Climbing out-of-pocket healthcare costs forecast through 2026


In 2021, total U.S. out-of-pocket healthcare spending by consumers reached an estimated $491.6 billion, up about 10% from the prior year with continued annual growth of 9.9% expected through 2026. This will result in almost $800 billion of consumer out-of-pocket healthcare spending in 2026, reports leading medical market research publisher Kalorama Information in the recent study Out-of-Pocket Healthcare Expenditures in the United States, 5th Edition.

Multiple drivers are contributing to significant out-of-pocket spending growth, including a variety of demographic, business, and government trends, such as:

  • government, regulatory and insurance/payer actions including Managed Care Organization cost shifting, the Affordable Care Act’s Individual Mandate Repeal, and various policy changes that make healthcare more expensive;
  • business and economic trends, including actions taken by the business community and healthcare providers;
  • demographic trends that affect large groups of people such as obesity, aging and chronic conditions. Less common, yet expensive, demographic trends include mental illness and addiction.

Continuing a long-standing trend, out-of-pocket expenditures for healthcare products and services in the United States represent a significant portion of consumers’ incomes as of 2021. This is the result of a variety of factors including an aging population, rising utilization of medical products and services, and ongoing cutbacks to both public and private health coverage.

Over the years, U.S. consumers’ annual out-of-pocket healthcare costs have risen from about $250 per person in 1980 to $1,650 in 2021, with yearly increases of about $40 to $50. Increases for health plan premiums, in particular, have outpaced increases in overall prices and workers’ earnings. Consumers have noticed this trend and are becoming increasingly concerned with their ability to pay for the costs of illness. And for the lowest wage earners, these healthcare costs have become astronomical.

Greater gains in out-of-pocket spending will be mitigated by continued rising usage of lower cost medications (generic drugs, OTC medicines, Rx-to-OTC switches), growing utilization of disease management programs and the proliferation of low premium, high deductible health plans. Furthermore, salary growth will continue to lag healthcare cost increases and as consumers are unable to afford rising expenditures, they will increasingly forgo treatment and/or search for less expensive options such as generic or OTC medications. The economic effects of the Covid pandemic will further dampen spending, although not significantly.

The IVD market’s growth in key segments in the U.S. has been accelerated due to COVID-19 and the need for testing.


The IVD market’s growth in key segments in the U.S. has been accelerated due to the COVID-19 pandemic and the need for testing for the coronavirus.

The United States is the largest healthcare market in the world with high privatization of payments relative to other major developed countries. The U.S. healthcare market serves as an incubator for medical technologies and treatments that are often subsequently marketed in the rest of the world. Unsurprisingly, the United States is also the world’s largest in vitro diagnostics (IVD) market at $41.3 billion—approximately 40%-45% of the global IVD market.

The findings are according to data published in the recently released report United States Market for In Vitro Diagnostic (IVD) Tests by leading medical market research publisher Kalorama Information. A companion report, The Market for In Vitro Diagnostic Tests in Latin America (Argentina, Brazil, Chile, Colombia, Mexico, Peru, Venezuela and other nations) is also available for sale from Kalorama Information.

The U.S. IVD market is projected by Kalorama Information to grow to an estimated $53.2 billion in 2025. Projected growth for the U.S. IVD market – 5.2% on average annually through 2025 – does not match the growth of developing and emerging markets abroad in Asia and Latin America but is projected to outpace other IVD markets in the developed world such as Western Europe and Japan.

Kalorama Information’s research reveals that the IVD market to some extent is in a state of flux, yet the market’s growth in various key segments in the United States has been accelerated due to the COVID-19 pandemic and the need for testing for the coronavirus. COVID-19 had a profound effect on the IVD diagnostic industry – some segments exploded and others languished. Looking ahead, COVID-19’s impact on future growth will result from the coronavirus remaining a component of the IVD market due to the likely continued prevalence of the virus and the evolving variants that are expected to persist.

COVID-19 related growth aside, the U.S. IVD market can expect moderate growth through the following market factors and trends:

  • demographic aging that increases demand for clinical testing paid for through the country’s leading vehicle for lab payments (Medicare);
  • relatively optimistic macroeconomic indicators vis-à-vis the domestic outlook five years ago or other developed markets in the world;
  • and continued product innovation and industry responsiveness to clients’ needs in the world’s largest IVD market.


Clinical Laboratory Services Market, 6th Edition

Global markets for clinical laboratory services are forecast to increase at a CAGR of 2.8% over the next five years.


The global market for clinical laboratory services grew to an estimated $150.4 billion during 2020, with COVID-19 testing demand increasing the market by more than $26 billion over the year. These findings are according to insights featured in Clinical Laboratory Services Market, 6th Edition, a new report by leading medical market research publisher Kalorama Information.

Clinical laboratories are an essential part of the health industry.  Kalorama Information estimates that between 70% – 80% of physicians’ diagnoses are a result of laboratory tests.  In addition to diagnosing patients, clinical lab testing is performed to evaluate disease progression, monitor drug treatment and conditions, determine individual therapy, and several other reasons.  In oncology indications, clinical laboratory services are involved in 100% of patient care plans.

The fact is, clinical laboratories are improving physicians’ ability to treat patients like never before.  There is a shift in healthcare utilization primarily due to reducing healthcare spending, which makes the laboratory an even more valuable part of the treatment plan.

Besides the remarkable growth in 2020 due to COVID-19 demand, Kalorama Information points to a number of other drivers affecting steady growth for this market.  Among these are:

  • an aging population,
  • a growing incidence of chronic diseases and management,
  • increasing emphasis on diagnosis and disease monitoring,
  • and a growth in advanced laboratory testing technologies and practices.

Global markets for clinical laboratory services are forecast to increase at a compound annual growth rate (CAGR) of 2.8% over the next five years. Emerging economies will be a driving source of new growth while increasing laboratory revenues are expected in the primary U.S. market.  The U.S. market is likely to experience continued downward pressure for pricing, however, Kalorama Information does not anticipate that it will be offset by an increase in volume.

New approaches to treating and monitoring patients–such as telehealth–are emerging in response to increased healthcare needs of an aging population, new wireless technologies, better video and monitoring technologies, decreasing healthcare resources, an emphasis on reducing hospital days, and proven cost-effectiveness.


Before COVID-19, the telehealth industry was evolving slowly with slight gains annually.  Today, the pandemic has thrust the world into a new era of remote life, including managing, monitoring and treating patients and their health conditions at a pace never experienced before.  As a result of COVID-19, the global market for patient monitoring and telehealth increased by more than $2.8 billion in 2020 to reach $54.5 billion, according to leading medical market research publisher Kalorama Information in the new report Remote Patient Monitoring.

There is a new focus on pandemic preparedness and in-place infrastructure development for quick deployment of remote care technologies, which have made telehealth among the most cost-effective ways for the healthcare industry to meet the evolving requirements of patients. Kalorama’s market estimate includes sales of devices, peripherals, software, packaged services, monitoring services and other patient monitoring and telehealth applications.

Telehealth (sometimes also referred to as telemedicine) includes sending images to a specialist, live two-way video consultations between patient and provider, capturing and sending data from monitoring devices, and/or incorporating data and images into EMRs.  Reasons for using telehealth include improved access to healthcare for patients in remote locations, cost effectiveness, and patient demand.

Beyond the impact of COVID-19, the patient monitoring and telehealth market has also benefited from the demand to move to a more wireless and streamline operation both within major health facilities and in-home treatment markets.  The demand to integrate data processing capabilities and electronic medical record (EMR) transfer options has also fueled the market. Further, there is an increasing trend to upgrade to ambulatory and hand-held devices.

Looking ahead, Kalorama Information forecasts the global patient monitoring and telehealth market will experience healthy growth between 2021 and 2025.  Growth in patient monitoring technologies will be due to several factors, including:

  • An aging population
  • Replacement of older, low-technology equipment with new wireless or remote units
  • Growing acceptability and knowledge of technology features and benefits
  • Additional monitoring efforts in an effort to alleviate healthcare problems before they require hospitalization or emergency department visits
  • New technological advancements in the area of wireless connectivity
  • Government incentives and rebates that will grow demands for health facilities
  • Increasing reimbursement coverage for remote care

For more insights and information, purchase Remote Patient Monitoring by Kalorama Information at:

The Global Market for Medical Devices, 11th Edition

Personal protective equipment (PPE) was among the medical device segments that grew due to COVID-19.


COVID-19, mergers & acquisitions, and innovation spurred notable gains in the sale of medical devices in 2020


The global market for medical devices rose to $472 billion in 2020, increasing 5.1% for the year over 2019, according to new data published in The Global Market for Medical Devices, 11th Edition, the latest report by leading medical market research firm Kalorama Information.

The coronavirus pandemic in particular had a notable impact on medical device sales. The report reveals that COVID-19 related product demand impacted all markets, all regions, and all vendors to some degree in 2020, and has continued through the early months of 2021.

Kalorama Information forecasts the global medical device market will continue to grow more than 3% annually through 2025, with sales cooling down in 2022 as markets stabilize and economic recovery becomes prevalent.  In 2023, growth is expected to reemerge and produce steady performance through the end of 2025.

Medical devices include any instrument, apparatus, appliance, machine, contrivance, implant, in-vitro device as well as any accessories or related components that facilitate any or some of the following functions pertaining to a disease, injury, or condition of handicap: diagnosis, prevention or monitoring, and treatment.  Kalorama Information’s research shows that the largest individual categories of medical devices are:

  • dental equipment, including products in the areas of preventive, restorative, orthodontics, endodontics, implants, prosthetics, CAD/CAM restoration systems (CEREC), digital intra-oral, panoramic and 3D imaging systems, dental treatment centers and instruments/handpieces;
  • catheters, including any of the three major types of catheters: coronary, renal, and infusion catheters;
  • dialysis equipment, including hemodialysis machines, bloodlines and dialyzers;
  • endoscopes, which are designed for direct visual inspection of the interior of a body cavity, hollow organ, or structure;
  • minimally invasive surgical instruments, which allow doctors to perform many complicated operations with a short hospital stay; and
  • personal protective equipment (PPE), including various device segments with the indication of protecting both caregivers and patients from contamination or disease risk, such as face masks, surgical masks, filtering facepiece respirators, and protective clothing.

Personal Protective Equipment Segment Sales Increase 190% Due to Pandemic

Out of all the major medical device categories, the COVID-19 pandemic had a major hand in market growth for PPE during 2020.  The market increased by more than 190% over 2019 as a result of the pandemic.  It is expected that for 2021 and potentially some of 2022, health facilities and practitioners will continue to replenish shortages of PPE and prepare for additional unforeseen health pandemics in the future with some degree of stockpiling.  Additionally, several governments around the world have placed orders for PPE in attempts to not be without this essential tool in the event of future pandemics.

M&A Activity Sees Billions of Dollars Exchanged

Beyond the impact of COVID-19, the overall medical device market is ripe with both acquisitions and innovation. Acquisitions drove growth, as there have been more than 300 significant device market mergers and acquisitions (M&A) since 2015.  In total, this amounts to the exchange of more than $400 billion over the six years. And as of early 2021, there is nearly $40 billion in pending M&A activity in the medical device industry.

Innovation Essential to Emerging International Markets

In addition, companies operating in the market remain optimistic and seek innovation. Kalorama Information estimates that medical device companies spent an average of 8.2% of revenue on R&D during 2020, up from 8.1% in 2019.  For example, innovations from Chinese manufacturers working closely with foreign companies include reusable sutures, portable ultrasound products, low-cost stents and patient monitors. Such innovations borne out of the Chinese healthcare market are important not only in steering foreign participants’ business development strategies, but also in establishing China as a base for greater exports to regional and overseas international markets.  China is already home to an estimated 15,000-16,000 domestic medical device manufactures. The United States’ medical device market is the largest in the world, but China is one of several emerging markets that will continue to drive growth and innovation. Other emerging markets include India, Turkey, Romania, South Africa, Saudi Arabia, South Korea, Poland and Brazil.

For more insights like these, purchase The Global Market for Medical Devices, 11th Edition by Kalorama Information at

Over the years, the increasing introduction of transportable, portable, and handheld medical instruments has resulted in the migration of point-of-care (POC) testing from the hospital environment to a range of medical and non-medical environments including the workplace, home, disaster care and most recently, convenience clinics. In the face of the ongoing global COVID-19 pandemic, the reliance upon and need for testing without the direct involvement of healthcare professionals has become arguably more important now than ever before, according to Kalorama Information in the new report At-Home Testing: COVID-19 Trends and Future Potential.

Rapid tests to detect the presence of the coronavirus at the point of care, which are faster and cheaper, are a vital addition to the testing arsenal needed to contain and fight COVID-19, even with vaccines readily available.  There are now FDA-authorized COVID-19 tests sold online and in stores that can be used completely at home.  At-home tests allow individuals to collect their own sample and test it with a system that gives results in minutes at home.

It’s been more than one year since the world was thrown into the chaos of the COVID-19 pandemic.  One thing that has become apparent is that early diagnosis is crucial to prevent the spread of such infectious diseases throughout a community.  Rapid diagnosis, such as what is offered through at-home testing, is also key to containing outbreaks by allowing for efficient contact tracing in communities.

In many situations, POC and self-testing at home are tools to overcome roadblocks in testing due to sampling issues and testing delays.  Self-collected samples and home tests are provided by a growing number of hospital and independent laboratories to expand the network of testing options in all major markets in North America and Europe.

Home self-testing is not new: pregnancy tests, urine screening dipsticks, and glucose monitoring products are readily available in pharmacies and retail outlets in various major markets worldwide.  Consumers also make online purchases of kits marketed for STIs, HIV, allergies, vitamin D, food sensitivity, ancestry, and DNA testing.  These kits generally involve the collection of cheek swabs and saliva specimens that are then sent to a laboratory for processing.

From a public health perspective, at-home self-tests can offer advantages when used to complement professionally administered rapid tests or lab-based tests.  They can improve the accessibility to testing.  They allow individuals to obtain the result very quickly, which could support the early detection of infectious cases and reduce further community transmission.

Despite the apparent positives, the home-based rapid tests for infectious diseases are a work in progress and have their share of critics. Naysayers contend that preanalytical problems often surface with self-collection methods and home tests that can put patients at risk.  While home sample collection kits are designed to be simple, problems commonly occur with self-collection that can affect the quality of the sample and, therefore, the subsequent test result.

Nevertheless, from a public health perspective, self-tests can offer advantages when used to complement professionally administered rapid tests or lab-based tests.  They can improve the accessibility to testing.  They allow individuals to obtain the result very quickly, which could support the early detection of infectious cases and reduce further community transmission.

Self-testing with over counter (OTC) and direct to the consumer (DTC) kits could therefore enhance disease control with efficient identification and isolation of cases. However, there again are potential disadvantages, as shifting the responsibility of reporting test results from health professionals and laboratories to individuals could lead to underreporting, and make response measures such as contact tracing and quarantine of contacts challenging because the test results do not enter a government database.  Current indicators for monitoring the intensity and spread of the COVID-19 pandemic such as testing rates, test positivity rates, and case notification rates, could be affected, and could make it difficult to monitor disease trends over time.  An additional challenge is that samples from self-testing would not be available for viral sequencing and monitoring variants.

For more information on these and other topics related to this market, purchase At-Home Testing: COVID-19 Trends and Future Potential by Kalorama Information at:

At-Home Testing: COVID-19 Trends and Future Potential

Rapid tests to detect the presence of the virus at the point of care, which are faster and cheaper, are a vital addition to the testing arsenal needed to contain and fight COVID-19.