General Radiography equipment is generally priced much cheaper than CT or MR modalities. In some regions, asking prices are as low as $35,000 for a fixed system, whereas CT and MR modalities typically are sold for >$500,000. In addition to being a lower-cost purchase, general radiography equipment is also still some of the most frequently used in the hospital, with a recent IMV survey estimating a total of 152.8 million exams performed in the U.S. on general X-ray equipment in 2018, compared to 114.9m in CT, MR, PET and NM combined. This positions the market well in comparison to larger modalities should healthcare providers seek to implement budget cuts.

Emerging markets are, however, going to be hit harder, especially as markets such as Brazil and Mexico continue to deal with the rising impact of COVID-19 with limited resources and no obvious plan to counter the pandemic. General radiography market growth in some emerging regions is therefore expected to be dampened throughout the forecast; emerging markets account for around 26.5% of the global market, with Latin America, Russia and India expected to be most impacted.

Will a second peak affect the market?
A further unknown on the horizon for most healthcare providers and vendors is the possibility of a "second peak" of cases. How much of an impact would a second peak have on the market?

In our opinion, there would be only a limited impact for general radiography and fluoroscopy X-ray. System demand for mobile imaging has already been addressed through emergency tenders. Vendors are also prepared for the pandemic to roll on throughout 2020; GE Healthcare in their latest earnings call exemplified this reporting:

“…we’re ramping production of critical medical equipment used to diagnose and treat COVID-19 patients, including respiratory, CT, monitoring solutions, X-ray, anaesthesia, and point-of-care ultrasound product lines.”

Markets are, therefore, only likely to be affected in the case of reverting to more stringent lockdowns, limiting access to hospital sites for installation of equipment, further delaying revenue. However, assuming imaging volumes will return to pre-pandemic levels in the interim, and reserves of critical care equipment will have been met, the impact of a second peak in most markets should be less pronounced than the first wave.

Where will change be most noticeable post COVID-19?
Radiography equipment can be found in acute hospitals, outpatient imaging centres and urgent care clinics. The balance of where radiography is performed is perhaps the most likely to change. Outpatient imaging centres broadly experienced the steepest decline across all imaging modalities following virus presence. This is shown in Figure 2. We also would expect patients may modify their behaviour to avoid exposing patients to imaging in hospitals. For this reason, outpatient X-ray imaging could become more common in the post-pandemic future.

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