Technology, need drive growth in enteral market

The enteral nutrition market is having a growth spurt, thanks to a combination of factors that show no signs of slowing down.

“Home enteral nutrition is a steadily growing market,” said Noreen Luszcz, national director of the nutrition program for Option Care, one of the largest providers of home infusion therapy in the country. “It's a very large patient population, it is less costly, and it has fewer
complications.”

It's hard to put an exact figure on the size of the enteral market, providers say, but Rick Winterich, CEO of the enteral business for Epic Health Services, cites a report from Bain Capital that projects the home infusion market will grow from about $12.3 billion in 2014 to $20.5 billion by 2020. Enteral nutrition is a subset of the market, comprising about 25%.

What's driving the growth? An aging population, growing malnutrition concerns, an increase in premature births and more appropriate use of nutrition therapy, says Luszcz.

“People aren't going straight to infusion therapy when they should be using enteral nutrition,” she said.

Technology is also a big factor in the market's growth, says Chris Roussos, CEO of Epic Health, which serves primarily the pediatric market.

“There have been incredible improvements in technology within the healthcare sector,” he said. “These very medically fragile children in the past would not have survived.”

Still, balancing the care of increasingly complex patients with stagnant or declining reimbursement is a challenge, say providers.

“There's a lot going on with these patients,” says Luszcz. “There is a need for close monitoring and a lot of documentation required to qualify the patient for reimbursement.”

Although the product category is included in competitive bidding, Luszcz says that it hasn't had a noticeable impact on patient access. However, that could change over time if more infusion and DME companies exit the market.

“I think the population is covered for now,” she said. “There's just less choice and, depending on the provider, less clinical oversight, which could negatively impact patient outcomes.”

As the bid program continues, Winterich definitely sees the pool of providers shrinking.

“When Round 1 came out, many providers failed,” he said. “With Round 2, even though we don't specifically go after the adult market, our referral sources beg us to take their adult patients.”