Facing the Crowd

One of the signs that a new industry or industry segment is poised for growth is the emergence of new competitors to challenge the incumbent players in that space. We are clearly seeing that come to pass in the neurotechnology industry.

The first neuromodulation industry segment to experience this was spinal cord stimulation when Advanced Neuromodulation Systems (now Abbott) and then Advanced Bionics (now Boston Scientific) challenged Medtronic’s dominance in that space. Nevro later joined the club with their paresthesia-free technology and now Saluda, Biotronik, and perhaps one or two others are ready to jump in.

As we report in our article on page 1 of this issue, a similar phenomenon is taking place in the much younger, but highly promising peripheral nerve stimulation market segment. The early market leaders Bioness (now Bioventus), SPR Therapeutics, and Stimwave are being challenged by newcomers Nalu, BlueWind, Neuspera, and Neuronoff. Our recently published market report, The Market for Implanted Pain Neuromodulation Systems: 2021-2026, projects the impact that some of these new players will have on both SCS and PNS market share in the years ahead.

Another neurotech market segment facing new competition is hypoglossal nerve stimulation, where Nyxoah is challenging incumbent Inspire Medical, with LivaNova and a bevy of startups like X-Nerve and Sonosa Medical waiting in the wings. With the help of some well heeled investors, the market for implanted BCI devices is getting crowded [see article p1]. Though Blackrock (and its predecessor Cyberkinetics) was the first real player in this small but emerging market segment, Neuralink, Synchron, and Paradromics are well positioned and several smaller players like Modular Bionics and Neurosoft are likely to join later on.

The issue of how many players can a market segment can support came up during the recent i3 session at the NANS Mid-Year meeting in Orlando, FL [see conference report p6]. While some medtech sectors like cardiac devices can flourish with a half-dozen or more competitors, the SCS market is not yet that big. On the other hand, the penetration of neuromodulation devices in the potential population of people with chronic pain is still very low, so there should be more room for other vendors.

Many of these topics will be on tap in a session entitled “Neuromodulation Battlegrounds: Insurgents Seek to Capture Share from Incumbents,” at the 20th Anniversary Neurotech Leaders Forum on November 8 in San Francisco. We look forward to continuing the discussion in more detail then.

James Cavuoto
Editor and Publisher


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