You've come to the right place to understand Ophthalmology (Outpatient) services in Europe and Emerging Markets. Here is how we can help you:
Detailed research report on Ophthalmology (Outpatient) services with marketshare and growth rates for 13 countries and information on a further 233 (HBI Intelligence)
Database of 233 Ophthalmology (Outpatient) service providers, including profile and major external investors (HBI Intelligence)
Merger and acquisition (M&A) intelligence showing likelihood of sale (HBI Intelligence)
News stories and interviews with Ophthalmology (Outpatient) operators (HBI Deals and Insights)
Events that cover healthcare services globally including Ophthalmology (Outpatient) (HBI 2024)
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Sector ReportOphthalmology (Outpatient) Sector
Updated: March 2024
Executive Summary
EXECUTIVE SUMMARY
Impact of Covid-19
We are in the process of analyzing the impact of Covid on the sector and we should have updates for every country’s growth forecasts for 2020 and 2021 by end of May. This is a partially elective sector and there has been a strong short-term impact which we have already reported in news. A serious recession will further hit demand and leave many investors breaking their bank covenants. Methodology
For the purposes of this report, wherever possible we break down each country market into the following:
The cataract market – usually funded by the state / via statutory insurance. Increasingly performed by state-funded private practices due to a shortfall in public provision.
The Lasik market – laser eye surgery. Often seen as a cosmetic procedure, this is a for-profit procedure.
The multifocal lens market – a premium lens attracting a premium price which unlike monofocal lenses, allows focus at distance and nearby. This is generally a for-profit only operation.
The AMD injection market – treatment for age related macular degeneration.
But it is also possible to break the market down into three constituent payment methods for most countries:
The medical public market where a public payor funds the patient
The private medical market (including co-pay)
Vision correction (a completely commercial play)
During the course of its preparation, we have spoken to, sometimes in person, European ophthalmology operators running some of the highest revenue companies, well respected analysts, advisors, and the largest suppliers. This report is a summary of the experience and wisdom they shared, and the trends and collective advice we have managed to extrapolate from that. Global Market Overview
The global ophthalmology services market is fairly evenly divided between outpatient and operating room. The conditions market is dominated by cataracts. See the report for full details, including global market figures. European Market overview
Ophthalmology is a big area of investor interest. For-profit ophthalmology markets across Europe are generally becoming stronger, and bigger, with considerable scope to consolidate - and crucially, in 2020 some of the largest players in Europe are either for sale, or we hear likely to come up for sale later in the year.
Some of the biggest markets in Europe are ripe for consolidation, and in many cases faltering public health systems unable to compete with slicker and quicker for-profit rivals for bread-and-butter procedures like cataracts are losing ground to the cheaper and / or more capable alternatives.
There is, as yet, no truly pan-European operator. But it is only a matter of time before one emerges and the seeds of such networks are already being sown by some of the larger players. Growth opportunities
The fastest growing area is premium cataract surgery and refractive lens exchange. While the volume of cataract operations is increasing due to an ageing population and technological improvements, it is premium, multifocal lenses which are really driving growth.
General trends Ophthalmology is moving away from the big hospitals. Very little ophthalmology needs to be done in a big hospital system – and less and less is actually being done there
As one advisor tells us: “Ophthalmology is increasingly coming out of the big hospital systems. Historically, in places like Germany, it’s been out of the hospital system for a long time.
“In many countries such as the UK it’s still in the process of coming out. Pretty much everything, barring around 5% of all ophthalmology work, can be done outside the big hospital systems. If you look at big eye hospitals like Moorfields, they don’t even have any beds anymore.” See the report for full details on general trends. See the table of contents for further details on what you can expect to see in the report. Drivers The growing geriatric population
An ageing population is creating incrementing demand, with the over-60s far more susceptible to eye conditions affecting normal function, and elasticity problems in the eye. Ageing is the key growth factor in the cataract market. New treatments are unavailable in public institutions and from the public payor
In some markets, especially in Eastern Europe, treatments like AMD injections are only just starting to be available and it is there we are likely to see explosive growth as waiting lists – in places like Czechia – are substantial. AMD injections, for example, are generally publicly funded but a reluctance to wait and growing disposable income is driving a growing private market. See the report for full details on drivers. See the table of contents for further details on what you can expect to see in the report. Countries to watch
Multiple sources tell us that – without question if you have money the markets to buy into are the UK and Germany.
France and Spain are where there has been considerable consolidation. And Italy, where one source succinctly tells us “the numbers cannot be believed”. See the full report for further details on countries to watch - and which ones to avoid. The chains best poised to create a pan-European ophthalmology network Bergman
Unlike the other large European players, Bergman has wider ambulatory care, cosmetics and dermatology. Rumours are swirling about a sale (see below). Last year’s ophtha acquisition Memira had around €40m in sales and retained its own branding (and CEO). Total group sales €250m. See the report for full details on top-players in the sector. See the table of contents for further details on what you can expect to see in the report. Deals – done and pending
There have been few recent major deals – but there are a lot of big deals waiting to be done in 2020 with some of the biggest players currently up for sale. Ober Scharrer (2018)
Germany’s largest ophthalmology chain by revenue was sold by Palamon Capital Partners to Nordic Capital for around 15x 2017’s 30m EBITDA. It makes around 70-75% of its sales in surgical centres and the rest in practices that mainly offer diagnosis. See the report for full details on significant deals in the sector and which ones we expect to sell. See the table on contents for further details on what you can expect to see in the report.
Sample report pages and data
What we offer
- Instant overview of the EMEA ophthalmologyservices market and players This report gives you visibility of this important, fast-growing market across 8 countries with market data on all as well as detailed profiles of the Top 50 players.
- Ever green! Updated throughout your subscription As part of our HBI intelligence platform this report is updated throughout the period of your subscription. You will also receive additional news stories and interviews on ophthalmology services throughout the period.
- Insights on business models The report is based on in-depth interviews with many operators. The report also looks at how ophthalmology services players can best build customer loyalty.
- Identify national opportunities We assess opportunities at national level based on the regulatory environment and proposed reforms.
- Size markets This report enables you to swiftly see market sizes and market shares
- Save time and money This report will save you weeks researching these opaque markets and enable you to swiftly identify investment opportunities, new partners and markets.
Table of Contents
Table of Contents
EMEA overview
Datasets Size of EMEA market 2018 Marketshare of major EMEA players 2018 Comparison of market sizes 2018 Comparison of market growth rates 2016-2020
Introduction
Methodology
Global Market Overview
European Market Overview
Growth opportunities
General trends
- A growing market – public sector is struggling
- Ophthalmology is moving away from big hospitals - Specialisation and increasing efficiency
- Attracting customers is expensive - Size matters
Drivers
- The growing geriatric population
- New treatments are unavailable in public sector - Public operators cannot compete generally
- New technology is creating new markets
Pricing
Investors should note
Countries to watch
- Most attractive - Buyer beware
The chains best poised to create a pan-European ophthalmology network
Deals – done and pending
- The done deals - Likely to sell in 2020
France
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Germany
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
India
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Italy
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Romania
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Spain
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
United Arab Emirates
Data sets For-profit /private market size and growth rates 2016-2020
Market description and trends.
United Kingdom
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Ophthalmology (Outpatient) News & Interviews
Our indepth stories dig deep and cover profit multiples, revenue, EBITDA and CEO thinking.
The UK’s for-profit ophthalmology sector is heating up, with multiple groups likely to come up for sale this year. This is being driven by the long term increase in the amount of cataract surgeries the NHS is outsourcing. Meanwhile deal activity in Germanyâ€...
This infographic showcases Europe's top 5 ophthalmology players by revenue in the reporting period 2018–2022: Veonet Group, Sanoptis, Artemis Augenkliniken, Clinica Baviera, and Optegra....
Last week Romesh Angunawela told us how doctors across a range of outpatient specialities are becoming increasingly interested in setting up their own businesses. This week we hear a bit more from him about how this trend applies to ophthalmology in particular...
Doctors are becoming increasingly interested in setting up clinics and running them as proper businesses. We spoke to Romesh Angunawela, who has recently completed an MBA especially for physicians in the US, and is the co-founder of OCL Vision, a three-clinic ...
Consolidation has been the primary way that PE-backed private health care groups have grown in Europe. A lot of the low hanging fruit has now been picked. But canny investors are adopting new models to open up new consolidation opportunities....
Multinational investment bank and financial services company Jefferies published its 2023 Healthcare Temperature Check report this week, to coincide with its healthcare conference which ran between Tuesday and Thursday this week....
HBI attended the Global Health Exhibition in Riyadh, Saudi Arabia, and saw first-hand how the country is changing ahead of its 2030 transformation plan. Here are our three key takeaways from the event....
A German outpatient operator tells HBI how providers are attracting and keeping patients within their businesses throughout the patient pathway, with as many as 50% of complex ophthalmology referrals coming from internal sources. HBI hears it pays to do basic ...
Anyone can put up a building. The key is staffing it with the right people, particularly in health care. This means the next decade will see the rise of new people-centric models and the demise of businesses that rely on more traditional employee/employer relat...
Database of 233 Ophthalmology (Outpatient) service providers
HBI has built a unique database of the Top 4,000 operators globally in health care services. As part of this, we have identified the top 233 Ophthalmology (Outpatient) operators in Europe and will soon add the major players in Emerging Markets.
Profiles include revenue/sales data as well as EBITDA and other profit margins where known. They also cover private equity ownership with dates and mergers and acquisitions.
Mergers & Acquisition (M&A) Intelligence
Our deal pipeline shows how likely all private equity and some privately companies are to sell based on algorithms and journalistic know-how.
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HBI 2020 – the only CEO-level conference to cover healthcare services globally
In 2019 this event brought together 700 delegates from over 40 countries. Over 60% are CEO level and they included 150 specialist investors in health care services. HBI 2020 includes a session on ophthalmology, where a panel of international CEOs from major operators and suppliers will discuss new technologies, payor changes and the growth of brands. The panel will also include a Partner from L.E.K. Consulting.
Other sessions look at trends in the investment and merger and acquisition, digital health and telehealth.
Contact us in the UK on 0207 183 3779 for more information.
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