1. Optical Coherence Tomography Industry Has Provided Well Over 20,000 Person-Years of Direct Employment

    Optical Coherence Tomography Industry Has Provided Well Over 20,000 Person-Years of Direct Employment

    The field of Optical Coherence Tomography (OCT) has grown dramatically since its discovery in the early 1990’s.  The commercialization and growth of OCT which has occurred over the past 25 years has been highly impactful, scientifically, clinically, and economically.  Many factors have helped drive this success starting with the clinical need for new cost-effective high-resolution minimally-invasive imaging solutions for various diagnostic and therapeutic applications.  But equally important to this success has been the worldwide ecosystem consisting of the intertwined role of scientists, engineers, clinicians, professional societies, government agencies, government funding, regulatory bodies, entrepreneurs, venture capitalists, and small and large corporate entities within the biomedical optics industry and as well as from other industries.

    There are many ways to observe and quantify the scientific, clinical, and economic impact.  Clinically, OCT has proven to be one of the fastest adopted imaging technologies in the history of ophthalmology, and is an increasingly important research and clinical tool in cardiology, gastroenterology, and dermatology.  Currently there are about 30 million OCT scans per year (one every few seconds) which is commensurate with other major imaging modalities such as PET, CT, and MRI.  According to Jay Wei, founder and CEO of Optovue, “The clinical benefit to the patient and the work flow to clinics have been a major impact to society.” 

    Government funding has been a major factor in the success of OCT and remains a critical component for its future success as there are many medical fields that can benefit from OCT but have too much R&D risk for industry to pursue.  Worldwide there has been over $500M of government investment in OCT research over the past decade.  Figure 1 shows the dramatic growth in OCT papers along with approximate indications of when some of the commercial clinical products were released.  A clear correlation with a release of a commercial product and increase in publications in that clinical area can be seen in the figure. 

    Economically, OCT system revenue is approaching $1B/year and there are between 50-100 companies supplying OCT systems or components.  Cumulatively since the first commercial product was released in 1996 this revenue has likely exceeded $5B.  The corporate and individual income tax receipts from this revenue base represents a substantial return on the $500M government investment.  Equally impressive is the massive savings in healthcare expenditures.  According to David Huang an MD/PhD at Oregon Health & Science University and one of the inventors of OCT, “OCT is a big saver of healthcare dollars – the guidance of anti-vascular endothelial growth factor therapy in age-related macular degeneration alone saves billions of dollars per year by avoiding unnecessary injections.” 

    Beyond the immediate tax payer return to government coffers, it is interesting to estimate the number of direct and indirect OCT jobs due to the OCT marketplace.  To estimate the historical OCT employment data, 70 OCT system and component companies were contacted and asked to supply their individual historical OCT direct employment per year since OCT efforts started at that company.  Instructions were to include any OCT linked job in any discipline such as R&D, Engineering, Manufacturing, Marketing, Sales, G&A, etc.  For companies that are pure OCT companies this represents 100% of their employment.  For the larger multi-product companies the instructions were to identify employment headcount directly linked to an OCT product.  A promise was made to each company that no individual company employment data would be shared and only the complied data would be made public.  NDAs were signed where requested.

     Figure 1: OCT Publications per Year (Note: there were some earlier GI, dermatology, and other OCT products introduced but they did not achieve large scale sales and some of those companies are no longer in existence).

    Nearly 90% of the companies contacted were supportive of this investigation for the benefit of the industry.  In total 64 of the world’s leading OCT system and component suppliers cooperated with the investigation and are listed here: Agfa Healthcare, Alazartech, Avinger, Axsun, Bausch+Lomb/Technolas Perfect Vision, Leica/Bioptigen, Canon, Cambridge Technology Inc., Convai Medical/Colibri, Compact Imaging, Corning, CyLite Optics, Damae Medical, DermaLumics, Diagnostic Photonics, Exalos, Gooch & Housego, Haag-Streit, Heidelberg Engineering, Imalux, Innoluce, Innolume GmbH, Insight Photonics, Jenoptik, Keysight Technologies, LLTech, Mabri.Vision, MedLumics, Michelson Diagnostics, Micron Optics, MicroTech, Shenzhen Moptim Imaging Technology, NinePoint Medical, NKT Photonics, Novacam, OCT Medical Imaging, OCTLight ApS, OFS/Furukawa, OPMedT, Optores, Optos, Optovue, Perimeter Medical, PhotoniCare, Physical Sciences Incorporated, Praevium, Santec, Schwind Eye-Tech Solutions, Sensors Unlimited/United Technologies Corporation, St. Jude Medical, Superlum, Terumo, Thorlabs, Tomey, Tomophase, Topcon, Tornado Spectral Systems, Unnamed Company, Unnamed Company, Vivolight, Voxeleron, Wasatch Photonics, WiO Technology Limited, Carl Zeiss Meditec.

    Only six companies did not supply information for this report and there are no estimates for the jobs associated with those companies included in this report.  Even though it is a small percentage, it is unfortunate those companies chose not to cooperate with this non-profit investigation for the benefit of the OCT community.  Those companies are listed here: Abbot/Optimedica, BaySpec, Denselight Semiconductors, Heliotis, Inphenix, Nidek. 

    Figure 2 shows the employment statistics.  By the end of 2016 the OCT industry will have provided ~20,000 person-years of cumulative direct high quality jobs.  It is important to note, there are many other OCT component and subsystem related supply chain jobs that are not included in this statistic and Figure 2 represents a coarse lower bound on direct yearly employment. For example, each OCT system shipped has many parts such as a monitor, computer, chassis, power supplies, galvanometric and other optical beam scanners, fiber optic components, etc.  All of the employment data associated with the companies that supply these and other items are not included in Figure 2.  This could easily represent a doubling in the employment number shown here based on an allocation of the COGS breakdown of system suppliers (OCT centric items vs more general components and subsystems). 

    Figure 2: Yearly and Cumulative Direct OCT Jobs at System and Component Companies.

    Another major source of employment not included in Figure 2 is employment data associated with doctors, nurses, technicians, and photographers that operate the installed clinical systems around the world.  It is estimated that well over 50,000 clinical OCT systems have been sold and many are in heavy use requiring technicians, photographers, nurses, receptionists, and administrators to operate and support them.  Making a coarse and likely conservative assumption that 20% of staff time is required to operate an installed system at a busy clinic implies ~10,000 jobs/year or ~100,000 additional full time cumulative person-years of employment.

    Also not included is an estimated 1000 additional jobs per year associated with the numerous OCT research groups around the world supporting professors, post-docs, students, and related university staff. 

    In summary, it is estimated that OCT systems and component companies support well over 2,500 high quality direct jobs and 5X-10X that number in indirect yearly jobs.  Cumulatively as of 2016 this represents well over 20,000 person years of direct employment and likely over ~100,000 person-years of indirect employment. There remain numerous exciting technology and application frontiers for OCT yet to be developed.  On the technology side there are innovations in hardware, optics, systems, probes, sources, multimodality imaging, surgical guidance, and software.  On the application side only a few of the many medical fields shown in Figure 1 have been commercialized and many remaining fields have TAM’s in excess of $1B.  Thus the OCT industry will likely grow in its scientific, clinical, and economic impact.

    Acknowledgements:  I would like to thank the 63 companies that supplied employment data.

    Note:  I your OCT related company has not supplied employment data, I would appreciated if your company would supply your OCT employment data even if that employment data is not large as there will be an update to this publication in a trade magazine and journal article in the not too distant future.

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    1. The clinical benefit to the patient and the work flow to clinics have been a major impact to society.
    2. OCT is a big saver of healthcare dollars – the guidance of anti-vascular endothelial growth factor therapy in age-related macular degeneration alone saves billions of dollars per year by avoiding unnecessary injections.
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