Peripherally inserted central catheters (PICCs) have a wide range of applications and are commonly used for delivering chemotherapy, antibiotics and for drawing blood. PICCs are introduced through the basilic, cephalic or median cubital veins in the arm and the tip of the catheter is then directed to the superior vena cava (SVC). Generally, the devices are used for one week to three months but can range in use from a few days to over a year. This flexibility sets PICCs apart from other vascular access catheters and contributes to the increased use of PICCs in general.
Although the number of PICC procedures is relatively small compared with those involving central venous catheters (CVCs), PICCs are taking market shares away from other catheter types. This is due to the fact that PICCs are associated with a lower infection rate than CVCs and are generally more comfortable for patients due to their placement in the arm rather than the neck or chest, where CVCs are commonly inserted. This increased comfort may contribute to better patient satisfaction and compliance with treatment.
The peripherally inserted central catheter (PICC) market in Europe holds a value of around $40 million in 2022 and it is projected to reach close to $65 million in 2029, indicating an impressive growth rate of approximately 60%. In the intravenous catheters category, PICCs stand out as a distinct option. This article explores their unique characteristics, advantages, and market expansion factors. Discover why PICCs have become a valuable choice for long-term intravenous therapy.
Exploring the Growing Popularity of PICCs
Although PICCs have substitute products such as midline catheters, PIVCs (peripheral intravenous catheters) and EDCs (extended dwell catheters), they exhibit distinct characteristics and set themselves apart in several key aspects. PICCs offer several advantages similar to those of EDCs. These include extended dwell times and the absence of trimming requirements before insertion. While EDCs are relatively shorter, typically measuring around 6 cm or less, with some models extending up to 8 cm to facilitate deep-vein access, PICCs are considered an intermediary option between a PIVC and a midline. PICCs also provide several advantages over PIVCs, such as extended dwell time and access to larger veins. PICCs are inserted peripherally but can reach deeper into the central circulation, making them suitable for patients who require longer-term intravenous therapy, but do not need the invasiveness of a midline catheter.
Several factors contribute to the expansion of the PICC market in Europe. First, the prevalence of chronic diseases is increasing, necessitating sustained intravenous treatments. Second, the growing demand for home healthcare services further fuels the adoption of PICCs, as they enable patients to receive treatment in the comfort of their own homes. Third, advancements in technology have led to the development of improved and safer catheter materials and designs, enhancing the overall efficacy and safety of PICCs.
Overall, PICCs have emerged as a valuable option for patients requiring long-term intravenous therapy. Their advantages over traditional methods, such as PIVCs, make them an attractive choice for healthcare providers, resulting in the continued growth of the PICC market.
Driving Factors in the PICC Market
Four main factors dictate the growth in the PICC market in Europe: reimbursement, practitioner placement, infection rates and technological improvements.
First, reimbursement is a significant driving factor in most countries within the European Union (EU), due to the reimbursement of ports remaining higher and more lucrative. However, the high value of the PICC’s market for reimbursement has led to an underdeveloped market for PICCs in Germany.
Second, practitioner placement plays a huge role in how the PICC market does in a specific country. For instance, in countries where nurses are not allowed to place PICCs, the usage is lower; this includes countries like Portugal, Belgium, and others. Conversely, countries like Italy, which have a strong base of nurses trained to insert PICCs, are experiencing significant PICC sales. There are also some countries who are experiencing growth in the PICC market due to policy changes. Notably, in France, a country where nurses traditionally had limited involvement in PICC placement, a significant shift has occurred in recent years. This change in trend has resulted in a notable surge, leading to a remarkable boom in the French PICC market.
Third, infection rates are lower when using PICCs when compared to other options, such as using uncoated CVCs. However, while this is a driving factor for the market, it should be noted that the efficacy and cost effectiveness of these devices have not been fully studied and trials such as the Cancer and Venous Access (CAVA) aim to provide a comparative analysis for the main vascular access devices.
Fourth, new and improved technologies, such as the introduction of ultrasound guidance’s, as well as top confirmations of ECGs, have allowed companies to garner higher ASPs for their products.
COVID-19's Impact on the PICC Landscape
Providing efficient and safe vascular access for critically ill COVID-19 patients presents unique challenges in the context of minimizing viral transmission to healthcare workers and the surrounding environment. Ensuring prompt, secure and durable access becomes paramount under these circumstances.
Emerging research has revealed notable differences in the procedures for accessing central veins between COVID-19 and non-COVID-19 patients1. Additionally, critically ill COVID-19 patients often require alternative methods for vascular access2.
One key advantage of PICCs is the decreased incidence of needlestick injuries due to their higher rate of first-stick success. Furthermore, the extended dwell time provided by PICCs reduces the need for subsequent insertions. Although PICCs offer several advantages over Midlines, EDCs and PIVCs, it should be noted that they are more expensive. Midlines, EDCs, and PIVCs markets all experienced significant declines in 2020 due to COVID and the growth observed in 2021 can be attributed to a recovery phase. In contrast, the PICC market was relatively less affected by COVID, showing a more resilient performance.
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PICC Market Growth and Resilience in Europe
In 2022, the total PICC market in Europe grew at a moderate rate. The market value is being driven primarily by increases in unit sales and a low single digit of ASP growth. ASP growth is due to the transition to the use of more expensive power-injectable PICCs, as well as the conversion to more expensive tip-placement configurations.
Growth seen in the PICC market is a result of PICCs taking some of the procedures from ports, CVCs and PIVCs, as well as new indication for PICCs. The unit share of each segment is expected to remain reasonably constant throughout the forecast period. Single-lumen PICCs are well supported in the market, due to the fact that a lower lumen count has been associated with lower infection rates in the past.
Despite the initial disruption caused by the pandemic, the market has rebounded strongly and returned to pre-COVID growth rates by 2022, thanks to factors such as increasing adoption of PICCs in critical care settings, rising healthcare expenditures, and ongoing technological advancements.
Closing Thoughts
The European market for Peripherally Inserted Central Catheters (PICCs) has experienced substantial growth due to their advantages in intravenous therapy. Offering extended dwell times, reduced complications, and improved safety, PICCs have gained popularity. Factors such as chronic disease prevalence, demand for home healthcare and technological advancements contribute to market expansion. Additionally, PICCs are taking more and more procedures from other catheters, with new indications driving growth. Despite challenges, reimbursement policies, practitioner placement regulations, infection rates, and advancements shape the market. Ongoing research enhances efficacy, safety, and cost-effectiveness, ensuring sustained growth in the European PICC market.
For more information, please see the report Vascular Access Devices Market Size, Share & Trends Analysis – Europe – 2023-2029 by iData Research.
About the Authors
Hadi Salempoor is a research analyst at iData Research. He works on research projects regarding the medical device industry, including the market for European vascular access devices and accessories.
Kamran Zamanian, Ph.D., is CEO and founding partner of iData Research. He has spent over 20 years working in the market research industry with a dedication to the study of medical devices used in the health of patients all over the globe.
About iData Research
For 19 years, iData Research has been a strong advocate for data-driven decision-making within the global medical device, dental and pharmaceutical industries. By providing custom research and consulting solutions, iData empowers its clients to trust the source of data and make important strategic decisions with confidence.
References
1. Gidaro, A., Vailati, D., Gemma, M., Lugli, F., Casella, F., Cogliati, C., ... & Giustivi, D. (2022). Retrospective survey from vascular access team Lombardy net in COVID-19 era. The journal of vascular access, 23(4), 532-537.
2. Chun, T. T., Judelson, D. R., Rigberg, D., Lawrence, P. F., Cuff, R., Shalhub, S., ... & Woo, K. (2020). Managing central venous access during a health care crisis. Journal of vascular surgery, 72(4), 1184-1195.
