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Metal’s New Rival Why PEEK Knee Implants Have Big Players on Edge by EOS Intelligence
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Metal’s New Rival: Why PEEK Knee Implants Have Big Players on Edge

Healthcare providers performed around 3.6 million knee replacement procedures globally in 2023, according to LSI’s Global Procedure Volumes Database, which covers 37 countries. This substantial volume highlights the massive clinical demand and shows a strong opportunity to innovate beyond traditional metal-on-polymer implant technologies. As more people age and joint problems from lifestyle become more common, the orthopedic field is turning to new, improved solutions that better meet what patients and healthcare systems need today. Will all-polymer implant technology drive the next breakthrough in total knee arthroplasty (TKA)?

Breaking the mold: Is metal-on-polymer TKA still the best we can do?

Healthcare community widely regards metal-on-polymer implants as the gold standard in TKA as these implants effectively handle the knee joint’s high load-bearing demands. Compared to all-polymer alternatives, metal-on-polymer designs provide greater mechanical strength, enabling them to withstand daily use and maintain long-term joint stability. According to the American Academy of Orthopaedic Surgeons, ~90% of total knee replacements continue to function effectively 15 years after surgery.

Maxx Orthopedics and Invibio (a Victrex PLC company) are set out to challenge this conventional view with the Freedom Total Knee System using PEEK-OPTIMA femoral component (PEEK standing for Polyether Ether Ketone).

In 2025, a research study (Cowie et al., Bioengineering 2025, 12(3):261) reported that PEEK-OPTIMA polymer-on-UHMWPE (Ultra-High-Molecular-Weight Polyethylene) knee implants showed UHMWPE wear comparable to metal-on-UHMWPE. Researchers based this conclusion on their evaluation of PEEK-OPTIMA and cobalt-chrome femoral components paired with polyethylene lower knee component in a knee simulator mimicking real walking and movement. Findings from this study address the key concern that all-polymer knee implants might wear out too fast.

Another research paper (ORS 2025 Annual Meeting Paper No.275) concluded that the wear behavior (including wear factor, rate, and volume) of PEEK-on-UHMWPE was comparable to cobalt-chrome-on-UHMWPE and met ASTM (Advancing Standards Transforming Markets) wear standards.

Overall, the collective evidence demonstrates that all-polymer PEEK implants could match the wear performance of metal-on-UHMWPE systems over millions of cycles, alleviating concerns about rapid degradation. Further research and clinical trials must still confirm real-world durability.

Beyond metal: could PEEK be the future of knee implants?

PEEK’s practical advantages are vast and include faster manufacturing, onsite customization, lower allergy risk, clearer imaging, and better bone compatibility. This could address longstanding issues with metal-based knee implants and reshape the TKA landscape, potentially becoming the new benchmark for knee implant materials.

Faster, lower-cost production

Studies show that manufacturers can injection-mold PEEK components in about three minutes and can have them ready for use within a week, in contrast to custom cobalt-chrome pieces, which often require months to finish. This rapid production cuts manufacturing costs and reduces hospital inventory requirements, making implants more affordable and improving access for patients facing long waitlists. Surgical centers can also benefit from greater flexibility to adjust designs quickly.

If PEEK adoption grows, patients, healthcare providers, payers, and PEEK producers will surely benefit. However, traditional metal-implant makers would face major disruption, forcing them to adapt or partner with polymer experts to stay relevant.

On-site 3D printing and customization

PEEK’s compatibility with high-temperature 3D printing allows hospitals to create patient-specific implants on demand. Such implants can fit the anatomy more precisely, potentially improving recovery and function. On-site implant printing also eliminates shipping delays and the need for large warehouses for hospitals and solution providers.

However, acquiring industrial-grade PEEK printers and training staff require significant investment, which will likely act as a factor slowing adoption. On the supply side, implant makers will be challenged with additive manufacturing (which they will likely have to bring in-house) and the need to forge partnerships with 3D-printing players. All players, whether established or start-ups, will have to navigate strict and demanding regulatory approval before hospitals adopt these materials.

Minimizing metal-related risks

As PEEK does not release metal ions into surrounding tissue, it eliminates the risks of irritation or hypersensitivity that affect up to 25% of patients with implants. This is a considerable benefit for patients with metal allergies. Hospitals may see fewer allergy-related follow-ups, fewer revision surgeries, and lower long-term costs. This is again challenging metal-implant makers, who will have to address this shift by developing hypoallergenic alternatives or risk losing market share as patients and healthcare professionals move to polymer-based options.

Enhanced imaging transparency

PEEK’s radiolucency produces clear standard imaging (X-rays, CT scans, and MRIs) without metal artifacts, enabling earlier detection of misalignment, loosening, or infection. This means a reduced need for specialized scans, lowers costs and radiation exposure. Change in implant materials will affect radiology solutions vendors, as they may have to adjust protocols to optimize scans for polymer implants.

Bone-friendly mechanics

PEEK is isoelastic and mimics the mechanical properties of natural bone, spreading pressure more naturally through the bone around it. This reduces stress shielding that can cause bone loss around stiffer metal implants. Patients may experience fewer long-term complications and easier revision procedures if needed.

Those bone-friendly mechanics offer a great benefit for several hospitals and payers, thanks to lower costs of managing bone-loss issues. Implant developers must consider whether newer low-modulus metal alloys can match PEEK’s bone-preserving properties at all, as polymer-based solutions can redefine TKA standards.

Considering these benefits, PEEK presents a compelling alternative to metal-based knee implants. Each benefit comes with practical considerations, including upfront equipment costs, regulatory challenges, and strategic shifts for established manufacturers. As clinical trials progress and real-world data accumulate, stakeholders across orthopedics will need to monitor the impact PEEK will have on reshaping the implant market.

Is all-polymer TKA entering the home stretch?

FDA Investigational Device Exemption (IDE) approval, global feasibility trials, and dedicated research funding signal that PEEK-based knee implants are on the verge of commercialization.

FDA approval accelerates clinical testing

In September 2024, the FDA granted an IDA for the Freedom Total Knee System using Invibio’s PEEK-OPTIMA femoral component in partnership with Maxx Orthopedics. This authorization clears the way for systematic safety and efficacy data collection under controlled conditions. IDA gives legitimacy to the solution, and hospitals and surgeons can begin preparing for a polymer-based alternative entering mainstream in the future.

Decades of collaboration accompany ready manufacturing

Invibio recognized PEEK’s medical potential in the early 2000s, and by 2024, over 15 million PEEK-OPTIMA devices were implanted worldwide. Since 2012, Invibio and Maxx Orthopedics have co-developed an all-PEEK femoral component paired with a UHMWPE tibial insert. Invibio can probably consider scaling its existing PEEK production facilities (although it already maintains large-scale PEEK-OPTIMA manufacturing facilities). Similarly, other PEEK producers might follow suit to offer reliable availability and cost predictability once approvals are in place. Incumbent metal-implant manufacturers may need to forge similar partnerships or invest in polymer capabilities to avoid losing market share.

Early trial results build confidence

Feasibility studies in India, Belgium, and Italy, ongoing since 2021, have shown no device-related adverse events with the PEEK-OPTIMA component in small patient cohorts. This suggests strong biocompatibility and mechanical resilience. Healthcare providers will continue watching further study results and might alter their component purchasing decisions. Established TKA suppliers will face renewed pressure to rethink their own implant solutions if studies show continued positive results.

India leads the commercial charge

Maxx Orthopedics plans to file for regulatory approval in India with a 2025 commercial launch target. India’s large patient base and growing demand for joint replacements create an ideal environment for initial commercialization. For players, early market entry here could build clinical experience and generate real-world data to support subsequent approvals in Europe and the USA.

Academic funding fuels long-term validation

In 2023, Invibio and academic partners, including the University of Leeds, secured a £1.7 million UK EPSRC grant for TKA patient outcome research. This funding will support ongoing research into wear patterns, revision rates, and other outcomes. Robust academic data will likely affect clinical decisions and payer coverage, while boosting evidence for PEEK implant solutions makers.

The momentum around all-polymer TKA continues to grow, thanks to regulatory milestones, scientific studies, strategic manufacturing alliances, and academic validation.

EOS Perspective

The ongoing developments from Invibio and Maxx Orthopedics mark a potentially transformative era in TKA, moving beyond conventional metal-on-polymer implants. However, all-polymer implants have yet to reach a point where they can directly compete with metal implants, which have demonstrated reliable durability over five decades. Although PEEK shows promise as a metal-free alternative, additional real-world studies are needed to validate its long-term effectiveness.

Nevertheless, the emergence of all-polymer knee implants will likely prompt a counter-response from incumbent players, further accelerating innovation in the field. The stakes are high, as LSI’s Global Market Analysis & Projections database shows that Zimmer Biomet, Stryker, and DePuy Synthes still dominated the TKA market in 2023, collectively accounting for about 80% of the overall market.

Zimmer Biomet, for instance, in March 2025 secured FDA clearance of Persona Revision SoluTion Femur, a revision knee implant component made of Tivanium (Ti-6Al-4V) alloy, offering an alternative for patients with metal sensitivities. This development reflects their strategic effort to address concerns around metal allergies and to strengthen their trusted metal implant offerings to stay competitive.

Most established market players have the know-how and infrastructure to drive R&D in all-polymer implants for TKA, given their experience with implant polymer technologies and the inclusion of PEEK-based implants within their broader portfolios and other applications. For instance, both Zimmer Biomet and Stryker successfully commercialized customized solutions for PEEK-based cranial implants. Their existing R&D pipelines and clinics networks position them to act fast. With this, they might be able to considerably stifle disruption from startups or niche players. The challenge for these large companies will likely be the execution.

Smaller competitors often innovate faster, while established players can be slowed by internal processes or reliance on existing metal implant revenue streams and supply chains. How they handle this transition will shape the future of knee replacements, either reinforcing their market leadership or allowing newer companies to gain a foothold.

Metaverse Meets Medicine: Spatial Computing's Game-Changing Potential by EOS Intelligence
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Metaverse Meets Medicine: Spatial Computing’s Game-Changing Potential

Spatial computing, sometimes called the metaverse, will revolutionize healthcare by seamlessly merging the digital and physical worlds. Leveraging technologies such as augmented reality (AR) and virtual reality (VR), it offers exciting transformative possibilities, from enhanced surgical training and improved diagnostics to personalized treatment plans and remote care solutions. As the technology matures, it presents both opportunities and challenges for technology solution providers.

AR, VR, and Extended Reality solutions offer an immersive healthcare experience

Spatial computing uses technologies such as virtual, augmented, and mixed reality to interact with digital information in 3D space, fundamentally changing how healthcare is delivered. It is gradually finding applications across the industry. For example, surgeons can practice complex procedures in realistic, risk-free VR environments, improving their skills and preparedness. Doctors can visualize medical images in 3D for more accurate diagnoses.

Patients also become more engaged in their care through interactive tools that explain their conditions and treatment options. Holographic images expand the scope of remote care, providing patients with a stronger sense of connection to their doctors. VR can even be used for immersive therapy sessions, helping patients manage anxiety or PTSD in a safe, controlled setting.

The potential applications are vast. AR solutions can overlay medical imaging data (CT scans, MRIs) onto a patient’s body for improved diagnosis. Virtual patient models can simulate treatment scenarios for optimized treatment planning. Tools such as EnVisio provide continuous 3D surgical awareness, enabling surgeons to plan approaches from any angle for increased precision.

Virtual clinics promise to reshape care delivery models, while live surgeries can also benefit from this technology. Within six months of Apple Vision Pro’s launch in February 2024, surgeons at UC San Diego Health successfully performed minimally invasive operations using Apple Vision Pro headsets, which offered significant cost advantages over traditional surgical monitoring systems.

Surgery-specific applications and AI integration drive innovation

The field is attracting significant innovation. Companies such as Medivis and Osso VR are pioneering the development of spatial computing solutions for surgical planning and medical training. There are several solutions (such as Medivis’s Surgical AR and Surgical Theater) available that use real-time camera images to project 3D models in a surgeon’s headset for both surgical planning and rehearsal before the procedure. Other solutions include AR and VR to help surgeons and health professionals in their medical training.

Since the launch of Apple Vision Pro, several large solution providers and startups started developing software solutions that leverage Apple’s advanced capabilities, specifically for applications in the healthcare sector. Siemens Healthineers developed its ‘Cinematic Reality’ app in March 2024, which offers advanced imaging and visualization solutions, including 3D reconstruction and VR tools for surgical planning.

Several large surgical players are also developing solutions that help optimize the processes, making surgeries more efficient and cost-effective. For example, Stryker‘s Mako SmartRobotics app for Apple Vision Pro (launched in March 2024) enables surgeons to review and visualize patients’ surgical plans. Zeiss‘s Surgery Optimizer (launched in April 2024), an AI-powered app for cataract surgery preparation using the Artevo 850 microscope and Apple Vision Pro, is another example of this trend.

Epic‘s Spatial Computing Concept for Apple Vision Pro aims to streamline charting, lab review, and secure communication for physicians. This also enables real-time updating of patient information on the hospital’s EHR systems. Integration of AI with spatial computing is a likely next step, promising optimized procedures with spatial computing overlays. AI is also likely to aid in better processing and analysis of spatial data.

Growth in spatial computing is also likely to bring in further investments from venture capital and existing healthcare giants. Spatial computing startup XRHealth raised US$6 million in funding in January 2024, while Medivis raised US$20 million in Series A funding that would enable it to develop advanced surgical solutions that integrate AR technology.

Apple Vision Pro is a key enabler for startups to develop healthcare solutions

The competitive landscape is dynamic, with various players vying for market share. Established medical technology giants such as Siemens Healthineers, GE Healthcare, and Philips are integrating spatial computing into their existing platforms. Meanwhile, startups such as Osso VR, Surgical Theater, and Medivis are disrupting the market with innovative solutions.

Software and hardware specialists, including Microsoft (HoloLens) and Apple (Vision Pro), are crucial enablers. While Apple Vision Pro is currently prominent, other hardware and platform developers are likely to emerge.

We can anticipate mergers and acquisitions as larger companies acquire promising startups. There is an increasing focus on user experience and integration with existing healthcare systems. Apple’s launch of the Vision Pro has spurred interest in spatial computing, with startups developing for the mixed reality environment offered by AR/VR headsets such as the Vision Pro and Meta Quest.

Dependence on limited hardware ecosystems is a key challenge for developers

Solution developers face several key challenges. Dependence on hardware companies, including Apple and Meta, creates vulnerabilities. These companies have their own ecosystems for developing supported applications that limit the possibilities and options for startups.

Data privacy and security, particularly compliance with regulations such as HIPAA and GDPR, are paramount, especially as AI integration becomes more prevalent. Compatibility with legacy systems, including imaging systems and EHRs, is also essential to be successful.

Maintaining cost-effectiveness is crucial, as the high prices of devices like the Vision Pro and HoloLens pose a barrier. Funding, particularly for startups, remains a challenge, although recent successful funding rounds offer encouragement.

EOS Perspective

The spatial computing market in healthcare is poised for substantial growth, driven by the increasing demand for immersive technologies, the rise of AR/VR in medical training, and the growing need for remote healthcare solutions.

Spatial computing advancements are transforming areas such as clinical education, surgical planning, training, medical imaging, and behavioral health. We can expect even more applications to emerge, improving care delivery and surgical outcomes. Imaging data will become more interactive, detailed, and accessible. Increased deployment in surgical settings will drive further growth in the development of supporting software and hardware. We may also witness an increase in hardware companies developing spatial computing systems suitable for application in the healthcare sector.

As the technology matures and costs decrease, spatial computing is expected to become an integral part of the healthcare ecosystem, transforming patient care and revolutionizing how medical professionals work.

Cashless Sweden: Prepared or Vulnerable? by EOS Intelligence
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Cashless Sweden: Prepared or Vulnerable?

Sweden’s cashless initiative is gaining momentum, driven by high digital literacy, favorable regulations, and rapid adoption of technology. Since most consumers (~95%) are digitally savvy, a tendency to prefer mobile payments over cash is pushing Sweden closer to its goal of becoming a cashless economy. Technology solutions will likely play a crucial role in shaping the evolution of payment systems as Sweden transitions to a cashless society.

Consumer preference for mobile payments drives Sweden’s cashless shift

The shift toward a cashless society in Sweden reflects both consumer preferences and the increasing number of businesses that prefer or require card and mobile payments. At the same time, Swedish society shows a high level of trust in banks and government institutions, which reduces resistance to financial innovation. Together, these factors create a strong foundation for the widespread adoption of new digital payment systems.

Since the COVID-19 pandemic began in early 2020, cash usage has declined, with cash in circulation accounting for only 1% of the country’s GDP, owing to the convenience and security of digital transactions.

Card offerings, such as Handelsbanken’s Allkort Mastercard, SAS EuroBonus Cards, and the Lunar-SAS partnership, encourage consumers to adopt digital payments by offering various reward programs, including cashback, bonus points, and travel incentives.

Growth in real-time payments fast-tracks the cashless initiative

The Swish mobile payment system is boosting the country’s cash-free initiative by driving growth in real-time payments. Swish is the country’s second most common payment method, highlighting its significance in Sweden’s digital payment landscape. A recent addition of the tap-to-pay function in December 2024 has further expanded Swish’s capabilities for in-store purchases for over 8.6 million Swedish app users (a high number, considering the country’s population is around 10.5 million).

Moreover, the Riksbank, Sweden’s central bank, intends to expand its RIX-INST, a real-time settlement service that currently only allows for domestic payments. The government plans to explore synergies between the RIX INST system and other regional systems, such as the European Central Bank, Banca d’Italia, and Danmarks Nationalbank, seeking to facilitate cross-border payments utilizing cross-currencies. The plan focuses on supporting seamless international transactions that would ultimately strengthen Sweden’s position as a global leader in digital payments.

Despite this favorable scenario for Sweden’s cashless initiative, Sweden’s central bank still aims to support both cash and digital payments, as a way to be more inclusive. This means that while digital payments will continue to be a popular option, cash payments should not disappear entirely. Swedish authorities acknowledge that the role of cash is still key, especially to protect vulnerable groups such as the elderly population and people with disabilities. In case of emergencies (natural disasters, cyberattacks, or other crises where digital systems might fail), cash will also be necessary.

Cashless Sweden: Prepared or Vulnerable? by EOS Intelligence

Cashless Sweden: Prepared or Vulnerable? by EOS Intelligence

Open-banking regulations aid in alternative payment adoption

In 2019, Sweden implemented the EU’s revised Payment Services Directive 2 (PSD2). This European law aims to strengthen customer authentication, ensure proper authorization and regulation of third-party providers, enhance security and data protection, and promote open banking.

The ratification of the recent revision to PSD2 fosters growth in open banking in Sweden, resulting in innovative fintech products such as digital identity BankID. This innovative system leverages secure certificates and biometric authentication to enhance security. Users across Sweden rely on this innovative system for secure authentication and digital signatures.

The adoption of open banking greatly benefits Sweden’s cashless initiative. Companies such as the Swedish payment platform Open Payments enable real-time payments directly from consumers’ bank accounts and facilitate seamless bank-to-bank transfers without intermediaries. These capabilities are accelerating the growth of account-to-account (A2A) payments and solidifying the foundations of a cashless economy.

Government plans new regulations to improve consumer protection

Alternative payment methods (APMs) such as Buy Now Pay Later (BNPL or simply Pay Later) have become essential to Sweden’s cashless success. Klarna has emerged as the leading provider of BNPL solutions, with other players, including Walley, Qliro, and Zaver, also growing their presence. BNPL’s seamless integration with all major e-commerce platforms, technology partners, and payment service providers (PSPs) enhances its accessibility and adoption.

Regulators plan to fully implement the updated regulation, the Consumer Credit Directive 2 (CCD2), by Q4 2026, aiming to make APMs even more accessible and safer for consumers. Under the directive, APM providers must conduct in-depth assessments of credit liability to ensure responsible lending, expand coverage of interest-free loans under €200, and comply with clearer advertising rules that include mandatory warnings when consumers take on debt.

AI and Blockchain facilitate secure and automated transactions

Tapping into the growing prevalence of cryptocurrency, the Riksbank has been exploring the development of its digital currency, e-Krona, based on distributed ledger technology (DLT), which offers a more secure digital payment method.

The Riksbank launched several pilot programs between 2021 and 2024 to explore the application of e-Krona in both retail and wholesale transaction setups. The bank expects this token-based, state-backed digital currency to complement existing payment systems and enhance financial stability. It also aims to promote greater inclusivity by acting as a public alternative to cash.

Technology is also driving a change in consumer preference for digital payments. The growing integration of IoT and AI enables seamless and automated transactions, further accelerating the country’s transition to a cashless society.

Although the vast majority of payments in Sweden are already digital, there is no precise data on how often consumers use voice‑activated transactions via Google Home, Alexa, or similar platforms. The rapid integration of payment apps with these connected devices suggests a strong likelihood that voice-activated and IoT-based payment solutions will gain traction in the future.

Added compliance and limited infrastructure access challenge fintechs

Lack of access to central financial infrastructure is a significant challenge for most fintech companies, forcing them to rely on banks and other intermediaries to provide essential financial services. This results in higher costs, reduced efficiency, and a limited ability to compete with traditional financial institutions.

Infrastructure upgrade and scalability

The Riksbank is looking to modernize the payments infrastructure to facilitate the integration of more fintech companies with its RIX payment system. This modernization aims to support the growing number of fintech companies adopting new cashless payment technologies while ensuring the stability and resilience of Sweden’s payment infrastructure.

e-Krona, albeit still in its pilot phase, presents a transformative initiative. However, the government must ensure scalability for successful widespread adoption among merchants. Processing a large volume of transactions without compromising speed or security remains a significant hurdle. Moreover, e-Krona must seamlessly integrate with Sweden’s payment systems, such as Swish.

Regulatory compliance

Fintech companies seeking to enter Sweden often find it difficult to navigate the complex regulatory landscape set by the Swedish Financial Supervisory Authority (Finansinspektionen). According to a survey by SweFinTech, an independent financial association, 82% of its fintech members reported being weighed down by the additional burden of anti-money laundering and combating the financing of terrorism (AML/CTF) regulations. Companies are increasingly implementing Regulatory Technology (RegTech) solutions to monitor transactions, ensure data integrity, and comply with Sweden’s national and international regulations.

As digital payments increase, merchants must also invest in cybersecurity measures against rising threats. This compounds costs due to high interchange fees, ultimately reducing profit margins.

Potential disruptions and cyberattacks

Disruptions and cyber risks regarding the country’s payment network are also a concern, prompting a cautious approach. Between 2023 and 2024, brief outages disrupted critical digital payment infrastructure, affecting the Riksbank’s RIX system and the supporting systems for Swish, including Bankgirot, Getswish AB (Swish), and BankID.

In these cases, the disruption did not cause major issues. However, with growing concerns about cyberattacks amid Europe’s uncertain geopolitical climate, Sweden is taking steps to protect its cashless economy. To reduce the impact of possible outages, the Riksbank is considering a system that would allow offline card payments for essential goods during disruptions lasting up to seven days.

The Swedish government has also encouraged people to keep enough cash on hand to cover a week’s worth of necessities, helping households stay prepared in case of a cyberattack.

EOS Perspective

Sweden’s swift move towards becoming cashless reflects the country’s focus on digitalization, innovation in fintech, and regulatory changes. The growing adoption of platforms such as Swish and Klarna suggests that Swedish consumers are highly tech-savvy, regardless of age. This trend also indicates that flexible payment solutions can drive consumer behavior to prefer digital payment methods over cash.

The integration of blockchain and IoT technologies into payment systems is likely to offer new opportunities in improving the efficiency and security of digital transactions, reinforcing Sweden’s position as a global leader in cash-free transactions.

There is significant room for developing and launching innovative financial tools and services, offering opportunities for fintech companies. Real-time payment innovations, such as Swish, and blockchain-based solutions that benefit from the rise of decentralized finance (DeFi) offer promising growth opportunities. RegTech tools that improve digital identity verification, AML compliance, and AI-driven financial planning tools may also witness growth.

Sweden’s strict regulatory and compliance requirements, as well as the difficulty of obtaining access to central financial infrastructure controlled by established banks, remain challenging, particularly for fintech companies attempting to enter the market. Arbitrary de-risking by banks, which has affected nearly 40% of fintech companies in 2023 by restricting banking services, further challenges companies.

Nonetheless, open-banking initiatives that grant access to third-party providers suggest a shift toward a more inclusive economy, enabling greater competition, easier market entry for fintech companies, and broader access to digital payment solutions for both consumers and businesses.

Further enhancements in financial infrastructure will support a cashless economy. Modernization of the Riksbank’s RIX payment system will enable more fintech companies to participate, while also facilitating integration into Sweden’s payment system.

The potential introduction of e-Krona offers further opportunities to increase inclusivity, which in turn boosts cashless adoption. However, we must wait and see how it evolves as the Riksbank continues to monitor the development of other digital currencies, such as the Digital Euro.

While Sweden has made significant strides toward its cashless vision, progress may stall due to Europe’s current scenario, amid a vulnerable political environment and the risk of susceptibility to cyberattacks. Nevertheless, the country has demonstrated a clear trend toward becoming a digital-first economy, evident in its low reliance on cash usage and the ongoing development of a robust digital payment infrastructure.

Cisco's Splunk Acquisition Shaking Up Observability and Security Market by EOS Intelligence
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Cisco’s Splunk Acquisition: Shaking Up Observability & Security Market

In March 2024, Cisco Systems, a California-based software and networking equipment company, acquired US-based big data analytics firm Splunk for US$28 billion. The acquisition marks a significant step in Cisco’s growth strategy to expand its presence in the tech industry and gain a strong foothold in the data analytics, observability, AI, and cybersecurity market. As enterprises move towards using a hybrid approach for complex IT solutions, the old ways of using separate tools are slowly becoming redundant. Cisco’s acquisition of Splunk brings a convergence of networking, security, and observability to running and protecting enterprise IT systems.

Enterprises are shifting to software-centric and subscription-based services

Cisco, known for its hardware networking products, has begun to move into high-growth areas of software and subscription-based services. Cisco wants to reduce its dependence on one-time hardware sales as growth and margins in this segment have declined compared to software services in recent years.

Pivoting to a software and subscription model marks a shift to a different way of operating and engaging with customers. The subscription model offers great advantages in terms of recurring revenue, customer retention, and scalability. Cisco’s acquisition of Splunk is a move to accelerate this transition by combining the strengths of both entities. Further, with this model, Cisco strengthens its position in the data management technology space, which demands scalable, flexible, and advanced cloud-based solutions.

The acquisition consolidates Cisco’s position in the software observability market

Many organizations face challenges in their digital transformation journey and are turning to cloud-enabled enterprise data platforms. Though these platforms offer scalability and flexibility in various cloud environments, the lack of end-to-end visibility may lead to new issues and higher costs. Enterprises increasingly use observability solutions that monitor and analyze the state of the whole IT system, providing better visibility and performance.

Cisco’s acquisition of Splunk will strengthen its position in the observability market. Cisco will likely combine its existing tools with Splunk’s advanced analytics to enhance its offerings. This will create a robust integrated observability platform and potentially consolidate Cisco’s market presence against competitors. This merger makes Cisco one of the top players in the observability market and sets the stage for further innovation and competitive dynamics in the industry.

Acquisition impact on the observability market

The acquisition may push competitors to develop full-stack observability solutions

With Splunk’s acquisition, Cisco provides an end-to-end observability solution and integrated security enabling advanced threat detection and response features within the same tool. As observability and security markets start to converge, Cisco has a strong position to capitalize on the growing security-driven observability trend. This might encourage other vendors to integrate both observability and security features into their platforms to remain competitive in the evolving complex IT market.

As Cisco deeply roots itself in the enterprise networking and cloud space, the post-acquisition entity is likely to facilitate the development of comprehensive observability solutions for complex distributed and hybrid IT infrastructure. As a result, vendors in the observability market are likely to feel the pressure to develop and adopt more advanced tools that can work on-premises and in multiple cloud environments.

Competitors might benefit from the acquisition challenges and potential delays

The acquisition of such a large scale may lead to short-term disruption as both entities adjust to the new joint entity and determine its implications. The observability market where Splunk operates is highly competitive. Companies such as Dynatrace, Datadog, and New Relic will see opportunities to pounce on any delays or conflicts during the integration.

Vendors, including Dynatrace and Elastic, also offer single unified solutions for observability, security, and business data, positioning them as direct competitors to Cisco-Splunk. These companies claim to have better value-to-cost, fast, and simple observability solutions suitable for cloud-native and hybrid environments. Dynatrace will likely benefit the most from any uncertainty in this deal as they are in a strong position to deliver enterprise-class observability solutions that Splunk-Cisco customers need.

Acquisition impact on the cybersecurity market

The acquisition might accelerate market shift to increase AI adoption in cybersecurity

The rapid advancement of AI technology has given rise to new security threats, and regulatory bodies recognize the need for AI implementation guidelines in cybersecurity. The acquisition adds Splunk’s security information and event management (SIEM) to Cisco’s extended detection and response (XDR) capabilities. This will allow Cisco to offer end-to-end security solutions that use AI to predict and prevent threats, not just detect and respond to them. This will accelerate the shift in the broader market towards more AI and machine learning integration in the cybersecurity space.

Cisco’s acquisition of Splunk can potentially drive consolidation and M&A activity among other cybersecurity vendors. Many strategic collaborations are likely to occur in various areas of cybersecurity, cloud security, and network monitoring as corporations seek to establish their end-to-end security suites.

Smaller cybersecurity companies that bring innovative solutions integrating AI are most likely to become acquisition targets. After the acquisition, these companies may play a crucial role for the more prominent players who look to expand their capabilities and compete with the new Cisco-Splunk venture.

As a combined entity offering an end-to-end innovative security solution, big enterprises may find the stack compelling and evaluate their current security strategies. This could lead to a possible switch to the Cisco-Splunk comprehensive security package, potentially impacting vendor relationships and long-standing security deployments.

The acquisition might offer opportunities for small and big vendors through their value proposition

The acquisition creates opportunities for XDR vendors such as CrowdStrike and Palo Alto Networks. These vendors have SIEM replacement strategies and can attract customers away from traditional SIEM deployments by riding the waves of change in the market caused by the Cisco-Splunk deal. Smaller SIEM vendors can also form relationships with customers who do not want to partner with Cisco because of the higher costs and vendor lock-in.

While the Cisco-Splunk deal will strengthen Cisco in cybersecurity, it also presents opportunities for big rival platforms, including Microsoft Sentinel and IBM Security QRadar. By focusing on agility, innovation, and customer centricity, these competitors can attract customers uncertain about the future of Splunk under Cisco’s ownership. This is especially true due to the slower innovation cycles often resulting from significant acquisitions.

EOS Perspective

There is a pool of opportunities for enterprises to build AI infrastructure in the big public clouds, and companies are aggressively pursuing that. The next big wave will be driven by the observability and security market. Companies that can build AI capabilities inside enterprises will be at the forefront and emerge as dominant players. Since enterprises need to protect the data, they do not necessarily want to ship up to the public cloud, which is a huge opportunity for Cisco and other competitors.

Acquiring Splunk put Cisco in a position to dominate the observability and cybersecurity space. The acquisition will also help Cisco expand its offering to big enterprises and tap into small and mid-sized businesses. Over the coming years, we could witness increased merger and acquisition activities of all scales. For instance, networking and security companies will likely enter into partnerships with GPU makers such as NVIDIA, Intel, and AMD to enhance their AI capabilities.

Cisco gets a powerful observability platform in Splunk, however, it may also face challenges in integrating Splunk into its large-scale business. Effective messaging to customers and integration will be key to making Cisco offer a cohesive and compelling observability and security stack. In the short term, Splunk’s acquisition may lead to the introduction of new innovative solutions in the observability market by the competitors. The long-term implications depend on Cisco’s ability to integrate Splunk’s products and innovate continuously.

Recall Aftermath Who is Gaining Share in the Sleep Apnea Devices by EOS Intelligence
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Recall Aftermath: Who is Gaining Share in the Sleep Apnea Devices and Ventilators Market?

In recent years, the number of ventilator recalls has increased considerably, primarily due to product quality issues, software malfunction, and manufacturing defects. This affected manufacturers such as Philips, Medtronic, and Vyaire Medical, leading to brand damage, financial losses, and a shift in the market competition. Existing players and new entrants such as Getinge and Nihon Kohden are stepping in to fill the gap with innovative and non-invasive products. The recalls caused challenges for manufacturers and patients, highlighting the need for strong quality control and regulatory oversight.

Recalls of its sleep apnea devices and ventilators hit Philips the hardest

The medical device industry has recently experienced many product recalls, particularly in the ventilators segment, impacting major market players such as Philips, Medtronic, Baxter, GE Healthcare, Hamilton Medical, and Vyaire Medical.

Philips (Philips Respironics) faced a series of class I respiratory product recalls, including CPAP and BiPAP machines, and ventilators, due to health risks caused by the polyester-based polyurethane (PE-PUR) sound abatement foam breakdown in the devices. Industry experts consider Philips’ sleep apnea devices and ventilator recalls among the most significant since 2021. As of January 2024, the company experienced a recall of over 15 million sleep apnea devices and ventilators, and reportedly hundreds of deaths. The recall seriously hurt the company’s reputation, weakened its position in the market, and caused significant financial problems.

The recalls led to a decline in the company’s share price by 60-70% in 2021, and it is still about 50% lower than its peak in April 2021 (US$ 53.45). Comparable sales of the connected care segment, including sleep apnea devices and ventilators, declined by about 19% in 2021 in comparison to 2020. This happened primarily due to sleep apnea devices and ventilators recalls, and the normalization of demand for hospital ventilators and monitoring systems following the COVID-19 surge. Recalls continued to drive down ventilator and sleep apnea device sales in 2022 and 2023.

The considerable impact on sleep apnea devices and ventilator sales resulted in a decline in Philip’s share in the sleep apnea device market, dropping to an estimated 20% between 2021-2023 from over 30% before the recall. The company also experienced a notable decline in market share in the ventilators market. Despite the decline in market share, Philips maintained its position as one of the leading players in both the sleep apnea devices and ventilators market.

However, in January 2024, Philips agreed to halt the sales of 19 sleep and respiratory products in the USA as a part of the consent decree with the US Department of Justice (DOJ). These products included hospital ventilation, certain home ventilation, sleep diagnostic devices, and portable and stationary oxygen concentrators. This affected the company’s brand image greatly and resulted in a further loss of market share in both ventilators and sleep apnea devices markets. Since the company will continue to sell consumables and accessories, including masks, it is anticipated to maintain a portion of its market share in both segments.

In April 2024, the company agreed to pay US$1.1 billion in legal settlement to resolve injury-related cases caused by sleep apnea devices and ventilators in the USA. Overall, sleep apnea device recalls cost the company over US$5 billion, likely including charges such as provisions for Philips Respironics-related litigation, consent decree, remediation costs, legal settlements, workforce restructuring, and quality remediation action. In addition, Philips cut 6,600 jobs by 2023 and is likely to reduce its workforce by a total of 10,000 by 2025.

Several companies bore the brunt of their own ventilator recall setbacks

Other prominent manufacturers such as Drägerwerk (Draeger), Medtronic, Vyaire Medical, Hamilton Medical, and Baxter also experienced various ventilator recalls due to manufacturing and quality defects. Although the FDA classified these recalls as serious, these companies did not face the same severe consequences as Philips, as these recalls did not result in major injuries.

All these manufacturers also witnessed a drop in ventilator sales largely due to the stabilization of demand for ventilators following the COVID-19 surge, with product recalls also contributing to the downturn.

In February 2024, Medtronic completely exited the ventilator market due to unprofitability. Similarly, in June 2024, Vyaire Medical filed for bankruptcy and was subsequently acquired in October 2024 by Zoll, an Asahi Kasei company engaged in the manufacturing of medical devices and related software solutions. This caused a profound impact on the ventilators market.

Market players are introducing products with advanced features to gain market share

The ventilator market encountered a radical shift in competition due to numerous product recalls. The suspension of sleep and respiratory product sales cost Philips its leading market position in sleep apnea devices and ventilators (except for certain home ventilators). It remains unclear when or if Philips will be able to resume sales of these devices. However, the company is unlikely to leave its presence in the sleep apnea devices and ventilators market entirely due to its commitment to service and supply of parts of ventilators in use, as well as its decision to continue the sale of consumables and accessories.

Existing market players such as Getinge, Hamilton Medical, Drägerwerk (Draeger), ResMed, and GE Healthcare, and newer entrants such as Nihon Kohden, are likely to fill in the gap left by Philips, Medtronic, and Vyaire Medical in the USA.

Market players such as Getinge, Drägerwerk (Draeger), and Nihon Kohden are focusing on introducing technologically advanced ventilators with features such as enhanced patient comfort, advanced monitoring capabilities, portability, and adaptive ventilation modes, to grab a slice of the pie. They are also increasingly focusing on expanding their portfolio of non-invasive ventilators with different interfaces, including face masks, nasal masks, helmets, and mouthpieces.

For instance, in October 2024, Nihon Kohden introduced a new ventilator system that combines invasive and non-invasive ventilation and high-flow oxygen therapy in one device, offering adaptability and eliminating the need to switch between machines. It also features a customizable, app-based touchscreen interface with advanced monitoring capabilities. Similarly, in January 2024, Getinge introduced ‘Servo-air Lite’, a non-invasive ventilator with high-flow therapy that offers optimal respiratory support, enhanced patient comfort, and ease of use for clinicians.

ResMed, a leading player in both the sleep apnea devices and ventilators market, is estimated to have grabbed over 10% of Philips’ market share in the sleep apnea devices market in the USA. ResMed witnessed a substantial increase in demand for its sleep and respiratory care products, including sleep apnea devices and ventilators, for various reasons, including Philips’ product recalls. The demand for its sleep and respiratory care products in the USA, Canada, and Latin America increased by 16%, 25%, and 10% in 2022, 2023, and 2024, respectively.

Companies engaging in sleep apnea devices and ventilator rentals, sales, and distribution, such as Trace Medical, also started adding brands from different companies to their product mix to meet the demand for these devices.

Patients experience delays in treatment and struggle to switch to other brands

Philips’ foam degradation issue has exposed patients to severe health risks, leading to respiratory complications and even cancer. Recalls of many ventilators and sleep apnea devices have left hospitals struggling to replace them, causing delays in patient treatment.

Patients relying on a specific brand faced reduced treatment options. Many patients found it difficult to switch to other brands due to cost and differences in machine settings or interfaces. With Philips halting sales of various sleep apnea devices and ventilators, patients have no choice but to switch to other brands.

The recall of various products from different companies has created significant demand and supply chain pressures for existing companies. These pressures will likely drive up ventilator and sleep apnea device prices, further burdening patients.

EOS Perspective

Product recalls in the sleep apnea devices and ventilator segment brought quality issues to the limelight. This highlights the need for stronger quality control processes and technologically advanced sleep apnea devices and ventilators incorporating virtual monitoring and AI integration, which can help detect defects earlier.

While the FDA received complaints about Philips’ degradation of the sound abatement foam in the sleep apnea devices and ventilators before the recall initiation, decisive action to force correction was not taken immediately. Also, despite knowing that Philips had been aware of the foam degradation issue for many years, the FDA did not take stronger enforcement measures against the company sooner. This situation highlights the importance of assessing and enhancing the FDA’s oversight process to ensure timely response to medical device complaints.

Philips suffered lasting brand damage due to the recalls. Although the company is trying to regain shareholder and consumer trust after settling US claims for an amount much lower than anticipated (US$2-5 billion) by analysts and the public, it faces a long road ahead.

Regarding market competition, ResMed is estimated to continue to lead and strengthen its dominant position in the sleep apnea devices market. The exit of well-established players from the ventilator market will intensify competition among existing companies and new entrants seeking to capture market share. However, it will be a gradual process as customers slowly transition from existing products to new brand ones. On top of that, the new entrants are likely to face stricter regulatory norms and product approval processes aimed at reducing the number of product recalls and enhancing patients’ safety.

DeepSeek’s Disruption Reshaping the Global AI Battlefield by EOS Intelligence
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DeepSeek’s Disruption: Reshaping the Global AI Battlefield

In January 2025, DeepSeek AI introduced two powerful large language models (LLMs) that shook the AI world. Developed at a fraction of the cost of its existing peers, DeepSeek holds the potential to transform the AI development landscape globally.

DeepSeek’s efficiency enables better cost-effectiveness by reducing computational needs

DeepSeek’s V3 and R1 models focus on efficiency and require less computing power than rival models while delivering equivalent performance. Its efficiency stems from using the “Mixture-of-Experts” (MoE) architecture, which activates only parts of the model for a given task, minimizing computational needs. This targeted use of computational memory reduces operational costs, giving it a significant edge over competitors who rely on more resource-intensive approaches.

The arrival of DeepSeek has sent shockwaves throughout the US tech industry, marked by a significant decline in stock values. The key headline event was Nvidia’s US$600 billion drop in market capitalization. The fact that a Chinese company was able to achieve groundbreaking results at a fraction of the cost by using low-power Nvidia H800 chips challenges the investment poured into the market by established players.

The open-source model enables widespread applications at a budget

DeepSeek has embraced a fully open-source model, allowing anyone to utilize their technology for commercial purposes. DeepSeek’s open-source approach democratizes access to AI, enabling a wider range of applications.

The availability of DeepSeek’s advanced APIs at a very low cost also appeals to customers who have previously been priced out of advanced AI applications due to the higher costs of proprietary LLM models such as OpenAI’s GPT.

The AI ecosystem already feels the impact of DeepSeek’s triumph. Its free AI assistant has also made a significant splash in the consumer market, with DeepSeek’s app surpassing ChatGPT in Apple Store charts. Its cost-effectiveness has even attracted the attention of major players such as AWS and Snowflake, which are now offering DeepSeek’s technology on their platforms.

Following DeepSeek’s success, several other Chinese companies may follow suit by developing more efficient yet high-performing AI models, further driving the costs down. Alibaba already released a new version of its Qwen 2.5 model at the end of January 2025.

Initial success of DeepSeek does not guarantee dominance

DeepSeek’s success does not guarantee its dominance in the AI landscape. We have had precedence of a similar company making headway and then falling off in the AI space. Mistral’s open-source AI model, Mixtral 8x7b, initially seemed poised to disrupt the field. However, it quickly fell off the radar when other closed-source models incorporated Mixtral’s innovations.

DeepSeek’s continued success will depend on whether it is able to maintain its edge through continuous innovation, particularly with limited access to high-performance chips.

Read our related Perspective:
 NVIDIA’s Meteoric Rise: Can the AI Chip Giant Sustain Its Dominance?

EOS Perspective

DeepSeek’s emergence as a serious contender has intensified the global AI race, challenging the dominance of established players such as OpenAI, Meta, and Google.

DeepSeek-R1, with its open-source foundation, has already demonstrated impressive abilities in handling complex text-based tasks, such as summarizing documents, answering technical questions, and generating codes. Moreover, it offers these capabilities through APIs at a fraction of the cost of its competitors, potentially disrupting the market and driving down prices for AI services.

With DeepSeek’s AI models requiring less computational power and hardware, they will offer significant cost savings for users. Combined with its open-source model, which fosters customization, collaboration, and broader access, DeepSeek is expected to gain traction rapidly. While it is currently limited to text-based queries, its potential is undeniable.

While questions about Chinese government influence and censorship persist, DeepSeek presents a compelling vision of AI disruption. In the short term, we can anticipate lower AI adoption costs and shrinking profit margins for established AI providers. Furthermore, DeepSeek’s emphasis on efficiency could spark a shift in the industry, prioritizing resource optimization over simply increasing computing power. The full scope of DeepSeek’s impact, however, will only unfold over time.

Personalized Image-Guided Therapy Medicine's New Crystal Ball by EOS Intelligence
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Personalized Image-Guided Therapy: Medicine’s New Crystal Ball?

Precision and personalized care are becoming the keys to unlocking better patient care in modern medicine. With personalized medicine image-guided therapy (IGT) systems offering physicians better control over therapy decisions, the healthcare industry hopes discomfort and uncertainty will give way to reliability and healing.

IGT enhances surgical precision and treatment management

IGT is an approach that uses various imaging technologies to plan, perform, and evaluate surgical procedures and treatments. There are two main groups: traditional surgeries enhanced by imaging technology and newer procedures that use imaging and specialized instruments to treat internal organs and tissues without surgery.

The IGT systems, such as Dutch Philips’ Azurion and American Varian’s Halcyon, help improve minimally invasive procedures by offering real-time imaging support during interventional techniques, especially in cardiology and oncology. They also aid in precise navigation and treatment delivery.

Azurion’s IGT system offers various clinical suites, including Coronary, Onco, and Neuro suites, tailored to a particular surgery. This customization can make a surgeon’s work easier. Many IGT systems also integrate with hemodynamic systems and similar interventional tools that give surgeons more information.

On the other hand, advanced imaging platforms such as the 1788 visualization platform by US-based Stryker, TIVATO 700 by Germany-based Zeiss, and VISERA ELITE II by US-based Olympus specifically work in open surgical settings, providing high-definition imaging that enhances visibility during more invasive procedures.

IGT employs imaging modalities and technological innovations for disease management

The most commonly used imaging modalities in IGT are X-rays, ultrasound, MRI, and CT scans, which provide detailed cross-sectional images of the body. Other supporting technologies include angiography, ultrasound, tracking tools, surgical navigation systems, and integration software.

IGT also offers invaluable insights into disease diagnosis and management of minimally invasive procedures. Significant advancements have been made in this field in recent years owing to developments and integration of innovations such as artificial intelligence (AI), big data, deep learning, sensor fusion, and advanced signal processing.

Personalized Image-Guided Therapy Medicine's New Crystal Ball by EOS Intelligence

Personalized Image-Guided Therapy Medicine’s New Crystal Ball by EOS Intelligence

IGT and advanced visualization systems complement each other in cancer surgeries

Applying advanced visualization systems for open cancer surgeries adds a competitive aspect to the image-guided therapy landscape. Systems such as Stryker’s 1788 have the potential to be a viable option in low-resource environments or hybrid surgical settings. Such facilities may view it as a cost-effective and simpler substitute for comprehensive IGT systems for certain cancer surgeries.

The competition could also intensify in niche applications where minimally invasive tumor resection overlaps with interventional oncology. This is especially true for hospitals that aim for a one-stop surgical solution without high investment in IGT infrastructure.

However, the IGT systems have a different clinical role, being particularly effective in procedures such as catheter-based interventions or radiotherapy, where accurate imaging is extremely critical. Therefore, the competition may be nuanced, depending on the specific surgical approach, as the two technologies could also complement each other by providing tailored solutions for distinct surgical techniques and scenarios.

IGT sector is rapidly growing in minimally invasive and specialized procedures

The IGT market has seen rapid development, especially in the post-pandemic era. The global IGT systems market was US$5.5 billion in 2023 and is estimated to reach US$8.9 billion by 2032, according to an India-based market research firm, IMARC. The company also forecasts the market to grow at a CAGR of 5.4% from 2024 to 2032.

Several factors drive this growth, including IGT’s ability to offer better health outcomes in treating severe conditions such as cancer, its application in treating old age-related conditions, such as stroke and vessel blockage, and the surge in demand for minimally invasive procedures.

Rising cancer cases are boosting sector growth

The American Cancer Society estimates that approximately 20 million new cancer cases were diagnosed, and 9.7 million people died from cancer worldwide. The number of cancer cases is expected to reach 35 million by 2050. The high prevalence of cancer has increased the need for innovative treatment options with limited damage to healthy cells. Oncologists and patients are now opting for IGT, such as image-guided surgeries and radiotherapy, to treat cancers, including severe and complex ones.

For example, hepatocellular carcinoma, the most common liver cancer, is a challenging disease to treat. A 2010 study published in Insights into Imaging, a peer-reviewed open-access journal, indicated that due to the advanced stage of the disease at diagnosis and limited donor availability, only 10–15% of HCC patients are eligible for surgical resection or liver transplantation. Surgical options are primarily reserved for patients with solitary, asymptomatic HCC and well-preserved liver function without significant portal hypertension or elevated bilirubin levels. Also, systemic chemotherapy has largely been ineffective for HCC.

Image-guided procedures can offer doctors detailed imaging data to aid diagnosis, patient risk assessment, and treatment planning during the early detection stages. Image-guided catheter-based techniques are used for treating larger lesions or more extensive liver involvement seen in intermediate-stage HCC, and ablative procedures are employed for early-stage HCC.

Minimally invasive image-guided therapies can also extend survival, preserve more healthy liver tissue (crucial for cirrhotic patients), allow for potential retreatment, and serve as a bridge to transplantation.

Growing geriatric population is also contributing to sector expansion

The rising geriatric population is also driving the need for image-guided therapies. UN estimates there were 761 million people aged 65 or older globally in 2021. This number is expected to rise to 1.6 billion in 2050. Age is a significant factor in determining the likelihood of developing serious conditions such as cancer. According to the National Cancer Institute (NCI), the average age of individuals diagnosed with cancer is 66, indicating approximately half of all cancer cases are diagnosed in people aged 66 and older.

Older people are also at a higher risk of suffering from severe post-procedural complications, especially in the case of invasive surgeries. IGT-supported therapies, especially minimally invasive surgeries, can help doctors treat geriatric patients with limited adverse effects.

Advancements in minimally invasive procedures and cancer radiotherapy are on the rise

The rising demand for minimally invasive procedures is another factor driving the increasing adoption of IGT systems. A 2015 study published in JAMA Network, an open-access medical journal, indicated that minimally invasive surgeries have fewer postoperative complications, provide better outcomes, and reduce healthcare costs. This has prompted many physicians and patients to choose IGT system-based minimally invasive therapies in treating complicated conditions that may otherwise require longer hospital stays and repeat visits.

The growing number of developments in cancer radiotherapy is also an important factor propelling the IGT market forward. AI in radiation therapy enhances the accuracy and precision of treatment. In image-guided radiotherapy (IGRT), AI-based algorithms are used to analyze images taken during treatment and make adjustments to the treatment plan in real time. This enables clinicians to target tumors with greater precision, reduce the amount of irradiated healthy tissue, and improve treatment outcomes.

Several premier institutions, such as Cancer Research UK, London-based Medical Research Council (MRC), and US-based Stanford Medicine, are involved in cancer radiotherapy research to develop cancer imaging, diagnostics, and minimally invasive treatment platforms. With the radiotherapy market will likely reach US$12.51 billion by 2029, according to a 2024 report by India-based market research firm Mordor Intelligence, these efforts can contribute to the growth of the IGT sector.

IGT therapies allow for prompt and low-risk interventions

The introduction of IGT into personalized medicine has had a crucial impact on patient outcomes. IGT enables healthcare professionals to diagnose and treat serious conditions more rapidly. This prompt initiation of treatment reduces the risks associated with delayed interventions.

An example of an IGT system offering better treatment management is Philip’s Azurion Lung Edition, a 3D imaging and navigation platform that streamlines the diagnosis and treatment of lung cancer. The system combines tableside CT-like images with real-time X-ray guidance and advanced tools to support guided procedures. It is specifically designed for bronchoscopy procedures and enables clinicians to perform minimally invasive biopsy and lesion ablation in a single procedure. This reduces the need for additional procedures and speeds up diagnosis.

IGT systems also offer a precise, real-time visualization of the therapy site, enabling highly targeted interventions. This level of accuracy can minimize complications and failures during procedures. For example, IGRT used in cancer treatment enables oncologists to target tumors while sparing healthy tissues precisely, reducing side effects and boosting treatment success rates. Surgeons also better comprehend spatial relationships between the tumor and vital organs or blood vessels when they can access high-resolution images highlighting the essential structures during the procedure.

Minimally invasive nature of IGT therapies minimizes complication and disability risks

IGT procedures are minimally invasive in nature. This reduces the trauma caused by the procedure, reducing the risk of complications. Patients can recover faster from IGT procedures, reducing hospital stays and lowering the likelihood of hospital-acquired infections and other potential complications. A 2022 study published in the National Library of Medicine’s (NLM) online portal indicated that image‐guided procedural techniques reduce risks, prompt faster recovery, and shorten hospital stays.

IGT’s minimally invasive nature also reduces the risk of disability post-treatment. In the case of complicated surgeries such as brain tumor removal, surgeons use techniques such as intraoperative MRI (iMRI) to get a detailed map of the tumor and surrounding brain structures before and during surgery. This allows for more precise resection of the tumor and reduces the risk of injury to critical brain areas, thereby lowering the possibility of neurological damage and associated disabilities. A 2014 article published in NLM’s online portal indicated that using iMRI improved surgical outcomes, including increased tumor resection and survival rates and decreased risk of neurological deficits.

IGT systems offer interventional tools supporting surgeons in complex procedures

Advanced IGT systems now come with integrated interventional tools, which can be especially beneficial during complex or delicate procedures. For example, Azurion, an IGT platform developed by Philips, has interventional tools integrated into the imaging system. It offers procedure cards that allow clinicians to pre-program routine tasks and preferences, as well as an interface for performing various procedures in interventional labs.

Integrations such as these can help surgeons make informed and data-driven decisions during procedures, allowing them to make mid-procedure adjustments. Such flexibility is crucial, particularly in complex surgeries or when treating conditions such as cardiovascular diseases.

Development high costs and cybersecurity issues hinder adoption

Despite offering numerous benefits to patients, the developers of IGT systems face several challenges.

Huge R&D costs and market competition are impacting new players

The significant financial burden of research and development in this field is one major obstacle for companies, especially newer ones entering the market with limited budgets. Developing advanced imaging technology that seamlessly integrates with therapeutic tools requires substantial investments in software and hardware.

Also, these systems require continuous refinement to ensure optimal accuracy and adaptability, as they must be able to accommodate diverse patient anatomies and conditions. This is a time-consuming and costly process. Consequently, only established companies with significant R&D budgets may be able to compete in the market.

Not just the R&D budget but also leading players’ brand equity is a significant challenge for new players trying to enter the IGT systems market. The newer entrants face intense competition from established players such as Philips, GE Healthcare, and Siemens. These companies have been in the market for years and have a strong foothold in terms of market share and brand recognition. This can make it challenging for new players to establish themselves in the sector, limiting innovation and market growth.

New companies can attempt to tackle this and make inroads into the market by forming partnerships with hospitals and public health initiatives to drive the adoption of their IGT systems.

High upfront costs are affecting the widespread adoption of IGT devices

The IGT devices’ market prices reflect the high R&D costs. Almost all IGT systems have high upfront costs. For example, an interventional radiology suite can cost anywhere between US$1 million to over US$3 million, depending on its sophistication. This can make acquiring and implementing IGT systems prohibitively expensive for many healthcare providers, particularly smaller or publicly funded organizations.

While healthcare providers can pass on the cost to patients, it can also cause many other challenges. Even with insurance coverage, some patients may not be able to afford certain procedures or treatments when the out-of-pocket expenses are significant. Consequently, this can reduce the overall demand for IGT devices, negatively impacting sales for manufacturers.

Companies can try tackling this issue by offering price flexibility and discounts for large orders or entering into long-term contracts with healthcare providers to help maintain demand. They may also offer leasing or subscription-based payment models instead of selling devices outright. This could encourage purchases by healthcare providers, allowing them to spread out the costs over time and lighten the upfront financial burden on patients.

Cybersecurity challenges are threatening patient care and security

Another significant challenge in adoption is cybersecurity and data management issues. A 2024 fact sheet by the US Office of the Director of National Intelligence indicated that there has been a 128% increase in healthcare ransomware attacks in 2023 over 2022 in the USA. As a result of these attacks, American hospitals have faced disruptions to medical procedures, patient care, and operations, including delayed procedures, diverted patients, rescheduled appointments, and strained acute care provisioning.

IGT systems generate and store vast amounts of imaging and procedural data on the cloud. Any security breach can lead to privacy leaks and misuse of patient data. Attackers can also maliciously embed images or reports and manipulate medical images, thereby delaying procedures and patient care and causing loss of life. This complexity often leads to hesitation in adoption, particularly for institutions that lack the necessary IT infrastructure.

Many companies are addressing this issue by creating devices with secure design and in-depth defense approaches. An example is Philip’s Azurion, which offers a six-layer protection to combat cyberattacks.

EOS Perspective

IGT systems promise to improve patient outcomes and revolutionize healthcare in the long run, particularly in treating serious medical conditions such as cancer. While there are some challenges to address in order to strengthen widespread adoption, with rapid developments underway in technologies such as AI and augmented reality, IGT can play a greater role in disease treatment in the coming years.

Currently, studies are underway using AI and machine learning to predict the response to minimally invasive image-guided therapies. Similarly, AI-based algorithms are also being developed to monitor tumor motion, reduce treatment uncertainty, and improve treatment precision.

One promising direction new entrants can push for is more portable and cost-effective IGT solutions. Research to miniaturize imaging devices and develop affordable hardware could make IGT systems more accessible to a broader range of healthcare providers, even those in remote areas, thereby expanding the market. Also, as costs come down and standardization improves, hospitals and clinics of varying sizes will be more likely to invest in IGT technologies.

In the short term, larger, well-funded players are likely to continue to lead the way in adopting and refining IGT systems. These companies have the resources to invest in technology and training, enabling them to push the boundaries of personalized medicine. However, as the technology matures and becomes more affordable, smaller players will increasingly be able to capture a market share.

Estonia's Rise as Europe's Fintech Powerhouse by EOS Intelligence
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Estonia’s Rise as Europe’s Fintech Powerhouse

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Estonia, a small Baltic country with a population of 1.4 million, is in the news for all the right reasons: its burgeoning fintech sector. With a market size of €15.2 billion in 2023 and projected growth of 5.7% CAGR from 2023 to 2028, Estonia’s number of fintech companies has increased by 23% from 2020 to 2023. The country has 264 fintech startups, half emerging between 2020 and 2022. Strategic investments in digital infrastructure, a progressive regulatory environment, and a tech-friendly culture make Estonia a leading hub for fintech innovation in Europe.

Estonia has become an important name in the fintech sector ever since its financial institutions started using fintech in the early 2000s. It has become the leading fintech hub in Europe, with 2.3 fintech unicorns (startups with a valuation exceeding US$1 billion) per million population.

Most fintech startups, accounting for 87% of all fintech companies in Estonia, fall into six categories: digital asset exchange (33%), digital lending (15%), enterprise technology provisioning (14%), digital payments (11%), wealthtech (9%), and digital capital raising (6%).

Startups dominate Estonia’s fintech landscape with fewer established companies, indicating a favorable environment for new players. Digital asset exchange services that facilitate the trade of cryptocurrencies or digital currencies for other assets form the lion’s share of these startups. This includes Tallinn-based companies such as AsicVault and Guardtime.

Finding customers is a concern for Estonia’s fintech sector

Fintech is flourishing in Estonia despite various challenges that players must navigate. Typically, these challenges affect the smallest and newest entrants to the market the most.

One of the significant challenges that businesses can expect is finding loyal customers for their solutions, according to the 2023 report by the TalTech School of Business. In their research, the respondents indicated finding customers as the most critical problem in two survey editions, 2021 and 2023.

Since Estonia has a small population of 1.4 million, the domestic market is relatively small. Businesses across sectors, including fintech, often face limitations in expanding their customer base. This can force companies to look beyond national borders to achieve significant growth, which can be difficult for new players.

Estonia's Rise as Europe's Fintech Powerhouse by EOS Intelligence

Estonia’s Rise as Europe’s Fintech Powerhouse by EOS Intelligence

Rising costs are affecting smaller and newer players

The financial side poses a substantial challenge for players with limited budget planning to start and expand a fintech firm in Estonia. Estonia used to be a place of low living costs and cheap labor since its independence in 1991. However, the rising operation costs now affect the fintech landscape. A 2023 report published by the European Commission indicated that in the fourth quarter of 2022, compared to the same period in the previous year, Estonia saw a 10.1% increase in hourly wage costs. This can harm small new players looking to enter Estonia’s fintech landscape.

Competition with Big Tech in foreign markets can challenge expansion

Estonian fintech companies attempting to expand into more mature markets can face several hurdles. For example, a high degree of sophistication and regulation characterizes the UK financial services sector, a desired expansion target, leaving little room for new entrants without an established brand presence or a solid track record.

Establishing trust is paramount for fintech startups, as consumers and businesses often prefer providers with known reputation, selecting them through word of mouth or established market presence. As a result, new entrants must devise comprehensive (and often cost-intensive) marketing strategies to overcome these initial credibility barriers.

Increased competition from established financial institutions that leverage their substantial resources to compete with startups can exacerbate these challenges. Big Tech firms such as Google, Amazon, and Apple have also begun to venture into the financial services sector. These companies possess strong brand recognition, customer trust, and rich data sets, enabling them to overshadow smaller fintech operations.

Cross-border expansion signals Estonia’s thriving fintech sector

Estonia’s cross-border expansion activities highlight its flourishing fintech sector. Fintech ranks as the second largest industry within the Estonian startup ecosystem, following business software and human resources, accounting for 13% of the nation’s startups. In terms of revenue, it also holds the second position, generating €196 million in turnover as of 2023.

Estonian fintech startups are actively pursuing opportunities beyond national borders. For instance, the financial cybersecurity firm Salv, based in Estonia, has extended its operations to Latvia and is planning further expansion to Lithuania and the UK. The firm aims to promote its AML solution, Salv Bridge, in these markets.

Additionally, in June 2024, Depowise, a startup located in Tallinn, announced its plans to expand into Ireland and the UK to enhance its market presence in the region.

Estonian fintech startups are increasingly seeking opportunities outside their home market, demonstrating the sector’s robust success and appetite for expansion.

Several catalysts are fueling the growth of Estonian fintech

Ease of doing business

The country ranks 18th in the World Bank’s ease of doing business index, beating more developed countries such as Germany (22nd), Canada (23rd), and Ireland (24th) as of 2019. This favorable business environment in the country is one of the main factors making it an attractive location for fintech businesses. According to the World Bank, the country has a highly conducive tax system, ranked 12th in the ease of paying taxes.

Efficient corporate tax systems

Due to its efficient tax policy and straightforward tax compliance frameworks, Estonia holds the top spot in the 2023 International Tax Competitiveness Index published by Tax Foundation, a US-based think tank. This allows companies to spend considerably less time (five hours per year in Estonia compared to 42 hours per year in an average OECD country) on tax-related tasks.

The Estonian tax system also boasts a similarly low compliance burden (resources and costs associated with complying with regulatory requirements) for other taxes, including value-added tax (VAT).

The country’s corporate tax rate is 20%, but it only applies to distributed profits. This means that if a company reinvests its profits back into the business, it does not pay any corporate income tax until it distributes those profits as dividends. This has significantly encouraged reinvestment, growth, and expansion of businesses, including fintech companies.

Internet freedom

Internet freedom is robust in Estonia, and the country is known for its numerous e-government initiatives. For the past several years, Estonia has maintained the second position globally in the Freedom on the Net reports by the US-based NGO Freedom House, indicating a very high internet freedom rating in the country. This minimal restriction on online content facilitates easy information and idea transfer and helps businesses, including fintech companies, to flourish.

Cybersecurity

Though online activities have minimal restrictions, the Estonian authorities have implemented proactive measures to ensure cybersecurity. The 2020 Global Cybersecurity Index (GCI) published by the International Telecommunication Union (ITU) ranks Estonia as the third most cybersecure nation. This is especially beneficial for fintech companies since most of their operation is online.

Estonia is a cashless society with around 99% of transactions occurring digitally. This creates a significant demand for innovative fintech solutions. Startups and established companies take this as an opportunity and offer services such as digital wallets, payment gateways, and peer-to-peer lending, among others, to which strong cybersecurity is essential.

E-residency scheme

Estonia’s e-residency program supports fintech investments by allowing foreign entrepreneurs to establish businesses remotely without a physical office. This program provides online business owners, digital entrepreneurs, and freelancers with a digital Estonian ID, granting access to various local services such as business registration, banking, payment processing, and tax management.

Since its introduction in 2014, the e-residency program has grown significantly, with 117,000 individuals from 185 nationalities obtaining e-resident status and creating over 31,800 Estonian companies. This represents roughly one in five new companies annually and links 38% of startups to e-residents. The initiative has also contributed €244 million to Estonia’s economy, generating €67.4 million in direct revenue in 2023 alone, with associated costs of €7 million, achieving a nearly tenfold return on investment.

Regulatory sandboxes

A regulatory sandbox (RS) is a framework established by regulators that allows businesses to test new products, services, or technologies in a controlled environment for a specified time. This concept is prevalent in various sectors, including finance, transportation, and healthcare.

In March 2024, Estonia expanded its RS through the Accelerate Estonia program to support non-fintech startups, inviting a medical startup, Your Cue, and a clean energy startup, O-Innovations. While regulatory sandboxes are more common in the US fintech sector, European countries such as the UK, Poland, and Spain are also developing their own. As of October 2023, there were 14 fintech sandboxes in 12 EEA countries, including Estonia, which launched its sandbox in August 2023 but has yet to invite any fintech participants.

Technological advancements dictate the direction of development

The use of newer and more innovative technologies is on the rise. Many Estonian fintech startups now use technologies such as artificial intelligence (AI), machine learning (ML), the Internet of Things (IoT), etc.

An example is Depowise, which has developed innovative AI-powered solutions to automate critical functions for financial institutions, including compliance oversight, cash flow monitoring, and digital asset safekeeping.

Companies such as Value.Space, an insurtech firm founded in Estonia and currently headquartered in London with an operating office based in Tallinn, uses deep tech (advanced technologies engaged to address and revolutionize the fields they are used in) such as InSAR (Interferometric Synthetic Aperture Radar), AI, predictive analytics, and satellite imagery to help businesses monitor and assess the risk of damage to commercial assets.

Open banking and embedded finance are the budding trends in Estonia’s fintech solutions developments. BaaS (Banking as a Service) enables secure data sharing and collaboration between financial institutions, technology companies, and customers. Open banking facilitates the entry of new players into the Estonian market through strategic partnerships with local fintech companies. This dynamic allows fintech and technology companies to challenge traditional financial models, creating innovative customer engagement methods with financial institutions. Furthermore, open banking grants developers access to an extensive financial data repository. This accessibility has spurred the emergence of novel fintech business offerings, including budgeting applications, robo-advisors, and automated savings solutions.

Embedded finance involves fluidly incorporating financial services and products into non-financial platforms, such as e-commerce websites, mobile apps, or other digital landscapes. One of the leading examples of fintech companies in Estonia leveraging embedded finance is Inbank, which has developed a portal for solar panel installers to provide financing solutions to their customers.

Opportunities for financial cybersecurity players emerge with increasing crime

Online financial crime and money laundering protection are also gaining traction in the development of fintech solutions. This has particularly accelerated following the 2007 mass cyberattack on a range of institutions and the 2017 money laundering scandal involving Danske Bank’s Estonian branch. Since those events, Estonia has seen a surge in demand for services and products providing solutions in compliance and AML measures.

An example of a solution meeting this demand is SalvBridge, Salv’s anti-money laundering solution, which uses advanced analytics and ML to detect and prevent financial crimes in real time. It also helps financial institutions meet increasingly stringent regulatory requirements and combat money laundering effectively.

Similarly, Tallinn-based Veriff offers solutions to help reduce fraud and ensure regulation compliance. Veriff protects against identity fraud and theft by automatically verifying customer identities through an AI system that assesses various technological and behavioral factors, including facial recognition.

Serokell is another Tallinn-based R&D company offering cybersecurity solutions for fintech companies. Its solutions use functional programming, making it ideal for the complex fintech sector.

Demand for such solutions will likely continue to grow, offering lucrative opportunities for players operating and innovating in this space.

Estonia’s fintech scene is shifting towards sustainable investing

As with many other industries, sustainability and environmental awareness have entered the fintech playing field. Some players attempt to improve their sustainability score while expanding their investment portfolios to include sustainable exchange-traded funds.

Companies that operate using carbon credits and sustainability fintech players are some of the newer market entrants. An example is Grünfin, founded in 2020, which facilitates investments in sustainable stocks.

Several fintech companies are also increasingly leveraging carbon credits to enhance their sustainability practices and offer financial solutions to clients. A notable example is the partnership between XTCC, an Estonia-based company specializing in exchange-traded carbon credits, and Finmaal, a UAE-based fintech platform. This collaboration allows customers purchasing financial products, such as insurance and banking, to offset their carbon emissions at the point of sale, thus integrating sustainability measures with financial transactions.

These activities reflect a broader trend in which fintech firms are leveraging cloud technologies and financial instruments to maintain a lower carbon footprint while contributing to carbon neutrality goals. It is fair to expect that the trend of focus on the environment and sustainability will gain more traction in the future.

EOS Perspective

Estonia is emerging as a strong and resilient ground for fintech startups as well as established fintech businesses. Given the country’s favorable conditions, this growth will likely continue. Industry experts expect the market to advance further in key areas such as digital payments, blockchain technology, and AI-driven financial services.

While no single company has a dominant market share, notable players such as Wise, Guardtime, and Bolt are likely to continue strengthening their positions. These companies have the financial resources, established brand presence, and technological capabilities to drive innovation and expand their market reach. Players can also expect increased competition from established financial institutions, such as banks, which are likely to enter the space.

New players and startups can expect a better level playing field in niche fintech areas, such as financial security or climate fintech, and other related areas often working in tandem with fintech, e.g., insurtech or regtech.

With several countries, including China, Egypt, Qatar, Oman, Morocco, Algeria, and Tunisia, banning bitcoin or other cryptocurrency mining due to high energy use and safety issues, climate fintech startups can use this opportunity to expand their operations to offer more sustainable financial solutions.

Fintech startups offering cyber protection and customer data safety are expected to grow significantly in the coming years, especially with large financial institutions such as US-based Evolve Bank & Trust experiencing cyberattacks and a subsequent data breach in 2024.

The new tax policies scheduled to take effect in 2025 will increase individual and corporate tax rates from 20% to 22%. These changes are likely to create some ripples in the fintech sector, at least in the portion of players’ profits that are not reinvested. The new tax laws may increase the operating costs for fintech companies, which could somewhat stifle innovation. This new development may curb investment, especially for small, budding players.

Over time, consolidation is likely to occur as the Estonian fintech market will head towards maturing. Larger companies may acquire smaller startups to expand their product offerings and increase their market share.

While development is rife in the global fintech sector, with its tech-savvy culture, strategic digital infrastructure investments, and progressive regulatory conditions, Estonia will likely carve out an even more prominent place in the fintech landscape.

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