Össur operates within the global non-invasive orthopaedic industry, delivering advanced and innovative solutions within the prosthetics and bracing & supports markets.
The Prosthetics Market
Prosthetics include artificial limbs and related products for people who were born with limb loss or limb difference, or who have had limbs amputated. Össur provides a full range of premium lower and upper limb prosthetics, including feet, knees, hands, fingers, liners, and other components.
The size of the global prosthetics component market is estimated to be approximately USD 1.4-1.5 billion. Össur is the second largest company operating in Prosthetics with a market share estimated at 23-24%.
The growth rate of the prosthetics market is estimated to be 3-5%.
Growth in the prosthetics market is mainly due to volume and product mix. The growth is driven by the renewal and maintenance cycle as well as better access to prosthetic solutions and reimbursement for higher quality Prosthetics.
Volume growth in the market is estimated to be moderate. Volume growth is determined by a relatively stable global amputee population and a moderate increase in the number of new amputees that get fitted with a prosthesis every year.
Pricing in the prosthetics market is on average relatively stable. However, due to global inflation rates, we estimate that various reimbursement systems are more likely to increase reimbursement price points in the short to medium term than in previous years.
Growth in the prosthetics industry is mostly driven by increased utilization of higher quality prosthetics that lead to increased mobility and quality of life for individuals as well as growth in emerging markets due to increased utilization of prosthetic solutions in the markets, better healthcare coverage and increasing disposable income.
Moderate volume growth
Relatively stable pricing
Positive product mix*
Primary Sales Channels
Orthotic & Prosthetic clinics (O&P)
Source: Össur management estimates
Note: Estimates only account for component sales from providers to suppliers, i.e. not clinical services
* Increased penetration of high-end innovative products
The Bracing & Supports Market
Bracing & Supports include products used to provide support for therapeutic and preventative purposes. Össur offers a comprehensive line of products with primary focus on osteoarthritis and injury solutions including devices supporting the spine, knee, hip, foot, ankle, and hands.
The size of the global bracing & supports product market that Össur operates in is estimated to be approximately USD 2.7-3.0 billion and Össur’s market share is estimated at 5-7%.
The growth rate of the bracing & supports market is estimated to be 2-3%.
Market growth is driven by a healthy volume growth, supported by global healthcare trends such as an aging and more active population. Price levels are relatively stable as bracing & supports products are reimbursed in most of the markets that Össur operates in. For some markets, there is moderate price pressure for selected product categories, mainly products of a lower innovation level. In addition, measures such as competitive bidding for off-the-shelf spinal and back braces in the US which came into effect in January 2021, puts further pressure on pricing for certain products.
Increased amateur sports and activity levels, increased volumes of elective surgeries such as knee replacement surgeries, that drive demand for post-operative bracing solutions, and the utilization of high-end innovative products such as the Unloader® OA bracing products, support market growth in Bracing & Supports.
Bracing & Supports Market
2.7 - 3.0
Moderate volume growth
Relatively stable pricing
Positive product mix*
Primary Sales Channels
Orthotic & Prosthetic clinics (O&P)
Source: Össur management estimates
Note: Estimates only account for component sales from providers to suppliers, i.e. not clinical services
* Increased penetration of high-end innovative products
Orthopaedic Industry Stakeholders
In the orthopaedic industry, many stakeholders and decision makers are involved in the purchasing decision. The stakeholders can be categorized into five groups.
People who use our products and services solutions.
Healthcare professionals who prescribe the products, based on the condition/ clinical indication of the end-user.
Healthcare professionals who provide end-users with products, such as CPO’s, doctors, podiatrists.
Public and private insurance companies. Around 90% of Össur product sales and services are reimbursed by a third party.
Healthcare systems, insurance companies, medical associations, end-users and their families.
Industry Trends Create Opportunities
Economic development around the world and global macrotrends create demand and opportunities for growth. We have selected six trends that have a positive impact on demand for Össur’s products and services.
An aging and more active population
- The global population of 65 and older is increasing and so is the amputee population.
- A growing number of people afflicted by vascular diseases, the leading cause of amputation.
- An increased number of fractures, joint instability, and joint afflictions.
Access to healthcare improving in emerging markets
- Global economic growth will be powered by emerging markets.
- Disposable income increasing in emerging markets and willingness to pay out-of-pocket.
- Increasing healthcare coverage in emerging markets.
Increased pressure on healthcare budgets
- Healthcare providers increasing efforts to manage cost.
- Demand for cost effective solutions without compromising quality.
- Consolidation in patient care.
Increased penetration of new technologies and high-end products
- New innovative technologies being accepted for reimbursement.
- Gradual transition from volume to value-based payment in healthcare.
- Increased acknowledgment of total healthcare economic benefits of Bionics and OA bracing.
Increasing regulatory requirements
- Investments in people and processes to adapt to changing healthcare requirements.
- Product development to meet prevailing regulatory requirements.
- Increasing importance of digital and personal data security.
Improved treatment options
- Increasing healthcare coverage and better access to patients.
- People with limb loss and limb difference more often get fitted with a prosthesis.
- Innovative products creating more benefits for prosthetic users.
Össur develops, manufactures, and brings to market a wide range of prosthetics and bracing & supports solutions with high standards of quality. Every year, Össur makes a significant investment in research and development to further advance products and technologies for the benefit of all stakeholders. These high-end products are developed with the objective to improve people’s mobility. The products are delivered to users of our products and solutions through healthcare providers who specialize in assisting individuals who suffer from impaired mobility. Össur’s main sales channels for both Prosthetics and Bracing & Supports are O&P clinics which provide end-users with solutions and subsequently claim reimbursement from private or public insurance as Össur’s products and services are in most cases reimbursed. Össur has also expanded in the value chain and selectively acquired O&P clinics which Össur operates.
The end-users we serve include people with lower and upper limb loss due to, for example, vascular diseases including diabetes as well as cancer, trauma and congenital defects. They also include individuals who require support as they may have, for example, developed osteoarthritis in knee or hip ligaments, or require enhanced healing post-surgery or due to injuries.
By collaborating closely with O&P professionals and the users of our products, Össur gains a better understanding of their needs and challenges. In turn, Össur improves their mobility by providing new technologically advanced products and service solutions.
New major lower limb amputees per year
New upper limb amputees per year
of new amputees are fitted
with prosthetic solutions
is the average age
of the amputee population
Source: Össur Management estimates
Össur develops Prosthetics and Bracing & Supports, from an idea to a finished product. With every product, the aim is to deliver cost effective medical solutions that provide value for end-users and the healthcare system.
Research and Development
To obtain independent clinical evidence for product outcomes as well as health economic data, Össur initiates and promotes clinical studies in cooperation with leading scientists, institutions, and healthcare professionals in the field.
As part of our ambition to be at the forefront of innovation and new technology, Össur R&D participates in externally funded projects, collaborating with partners from industry and academia alike. We take part in various projects where world class scientists are involved in cutting edge research. This enables us to join forces in shaping the technology of the future with the mission of improving people's mobility.
Manufacturing and Quality
Össur maintains a strong global manufacturing function. At Össur, there is a continuous strive for efficiency, which includes finding ways to optimize the manufacturing process. Most of our products are manufactured in Iceland, Mexico and China. Manufacturing of advanced prosthetic solutions, including bionics, takes place in Iceland and Scotland. Manufacturing of most other prosthetics solutions, components and premium bracing solutions takes place in Mexico. Finally, Össur outsources the manufacturing of soft goods to China. In addition, Össur has smaller specialized manufacturing facilities in four locations in the US and one in France.
Great emphasis is placed on quality, and it is an intrinsic part of our processes. Össur has had a certified Quality Management system in place since 1993 which is based on ISO management standards and complies with the applicable medical device regulations in the countries that Össur operates in. Össur is certified to the global ISO 13485:2016 Medical Device Standard and the Medical Device Single Audit Program (MDSAP).
For the past years, multiple changes emphasizing safety have been implemented to the global regulatory framework for medical devices. We have successfully transformed our quality management system to ensure compliance with those changes emphasizing patient safety. Our extensive globally aligned quality management system is regularly audited by Össur’s notified body BSI.
Sales and Marketing
Össur operates within a highly specialized industry where the primary customers are specialized healthcare providers who provide and fit individuals with Össur products and solutions. In Prosthetics, these customers are O&P clinics and in Bracing & Supports, it is a combination of O&P clinics, hospitals, and surgery centers. In a few selected markets in Americas and EMEA, Össur operates its own O&P clinics.
Össur has operations in 36 countries and largely sells its products through its own direct sales network.
Prescribers, Providers and Payers
Prescribers include healthcare professionals who prescribe products and services based on the clinical indication of the end-users. These include orthopaedic surgeons, non-surgical physicians, rehabilitation and emergency physicians as well as other professionals providing medical diagnosis.
Össur’s customers are mostly the providers of products and service solutions to end-users. Providers are healthcare professionals who provide end-users with prosthetic and bracing & supports products, and related services. These include certified prosthetists and orthotists (CPOs) working at O&P clinics, durable medical equipment (DME) clinics, orthopaedic clinics, and hospitals. Many providers not only recommend specific products but also fit and tailor-make certain products. For non-reimbursed products, a provider can be a pharmacy or a sports store.
Payers include healthcare systems, insurance companies and individuals. In most cases, when an individual has been fitted with a product, Össur’s customers claim reimbursement from the relevant public institutions or private insurance companies. Around 90% of Össur’s product sales and services are estimated to be reimbursed by a third party. However, reimbursement systems vary substantially between countries. In other cases, the end-user of the products pays out-of-pocket for the solution provided. Overall, Össur’s sales in the Western world are mostly reimbursed while sales in emerging markets are mostly paid out-of-pocket.
Össur’s mission is to improve people’s mobility and our vision is to enable Life Without Limitations®. Össur is a technology pioneer and by listening to our end-users and understanding their needs, as well as continuously improving and pushing the boundaries, we continue to create advanced mobility products and services. Össur fosters an inclusive and innovative culture with its diverse workforce. Össur continues to generate value for individuals and healthcare systems by focusing our business strategy on innovative solutions, delivering profitable and sustainable growth, and efficiency.
We execute ideas that add value
We deliver profitable and sustainable growth
We conduct business efficiently
Innovation is one of the three main pillars of our strategy. Developing and maintaining a strong intellectual property (IP) portfolio is key in sustaining our position as an innovation leader in the industry.
Strong Intellectual Property Portfolio
Our IP portfolio consists of various types of IP rights, strategically developed, and registered to protect our products and technologies, as well as the Össur brand. At year-end 2022, the IP portfolio consisted of, inter alia, over 2,000 patents and patent applications and around 650 trademarks.
To sustain a successful innovation level and improve people’s mobility, we utilize the vast knowledge and expertise accumulated over the years at Össur in diverse technology platforms. We are focused on functional trade-up which entails providing people with more advanced mobility solutions. The products that we introduce to the market are a result of our R&D processes and are deeply rooted in understanding and addressing the needs of people with limb loss and limb difference. In 2022, 10 prosthetic products were launched to the market.
Following the introduction of the new generation Power Knee™ in 2021, the bionic product was successfully launched in all major markets at the beginning of 2022 and continues to receive excellent feedback. This first motor powered prosthetic knee, is ideal for individuals seeking increased assistance from their prosthetic device and those who require better symmetry and more natural gait.
Our broad selection of waterproof products is another example of our efforts to enable people to utilize their prosthetic devices to the fullest in diverse types of environments. The use of first-rate materials such as carbon fiber, titanium and high-grade aluminum provides permanent protection against harmful ingress of water. Even after submersion in freshwater, salt water and chlorinated water, the parts maintain their integrity and continue to provide full support, function, and durability.
Two new waterproof prosthetic feet were launched into the Pro-Flex® family during the year: Pro-Flex® ST and Pro-Flex® Modular which are both designed for low to high active amputees.
Pro-Flex® ST provides a smooth rollover and controlled push off. Pro-Flex® Modular is a lightweight shank height adjustable prosthetic foot, minimizing the need for additional components between the socket and foot. Both feet make it easy for amputees to go through the full stride on different terrains due to its multifunctional design, combining dynamics and ground compliance.
We now have 20 waterproof prosthetic feet in our product portfolio along with a selection of adapters and locks.
The acquisition of Naked Prosthetics, a leading provider of durable, custom, and functional prostheses for finger and partial hand amputees, is a welcome addition to our product portfolio. It is complementary to our product range, and strengthens our upper limb product offering globally, allowing us to cater to a broader group of individuals.
Making use of macro trends within healthcare and the O&P industry, we have identified an opportunity and pursued our Össur Legs strategy. Increased time and cost per patient due to regulatory and reimbursement obligations call for improved efficiencies, and a shortage of qualified prosthetists and technicians calls for optimizing workflows in O&P clinics. In addition, a new generation of CPOs is more focused on patient interaction and less on prosthetic fabrication which creates a demand for alternative solutions. Össur Legs is a service for O&P clinics where Össur offers complete prosthetic leg solutions, fabrication expertise, skilled design, a streamlined ordering process, and leg maintenance services. In essence, as Össur offers a complete portfolio of all the product components that are needed to assemble a full leg solution for patients, we can provide complete solutions as well as associated services to O&P clinics.
Over the last 100 years, a prosthetic leg has changed from being fully fabricated in the O&P clinic to being assembled from advanced product components such as the Pro-Flex® foot and the Power Knee™. Only the socket, the device that goes over the residual limb and joins it with the rest of the prosthesis, is still most often made in an O&P clinic. Creating a socket is traditionally done by taking measurements of the residual limb by scanning, or using plaster casting, and then fabricating the socket and adjusting it until it fits the patient. The process is both labor intensive and time consuming, while consistent results depend on the CPO's experience and craftsmanship. Also, due to the complexity of socket fabrication and lack of socket adjustability, some people with above knee limb loss may never receive a prosthesis. This is now beginning to change as more advanced technology and standard processes are adopted within O&P clinics.
Össur has developed a holistic product portfolio that can be configured and customized for a wide range of patients. We also offer a range of socket solutions, including new innovative solutions as well as traditional socket fabrication outsourcing. The Össur Direct Socket and Connect® TF products are designed to give more people the possibility to use a prosthesis. The Direct Socket offering enables CPOs to fabricate and fit patients with a high quality, good fitting socket in one session. While not an “off-the-shelf ready product,” the Direct Socket is a set of materials, tools, and standardized fabrication process, designed to increase patient satisfaction. Connect® TF is an adjustable socket that addresses some of the struggles people face with putting on, taking off, and adjusting conventional sockets. Connect® TF offers a solution that is easy to put on while sitting and is comfortable to wear while sitting, standing, and walking. Along with the unique design that allows for adjustment to limb changes, it is an ideal alternative to conventional sockets. In addition, our facility in Orlando in the US, offers quality socket design and fabrication based on 3D scans and measurements of the residual limb.
With Össur Legs and our broad prosthetic solutions offering, consisting of a wide range of feet, knees, sockets, liners and componentry, we are in a unique position to enable CPOs to dedicate more time to patients' needs and optimize the productivity and value chain of O&P clinics. To support this growing offering, we have invested in digital initiatives such as the Össur Portal that contains a leg configurator catered to CPOs' needs and simplifying the ordering process.
Össur Legs are well established in Americas and further market reach is under way. O&P clinics see value in adopting Össur Legs and customer loyalty for the offering is high. In 2022, we launched the Össur Portal in Americas to support the Össur Leg offering with an impressive adoption rate. We will continue to develop Össur Legs and the Össur Portal in close collaboration with O&P clinics, focusing on adding value and optimizing the O&P value chain.
Bracing & Supports
We launched five bracing & supports products in 2022. The CTi®3 knee brace is the newest addition to our ligament knee bracing flagship CTi® product family and was launched mid-year 2022. Using the latest in design, materials, and manufacturing methods, CTi®3 is built to deliver exceptional value with its simplicity and durability. It is an off-the-shelf option for post-operative use or to provide support for ligament instabilities during sporting activities or daily wear.
We aim to minimize our negative environmental impact by preventing, reducing, and controlling waste and pollution from all our operations. In 2022, we continued our journey of reducing environmental impact from product packaging. As an example, we implemented packaging improvements for all OA and ligament knee braces shipped from our manufacturing facility in Mexico by removing plastic bags and reducing dimensions, material content and ink used on boxes of selected products. Furthermore, the new cardboard used is of certified origin (FSC) with a minimum of 30% recycled content and easily recyclable after use. Besides the significant reduction of plastic, the change resulted in an average of 60% reduction in cardboard weight and 13% reduction in box volume, which results in reduced emissions during transport.
At Össur, we nurture a spirit of innovation. We offer an environment where each employee can achieve their full potential and has a sense of belonging. We live by a set of values that are the foundation for our strategy and success.
Our core values are Honesty, Frugality, and Courage, and these values guide our decisions. We live these values every day in everything we do—in our interactions with colleagues and customers, and in our work efforts.
We have around 4,000 employees working in 36 countries. While we are a diverse company, we work as one to improve people’s mobility. Different ideas and points of view are beneficial to our business, and we believe in creating an environment where diversity, knowledge, skills, and strengths are fully utilized. As individuals, our employees can expect fair and equal treatment and equal opportunities for growth within Össur. Our employees take responsibility, both for their job and for their career advancement. We offer various learning opportunities, so employees can build a lasting and rewarding career with us.
We measure our employees’ engagement at least once a year and we are proud that our engagement and employee satisfaction is high. Our greatest assets are our employees’ passion, drive, and capabilities to help our customers and end-users.
We have a Competency Framework within Össur that allows us to identify the behaviors that drive successful performance and supports our business strategy. Our competencies are collaboration, communication, driving results, customer focus and change. We have annual performance reviews, where we review the performance of the past year and plan for the performance of the coming year. Regular check-ins are encouraged between employees and managers to discuss both the performance and development of our competencies which are supported by Össur‘s Development Guide that lists training and development opportunities for each competency. All employees, regardless of their role or location, have access to thousands of online and virtual courses to learn from and grow. All leaders go through our LEAD program, a global leadership development program. We also offer mentoring, 360° assessments, and 1:1 coaching to support the development efforts and to further grow our talented employees.
Össur recruits competent and ambitious individuals who can work on demanding projects. Our hiring decisions are based on the skills and abilities we need to grow the business and our global team of talented professionals is passionate about helping people live a Life Without Limitations® .
If you are interested in joining our team, you can view and apply for an open position on Össur’s applicant portal.
Make Every Step Count
Diversity, Equity and Inclusion
Every day, we interact with people from a wide range of cultures and backgrounds. We do business in numerous locations around the world, working and communicating with many different colleagues, customers and other stakeholders in our industry.
Diversity, equity and inclusion are extremely important to us. At Össur, we have a passion for helping people pursue a Life Without Limitations. We celebrate different ideas, perspectives and backgrounds. We are committed to creating a culture of acceptance and belonging, while proudly serving as a diverse, global community. To make a difference in this world, we embrace differences within the world.
We monitor and measure diversity, equity and inclusivity on a continuous basis, making sure it is part of our company culture. Therefore, we include questions on diversity and inclusion in our annual workplace survey. We have increased training opportunities on diversity, equity and inclusion in our online learning system and we have a diversity dashboard available for our leaders so they can monitor the diversity of their teams. We offer flexible work arrangements for positions that can be done remotely, so employees can more flexibly manage how and where they work.
Female in Management Positions
Össur Give Back Program
Össur has long placed emphasis on making a positive contribution to the local communities where we do business.
The Össur Give Back Program offers all employees globally, one volunteer day per year with pay to give back to their communities. We encourage our team members around the world to work with local causes and charities to make a difference. The Give Back Program has been very well received by Össur employees who actively participate in volunteer activities in their communities.
Diverse causes and charities benefited from donated working hours in 2022, such as the following:
- March Against Loneliness in Denmark
- Ronald McDonald House in Southern New Jersey, US
- South Jersey Food Bank in New Jersey, US
- River Kids Charity in Scotland
- West Lothian Food Bank in Livingston, UK
- Beach clean-up in the Netherlands
- Adaptive Sports Connection in Ohio, US
- Project Hope Alliance in Orange County, California, US
- Woodbank Community Food Hub in Stockport, UK
- Beach clean-up on the Southern Coast of Iceland
- Bannerman Island Historical Castle restoration in New York, US
- Tree planting with the Icelandic Forestry Association in Iceland
- Oertijdmuseum Garden clean-up in the Netherlands
- Ukrainian House, a Center for Ukrainian Culture in Szczecin, Poland
- Forest clean-up in Stockholm, Sweden
- Christmas gifts preparation for seniors living in social welfare homes in Szczecin, Poland
Ramp Up Iceland
Ramp Up Iceland was originally initiated in Reykjavik in March 2021 with the goal of helping local businesses in the capital city to install wheelchair ramps to improve accessibility for people with mobility challenges. The project was very successful and was expanded to other towns and communities in Iceland this year. Össur is one of the founding members of the project, spearheaded by entrepreneur Halli Thorleifsson. The original goal of Ramp Up Iceland was to complete 1,000 ramps around Iceland by the end of 2025 but the project has progressed so well that the goal has been increased to 1,500 ramps within the same timeframe. The project is supported by the President of Iceland, Gudni Th. Jóhannesson, and the Icelandic Government.
Össur Mobility Clinics
For nearly 30 years, Össur has partnered with the Challenged Athletes Foundation (CAF) to host running and mobility clinics in the US. Held at various locations throughout the year, these free clinics provide opportunities for people with limb loss and limb difference to learn useful techniques and gait training from elite faculty. Össur athletes and CAF mentors participate in the clinics with the goal of helping individuals move better and more confidently with their prosthesis.
Össur Mobility Clinics have also been held in Australia, France, South Africa and other countries over the years. In 2022, Össur Australia held specialized mobility clinics focused on individuals participating in golf, skiing and surfing, and Össur France held a Junior Day which was dedicated to children.
Four Key Risks
An investment in Össur involves various risks as the business, financial conditions, and operational results rest upon certain assumptions and could be negatively affected if any of the factors described in this chapter occur. Even though the long-term prospects and underlying fundamental drivers of our markets are not expected to change, Össur highlights four key risks which are currently considered the most relevant. In addition to these risks, Össur faces a range of other risks described on our corporate website.
Össur cannot ensure that the given assumptions for the description of any of these risks are correct. Additional risks and uncertainties, as well as risks that Össur currently deems immaterial or are not presently known to us, may adversely affect our business, financial conditions, and operational results.
I. Reimbursement Landscape
Most of Össur’s products and services are reimbursed by third-party payers, including both government healthcare programs and private health insurance plans. Third-party payers continue to develop methods of controlling healthcare costs, including reviews of claims, selective contracting, and competitive bidding. Our business depends on understanding and adapting to reimbursement and insurance plans in all markets where we conduct our business.
These cost-control methods may limit or even eliminate the coverage and the amount of payment for which third-party payers may be willing to pay for Össur products and services. As a result, customers may reduce or eliminate purchases and sales may decline significantly. Reviews of claims may lead to repayment of prior sales. Finally, failing to understand and adapt to changes in reimbursement systems, may affect Össur’s license to operate and thus affect our sales.
Össur only brings products and services to the market that address medical indications, and which are clinically validated. In addition, we apply our reimbursement knowledge from the earliest stages of product development to the post-sale education of customers. Finally, we monitor and analyze changes to the reimbursement landscape in the markets where we operate and we adapt our reimbursement strategy accordingly.
II. Regulatory Requirements
Össur’s products and services are subject to global and local regulations. Such regulations can restrict practically all aspects of a medical device’s design and testing, manufacturing, safety, labeling, storage, record-keeping, reporting, clearance and approval, promotion, distribution, and services. In our interactions with government officials, healthcare professionals, business partners, we must comply with relevant third-party regulatory requirements as well. Finally, our footprint is growing in new emerging markets which are characterized by complex regulations, business volatility and unpredictability.
Failure to comply with the regulatory requirements of the applicable authority may subject Össur to fines, penalties, sanctions, or product withdrawals. If we would fail to receive regulatory clearance and approval for our products and services it could adversely affect our sales and potential for future growth, threaten our license to operate in the respective market, and affect our brand and reputation.
Össur maintains a robust global quality system that complies with international medical device standards, and which forms an intrinsic part of internal processes. Össur also has a global regulatory compliance program, including a Code of Conduct, in which our employees identify, assess, manage, and report potential risks from international and local regulations in the countries where we market and sell our products and services. Finally, tracking and analyzing regulatory requirements of new markets forms a part of our market access strategy.
III. New Technologies
Össur operates in markets that are characterized by rapid technological change, driven by extensive research that is conducted by market participants. Technological innovation takes place at various stages in our value chain and may include individual components, design, and functionalities of our products and services.
The development by suppliers or competitors of substitute products or components that better satisfy market demands could have a material adverse effect on Össur’s business and results of operations. A failure to develop new products or enhance existing products could also have a material adverse effect on our operations and potential for future growth.
Össur’s significant investment in research and development and constant strive to finding innovative technologies, has resulted in a vast IP portfolio and a strong position to compete with potential new entries. External connections with universities, research institutes and investors, provide us with the opportunity to stay informed and review emerging innovation as part of acquisitions or research cooperation initiatives.
IV. Industry Consolidation and Forward Integration
Major shifts in Össur’s marketplace include the consolidation of orthotics and prosthetics (O&P) manufacturers and forward integration, which involves acquiring service providers in the O&P industry. It remains uncertain to what degree we will be able to participate in further consolidation and forward integration and how it will affect our operations. Industry consolidation and forward integration can lead to increased challenges and complexity and our success depends in part on our ability to effectively operate in this changing marketplace.
The consolidation has been a material contributor to the external growth of Össur in the past. If we were not to participate in further consolidation or forward integration, it might limit our potential for future growth. In addition, these market trends may impact the competitive landscape of the industries and the associated market shares. Finally, these changes in the marketplace may impact our customers, CPOs and end-users, and interactions with them.
It is at the core of our strategy to operate effectively in this changing marketplace. Össur continuously reviews value enhancing acquisitions and investment opportunities in our business segments and keeps a good relationship with the relevant stakeholders in the industry. We operate our own clinics in certain regions and have partnership programs in place with healthcare providers to offer customers quality products and services in the interest of our end-users.