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Multiple sclerosis (MS) is a disabling autoimmune disease affecting the brain and the spinal cord, eventually causing nerve deterioration or permanent damage. The types of MS include relapsing-remitting MS (RRMS), primary progressive MS (PPMS) and secondary progressive MS (SPMS). RPMS is the most common type characterized by defined attacks with increasing neurological symptoms, PPMS is the rare form characterized by gradual progression of disease, whereas SPMS is commonly identified in people living with relapsed-remitting MS. The most common symptoms of the disease include partial or complete vision loss, prolonged vision loss, lack of coordination and slurred speech.

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A combination of genetic and environmental factors is responsible for the occurrence of the condition. According to a study by International Progressive Alliance, 2013, MS is two to three times more common in women than in men, suggesting that hormones play a significant role in determining susceptibility to the disease.

Multiple sclerosis is a widespread disabling neurological condition, mostly diagnosed in people in the age group 20–50 years. According to the Multiple Sclerosis Foundation, 2017, this autoimmune condition affects 2.5 million people with the global incidence of around 7 cases per 100,000 people per year. The study also states that prevalence rates varies between ethnic and geographical latitudes, ranging from 50 to 120 people per 100,000 population. North America dominates the multiple sclerosis therapeutics market owing to the high prevalence of the condition and the rising economic burden of the disease leading to the adoption of novel therapeutics.

According to the Multiple Sclerosis Foundation, 2015, an estimated 400,000 people live with the disease in U.S., and about 200 new cases are diagnosed every week. According to a survey by Healthline Media, 2015, multiple sclerosis ranks second after congestive heart failure with direct and indirect health care costs ranging from US$ 8,528 to US$ 54,244 per patient per year. Higher therapy cost is restraining the growth of the multiple sclerosis therapeutics market.

Vascular closure devices (VCDs) are medical devices used to achieve vascular hemostasis after the puncture of femoral artery during diagnostic angiography procedures or interventional procedures. VCDs are developed as an alternative of mechanical compression. Although mechanical compression is effective method for treatment of hemostasis, it take a longer time period to effectively achieve hemostasis than vascular closure devices. VCDs has been available in the U.S. since 1995, when St. Jude Medical, Inc. received the approval for VasoSeal device. Since then, number of leading medical devices such as Abbott Laboratories, Medtronic Plc, and Terumo Corporation companies have entered in the market.

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Vascular closure devices are medical devices used in sealing puncture of the femoral artery in patients who have undergone diagnostic angiography procedures or interventional procedures. Vascular closure devices are alternative to manual compression method, manually compression takes longer time, depending on the size of the plastic sheath placed in the artery. Vascular closure devices provide immediate sealing of the femoral artery access site, which is not the case with mechanical or manual compression.

Increasing demand for diagnostic angiography procedures due to increasing prevalence of Coronary heart disease (CHD) is expected to increase demand for vascular closure device in near future. For instance according to the research published in Centers for Disease Control and Prevention (CDC) in 2017, Coronary heart disease (CHD) is one common type of heart disease, which causes about 370,000 deaths in U.S. annually. Furthermore the launch of innovative vascular closure devices in market is also expected create lucrative environment for market growth. For instance in 2014, AccessClosure Inc. launched Mynx Ace vascular closure device at annual scientific session of the American College of Cardiology in Washington, DC. Furthermore, in 2017, Vasorum Ltd. launched Celt ACD second generation vascular closure device in the U.S. market.

Vascular closure device are primarily used for vascular hemostasis after puncture of the femoral artery during angiography. Angiography is an imaging technique used to visualize interior of blood vessels including artery. The technique has been increasingly used for finding out if the arteries are blocked, closed or narrowed. According to research published by World Health Organization (WHO) in 2017, about 17.7 million people died from cardiovascular diseases in 2015, which is about 31% of all global deaths. Among these death around 7.4 million death were due to coronary heart disease and 6.7 million were due to stroke. As the prevalence of the cardiovascular disease is increasing, the demand for angiography, a diagnosis technique, is expected to increase which in turn will lead to growth in global vascular closure devices market.

This market has witnessed few recalls, which has proved to be major restraining factor for market growth. For instance, in 2017 Abbott Vascular recall 66 lots of the StarClose SE Vascular system due to difficulty in deploying the clip.

Parenteral are sterile dosage form that are administered through route other than oral route of administration. They are injected into one or more layer of skin and active ingredient directly come in contact with tissue or blood vessel. Large volume parenteral are of two types, small volume parenteral are single or multi dosage preparation with volume 100 ml or less quantity whereas large volume parenteral has volume more than 100 ml. Large volume parenteral comes in bag or bottle for intravenous administration and are used for correction of fluid/electrolyte balance, providing nutrition such as dextrose.

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Increasing demand for palliative care worldwide is expected to drive growth of the large volume parenteral market, owing to use of large volume parenteral to provide electrolyte balance and nutritional fluids. According to World Health Organization (WHO), 2017, an estimate of 40 million people need palliative care worldwide. Around 78% among those people, live in low- and middle-income economies and only 14% of people in need of palliative care receives it. Disease which require high palliative care are cardiovascular diseases (38.5%), cancer (34%), chronic respiratory diseases (10.3%), AIDS (5.7%) and diabetes (4.6%), kidney failure, chronic liver disease.

This creates potential opportunity for large volume parenteral market players. Increasing number of surgeries are expected to propel growth for the large volume parenteral market worldwide. For instance, according to World Bank statistics, in 2012, around 4511 surgeries were performed per 1,00,000 population across the globe. As per Lancet Commission for Global Surgery, 2015, an estimate of 143 million unmet surgical need per year, surgical need in turn drives large volume parenteral market as they are essential part of pre and post-operative care.

Regional segmentation of the large volume parental market by Coherent Market Insights consist of North America, Europe, Asia Pacific, Latin America, Middle East, and Africa. North America is expected to dominate the large volume parenteral market, owing to increasing number of hospital admissions and cost associated with such admission (an estimated US$ 1900 in 2013 as per Kaiser Health fact). According to American Hospital Association factsheet 2018, an estimated 35,158,934 hospital admissions were reported in 2017, large volume parenteral is integral part of any admission procedure, as nutrition and electrolyte support is essential in most of the cases.

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Key Vendors:

Baxter International Inc., Teva Pharmaceutical Industries Limited, Kelun Pharmaceutical Inc., BAG Healthcare GmbH, Hospira, Inc., Patheon Inc., Otsuka Pharmaceutical, Wockhardt Ltd., Southwest Pharmaceutical Co. Ltd., and Cook Pharmica LLC.