In 2022, the total market size of anti-adhesion products in Korea is estimated to be approximately USD *** million (manufacturers/importers’ initial selling prices) and USD *** million (medical institutions’ purchase prices).

While some estimates put the market size at around USD *** million for all therapeutic materials and drugs with anti-adhesion function or anti-adhesion effect, this report estimates the market size only for those two medical devices approved as (1) Adhesion barrier dressing (Product Classification Number B07070.14 Class 3) and (2) Biodegradable polymeric mesh (Product Classification Number B03330.04 Class 4).

The anti-adhesion product market is expected to grow at a compound annual growth rate of **% over the next five years from 2022, reaching a market size of approximately USD *** million in terms of manufacturers/importers’ initial selling prices and USD *** million in terms of medical institutions’ purchase prices in 2027.

It is estimated that out of around USD *** million (medical institutions’ purchase prices) in 2022, approximately USD *** million was from the National Health Insurance reimbursement, and the remaining about USD *** million was from the patients’ out-of-pocket expenses (non-reimbursement).

Currently, all postoperative anti-adhesion products are reimbursed (select reimbursement, out-of-pocket 80%), and only spinal epidural anti-adhesion products are the subject of non-reimbursement claims. Unlike other therapeutic materials, there is no known off-label use of anti-adhesions products since there is no separate reimbursement criteria.

The reimbursement volume for anti-adhesion products in 2022, USD *** million, is about ***% increase from USD *** million in 2021. In 2021 (approximately USD *** million), there was a sharp increase of ***% compared to 2020 (approximately USD *** million) which can be interpreted as the result of the implementation of the new National Health Insurance reimbursement system effective from January 2020.

It was the first year that postoperative anti-adhesion products on the NHIS reimbursement list could be billed for fully separate non-inclusive claims under the 7-DRG scheme.

With postoperative anti-adhesion products having been fully separately non-inclusive therapeutic materials for about three years (2020, 2021, and 2022), it is now expected that single-digit growth will continue in the near future rather than the double-digit growth from 2020 to 2022.

Looking at the 2022 reimbursement claims of the anti-adhesion products by medical department, general surgery is about USD *** million and obstetrics and gynecology is about USD *** million, accounting for about ***% of the total claims. The remaining ***% includes orthopedics about USD *** million, otolaryngology/internal medicine about USD *** million, urology about USD *** million, thoracic surgery about USD *** million, and neurosurgery about USD *** million.

In terms of the 2022 reimbursement claims of the anti-adhesion products by end-user type, tertiary-referral hospitals account for approximately USD *** million (***%), the largest portion of the total reimbursement volume (about USD *** million). This is followed by general hospitals about USD *** million (***%) and hospitals about USD *** million (***%).

One of the natures of the anti-adhesion products is that they are closely related to surgical operations. Therefore, among various types of medical institutions, the combined claims of tertiary-referral hospitals and general hospitals account for approximately ***% of the total claims.

In 2022, about *** products from *** manufacturers/importers are listed on the National Health Insurance of Korea. Major suppliers of the anti-adhesion product market include GC Biopharma, Dalim Tissen, Medtronic, Baxter, Samyang Biopharm, CGbio, Shinpoong Pharm, LG Chem, Genewel, BNC Korea, Cares, BMI Korea and Johnson & Johnson Medtech (in Korean-alphabetical order).

Among them, the combined market share of the top three suppliers (Genewel, CGbio and Shinpoong Pharm) accounted for about ***% of the total market, while the remaining *** suppliers accounted for about ***% of the market.

The market share of the top three suppliers is estimated as follows: Genewel (manufacturer of Guardix) about ***%, CGbio (manufacturer and supplier of Mediclore) about ***% and Shinpoong Pharm (manufacturer and supplier of Medicurtain) about ***%.

In terms of the physical state, the anti-adhesion product market is divided into film type, gel type and solution type, with the gel type accounting for more than ***% of the market share. The market can be also categorized by substances or size/dosage but this report does not cover them in detail since substances are not a differentiating factor.

The size and dosage along with the physical state of the product varies between medical deparments. Therefore, anti-adhesion product companies are supplying diverse products with different product types, substances, sizes and dosages to meet the diverse needs of end users through differentiated sales and marketing strategies.

The anti-adhesion product market of Korea began in the 1990s when film-type products such as Interceed and Seprafilm were introduced as non-reimbursement therapeutic materials.

On 1 April 2016, with the partial revision of “The National Health Insurance Service Reimbursement Therapeutic Materials & Maximums Formulary” therapeutic materials for the purpose of ‘postoperative adhesion prevention’ were converted into reimbursement products (less than 100% out-of-pocket).

Subsequently, they were classified as products with differently applied out-of-pocket rates (80% out-of-pocket) within the limit of less than 100% of the reimbursement benefits, their usage considerably increased. As such, the market for anti-adhesion products is highly influenced by health insurance reimbursement policies, and they will continue to play a role in the future.

The anti-adhesion product market is expected to grow continuously at an average annual rate of **% for the next five years driven by the following factors. Competition between medical institutions for securing more hospital beds, aging population, increasing numbers of surgeries, laparoscopic procedures, obstetrics and gynecology treatments, spinal treatments, 7-DRG cases and subscribers of indemnity health insurance, growing public awareness of anti-adhesion products and changes in patient perception.

On the other hand, since the National Health Insurance Service determines the reimbursement price based on the phycial state, size and dosage of the product, it can be a restraint factor to the emergence or supply of anti-adhesion products attempting and/or utilizing a wider range of materials or substances.

The preference for existing products among the healthcare providers has been accumulated over a long period of time and it seems to be difficult to expect a change in the short term.

However, an interest in anti-adhesion products with new functions or better qualities for patients is substantially high among the healthcare providers, general consumers, and the indemnity health insurance companies.

Therefore, it can be said that potential demands and unmet needs are also high as well. New products improving the usability and the cost-effectiveness will have opportunities for growth in the future.

Chapter 1 Introduction
   1.1 Purpose
   1.2 Suggestions for Best Use
   1.3 Scope
   1.4 Market Segmentation
   1.5 Research Methods
      1.5.1 Desk Research
      1.5.2 Primary Research
   1.6 Analysis and Estimation Methods
      1.6.1 Data Sources
      1.6.2 Exchange Rate
      1.6.3 Market Size Estimatiom Methods
         1.6.3.1 Reimbursement Volume Estimation Methods

Chapter 2 Executive Summary

Chapter 3 Market Overview
   3.1 Market Size at Initial Selling Prices
      3.1.1 Five-Year Forecast of Market Size
   3.2 Market Size at Purchase Prices
   3.2.1 Reimbursement Volume
      3.2.1.1 Reimbursement Volume by Medical Department
      3.2.1.2 Reimbursement Volume by End-User Type
   3.2.2 Reimbursement Volume by Product Type
      3.2.2.1 Reimbursement Volume by Product & Specialty
      3.2.2.2 Reimbursement Volume by Product & End-User Type

Chapter 4 Major Suppliers
   4.1 GC Biopharma
   4.2 Dalim Tissen
   4.3 Medtronic
   4.4 Baxter
   4.5 Samyang Biopharm
   4.6 CGbio
   4.7 Shinpoong Pharm
   4.8 LG chem
   4.9 Genewel
   4.10 BNC Korea
   4.11 Cares
   4.12 BMI Korea
   4.13 Johnson & Johnson Medical

Chapter 5 Market Dynamics
   5.1 Impact of COVID-19
   5.2 Characteristics of Healthcare Market in Korea
      5.2.1 History of Anti-Adhesion Products
      5.2.2 Change History of Payment Environment
      5.2.3 Number of Medical Institutions in Korea
      5.2.4 Determination Criteria for Reimbursement
   5.3 Key Indicators
      5.3.1 Rising Medical Costs and Hospital Beds
      5.3.2 Aging Population
      5.3.3 Number of Surgical Operations
      5.3.4 Number of Laparoscopic Procedures
      5.3.5 Obstetrics and Gynecology Treatments and Surgeries
      5.3.6 Urology Treatments
      5.3.7 Orthopedic Treatments and Surgeries
      5.3.8 Otolaryngology/Internal Medicine Treatments & Surgeries
      5.3.9 Seven Diagnosis-Related Groups
   5.4 Market Drivers
      5.4.1 Demand
      5.4.2 Increase in Number of Suppliers
   5.5 Market Opportunities
      5.5.1 Rising Demand with Surgical Operations
      5.5.2 Reimbursement Coverage Expansion Policy
      5.5.3 Therapeutic Materials under 7-DRG Scheme
      5.5.4 Clinical Trials on New Anti-Adhesion Technologies
   5.6 Market Restraints
      5.6.1 Reimbursement Pricing Scheme of NHIS
      5.6.2 Concentration of Specific Physical States
   5.7 Unmet Needs

Appendix1 Postoperative Anti-Adhesion Products Reimbursed 2016-2020

[Table 1] Classification of Anti-Adhesion Products Approval
[Table 2] Market Size at Initial Selling Price 2018-2022 (USD thousands)
[Table 3] Five-Year Forecast of Market Size 2022-2027 (USD thousands)
[Table 4] Reimbursement Volume of Anti-Adhesion Products 2018-2022
[Table 5] Reimbursement Volume by Specialty 2018-2022
[Table 6] Market Size Forecast for Major Specialties
[Table 7] Reimbursement Volume by End-User Type 2018-2022
[Table 8] Reimbursement Volume by Product Type 2018-2022
[Table 9] Reimbursement Volume by Product & Specialty 2021-2022
[Table 10] Reimbursement Volume by Product & End-User Type 2021-2022
[Table 11] Manufacturers and Suppliers of Key Brands
[Table 12] Substances and Physical-states of Key Brands
[Table 13] Characteristics of Each Product Type
[Table 14] Key Brand of GC Biopharm - Hyalobarrier
[Table 15] Key Brand of Dalim Tissen - Collabarrier
[Table 16] Key Brand of Medtronic - Medishield
[Table 17] Key Brand of Baxter - Adept
[Table 18] Key Brand of Baxter - SepraFilm
[Table 19] Key Brand of Samyang Biopharm - Interguard
[Table 20] Key Brand of CGbio - Mediclore
[Table 21] Key Brand of Shinpoong Pharm - Medicurtain
[Table 22] Key Brand of LG Chem - Protescal
[Table 23] Key Brand of Genewel - Guardix SOL
[Table 24] Key Brand of Genewel - Guardix SG
[Table 25] Key Brand of Genewel - Guardix SP
[Table 26] Key Brand of Genewel - Guardix SP Plus
[Table 27] Key Brand of BNC Korea - Hibarry
[Table 28] Key Brand of Cares - SurgiWrap
[Table 29] Key Brand of BMI Korea - Qblock
[Table 30] Key Brand of Johnson & Johnson Medical- Interceed
[Table 31] Number of Medical Institutions 2022
[Table 32] Number of Beds for Major Hospitals 2022
[Table 33] Determination Criteria for Reimbursement vs. Non-Reimbursement
[Table 34] Number of Hospital Beds of OECD countries 2021
[Table 35] Percentage of Estimated Health Spending to GDP 2021
[Table 36] Estimate of Elderly Population Over 65 Years Old
[Table 37] Healthcare Spending for Elderly Population (65 years above)
[Table 38] Number of Surgical Claims 2018-2022
[Table 39] Number of Surgical Operations 2018-2021
[Table 40] Number of Laparoscopic Surgeries 2017-2021
[Table 41] Obstetrics and Gynecology Care 2017-2021
[Table 42] Obstetrics & Gynecology Surgeries (DRG Cases) 2017-2021
[Table 43] Obstetrics and Gynecology Surgeries 2017-2021
[Table 44] Urology Care 2017-2021
[Table 45] Orthopedic Care 2017-2021
[Table 46] Number of Spinal Surgical Operations 2017-2021
[Table 47] Otolaryngology and Internal Medicine Care 2017-2021
[Table 48] Thyroid Surgery Operations 2017-2021
[Table 49] DRG Claim Cases 2017-2021
[Table 50] Summary of Market Drivers
[Table 51] Changes in Number of Anti-Adhesion Products
[Table 52] Clinical Trials of Anti-Adhesion Products 2018-2022 (as of 1 March 2023)
[Table 53] Classification Method and Reimbursement Criteria for Anti-Adhesion Products
[Table 54] Non-Reimbursement Spinal-Epidural Products (as of March 2023, in KRW)

[Fig 1] Market Size at Initial Selling Prices 2018-2022 (USD thousands)
[Fig 2] Five-Year Forecast of Market Size 2022-2027 (USD thousands)
[Fig 3] Market Size at Hospital Acquisition Price 2022
[Fig 4] Market Size Forecast at Purchase Prices 2027
[Fig 5] Reimbursement Volume of Anti-Adhesion Products 2018-2022
[Fig 6] Reimbursement Volume by Medical Department 2022 (USD thousands)
[Fig 7] Reimbursement Volume by Medical Department 2018-2022
[Fig 8] Reimbursement Volume by End-User Type 2022 (USD thousands)
[Fig 9] Reimbursement Volume by End-User Type 2018-2022
[Fig 10] Reimbursement Volume by Product Category 2022 (USD thousands)
[Fig 11] Reimbursement Volume by Product Category 2018-2022
[Fig 12] Reimbursement Volume by Product & Specialty 2022 (USD thousands)
[Fig 13] Reimbursement Volume by Product & Specialty 2022 (EA)
[Fig 14] Reimbursement Volume by Product & End-User Type 2022 (USD thousands)
[Fig 15] Reimbursement Volume by End-User Type 2022
[Fig 16] Estimated Market Share of Key Anti-Adhesion Products 2022
[Fig 17] Trend in Number of COVID-19 Patients 2020-2022
[Fig 18] Reimbursement Volume of Big 5 Hospitals 2016-2020 (USD 100,000)
[Fig 19] Tertiary Hospital Ranking with Decreased Volume 2018-2021 Q3
[Fig 20] Number of Medical Institutions 2012-2022
[Fig 21] Percentage of Healthcare Spending Compared to GDP 2012-2021
[Fig 22] Percentage of Elderly Population (65 years+)
[Fig 23] Health Spending on 65+ population (in USD 100,000 per 1,000 persons)
[Fig 24] Number of Surgical Operations 2018-2022
[Fig 25] Number of Laparoscopy Care Patients 2017-2021
[Fig 26] No. of Obstetrics & Gynaecology Treatments 2017-2021 (Unit: 1,000 cases)
[Fig 27] Number of Urology Treatments 2017-2021 (Unit: 1,000 cases)
[Fig 28] Number of Orthopedic Treatments 2017-2021 (Unit: 1,000 cases)
[Fig 29] Number of Spinal Surgical Operations 2017-2021
[Fig 30] Otolaryngology & Internal Medicine Treatments 2017-2021 (Unit: 1,000 cases)

GC Biopharma
Dalim Tissen
Medtronic
Baxter
Samyang Biopharm
CGbio
Shinpoong Pharm
LG chem
Genewel
BNC Korea
Cares
BMI Korea
Johnson & Johnson Medical