Driven by the continued increase in minimally invasive surgery penetration and policies promoting medical equipment upgrades, China’s medical endoscope market demonstrated strong growth resilience in the first half of 2025. Both the rigid and flexible endoscope markets exceeded 55% year-on-year growth. The deep integration of technological advancement and domestic substitution is driving the industry’s transition from “scale expansion” to “quality and efficiency upgrades.”
Market Size and Growth Momentum
1. Overall Market Performance
In the first half of 2025, China’s medical endoscope market continued its rapid growth, with the rigid endoscope market increasing by over 55% year-on-year and the flexible endoscope market increasing by over 56%. Breaking down the figures by quarter, domestic endoscope sales in the first quarter increased by approximately 64% year-on-year in value and 58% in volume, significantly outpacing the overall growth rate of medical imaging equipment (78.43%). This growth was driven by increased penetration of minimally invasive surgery (national endoscopic procedure volume increased by 32% year-on-year) and the demand for equipment upgrades (equipment upgrade policies drove a 37% increase in procurement).
2. Structural Changes in Market Segments
• Rigid endoscope market: Concentration among foreign brands increased, with Karl Storz and Stryker increasing their combined market share by 3.51 percentage points, raising the CR4 ratio from 51.92% to 55.43%. Leading domestic brands, Mindray Medical and Opto-Meddy, saw their market share shrink slightly. However, Tuge Medical emerged as a surprise winner with a year-on-year growth rate of 379.07%. Its 4K fluorescence laparoscopes achieved a 41% bidding success rate in primary hospitals.
• Flexible endoscope market: Olympus’s share fell from 37% to below 30%, while Fujifilm, Hoya, and domestic brands Aohua and Kaili Medical saw a combined increase of 3.21 percentage points. The CR4 ratio dropped from 89.83% to 86.62%. Notably, the disposable electronic endoscope market grew by 127% year-over-year. Companies like Ruipai Medical and Pusheng Medical achieved sales exceeding 100 million yuan per product, with penetration rates in gastroenterology and urology reaching 18% and 24%, respectively.
Technological Innovation and Product Iteration
1. Core Technology Breakthroughs
• Optical Imaging: Mindray Medical launched the HyPixel U1 4K fluorescence light source, boasting a brightness of 3 million lux. Its performance rivals that of the Olympus VISERA ELITE III, while offering a 30% lower price. This has helped increase the market share of domestic light sources from 8% to 21%. MicroPort Medical’s 4K 3D fluorescence endoscope system has been clinically validated, achieving fluorescence imaging accuracy of 0.1mm and accounting for over 60% of applications in hepatobiliary surgery.
• AI Integration: Kaili Medical’s ultrasound endoscope probe boasts a resolution exceeding 0.1mm. Combined with its AI-assisted diagnosis system, it has increased the detection rate of early gastric cancer by 11 percentage points. Olympus’ AI-Biopsy system has increased the adenoma detection rate by 22% during colonoscopy. However, due to the accelerated substitution of domestic products, its market share in China has shrunk by 7 percentage points.
• Disposable technology: Innova Medical’s fourth-generation disposable ureteroscope (7.5Fr outer diameter, 1.17mm working channel) has a success rate of 92% in complex stone surgery, shortening the operation time by 40% compared with traditional solutions; the penetration rate of Happiness Factory’s disposable bronchoscopes in respiratory outpatient clinics has jumped from 12% to 28%, and the cost per case has been reduced by 35%.
2. Emerging Product Layout
• Capsule Endoscope: Anhan Technology’s fifth-generation magnetically controlled capsule endoscope enables a “one person, three devices” operation mode, completing 60 gastric examinations in 4 hours. The AI-assisted diagnosis report generation time has been reduced to 3 minutes, and its penetration rate in tertiary hospitals has increased from 28% to 45%.
• Smart Workstation: Mindray Medical’s HyPixel U1 system integrates 5G remote consultation capabilities and supports multimodal data fusion (endoscopic imaging, pathology, and biochemistry). A single device can process 150 cases per day, an 87.5% improvement in efficiency compared to traditional models.
Policy Drivers and Market Restructuring
1. Policy Implementation Effects
• Equipment Replacement Policy: The special loan program for medical equipment replacement (totaling 1.7 trillion yuan), launched in September 2024, yielded significant dividends in the first half of 2025. Endoscope-related procurement projects accounted for 18% of total projects, with high-end equipment upgrades in tertiary hospitals accounting for over 60%, and domestic equipment procurement in county-level hospitals increasing to 58%.
• Thousand County Project Progress: The proportion of rigid endoscopes purchased by county-level hospitals decreased from 26% to 22%, while the proportion of flexible endoscopes decreased from 36% to 32%, reflecting a trend of upgrading equipment configuration from basic to high-end. For example, a county-level hospital in a central province won a bid for a Fujifilm ultrasonic electronic bronchoscope (EB-530US) for 1.02 million yuan, a 15% premium over similar equipment in 2024.
2. Impact of Volume-Based Procurement
The volume-based procurement policy for endoscopes implemented in 15 provinces nationwide has resulted in an average price reduction of 38% for foreign brands and a winning rate for domestic equipment exceeding 50% for the first time. For example, in the procurement of laparoscopes by a province’s tertiary hospitals, the proportion of domestic equipment increased from 35% in 2024 to 62%, and the cost per unit dropped from 850,000 yuan to 520,000 yuan.
Electrical/Lighting System Failure
1. Light source flickers/intermittently dims
• Possible causes: Poor power connection (loose socket, damaged cable), light source fan failure (overheating protection), impending bulb burnout.
• Action: Replace the power socket and check the cable insulation. If the fan is not rotating, shut down the device to cool it down (to prevent the light source from burning out).
2. Equipment leakage (rare but fatal)
• Possible causes: Deterioration of the internal circuit (especially high-frequency electrosurgical resection endoscopes), failure of the waterproof seal, allowing liquid to seep into the circuit.
• Troubleshooting: Use a leakage detector to touch a metal part of the device. If an alarm sounds, immediately turn off the power and contact the manufacturer for inspection. (Absolutely do not continue to use the device.)
Regional and Hospital-Level Procurement Characteristics
1. Regional Market Differentiation
• Rigid Scope Purchases: The share in the eastern region increased by 2.1 percentage points to 58%. Driven by equipment upgrade policies, procurement in the central and western regions increased by 67% year-on-year. County-level hospitals in Sichuan Province doubled their procurement of rigid scopes year-on-year.
• Flexible Scope Purchases: The share in the eastern region decreased by 3.2 percentage points to 61%, while the central and western regions saw a combined increase of 4.7 percentage points. Flexible scope purchases by tertiary hospitals in Henan Province increased by 89% year-on-year, primarily focusing on high-end products such as ultrasound endoscopes and magnifying endoscopes.
2. Hospital-Level Demand Stratification
• Tertiary hospitals remained the primary purchasers, with rigid and flexible scope purchases accounting for 74% and 68% of the total value, respectively. They focused on high-end equipment such as 4K fluorescence laparoscopes and electronic bronchoscopes. For example, a tertiary hospital in East China purchased a KARL STORZ 4K thoracoscopic system (total price: 1.98 million yuan), with annual costs exceeding 3 million yuan for supporting fluorescent reagents.
• County-level hospitals: There is a significant demand for equipment upgrades. The proportion of basic products below 200,000 yuan in rigid endoscope purchases has dropped from 55% to 42%, while the proportion of mid-range models priced between 300,000 and 500,000 yuan has increased by 18 percentage points. Soft endoscope purchases are mainly high-definition gastroscopes from domestic Kaili Medical and Aohua Endoscopy, with an average price of approximately 350,000 yuan per unit, 40% lower than foreign brands.
Competitive Landscape and Corporate Dynamics
1. Strategic Adjustments by Foreign Brands
• Strengthening Technological Barriers: Olympus is accelerating the rollout of its AI-Biopsy system in China, collaborating with 30 Class-A tertiary hospitals to establish AI training centers; Stryker has launched a portable 4K fluorescence laparoscope (weighing 2.3 kg), achieving a 57% winning rate in day surgery centers.
• Difficulty in Channel Penetration: The winning rate of foreign brands in county-level hospitals has dropped from 38% to 29% in 2024. Some distributors are switching to domestic brands, such as the East China distributor of a Japanese brand, which abandoned its exclusive agency and switched to Mindray Medical products.
2. Accelerating Domestic Substitution
• Performance of Leading Companies: Mindray Medical’s rigid endoscope business revenue increased by 55% year-on-year, with winning contracts reaching 287 million yuan; Kaili Medical’s flexible endoscope business saw its gross profit margin increase to 68%, and its AI ultrasound endoscope penetration rate in gastroenterology departments exceeded 30%.
• The rise of innovative companies: Tuge Medical has achieved rapid growth through the “equipment + consumables” model (annual repurchase rate of fluorescent agents is 72%), and its revenue in the first half of 2025 has exceeded the full year of 2024; Opto-Mandy’s 560nm semiconductor laser system accounts for 45% of urological surgery, which is 30% lower than the cost of imported equipment.
Challenges and Future Outlook
1. Existing Issues
• Supply Chain Risks: Import dependence for high-end optical components (such as fiber optic image bundles) remains at 54%. The addition of endoscope components to the US export control list has increased inventory turnover days for domestic companies from 62 days to 89 days.
• Cybersecurity Weaknesses: 92.7% of new endoscopes rely on hospital intranets for data transmission, yet domestic equipment security investment accounts for only 12.3% of R&D budgets (compared to the global average of 28.7%). One STAR Market-listed company received a Yellow Card Warning under the EU MDR for using chips that were not FIPS 140-2 certified.
2. Future Trend Forecast
• Market Size: The Chinese endoscope market is expected to exceed 23 billion yuan in 2025, with disposable endoscopes accounting for 15% of the total. The global market is projected to reach US$40.1 billion, with the Asia-Pacific region leading the growth rate (9.9%).
• Technology Direction: 4K ultra-high definition, AI-assisted diagnosis, and fluorescence navigation will become standard features, with the market share of smart endoscopes expected to reach 35% by 2026. Capsule endoscopes will be upgraded with multispectral imaging and 3D reconstruction. Anhan Technology’s Wuhan base will capture a 35% domestic market share after its production begins.
• Policy Impact: The “Equipment Upgrade” and “Thousand Counties Project” continue to generate demand. County-level hospital endoscope procurement is expected to increase by 45% year-on-year in the second half of 2025, with the winning rate of domestically produced equipment exceeding 60%.
Policy dividends continue to be unleashed. The “Equipment Upgrade” and “Thousand Counties Project” will drive a 45% year-on-year increase in endoscope procurement by county-level hospitals in the second half of the year, with the winning rate of domestic equipment expected to exceed 60%. Driven by both technological innovation and policy support, China’s medical endoscope market is transitioning from “following” to “running alongside,” embarking on a new journey of high-quality development.
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Post time: Aug-12-2025