Chronic Thromboembolic Pulmonary Hypertension Market By Treatment Modality (Pulmonary Endarterectomy, Balloon Pulmonary Angioplasty, Pharmacotherapy); By Drug Class (Soluble Guanylate Cyclase Stimulators, Prostacyclin Analogs, Endothelin Receptor Antagonists, Anticoagulants); By End User (Specialized CTEPH Centers, Tertiary Hospitals, General Hospitals, Diagnostic & Outpatient Centers); By Geography, Segment Revenue Estimation, Forecast, 2024–2030

Introduction And Strategic Context

The Global Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Market will witness a robust CAGR of 6.8% , valued at USD 1.7 billion in 2024 , expected to reach nearly USD 2.7 billion by 2030 , according to Strategic Market Research .

 

CTEPH is a rare but serious complication of pulmonary embolism where unresolved clots transform into fibrotic tissue, obstructing pulmonary arteries and driving progressive pulmonary hypertension. Unlike acute pulmonary embolism, which can often be managed with anticoagulants alone, CTEPH demands complex interventions ranging from surgical pulmonary endarterectomy (PEA) to balloon pulmonary angioplasty (BPA) and long-term pharmacotherapy.

 

The market is strategically relevant for multiple reasons. First, survival outcomes depend heavily on early detection and access to advanced interventions, meaning demand is closely tied to diagnostic improvements and referral networks. Second, drug innovation is shifting the treatment paradigm. Oral therapies such as soluble guanylate cyclase stimulators and novel combination regimens are being positioned as long-term management tools, particularly for patients ineligible for surgery. Third, global awareness campaigns are pushing more patients to specialized CTEPH centers , which in turn accelerates adoption of new procedures and devices.

 

Stakeholders in this space include pharmaceutical companies pioneering targeted vasodilators, device manufacturers enabling catheter-based BPA procedures, and academic hospitals driving outcome-based protocols. Governments and payers are also playing a visible role by funding specialized centers of excellence, particularly in Europe and Asia. Investors, meanwhile, are drawn to the market’s dual profile: it’s rare enough to command orphan drug pricing advantages, yet growing steadily as diagnosis rates improve worldwide.

 

To be honest, CTEPH has long been overshadowed by broader pulmonary hypertension markets. But that’s shifting. With more real-world data validating BPA outcomes and next- gen therapies in late-stage clinical trials, this market is gaining its own strategic identity rather than being treated as a small subsegment.

 

Market Segmentation And Forecast Scope

The chronic thromboembolic pulmonary hypertension (CTEPH) market can be segmented across four major dimensions — treatment modality, drug class, end user, and geography. Each dimension reflects how providers balance surgery, pharmacotherapy, and interventional procedures depending on patient eligibility and health system maturity.

By Treatment Modality
Pulmonary endarterectomy (PEA) remains the gold standard and accounts for the largest share in 2024, as it offers a potential cure for eligible patients. However, balloon pulmonary angioplasty (BPA) is gaining traction as a minimally invasive alternative, especially in Asia and Europe where procedural expertise is growing quickly. Pharmacotherapy holds a strong presence for inoperable cases, with adoption driven by increasing access to targeted oral therapies.

 

By Drug Class
Soluble guanylate cyclase ( sGC ) stimulators represent the fastest-growing segment. Their role in improving hemodynamics and exercise capacity has made them a preferred option for long-term disease management. Prostacyclin analogs and endothelin receptor antagonists are also prescribed, though often as adjunct therapies or for patients transitioning post-surgery. Anticoagulants remain a baseline therapy, but they are no longer the market’s primary growth driver.

 

By End User
Specialized CTEPH centers and tertiary hospitals dominate, as they perform both PEA and BPA procedures. General hospitals treat lower complexity cases, largely through pharmacotherapy. Diagnostic centers are playing a growing role in patient referrals, particularly in regions where echocardiography and V/Q scans are increasingly used to identify chronic thromboembolic disease.

 

By Region
North America leads in revenue share due to strong infrastructure and a well-established referral system. Europe closely follows, backed by reimbursement for advanced procedures and cross-border patient programs. Asia Pacific is the fastest-growing region, with Japan and China expanding BPA adoption rapidly. Latin America and the Middle East & Africa remain underpenetrated, but gradual expansion of cardiac centers is opening new patient pools.

 

Scope-Wise , this segmentation covers both clinical and commercial perspectives. While surgery and BPA drive high upfront revenue, drug classes ensure recurring revenue streams, and regional adoption patterns highlight where infrastructure investments will unlock the next wave of growth. In 2024, PEA accounts for just under half of the market share, but BPA is expected to outpace other modalities in growth rate between now and 2030.

 

Market Trends And Innovation Landscape

The CTEPH market is in a transition phase where innovation is no longer limited to surgical techniques. Instead, it now spans pharmacology, interventional cardiology, and digital diagnostics. Several notable trends are shaping its future.

One of the most visible shifts is the steady rise of balloon pulmonary angioplasty (BPA). Once seen as experimental, BPA has matured into a validated option, particularly in Japan and parts of Europe. Iterative catheter design, imaging-guided navigation, and better complication management have made it safer and more reproducible. For patients deemed inoperable for pulmonary endarterectomy, BPA offers a chance at meaningful functional recovery. Specialists note that many cases once thought inoperable can now be reconsidered with BPA, effectively enlarging the treatable population.

 

On the pharmacology side, targeted oral therapies are expanding their foothold. Soluble guanylate cyclase stimulators have demonstrated strong efficacy, while prostacyclin analogs are increasingly offered through inhaled or oral routes, making adherence easier. Pipeline innovation is also active: several companies are testing combination regimens that bridge the gap between post-surgical stabilization and chronic management. Analysts suggest that the real long-term growth lies in these novel oral therapies, as they create recurring revenue streams beyond procedural interventions.

 

Digital tools are beginning to make their mark as well. AI-driven imaging interpretation for ventilation-perfusion scans and CT pulmonary angiography is being piloted to speed up diagnosis and reduce missed cases. Remote monitoring tools are being explored to track post-operative patients for early signs of restenosis or recurrent hypertension. While still in early stages, these technologies align with a broader healthcare push toward proactive rather than reactive management.

 

Collaborations are also an important trend. Pharmaceutical firms are partnering with surgical and interventional centers to run outcome-based studies, often including real-world registries. These data sets are vital in convincing payers to expand reimbursement coverage. In parallel, device manufacturers are investing in training programs for BPA, particularly in Asia, where procedural volume is accelerating.

 

To be honest, the innovation landscape here isn’t about one big breakthrough. It’s about incremental but steady progress across multiple fronts — safer procedures, smarter drugs, and sharper diagnostics. Together, these are expanding the boundaries of who can be treated, how early they can be diagnosed, and how effectively long-term outcomes can be managed.

 

Competitive Intelligence And Benchmarking

The CTEPH market is defined by a concentrated group of pharmaceutical innovators, device manufacturers, and specialized healthcare centers . Each player approaches the field with a unique strategy, often balancing the challenges of a rare-disease market with the potential benefits of orphan-drug pricing and procedure-driven growth.

Bayer AG
Bayer remains the most influential pharmaceutical player, thanks to its soluble guanylate cyclase stimulator, which set a new benchmark for medical therapy in inoperable CTEPH. The company continues to expand its presence through clinical trials, combination therapy studies, and strong market access strategies. Its edge lies in being the first mover with a targeted oral drug backed by robust long-term data.

 

Johnson & Johnson (Janssen Pharmaceuticals)
Through its pulmonary hypertension portfolio, Janssen has carved out a strong position. While best known for endothelin receptor antagonists and prostacyclin analogs in broader pulmonary arterial hypertension (PAH), the company is increasingly extending its footprint into CTEPH. Strategic collaborations with specialty centers are helping position its therapies as adjunctive or sequential options.

 

Merck & Co.
Merck’s entry into pulmonary vascular disease is still evolving, but the company’s R&D investments in cardiopulmonary conditions make it a likely competitor over the forecast horizon. Their focus on precision therapies and biomarker-driven trials indicates a long-term ambition to diversify beyond oncology and immunology into high-value rare diseases.

 

AbbVie
AbbVie has a growing interest in cardiopulmonary indications, with investments in prostacyclin analog pipelines. While it has not yet established dominance in CTEPH, partnerships with academic research programs are signaling its intent to enter more aggressively.

 

Terumo Corporation
On the interventional side, Terumo has positioned itself as a leader in balloon pulmonary angioplasty technology. Its catheters and vascular devices are widely used in Asia, where BPA volumes are climbing rapidly. Training initiatives supported by Terumo have helped standardize techniques, making BPA safer and more reproducible.

 

Medtronic
Although better known for cardiovascular devices, Medtronic is exploring synergies between its structural heart expertise and pulmonary vascular interventions. Its role in BPA is still emerging, but its global reach and distribution networks could allow it to scale quickly once dedicated technologies are commercialized.

 

Benchmarking across these players highlights a key dynamic: pharmaceutical companies dominate in chronic disease management, while device firms hold the procedural innovation frontier. The competitive race isn’t just about market share, but about credibility with specialized centers of excellence. Hospitals often align with the companies that can offer not just products, but also training, registries, and reimbursement support.

To be honest, the winners in this space will be those who blend science with ecosystem building. Offering a drug or a device isn’t enough — building trust with providers and ensuring patients can access therapies through structured care pathways is what sets the leaders apart.

 

Regional Landscape And Adoption Outlook

Regional adoption of CTEPH therapies and interventions varies widely, driven by differences in healthcare infrastructure, referral systems, reimbursement policies, and procedural expertise. While high-income regions are leading in both diagnosis and treatment innovation, emerging markets are slowly building capacity through targeted investments.

North America
North America leads in terms of overall revenue, supported by strong referral pathways, specialized CTEPH centers , and comprehensive insurance coverage. The United States is home to several globally recognized institutions performing pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA) at high volumes. Reimbursement for advanced procedures is well established, and patient advocacy groups have improved awareness around chronic thromboembolic disease. Canada follows a similar path, though the number of specialized centers is more limited, leading to longer referral times in certain provinces.

 

Europe
Europe is highly advanced in procedural adoption, particularly in Germany, the UK, and France. German centers are regarded as pioneers of BPA, with outcomes that have shaped global practice. The European Medicines Agency (EMA) has been supportive of orphan-designated therapies, helping drive access to novel drugs. Cross-border referral systems under EU healthcare frameworks allow patients from smaller countries to access advanced procedures in high-volume centers , a unique advantage over other regions. Eastern Europe lags behind, largely due to infrastructure gaps and limited access to specialized surgical expertise.

 

Asia Pacific
Asia Pacific is the fastest-growing region, with Japan leading BPA adoption worldwide. Japanese centers have standardized protocols, producing strong real-world outcomes that are influencing global practice. China and India are investing heavily in cardiopulmonary programs, with major urban hospitals beginning to adopt BPA alongside medical therapy. However, access outside large metropolitan areas remains limited. South Korea, Singapore, and Australia are also expanding advanced treatment options, with government support for rare disease management contributing to steady growth.

 

Latin America
Latin America is underpenetrated but showing signs of momentum. Brazil and Mexico are beginning to develop referral networks for pulmonary hypertension, but the number of CTEPH-dedicated centers remains very small. Drug availability is improving, particularly with multinational pharmaceutical firms expanding their orphan drug portfolios in the region. Public-private collaborations will be key in expanding procedural access.

 

Middle East and Africa
Adoption here remains nascent. Wealthier Gulf states such as Saudi Arabia and the UAE are investing in specialty cardiopulmonary centers , often staffed by internationally trained physicians. Africa, however, faces significant barriers, including limited diagnostic capacity and very low awareness of CTEPH. NGOs and regional collaborations are beginning to lay the foundation, but significant gaps remain.

 

At a high level, North America and Europe dominate in procedure volume and innovation, while Asia Pacific represents the most promising growth frontier due to rising diagnosis rates and procedural expansion. Latin America and the Middle East & Africa remain underpenetrated but hold long-term potential as infrastructure gradually improves. For companies, this means tailoring strategies: innovation-led in developed regions, and access-focused in emerging markets.

 

End-User Dynamics And Use Case

The CTEPH market is shaped not only by the drugs and devices available but also by the types of institutions that deliver care. End users differ in terms of expertise, infrastructure, and patient flow, which in turn drives how therapies and interventions are adopted.

Specialized CTEPH and Pulmonary Hypertension Centers
These are the core drivers of the market. They handle complex surgical cases, offer balloon pulmonary angioplasty (BPA), and manage long-term pharmacotherapy. Their edge lies in multidisciplinary teams that include surgeons, interventional cardiologists, pulmonologists, and imaging specialists. Patients referred here are more likely to receive guideline-based, comprehensive care. These centers are also the hubs for clinical trials and data registries, giving them an outsized influence on adoption trends.

 

Tertiary Hospitals
Large academic hospitals with cardiothoracic surgery and interventional cardiology programs manage a significant share of patients. Many perform pulmonary endarterectomy (PEA) and some are developing BPA capabilities. They often serve as referral points from regional hospitals, balancing both high-complexity procedures and follow-up care.

 

General Hospitals
Most general hospitals focus on diagnosis and stabilization. They initiate anticoagulation, perform imaging such as echocardiography or CT pulmonary angiography, and refer patients onward to specialized centers . Their role is crucial in identifying potential CTEPH cases early, even if they rarely manage definitive interventions themselves.

 

Diagnostic Imaging and Outpatient Clinics
These centers are not treatment providers but play a growing role in patient detection. As ventilation-perfusion (V/Q) scans and CT pulmonary angiography become more available, outpatient diagnostic centers are helping close the gap between missed and timely diagnoses. Their collaboration with referral hospitals is strengthening the overall care pathway.

 

Use Case Example
A tertiary hospital in South Korea faced rising referrals for suspected inoperable CTEPH. Historically, these patients were managed medically with limited improvement in long-term outcomes. The hospital invested in BPA capability, training interventional cardiologists in partnership with a Japanese center of excellence. Within a year, procedural success rates matched international benchmarks, with patients reporting significant improvements in exercise tolerance and quality of life. Importantly, the program reduced reliance on long-term high-cost therapies, easing the burden on the national insurance system.

 

This example highlights how end-user dynamics extend beyond individual patient care. They affect costs, resource allocation, and treatment equity. Specialized centers drive innovation, tertiary hospitals bridge access, general hospitals expand detection, and diagnostic centers improve the referral pipeline. The more cohesive the ecosystem, the greater the chance patients are diagnosed early and treated effectively.

 

Recent Developments + Opportunities & Restraints

Recent Developments (Last 2 Years)

• Bayer announced long-term registry data in 2023 showing durable outcomes of its soluble guanylate cyclase stimulator in inoperable CTEPH patients.

• Japanese centers published multicenter real-world results in 2024 that validated balloon pulmonary angioplasty (BPA) as a safe and effective option, reinforcing its global adoption.

• Terumo expanded its interventional cardiology portfolio in 2023 with new BPA catheter technology, designed to improve precision and reduce complication rates.

• Academic collaborations in Europe launched large-scale imaging studies using AI-driven V/Q scan interpretation to accelerate CTEPH diagnosis.

• Regulatory agencies in North America and Europe provided orphan-drug incentives in 2023–2024 for pipeline therapies, encouraging further R&D investment.

 

Opportunities

• Expanding BPA expertise beyond Japan and Germany offers room for global growth, especially in Asia Pacific and North America.

• Novel oral therapies, including next-generation soluble guanylate cyclase stimulators and prostacyclin analogs , promise recurring revenue streams and better long-term management.

• Digital health tools such as AI imaging and remote patient monitoring create opportunities for earlier detection and personalized follow-up care.

 

Restraints

• High cost and complexity of pulmonary endarterectomy and BPA procedures limit adoption in low- and middle-income regions.

• Limited awareness and delayed diagnosis remain persistent barriers, as many patients are treated for pulmonary embolism without recognition of progression to CTEPH.

• Shortage of specialized surgical and interventional expertise restricts procedural availability, even in developed regions.

 

7.1. Report Coverage Table

Report Attribute	Details
Forecast Period	2024 – 2030
Market Size Value in 2024	USD 1.7 Billion
Revenue Forecast in 2030	USD 2.7 Billion
Overall Growth Rate	CAGR of 6.8% (2024 – 2030)
Base Year for Estimation	2024
Historical Data	2019 – 2023
Unit	USD Million, CAGR (2024 – 2030)
Segmentation	By Treatment Modality, By Drug Class, By End User, By Geography
By Treatment Modality	Pulmonary Endarterectomy (PEA), Balloon Pulmonary Angioplasty (BPA), Pharmacotherapy
By Drug Class	Soluble Guanylate Cyclase (sGC) Stimulators, Prostacyclin Analogs, Endothelin Receptor Antagonists, Anticoagulants
By End User	Specialized CTEPH Centers, Tertiary Hospitals, General Hospitals, Diagnostic & Outpatient Centers
By Region	North America, Europe, Asia-Pacific, Latin America, Middle East & Africa
Country Scope	U.S., Canada, Germany, UK, France, Japan, China, India, Brazil, Saudi Arabia, etc.
Market Drivers	- Rising adoption of BPA as a minimally invasive therapy option - Expanding pipeline of targeted oral therapies - Growing establishment of specialized CTEPH referral centers
Customization Option	Available upon request