegas. Burns expects another 5% decrease by January 1994. Thereduction in dual-head SPECT prices has a domino effect on theprices commanded for triple-head and single-head systems.