OD4954 Medical Couriers Industry Report

Medical CouriersAugust 2014 1
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Special delivery: As technology changes, demand

for specialized industry services will grow
IBISWorld Industry Report OD4954
Medical Couriers
August 2014
Daniel Carusotto
2 About this Industry
16 International Trade
28 Key Statistics
Industry Definition
17 Business Locations
28 Industry Data
Main Activities
Similar Industries
19 Competitive Landscape
Additional Resources
19 Market Share Concentration
28 Annual Change
19 Key Success Factors
3 Industry at a Glance
28 Key Ratios
29 Jargon & Glossary
19 Cost Structure Benchmarks

21 Basis of Competition
4 Industry Performance
22 Barriers to Entry
Executive Summary
22 Industry Globalization
Key External Drivers
Current Performance
Industry Outlook
11 Industry Life Cycle
23 Major Companies
24 Operating Conditions
24 Capital Intensity
13 Products & Markets
25 Technology & Systems
13 Supply Chain
26 Revenue Volatility
13 Products & Services
26 Regulation & Policy
15 Demand Determinants
27 Industry Assistance
15 Major Markets
www.ibisworld.com | 1-800-330-3772 | info @ibisworld.com
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About this Industry

Industry Definition
Medical couriers deliver medical

equipment to patients and healthcare
providers, and they deliver specimens
to medical laboratories for testing.
Some medical couriers carry donor
organs and recipient patients to
hospitals. Couriers are distinguished
Main Activities
The primary activities of this industry are
from other medical distributors by

features such as speed, security,
tracking, specialization and
individualization of services. This
industry excludes courier companies
that do not primarily serve healthcare
industries or patients.
Laboratory and specimen delivery services

Blood and tissue delivery services
Medical equipment warehousing and delivery services
Donor organ delivery services
The major products and services in this industry are

Blood and tissue delivery
Donor organ delivery
Laboratory and specimen delivery
Medical equipment warehousing and delivery
Similar Industries
62111a Primary Care Doctors in the US

Industry operators provide general and family physician services.
62191 Ambulance Services in the US
The industry includes private and municipal operators that provide transportation of patients by ground or
air, along with medical care.
62211 Hospitals in the US
The Hospitals industry includes firms licensed as general medical and surgical hospitals that provide surgical
and nonsurgical diagnostic and medical treatment to inpatients with medical conditions.
49222 Couriers & Local Delivery Services in the US
Couriers are establishments that primarily engage in delivery services between urban centers using a
network of air and surface transportation systems.
Additional Resources
For additional information on this industry

www.mcaa.com
Messenger Couriers Association of the Americas
www.bls.gov
US Bureau of Labor Statistics
www.census.gov
US Census Bureau
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Medical Couriers August 2014
Industry at a Glance
Medical Couriers in 2014
Key Statistics
Snapshot
Revenue
Annual Growth 09-14
1.5%
Annual Growth 14-19
Profit
Wages
Businesses
$3.8bn
3.1%
$308.7m $921.6m 7,463
Number of physician visits
Revenue vs. employment growth
% change
There are no
Major Players in
this industry
10
15
10
% change
Market Share
10
Year 06
08
10
12
Revenue
14
16
18
20
Year
08
10
12
14
16
18
20
Employment
SOURCE: WWW.IBISWORLD.COM
p. 23
Products and services segmentation (2014)
3.7%

Regulation
21.2%
Medical equipment
warehousing and delivery
Total health expenditure

Technological change
45.3%
World price of crude oil

External competition
Laboratory and
specimen delivery
29.8%
p. 4
Industry Structure
Life Cycle Stage

Revenue Volatility
Capital Intensity
SOURCE:
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SOURCE:
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Growth
Low
Medium
Regulation Level
Medium
Technology Change
Medium
Barriers to Entry
Low
Industry Assistance
Low
Industry Globalization
Low
Concentration Level
Low
Competition Level
FOR ADDITIONAL STATISTICS AND TIME SERIES SEE THE APPENDIX ON PAGE 28
Medium
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Industry Performance
Executive Summary | Key External Drivers | Current Performance

Industry Outlook | Life Cycle Stage
Executive
Summary
The Medical Couriers industry transports

medical equipment, specimens and organs
for participants in the healthcare and
pharmaceutical sectors. As a result of the
industrys connection to the healthcare
space, revenue for the industry tends to be
somewhat resistant to economic
downturns. Demand for medical courier
services relies heavily on healthcare
utilization rates, which IBISWorld
determines by looking at the number of
physician visits and total health
expenditure. Fortunately for industry
participants, the number of physician
Technological
advancements will boost

demand for specialized medical courier services
visits and total health expenditure have
increased over the five-year period to
2014, as a result of increased healthcare
coverage and the prevalence of chronic
disease. With healthcare utilization rates
increasing over the five years to 2014,
IBISWorld estimates that industry
revenue has grown at an annualized rate
of 1.5% to $3.8 billion over the period,
including growth of 4.5% in 2014 alone.
Aided by increased regulation and
demand from pharmaceutical companies
for a more controlled transportation

The number of physician visits is a proxy
for healthcare utilization. As individuals
use healthcare services more frequently,
demand for transporting medical products
increases. This driver is expected to
increase in 2014, representing an
opportunity for the industry.
Regulation
Heightened regulation in the healthcare
sector can result in stricter transportation
requirements for healthcare providers
environment, the Medical Couriers

industry has experienced stable demand.
Regulations on perishable healthcare
cargo specify that when transporting
certain products, the internal temperature
must remain within a certain range,
typically between 15 and 25 degrees
Celsius. As a result of these specifications,
coupled with the sensitive nature of the
products industry participants transport,
medical couriers have become increasingly
important in the healthcare and
pharmaceutical sectors supply chain. As a
result of increased demand for industry
services from pharmaceutical companies
and other customers, profit margins have
expanded over the five years to 2014.
In the coming five years, similar trends
are expected to persist, resulting in solid
demand for industry services. Healthcare
utilization rates will grow at a faster rate
than in the previous five years, as the
Patient Protection and Affordable Care
Act increases the number of individuals
with healthcare coverage. As a result, over
the period IBISWorld expects industry
revenue to grow at an annualized rate of
3.1% to $4.4 billion in 2019. While
demand for industry services will increase,
competition from the general courier
industry is expected to intensify as
companies such as FedEx continue their
push into the healthcare transport space.
and medical product manufacturers. In

turn, demand for specialized medical
courier services rises. Regulation is
expected to increase in 2014.
Total health expenditure is used as a
proxy for healthcare utilization. The level
of spending on healthcare services
usually dictates the level of demand for
medical couriers. When expenditure on
healthcare is high, healthcare providers
require medical couriers to deliver
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supplies, medicine and lab samples. In

2014, IBISWorld expects total health
expenditure to increase.
Technological change
Technological developments within the
industry make medical courier services
more valuable to customers. Additionally,
technological advancements in the
industrys markets, such as the
biotechnology industry, result in stronger
need for specialized couriers to deliver
more time- and temperature-sensitive
materials. This driver is expected to
increase in 2014.
World price of crude oil
The price of fuel affects industry
profitability. Medical couriers transport
products, materials and specimens

locally and internationally. Couriers are
increasingly global in scope. This global
reach makes fuels costs a larger
percentage of total costs. The world
price of crude oil is expected to increase
slowly in 2014.
The industry faces a high level of
external competition for delivery
services. External competitors include
large couriers that do not specialize in
medical products and healthcare
providers and medical manufacturers
performing courier services
internally. This driver is expected to
increase in 2014, thus posing a threat
to the industry.

15
10
% change
% change

continued
5
0
5
Year
5
4
08
10
12
14
16
18
20
Year
08
10
12
14
16
18
20
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The Medical Couriers industry has fared

well over the five years to 2014, as a rise
in the number of physician visits and
total health expenditure has buoyed
demand for industry services. Despite
tough economic conditions, consumers
increased their use of healthcare services,
which required healthcare providers to
rely on couriers to pick up and deliver
medical supplies, lab samples and
organs. Additionally, increasing
regulations on the transportation of
potentially infectious substances has
increased the importance of medical
couriers in the healthcare sectors supply
chain. As a result, in the five years to
2014, IBISWorld expects industry
revenue to increase at an annualized rate
Healthcare Utilization The Medical Couriers industry serves
Regulation makes
specialized couriers
more valuable
Industry revenue
6
4
% change
Current
Performance
2
0
2
Year 06
08
10
12
14
16
18
20
of 1.5% to $3.8 billion, including growth

of 4.5% in 2014 alone.
many segments of the healthcare sector,

including managed care organizations,
which consists of doctors, clinics and
hospitals and biotech companies that
develop different drugs and vaccinations.
Overall, the industry benefits from a
population that utilizes healthcare
services at a high rate, which typically
leads to demand for medical supplies
transportation. Fortunately for industry
participants, indicators of healthcare
utilization such as total health
expenditure and the number of physician
visits have experienced solid growth in
the five years to 2014. Over the five-year
period, total health expenditure and the
number of physician visits have increased
at annualized rates of 4.3% and 2.1%,

respectively, benefiting demand for
industry services.
Population growth has been partly
responsible for the increase in the
number of physician visits. Additionally,
according to the US Department of
Health and Human Services the number
of physician visits has increased from 3.4
visits per person in 2009 to an estimated
3.6 visits in 2014. Growth in the number
of visits per person is largely due to the
prevalence of chronic diseases, increased
health coverage and an aging population.
The more visits a person makes to a
physician, the more likely lab work or
other procedures will be required,
increasing demand for courier services.
Regulations on perishable healthcare cargo

frequently change, making it expensive and
burdensome for healthcare providers and
manufacturers to comply with all the
necessary regulations. It is essential that the
integrity of healthcare products and devices
not be compromised as they are packaged
and shipped. The responsibility falls on the

manufacturer for any undesirable effects if
products are packaged or shipped in
improper conditions or at temperatures that
are too high.
The majority of biotech products
require refrigerated storage and
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Regulation makes
specialized couriers
more valuable
continued
transportation, as do most vaccines,

blood products and other injectable
medicines. The regulatory requirements
for what has traditionally been called
controlled room temperature (CRT)
storage and transportation are
tightening; this regulation covers the
majority of all pharmaceuticals. CRT
regulations mandate that packages be
kept at a temperature range of roughly
between 15 and 25 degrees Celsius,
through the use of packaging or thermal
blankets covering pallets. Evolving
regulations require temperature
monitoring and, in some cases,
documenting the shipment transit.
Containers need to be serviced when they
contain refrigerants or battery power,
and the deliveries have a precise time
limit that conventional package delivery
often cannot adhere to. In addition to the
refrigerated requirements, there are new
regulations for CRT delivery.
Manufacturers and distributors are
struggling to meet CRT requirements
uniformly around the world, and these
requirements are becoming present in
more countries for medical
transportation. Concurrently,
healthcare providers are battling with
cost pressures from government and
private payers. Many healthcare
industries have had to cope with lower
reimbursement rates from Medicare or
threats of future cuts. These regulation
issues represent a challenge for
manufacturers and providers to meet,
and the solutions tend to add to
company costs. Even temporary
temperature fluctuations called
shipping excursions can make medical
supplies unusable. A shipping excursion
is a negative event that occurs during
shipping, wherein the product exceeds
its specified temperature limits. The
average cost for shipping excursions
can exceed $150,000. For a large
pharmaceutical company, which may
have numerous studies per year, such
Facing
drops in demand,
general couriers have
started to provide medical
courier services
excursions may multiply costs by
millions of dollars. Consequently, the
outsourcing of courier processes to
specialist firms grows more appealing
as regulation standards increase. In the
meantime, the technology that industry
operators use to monitor, record and
report transportation conditions is
advancing rapidly. Due to the value that
medical couriers provide, along with
increased demand, industry profit
margins have expanded over the
five-year period.
Technological developments and rising
regulatory standards have been leading
to a need for more skilled and trained
labor in the industry. Employees and
independent contractors need to learn
the applicable regulations (e.g.
Occupational Safety and Health
Administration and Health Insurance
Portability and Accountability Act rules)
and keep abreast of changes in the laws
that affect medical courier companies. In
the five years to 2014, IBISWorld expects
annualized employment growth of 1.7%
to 30,368.
The biotechnology sector is a large
user of CRT shipping due to the sensitive
nature of the sectors products. According
to the Journal of Pharmaceutical and
Biopharmaceutical Contract Services cold
chain biopharma products are projected
to grow over 27.0% between 2008 and
2011 (latest available data). Growth in
this segment has increased the number of
Medical Couriers industry entrants. As a
result, IBISWorld estimates that industry
establishments will increase at an
annualized rate of 2.4% to 9,899 over the
five years to 2014.
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Competition
The growth in medical courier services

has not gone unnoticed by medical device
and product distributors and general
couriers. General couriers and
distributors have been struggling in
recent years due to technological
developments, such as digital documents
and fax and email systems that have
rendered their services less valuable.
As a result, other types of couriers
and distributors have started to provide
medical courier services. For instance,
the US Postal Service (USPS) has been a
major competitor for couriers. The USPS
offers a nationwide network of shipping

and receiving hubs as well as a fleet of
transportation options including ground
and air. Moreover, the USPS charges
competitive rates compared to most
privately held medical courier
companies. Given the resources,
manpower and geographic reach of the
USPS, larger industry operators may
find it difficult to compete. Although the
USPS provides competitive services, it
does not have many of the value-added
and specialized services that dedicated
medical couriers offer.
Industry
Outlook
As a result of the implementation of the

Act (PPACA), more individuals are
expected to have some form of healthcare
coverage, which is expected to benefit
healthcare utilization rates. Higher
utilization rates generally translates to
stronger demand for courier services due
to more lab tests and other services being
conducted by the healthcare industry.
Additionally, the race to create new drugs

by biopharmaceutical companies will
increase demand for couriers who can
transport temperature-sensitive
materials in a timely manner. As a result
of these positive trends, in the five years
to 2019, IBISWorld expects industry
revenue to increase at an annualized rate
of 3.1% to $4.4 billion, including growth
of 4.6% in 2015 alone.
Affordable Care Act
Demand for medical courier services will

rise as healthcare utilization increases
during the five years to 2019. For
instance, as more patients visit
physicians, more lab specimens will need
to be transported between healthcare
sites. Healthcare utilization rates in the
United States are projected to continue to
grow in the five years to 2019 when
health insurance exchanges and
subsidization of insurance premiums will
be established for individuals with
income less than 400.0% of the national
poverty line. The health insurance
exchange will be a new entity intended to
create a more organized and competitive
market for health insurance by offering a
choice of plans, establishing common
rules regarding offering and pricing
As
more people seek

healthcare, demand for
medical courier services
will increase
insurance, and providing information to
help consumers better understand the
options available to them.
These initiatives, which are part of the
Act (PPACA) of 2010, are forecast to
increase the number of individuals with
healthcare coverage. Since insurance
coverage reduces the patients out-ofpocket expense for physician visits and
prescription drugs, patients will be better
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Affordable Care Act

continued
able to afford visits to the doctor and the

cost of medicine. While doctor
appointments will be more affordable,
IBISWorld data suggests that the health
of the US population will further decline.
Chronic health ailments, such as obesity
and diabetes, as well as the continued
aging of the population, will augment
healthcare utilization in the United
States, as these patients increasingly
require check-ups.
The PPACA also created an approval
pathway for generic versions of biologic
drugs called biosimilars. These drugs
tend to be very sensitive to climate
changes, otherwise their beneficial

properties may be lost. As a result, a
major factor in maintaining the integrity
of biopharmaceuticals is to carefully
monitor the storage and temperature
conditions during transport. According
to Pharmaceutical Commerce, a news
provider for biopharmaceutical
companies, seven of the top 10 global
pharmaceutical products in 2014 will
require cold-chain handling. Due to
explosive growth in this segment and
the biopharmaceuticals sensitive
nature, medical couriers will continue
to grow in importance.
Technological
advances lead to
further globalization
and strong demand
Further technological developments are

forecast for the packaging and equipment
used to transport temperature-sensitive
medical materials. Manufacturers of
these inputs have been investing heavily
in research and development in
anticipation of further globalization.
Globalization is forecast to increase,
partly due to improved capabilities of the
packaging and transport equipment, but
also due to other factors. These drivers
include economic recoveries and
development around the globe, and
heightened public sector assistance for
exporting companies.
Brand-name pharmaceutical
manufacturers based in the United States
are losing profitability due to the patent
cliff, whereby several blockbuster drug
patents are expiring and generic versions
are taking market share. In response to
lower profitability and higher regulatory
costs in the United States, drug
manufacturers are forecast to
progressively conduct clinical trials and

manufacture key ingredients abroad.
Moreover, pharmaceutical manufacturers
are expected to continue to emphasize
biologic drugs, which are more
temperature sensitive than small
molecule synthetic drugs. These global
activities will drive heightened need for
specialized courier services. While
globalization offers many benefits for
trial sponsors, it also creates significant
logistical challenges. Effective
management of the clinical supply chain
for large, multinational trials requires
centralized coordination and countryspecific knowledge to maintain reliable
deliveries and avoid costly delays. As a
result, medical companies are forecast to
increasingly rely on medical couriers that
can meet their complete clinical trial
logistical requirements. Industry
operators are expected to further
augment their services to meet the needs
of customers in response.
Increased
competition
In the previous five-year period,

general couriers began to push into the
medical couriers space. Companies
such as FedEx and UPS began to offer
healthcare clients more affordable

solutions for their shipping needs. For
example, FedEx now offers
temperature-controlled shipping with
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Increased
competition
continued
tracking options that give clients

real-time updates on the status of their
packages. In the coming five years,
general couriers are expected to
continue making a push into this niche
segment, effectively pressuring profit
margins for traditional medical
couriers. Further pressuring profit
margins will be the entrance of new
participants. As a result of the generally
low barriers to entry, smaller
establishments will begin to pop up,
aiming to serve niche segments of the
Medical Couriers industry. In the five
Technological
advancements and the

resulting growth potential
will entice new entrants
years to 2019, IBISWorld expects the
number of establishments to grow at an
annualized rate of 2.9% to 11,416.
Employment will follow, growing at an
annualized rate of 2.5% to 34,292 over
the same period.
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The value that the industry adds to the overall
economy is forecast to grow faster than US GDP
Life Cycle Stage
The industry invests heavily in

technological developments
% Growth in share of economy
The number of industry operators

is forecast to increase
20
Maturity
Quality Growth
Company
consolidation;
level of economic
importance stable
High growth in economic

importance; weaker companies
close down; developed
technology and markets
15
Key Features of a Growth Industry

Revenue grows faster than the economy
Many new companies enter the market
Rapid technology & process change
Growing customer acceptance of product
Rapid introduction of products & brands
10
Quantity Growth
Many new companies;

minor growth in economic
importance; substantial
technology change
Specialty Hospitals
Laboratory Testing Services
0
Medical Couriers
Primary Care Doctors
Couriers & Local Delivery Services
Decline
-5
Shrinking economic
importance
-10
-10
-5
10
15
20
% Growth in number of establishments

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Industry Life Cycle

This
industry
is G
rowing
The Medical Couriers industry in the

growth phase of its economic life cycle;
this stage is characterized by
establishment growth, rapid
technological change and new types of
buyers. Industry value added (IVA),
which measures an industrys
contribution to the overall economy, is
expected to increase at an annualized rate
of 3.4% over the 10 years to 2014. In
contrast, US GDP is projected to grow at
an annualized rate of 2.5% during the
same period. Typically, an industry is
considered to be in the growth stage of its
economic life cycle when growth in IVA
trends at a faster rate than GDP growth
over a 10-year period.
Over the 10 years to 2019, the
industry is set to expand with the
number of enterprises forecast to
increase at an annualized rate of 2.3% to

reach 8,593 companies. As biosimilars,
along with biopharmaceutical products
continue to be developed, medical
couriers will be needed to transport
these sensitive products. Growth from
this market is expected to be extremely
strong in the coming five years
benefiting industry participants.
Further cementing this industry in a
growth phase is the implementation of
Act (PPACA) of 2010. This act is
supposed to increase the number of
individuals with health coverage,
which should effectively increase
healthcare utilization rates. Rising
utilization rates generally lead to
increased lab tests and heightened
demand for medical courier services.
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Products & Markets
Supply Chain | Products & Services | Demand Determinants

Major Markets | International Trade | Business Locations
Supply Chain
KEY BUYING INDUSTRIES

54138
Laboratory Testing Services in the US

Laboratories use medical couriers to transport samples (i.e. blood and urine).
62111a
Primary Care Doctors in the US

Doctors use medical couriers to transport medical samples.
62211
Hospitals in the US
Hospitals use medical couriers to transport medical supplies, samples and organs.
62231
Specialty Hospitals in the US

Specialty hospitals use medical couriers to transport medical supplies, samples and organs.
KEY SELLING INDUSTRIES
Products & Services
33341
Heating & Air Conditioning Equipment Manufacturing in the US

Operators in this industry manufacture cooler equipment for medical couriers to transport
temperature sensitive deliveries.
33641a
Aircraft, Engine & Parts Manufacturing in the US

Operators in this industry manufacture planes for medical couriers to use to make deliveries.
44719
Gas Stations in the US

Medical couriers get fuel to make deliveries from gas stations.
Laboratory and specimen delivery

Laboratory and specimen delivery is
expected to generate 45.3% of industry
revenue in 2014, and primarily consists
of services related to clinical trial
logistics. At the larger medical courier
companies, such as World Courier Inc.
these services include complete logistics
services across the full cycle of the clinical
trial. First, the company provides pretrial coordination services between
biopharmaceutical companies,
laboratories and other organizations
involved in the trial. Logistics of
transport follows, which includes
packaging, scheduling and routing trial
materials. Often, transportation of
laboratory specimens necessitates the use
of temperature-controlled containers
combined with dry ice. Dry ice is used
extensively in shipping to maintain a
frozen state for a period of one to four
days and is used in the transport of many
biological products, such as
pharmaceuticals, laboratory specimens
and certain infectious materials that do
not require true cryogenic temperatures.
In some cases, the limitations of dry ice

necessitate the use of liquid nitrogen as
well. In addition to the actual
transportation of medical samples, some
companies assist with regulatory and
permit issues in addition to managing the
transportation of bulk drugs and supplies
into and out of countries other than the
United States. Finally, services extend to
management of patient samples and the
destruction of laboratory waste. As the
regulatory environment for clinical
testing becomes more restricted in the
United States, more industry players will
have to provide international services
similar to World Courier.
Companies that do not operate on a
global basis typically do not provide the
same set of services for clinical trials.
These companies tend to focus more on
the packaging and transportation of
samples and medical supplies in addition
to customer relations services. More
recently, such companies have started to
expand their services by providing a more
comprehensive solution that often goes
beyond transportation.
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Products & Markets
Products & Services

continued
Products and services segmentation (2014)
3.7%
21.2%
Medical equipment
45.3%
Laboratory and
specimen delivery
29.8%
Total $3.8bn

Blood and tissue delivery services are
expected to generate 29.8% of industry
revenue in 2012, and are typically
confined to the domestic marketplace.
Hospitals and primary care physicians
commonly use these services to outsource
blood and tissue samples for testing.
Similar to laboratory and specimen
delivery services, the transportation of
blood and tissue requires the use of
temperature controlled storage
mechanisms, which become more
advanced depending on the distance
required for transport. The scope of the
courier company relates to the quality
and quantity of service options available.
For example, some couriers are able to
offer door-to-door service with no
exchanges. Most industry participants
provide these services on a regional
basis and often maintain long-term
contracts with hospitals and other
healthcare providers.
Medical equipment
The regional scope of many industry
participants limits their ability to
maintain stocked warehouses, but those
companies with a nationwide presence
will often make the investment in
facilities and infrastructure to

successfully provide this service. For
example, World Courier offers clients
access to several depot locations around
the world, which allows the company to
service hospitals and biopharmaceutical
companies no matter where they are
located. As part of the service, clients are
able to keep extra supplies that may be
necessary for a particular scenario close
to the operation. Industry participants
then deliver the supplies and deliver it on
call, often around the clock. In 2014, this
product segment is expected to generate
21.2% of industry revenue.
While donor organ delivery services
make up the smallest segment of
industry revenue, they often require the
most accurate transportation procedures
and execution because of their
sensitivity. Industry participants are
on-call every day in the event that an
organ needs to be transported from
hospital to hospital. Additionally, the
transportation of organs demands the
same temperature-controlled storage
units as used for blood and tissue
samples. In 2014, IBISWorld estimates
donor organ delivery services to
generate 3.7% of industry revenue.
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Products & Markets
Demand
Determinants
Major Markets
Demand for medical couriers depends on

several factors, including the demand for
healthcare services in the United States. In
particular, the number of physician visits
acts as a proxy for such demand and is
expected to increase at an annualized rate of
2.1% in the five years to 2014. An increase in
the number of physician visits correlates to
more shipments of medical supplies and test
samples, which drive industry revenue. In
the five years to 2019, this figure is
forecasted to increase at an annualized rate
of 2.2%, further driving demand for industry
services. While increased demand for
healthcare services helps the industry, such
demand also leads to increased regulation of
medical transportation services by state and
federal authorities. Although the rise in
regulation causes industry participants to
adjust their services, it also pushes out
third-party healthcare providers and
medical product manufacturers from
developing their own transportation
services. As a result, demand for industry
services increases as these companies
outsource to medical couriers.
Over the past five years, globalization

has become a larger part of the industry
because many biopharmaceutical and
biotechnology companies have started to
conduct the majority of their research
outside of the United States due to
domestic regulations. Furthermore,
increases in total exports have resulted in
higher demand for medical couriers
because more medical supplies are being
shipped internationally.
With healthcare companies becoming
increasingly more comprehensive,
external competition has increased for the
industry. Healthcare providers and
medical manufacturers have started to
develop their own medical transportation
services, which has taken a bite of out of
industry revenue. Furthermore, larger
couriers, such as FedEx, have started to
offer specialized medical courier services.
FedExs presence in the business poses a
major threat to industry demand because
the company has a much larger
transportation system compared to any
industry operators.
Major market segmentation (2014)
16.8%
Other
48.7%
34.5%
Managed care organizations
Commercial clients
Total $3.8bn
Managed Care Organizations
Managed care organizations are
expected to account for 48.7% of
industry revenue in 2014. Managed

Care Organizations consists of a group
of doctors, clinics, hospitals, and other
WWW.IBISWORLD.COM
Products & Markets
Major Markets
continued
International Trade
providers that work together to take

care of a patients needs. Medical
couriers transport a range of medical
supplies, samples and organs between
hospitals, doctors and clinics. Due to
the large volume of patients manage
care organizations deal with, they are a
major customer of courier
establishments. This segments share of
revenue has stayed fairly stable over the
five-year period as a steady flow of
patients through good and bad
economic times has caused demand
from this segment to be steady.
operators to make deliveries from

pharmacies to customers homes; from
institutional pharmacies to long-term
care homes and assisted-living care
facilities, from wholesale pharmacies to
retailers and from one pharmacy to
another. Some companies also provide
transportation services for timesensitive radioactive medicines that are
used to treat cancer patients.
Commercial Clients
Commercial clients are the Medical
Couriers industrys second largest
market and in 2014, are expected to
account for 34.5% of industry revenue.
Commercial clients are comprised of a
wide range of customers and include
businesses performing drug screening
on their employees, biopharmaceutical
companies requiring samples to be
transported, pharmacies and dental
labs. Pharmacies are large clients of
medical couriers and require industry
Other
Other markets consist of blood banks,
public health departments, imaging
centers, and private patients among
other customers. In 2014, IBISWorld
expects other customer market segments
to account for 16.8% of industry
revenue. Blood banks tend to be a large
customer of the Medical Couriers
industry and rely on industry
establishments to transport blood from
blood banks to hospitals for routine
scheduled restock. Industry firms also
provide cross-match services, which
include delivering specific patient blood
samples to a blood bank in an effort to
find a similar match.
The Medical Couriers industry has a

low level of international trade
because medical couriers primarily
operate on a domestic basis due to
federal regulations restricting the

transport of medical supplies,
prescriptions and hazardous samples
across US borders.
WWW.IBISWORLD.COM
Products & Markets

Business Locations 2014
West
New
England
AK
0.5
Great
Lakes
WA
ND
MT
2.2
Rocky
Mountains
ID
OR
1.6
West NV
0.9
1.7
SD
0.5
WY
0.8
MN
0.4
0.7
Plains
CO
1.1
KY
1.0
OK
0.9
NC
3.0
TN
AZ
NM
2.1
0.9
Southwest
TX
7.6
HI
0.4
Additional States (as marked on map)

1 VT
2 NH
3 MA
4 RI
5 CT
6 NJ
7 DE
8 MD
0.2
1.0
0.5
3.0
1.9
0.4
SC
Southeast
1.1
MS
AL
1.4
1.3
GA
3.0
0.9
LA
1.3
FL
6.5
Establishments (%)
0.2
1.4
AR
0.7
4.2
10.9
WV VA
2.5
1.6
1.8
CA
West
2.9
MO
KS
2.1
OH
1.9
3.2
3.7
IN
IL
0.8
UT
PA
2.8
1.1
0.6
1 2
3
NY
6.5
5 4
MI
1.8
IA
NE
0.4
WI
ME
MidAtlantic
9 DC
0.2
Less than 3%
3% to less than 10%
10% to less than 20%
20% or more
WWW.IBISWORLD.COM
Products & Markets
West
The West region is home to 16.5% of
industry establishments while
accounting for 17.1% of revenue. This
region houses California which
accounts for more industry
establishments than any state (10.9%).
This region is popular due to its densely
populated areas, which are flooded with
doctors and hospitals. According to
American Hospital Directory, California
has more hospitals than any other state
30
20
10
Southwest
Southeast
Rocky Mountains
Plains
New England
Mid-Atlantic
0
Great Lakes
Southwest
The Southeast region is home to 27.2% of
industry establishments while accounting
for 25.4% of the overall population. This
region houses Florida, which accounts for
6.5% of industry establishments. The
Southwest region is a popular location for
smaller couriers as a result of the elderly
population who typically are frequent
visitors of doctors. The more a patient
goes to a doctor the more likely tests such
as blood work are performed, requiring
medical courier services.
Distribution of establishments vs. population
West
Like the general courier industry, the

geographic spread of medical couriers
establishments closely mirrors the
distribution of the population. As a result
of densely populated areas typically
having a higher proportion of healthcare
facilities, the need for courier services is
generally higher.
Business Locations
Establishments
Population
with 349. The more hospitals there are

in a region, the more likely courier
services will be needed.
Other
The Mid-Atlantic is home to 15.2% of
hospitals while housing 15.5% of the
population. The Great Lakes and the
Southwest hold a large number of
establishments with 12.6% and 11.4%
respectively. These two regions tend to
more spacious and less densely
populated, as a result medical courier
services are less prevalent in these areas.
WWW.IBISWORLD.COM
19
Competitive Landscape
Market Share Concentration | Key Success Factors | Cost Structure Benchmarks

Basis of Competition | Barriers to Entry | Industry Globalization
Market Share
Concentration
Level
Concentration
in
this industry is L ow
Key Success Factors

IBISWorld
identifies
250 Key Success
Factors for a
business. The most
important for this
industry are:
Cost Structure
Benchmarks

low level of market share concentration
with the largest firm in the industry
accounting for less than 2.0% of
industry revenue. The industry is highly
fragmented with an estimated total of
9,899 establishments in the industry.
While some operators operate on a
national basis, the majority of
establishments seek to serve a local
area. This strategy allows companies to
build relationships with clients and
save on fuel costs. With barriers to
entry being fairly low entrants can

come and go as they please, leading
competition within the industry to be
fairly high and market share
concentration to be low.
In the coming five years, market share
concentration is expected to remain low
as the majority of industry participants
will operate on a regional basis.
Competition from general couriers such
as FedEx and UPS is expected to
increase, taking away potential revenue
for industry participants.
Ability to pass on cost

increases to clients
Operating costs in this industry are
high and margins are low, so it is
important that participants are able to
pass on cost increases to clients to
maintain profit margins.
Ability to utilize technology

advancements
The use of up-to-date technology is essential
for couriers to maintain productivity and
reliability. Clients also demand technologies
for tracking and verifying deliveries.
Optimum capacity utilization

Margins per delivery are low, so it is
important for firms to maintain a high
frequency of deliveries to use assets
and maintain profitability.
Effective quality control

Service providers often deliver packages and
other items that are perishable or time
sensitive, so it is vital for industry
participants to have control systems in place
that ensure deliveries are not lost or delayed.
Profit
The industrys profit margin is expected to
account for 8.2% of industry revenue in
2014, up slightly from 6.0% in 2009. Even
though the US economy experienced a
severe recession, the healthcare industry
was somewhat shielded benefiting
industry operators. From 2008 to 2009,
total health expenditure increased by 3.7%
despite GDP contracting by 2.8%,
effectively benefiting industry
participants. Despite solid demand over
the five-year period, profit margins have
only expanded slightly, as robust margin
expansion has been kept in check by rising
fuel costs and increased competition both
internally and externally.
Wages
The industry relies on labor to pick up
and drop off medical supplies, lab
samples and organs, as a result wages
represent a significant expense in an
establishments cost structure. According
to IBISWorld estimates, in 2014, wages
will account for 26.4% of industry
revenue. The business model for the
industry is particularly dependent on
independent contractors, which are used
in addition to dedicated employee
resources. Medical couriers follow an
on-demand, often unscheduled delivery
model. This model requires a varying
number of courier drivers on any given
day and time to complete a set service.
WWW.IBISWORLD.COM
20
This lack of consistency makes it

impractical to hire a staff of full-time
employees. By hiring a large amount of
independent contractors, industry
establishments are able to keep costs
down while still having enough staff to
keep up with demand. Wages have been
increasing in recent years due to
requirements for more skilled labor.
Changing regulations force companies to
frequently retrain employees, thus
heightening labor expenses. To minimize
costs, larger couriers must effectively
manage staff, employ part-time workers
and take advantage of technology that
automates various delivery processes.
Purchases
In 2014 IBISWorld expects purchases to
account for 24.0% of revenue. The
industrys largest expense relates to fuel
costs. The industrys main mode of
transportation are planes and cars,
leading the cost of fuel to be significant.

The price and use of fuel can fluctuate
dramatically on a year-over-year basis.
However, to offset the volatility of fuel
markets, some operators have fuel
managers that are responsible for
hedging against any fluctuations in price
by buying futures or maintaining
distribution contracts with suppliers that
keep costs fixed over a certain period of
time. Likewise, local messengers and
delivery services generally experience
lower purchase costs as short distances
and cheaper modes of transportation
allow for fewer purchases.
Fuel prices have risen steeply during
the five years to 2014 for numerous
reasons. These reasons include growth in
India and China, more challenging access
to oil and unrest in major oil countries
(e.g. Iran and Nigeria). Fluctuating
exchange rates and mounting investment
activity in oil futures have also caused oil
Sector vs. Industry Costs
100
Average Costs of
all Industries in
sector (2014)
Industry Costs
(2014)
8.5
8.2
Profit
Wages
Purchases
Depreciation
Marketing
Rent & Utilities
Other
24.5
80
Percentage of revenue
Cost Structure
Benchmarks
continued
43.4
60
40
20
24.0
3.5
6.2
17.9
2.9
6.1
19.0
2.5
2.3
31.1
0
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21
Cost Structure
Benchmarks
continued
prices to soar. Additionally, the easiest oil

to extract has already been extracted, and
now every barrel taken from the ground
costs more than the one before it. The
rising political instability in many of the
leading third-world countries in
petroleum production is a further reason
for rising prices.
Other purchases for medical couriers
include dry ice and other cooling agents
used to keep temperature sensitive
materials such as organs safe. Industry
participants must also purchase latex
gloves and packaging materials.
Rent and utilities
In 2014, IBISWorld estimates that rent
and utilities will make up 6.2% of an
establishments costs structure.
Operators in this industry may have a
physical location to store items waiting to
be delivered. Additionally, operators
need a physical location to meet with
potential clients. In this physical location,
operators will usually employ a
dispatcher who is watching the location
Basis of Competition
Level & Trend
ompetition
C
in
this industry is
Mediumand the
trend is I ncreasing
Internal competition
medium level of internal competition.
Medical couriers compete on the basis of
price, quality of service, number of
available shipping options and
transportation range. Large players in
the industry are able to gain an
advantage from economies of scale,
meaning they can lower variable costs by
offering services domestically and
internationally. For example, World
Courier is able to offer lower prices on
all of their products because they make
more deliveries than most other industry
players. On the other hand, small-sized
medical couriers typically take
advantage of regional knowledge and
relationships to build their businesses
around a specific group of clients.
of all the vehicles in operations,

communicating with employees
constantly keeping them update to date
on statuses of pick-ups and deliveries.
Depreciation
In 2014, depreciation costs are expected
to account for 3.3% of revenue. Some
industry operators employ independent
contractors who use their own vehicles,
effectively keeping depreciation costs
low. Other establishments within the
industry may provide workers with
company vehicles, these companies will
have higher depreciation costs, as the
cost of the vehicle is depreciated over
time. Other depreciation expenses relate
to the purchases of tracking material
such as GPSs and dispatching systems.
Other expenses
Other expenses include license and
registration fees, insurance premiums,
tolls, cleaning costs, fines, and repairs. In
total, these costs are expected to add up
to 29.4% of revenue in 2014.
Recently, medical couriers have been

competing to offer a more comprehensive
solution to their clients. For example,
industry players go beyond traditional
courier services to provide supply chain
analysis, inventory control, organization
of clinical trial logistics and operational
efficiency control.
Over the past five years, external
competition has been increasing for this
industry. Biopharmaceutical companies
and hospitals have been developing
internal courier services to lower costs
associated with outsourcing to industry
participants. Additionally, many
mainstream traditional couriers, such as
FedEx, UPS and DHL have been
investing in acquisitions of medical
WWW.IBISWORLD.COM
22
Basis of Competition
continued
couriers and developing their own

transportation solutions for healthcare
clients. For example, FedEx launched a
healthcare solutions business unit in
Barriers to Entry
The Medical Couriers industry is

comprised of two subsectors with
different barriers to entry. Barriers are
higher for global medical couriers as
these participants are required to set up
vast distribution networks containing
sophisticated technological systems,
specialized transportation containers and
a variety of vehicles. Large-scale couriers
must compete with well-established
mainstream courier services (i.e. FedEx,
UPS and DHL) and their entrenched
brand power. In contrast, local deliverers
often do not require an integrated
network of transportation systems, so
barriers to entry are low.
Technically, anyone with a vehicle and
communication equipment, such as a
mobile phone, can operate a medical
courier business. However, these
participants have low bargaining power
as they rely on a niche market or specific
metropolitan area for business and often
lack the proper equipment to transport
medical samples, blood and organs. In
contrast, larger couriers must purchase
Level & Trend

arriers to Entry
B
in this industry are

Lowand S
teady
Industry
Globalization
Level & Trend
lobalization
G
in
this industry is
Lowand the trend
is I ncreasing
The Medical Couriers industry is

increasingly expanding operations to
foreign nations. In particular,
biopharmaceutical companies have started
to demand better international
transportation services because they have
started to move their clinical trials overseas.
Nevertheless, the majority of medical
2012 that uses the companys ground,

express and custom critical shipping
solutions to provide healthcare clients
with a global closed loop service option.
Barriers to Entry checklist

Competition
Concentration
Life Cycle Stage
Capital Intensity
Technology Change
Regulation & Policy
Industry Assistance
Level
Medium
Low
Growth
Medium
Medium
Medium
Low
specialized machinery, vehicles and

aircraft or build strong relationships with
airline companies. These companies also
rely on skilled labor as delivery personnel
are required to have commercial driving
licenses, pilot licenses and knowledge of
medical packaging equipment. A high
level of capital investment is also needed
for delivery systems that allow customers
and couriers to track packages and
confirm deliveries. These systems are
essential for improving productivity and
efficiency, particularly for firms that
operate on an international basis.
couriers generally do not have any foreign

operations. However, there are a few
exceptions, such as World Courier, which
provides services in more than 52 countries.
The company has rapidly developed its
international operations in response to
increased demand for transportation
logistics in emerging markets.
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Major Companies
There are no Major Players in this industry | Other
Other Companies
The Medical Couriers industry is highly

fragmented with the average
establishment employing less than five
people and accounting for well under
1.0% of industry revenue. These
establishments operate primarily on a
regional basis and compete on
reputation, price and range of service
offerings. To gain an advantage over
larger competitors, many smaller
companies have been expanding into
logistics. Furthermore, some companies
are even building relationships with
manufacturers and wholesalers to
provide supply chain analysis and
management services.
World Courier Inc.
Estimated market share: Less than 1.5%

Founded in 1969 and headquartered in
New Hyde Park, NY, World Courier Inc.
is a significant player in the Medical
Couriers industry. The company is a
provider of logistics and supplier of
transportation, storage and distribution
services for multinational
biopharmaceutical clinical trials. The
company currently has over 500

biopharmaceutical companies as clients.
World Courier has annual revenue of
over $500.0 million and operates 150
locations globally, with two located in the
United States. The companys integrated
network and technology offers solutions
to clients across the whole supply chain.
World Courier Inc. is the only courier
operating on a global scale that is
compliant with the generally accepted
biopharmaceutical good practice
standards (GxP).
After being approached by both UPS
and AmerisourceBergen, World Courier
Inc. was eventually bought by
AmerisourceBergen for $520.0 million in
2012, and now operates as a subsidiary of
the company. The companys scale has
allowed it to offer more services at a
lower price compared to the internal
operations of many biopharmaceutical
companies. IBISWorld expects the
company to generate more than $500.0
million in industry-specific revenue,
with less than $50.0 million coming
from US operations.
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Operating Conditions
Capital Intensity | Technology & Systems | Revenue Volatility

Regulation & Policy | Industry Assistance
Capital Intensity
Level
The level
of capital
intensity is M
edium

moderate level of capital intensity. The
average industry operator allocates $0.14
toward capital investment for every one
dollar spent on labor. Wages account for
a high proportion of revenue (24.5% in
2014). The industry relies on skilled
employees to transport materials and
meet strict regulatory and customer
standards. Labor expenses include the
wages and salaries paid to drivers,
ground staff and administrative staff.
While wages do account for a significant
expense, industry operators keep wages
costs to a minimum by employing
independent contractors to transport
materials. Independent contractors allow
industry operators to increase and
decrease staff as demand warrants. While
Capital intensity
Capital units per labor unit

0.5
0.4
0.3
0.2
0.1
0.0
Economy
Healthcare and Medical Couriers

Social
Assistance
Dotted line shows a high level of capital intensity

wage costs are significant, investment in

capital expenditure is equally as
important. Industry operators must
Tools of the Trade: Growth Strategies for Success

Investment Economy
Recreation, Personal Services,

Health and Education. Firms
benefit from personal wealth so
stable macroeconomic conditions
are imperative. Brand awareness
and niche labor skills are key to
product differentiation.
Information, Communications,
Mining, Finance and Real
Estate. To increase revenue
firms need superior debt
management, a stable
macroeconomic environment
and a sound investment plan.
Capital Intensive
Labor Intensive
New Age Economy
Laboratory Testing Services

Specialty Hospitals
Primary Care Doctors
Traditional Service Economy

Wholesale and Retail. Reliant
on labor rather than capital to
sell goods. Functions cannot
be outsourced therefore firms
must use new technology
or improve staff training to
increase revenue growth.
Couriers &
Local
Delivery
Services
Medical Couriers
Old Economy
Agriculture and Manufacturing.

Traded goods can be produced
using cheap labor abroad.
To expand firms must merge
or acquire others to exploit
economies of scale, or specialize
in niche, high-value products.
Change in Share of the Economy
WWW.IBISWORLD.COM
Capital Intensity
continued
invest in vehicles for transportation

services and in cooling systems among
other things.
Larger participants are required to
make substantial investments in
technology, tracking and communication
systems. The rise in e-commerce and
customer demand for real-time tracking
services has also forced many
participants to provide internet-based
delivery systems, which allow individuals
and businesses to follow packages and
confirm delivery. In addition, those
players involved in nationwide and
international networks invariably need to

invest in their own aircraft to provide
flexibility demanded by clients. The
majority of packages are monitored and
tracked via advanced electronic
communication devices, which ensure
that goods and security guidelines are
accounted for, reducing the opportunity
for tampering or security gaps in a supply
chain. Over the longer term, capital
investment in the industry should
increase as competition becomes more
intense and there is a greater demand for
high quality secure shipping options.
Technology
& Systems
Medical couriers use different

technologies to assist in tracking
medical deliveries and providing proof
of delivery. These include bar-code
scanners, palm pilots and infrared pens
for scanning signatures. The use of
effective tracking and proof-of-delivery
technologies, which have constantly
evolved over the past decade, are a key
success factor for enterprises in the
industry. Larger enterprises make use of
specialized communication equipment
and software that facilitate routescheduling, employee management and
vehicle assignments via GPS.
Additionally, companies are
increasingly using RFID (Radio
Frequency ID) technology in the Medical
Couriers industry. In the past, RFID has
been used for basic tasks such as the
evaluation of delivery performance, but
there have been larger innovations in
RFID technology in the industry. RFID
technology is a wireless link to uniquely
identify objects or people, allowing for
greater efficiency and fewer human
errors. Electronic tags are attached to an

item and then scanned with an RFID
reader. RFID tags are much more
versatile than bar codes; RFID tags can
store larger amounts of information and
can be updated at any point of travel.
Additionally, RFID tags can be scanned
even if the tag is on the inside of a
package and the reader can scan
hundreds of tags simultaneously. This
technology has been increasing over the
past five years, becoming less expensive
as well, and is expected to grow over the
next 10 years.
Packing methods employed by
medical couriers have not changed
much over the past five years. Industry
participants still rely on dry ice to
transport blood, tissue samples and
other perishable deliveries. Dry ice is a
reliable method because it can keep
biological products in a frozen state for
up to four days. Other methods include
the use of liquid nitrogen, but this is
only used for especially time
consuming transports.
Level
The level
of
Technology Change
is M
edium
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Level
The level
of
Volatility is L ow
The Medical Courier industry has a low

level of revenue volatility. The industry
serves the healthcare industry by
transporting medical supplies, specimens
and organs. As a result of this industrys
exposure to the healthcare industry, the
Medical Courier industry is less
susceptible to swings in the overall
economic environment relative to other
industries. Year-over-year changes in
industry revenue have averaged 2.4% in
the five years to 2014. The industry is
expected to experience its strongest
growth in 2014, as the number of
physician visits and total health
expenditure grow strongly aided by the
implementation of the Patient Protection
and Affordable Care Act (PPACA) of
2010. In contrast, the industry
A higher level of revenue
volatility implies greater
industry risk. Volatility can
negatively affect long-term
strategic decisions, such as
the time frame for capital
investment.
When a firm makes poor
investment decisions it
may face underutilized
capacity if demand
suddenly falls, or capacity
constraints if it rises
quickly.
experienced its largest contraction in

2013 as the number of physician visits
grew by just 0.9%, effectively decreasing
demand for industry services.
Certain types of companies are
exposed to annual seasonality. For
instance, operators that transport flu
vaccine inputs or goods related to
seasonal diseases may experience sales
fluctuations during the September and
December quarters. Further, disruptions
in the vaccine supply can lead to volatility
for these types of companies. In the
coming five years, IBISWorld expects
revenue volatility to remain low as
healthcare utilization rates continue to
increase as a result of increased
healthcare coverage and improving
economic conditions.
Volatility vs Growth
1000
Revenue volatility* (%)
Revenue Volatility
Hazardous
Rollercoaster
100
10
Medical Couriers
1
0.1
Stagnant
30
10
Blue Chip
10
30
50
70
Five year annualized revenue growth (%)

* Axis is in logarithmic scale
Regulation & Policy

Level & Trend
he level of
T
Regulation is
Mediumand the
trend is S
teady

medium level of regulation and policy.
For diagnostic specimens and infectious
substances, the Department of
Transportation (DOT) regulates the
transport under Section 49 CFR part
173.199 and 173.196. This regulation
states that Special Packaging is required
for shipping a diagnostic specimen.
Additionally, the industry is regulated by
the FDA, according to Code of Federal

Regulations (CFR) Title 21, Section
211.94 (b), Container closure systems
shall provide adequate protection against
foreseeable external factors in storage
and use that can cause deterioration or
contamination of the drug product.
Many of the regulations for
transporting dangerous goods in the
United States are determined by
WWW.IBISWORLD.COM
Regulation & Policy

continued
international rules formulated under the

auspices of the United Nations. For
example, the International Civic Aviation
Organization (ICAO) is a United Nations
organization that develops regulations
for the safe transport of dangerous
goods by air. If shipment is by air,
compliance with the rules established by
International Air Transport Association
(IATA) is required. IATA is a trade
association made up of airlines and air
cargo couriers that publishes annual
editions of the IATA dangerous goods

regulations. These regulations interpret
and add to the ICAO guidelines to reflect
industry practices.
Additionally, the Centers for Disease
Control and Prevention organization
(CDC) regulates interstate shipping of
specimens. The industry is also subject to
numerous other federal, state and local
laws relating to such matters as safe
working conditions, environmental
protection and licensing issue
Industry Assistance
The Medical Couriers industry has a low

level of industry assistance. Medical
couriers do not receive any direct
assistance from state and federal
governments. However, public health
departments that use industry services
routinely are able to receive federal
funding from the Public Health
Emergency Preparedness fund and the
Hospital Preparedness fund to make
using medical couriers a cost effective
solution. The industry also receives
assistance from industry associations.
The Messenger Courier Association of
the Americas (MCAA) is the national
industry body. It provides financial
assistance to its members in fighting legal

cases where their ability to retain
independent contractor (IC) status has
been challenged by the state in which they
operate. The MCAA has also been active in
lobbying government on the importance
of retaining IC status for their members
and suppliers of their members. The
association announced in 2009 that it has
combined resources with the National
Transportation and Logistics Association
in order to represent the same-day
delivery industry. There are also many
state-based courier and messenger
associations, which aim to support
independent contractor members.
Level & Trend

he level of
T
Industry Assistance
is L owand the
trend is S
teady
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Key Statistics
Industry Data
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Revenue
($m)
3,453.8
3,409.6
3,359.7
3,448.6
3,489.4
3,503.3
3,608.8
3,620.4
3,602.3
3,765.2
3,938.1
4,089.9
4,202.1
4,298.3
4,386.2
Annual Change
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
Revenue
(%)
-1.3
-1.5
2.6
1.2
0.4
3.0
0.3
-0.5
4.5
4.6
3.9
2.7
2.3
2.0
Industry
Value Added
($m)
947.1
936.4
949.9
1,019.3
1,160.6
1,172.4
1,149.7
1,176.6
1,247.0
1,362.2
1,389.2
1,475.4
1,536.3
1,594.6
1,632.0
Establishments
8,542
8,956
9,811
9,471
8,803
8,595
8,889
9,380
9,594
9,899
10,253
10,560
10,865
11,126
11,416
Enterprises Employment
6,789
27,816
7,144
29,395
7,846
30,010
7,368
30,311
6,844
27,937
6,796
26,547
6,977
27,559
7,147
28,586
7,241
29,325
7,463
30,368
7,722
31,343
7,947
32,341
8,176
33,013
8,372
33,731
8,593
34,292
Exports
----------------
Industry
Value Added
(%)
-1.1
1.4
7.3
13.9
1.0
-1.9
2.3
6.0
9.2
2.0
6.2
4.1
3.8
2.3
Establishments
(%)
4.8
9.5
-3.5
-7.1
-2.4
3.4
5.5
2.3
3.2
3.6
3.0
2.9
2.4
2.6
Enterprises Employment
(%)
(%)
5.2
5.7
9.8
2.1
-6.1
1.0
-7.1
-7.8
-0.7
-5.0
2.7
3.8
2.4
3.7
1.3
2.6
3.1
3.6
3.5
3.2
2.9
3.2
2.9
2.1
2.4
2.2
2.6
1.7
Exports
(%)
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Key Ratios
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
IVA/Revenue
(%)
27.42
27.46
28.27
29.56
33.26
33.47
31.86
32.50
34.62
36.18
35.28
36.07
36.56
37.10
37.21
Figures are inflation-adjusted 2014 dollars.
Imports/
Demand
(%)
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Exports/
Revenue
(%)
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Revenue per
Employee
($000)
124.17
115.99
111.95
113.77
124.90
131.97
130.95
126.65
122.84
123.99
125.65
126.46
127.29
127.43
127.91
Wages/Revenue
(%)
18.72
18.76
19.57
21.67
23.04
22.91
21.31
22.16
23.45
24.48
23.57
24.27
24.56
24.90
25.01
Imports
----------------
Wages
($m)
646.6
639.8
657.5
747.3
804.1
802.6
769.2
802.2
844.9
921.6
928.4
992.8
1,032.0
1,070.3
1,096.8
Domestic
Demand
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
No. of physician visits

(Billion)
1.0
0.9
1.0
1.0
1.0
1.0
1.0
1.1
1.1
1.2
1.2
1.2
1.2
1.2
1.2
Imports
(%)
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Wages
(%)
-1.1
2.8
13.7
7.6
-0.2
-4.2
4.3
5.3
9.1
0.7
6.9
3.9
3.7
2.5
Domestic
Demand
(%)
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
No. of physician visits

(%)
-6.4
10.2
-3.8
8.5
-2.8
3.8
2.0
0.9
6.9
3.2
-2.1
2.9
-1.0
-0.1
Employees
per Est.
3.26
3.28
3.06
3.20
3.17
3.09
3.10
3.05
3.06
3.07
3.06
3.06
3.04
3.03
3.00
Average Wage
($)
23,245.61
21,765.61
21,909.36
24,654.42
28,782.62
30,233.17
27,911.03
28,062.69
28,811.59
30,347.73
29,620.65
30,697.88
31,260.41
31,730.46
31,984.14
Share of the
Economy
(%)
0.01
0.01
0.01
0.01
0.01
0.01
0.01
0.01
0.01
0.01
0.01
0.01
0.01
0.01
0.01
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Jargon & Glossary
Industry Jargon
BIOPHARMACEUTICALMedical drugs produced using

biotechnology; they include proteins, nucleic acids and
living microorganisms like virus and bacteria.
COLD CHAINA temperature-controlled supply chain.
IBISWorld Glossary
BARRIERS TO ENTRYHigh barriers to entry mean that

new companies struggle to enter an industry, while low
barriers mean it is easy for new companies to enter an
industry.
CAPITAL INTENSITYCompares the amount of money
spent on capital (plant, machinery and equipment) with
that spent on labor. IBISWorld uses the ratio of
depreciation to wages as a proxy for capital intensity.
High capital intensity is more than $0.333 of capital to
$1 of labor; medium is $0.125 to $0.333 of capital to $1
of labor; low is less than $0.125 of capital for every $1 of
labor.
CONSTANT PRICESThe dollar figures in the Key
Statistics table, including forecasts, are adjusted for
inflation using the current year (i.e. year published) as
the base year. This removes the impact of changes in
the purchasing power of the dollar, leaving only the
real growth or decline in industry metrics. The inflation
adjustments in IBISWorlds reports are made using the
US Bureau of Economic Analysis implicit GDP price
deflator.
DRY ICEThe solid state of carbon dioxide used primarily

for cooling purposes.
LOGISTICSManagement of the flow of resources from
the point of origin to the destination.
INDUSTRY REVENUEThe total sales of industry goods

and services (exclusive of excise and sales tax); subsidies
on production; all other operating income from outside
the firm (such as commission income, repair and service
income, and rent, leasing and hiring income); and
capital work done by rental or lease. Receipts from
interest royalties, dividends and the sale of fixed
tangible assets are excluded.
INDUSTRY VALUE ADDED (IVA)The market value of
goods and services produced by the industry minus the
cost of goods and services used in production. IVA is
also described as the industrys contribution to GDP, or
profit plus wages and depreciation.
INTERNATIONAL TRADEThe level of international
trade is determined by ratios of exports to revenue and
imports to domestic demand. For exports/revenue: low is
less than 5%, medium is 5% to 20%, and high is more
than 20%. Imports/domestic demand: low is less than
5%, medium is 5% to 35%, and high is more than
35%.
EMPLOYMENTThe number of permanent, part-time,

temporary and seasonal employees, working proprietors,
partners, managers and executives within the industry.
LIFE CYCLEAll industries go through periods of growth,

maturity and decline. IBISWorld determines an
industrys life cycle by considering its growth rate
(measured by IVA) compared with GDP; the growth rate
of the number of establishments; the amount of change
the industrys products are undergoing; the rate of
technological change; and the level of customer
acceptance of industry products and services.
ENTERPRISEA division that is separately managed and

keeps management accounts. Each enterprise consists
of one or more establishments that are under common
ownership or control.
NONEMPLOYING ESTABLISHMENTBusinesses with

no paid employment or payroll, also known as
nonemployers. These are mostly set up by self-employed
individuals.
ESTABLISHMENTThe smallest type of accounting unit

within an enterprise, an establishment is a single
physical location where business is conducted or where
services or industrial operations are performed. Multiple
establishments under common control make up an
enterprise.
PROFITIBISWorld uses earnings before interest and tax

(EBIT) as an indicator of a companys profitability. It is
calculated as revenue minus expenses, excluding
interest and tax.
DOMESTIC DEMANDSpending on industry goods and

services within the United States, regardless of their
country of origin. It is derived by adding imports to
industry revenue, and then subtracting exports.
EXPORTSTotal value of industry goods and services sold

by US companies to customers abroad.
IMPORTSTotal value of industry goods and services
brought in from foreign countries to be sold in the
United States.
INDUSTRY CONCENTRATIONAn indicator of the
dominance of the top four players in an industry.
Concentration is considered high if the top players
account for more than 70% of industry revenue.
Medium is 40% to 70% of industry revenue. Low is less
than 40%.
VOLATILITYThe level of volatility is determined by

averaging the absolute change in revenue in each of the
past five years. Volatility levels: very high is more than
20%; high volatility is 10% to 20%; moderate
volatility is 3% to 10%; and low volatility is less than
3%.
WAGESThe gross total wages and salaries of all
employees in the industry. The cost of benefits is also
included in this figure.
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Medical CouriersAugust 2014 1

Special delivery: As technology changes, demand

IBISWorld Industry Report OD4954

2 About this Industry

19 Market Share Concentration

19 Key Success Factors

29 Jargon & Glossary

19 Cost Structure Benchmarks

Key External Drivers

11 Industry Life Cycle

13 Products & Markets

25 Technology & Systems

13 Products & Services

26 Regulation & Policy

www.ibisworld.com | 1-800-330-3772 | info @ibisworld.com

Medical CouriersAugust 2014 2

About this Industry

Medical couriers deliver medical

The primary activities of this industry are

from other medical distributors by

Laboratory and specimen delivery services

The major products and services in this industry are

62111a Primary Care Doctors in the US

For additional information on this industry

Medical Couriers August 2014

Annual Growth 09-14

Annual Growth 14-19

Revenue vs. employment growth

Products and services segmentation (2014)

Key External Drivers

Donor organ delivery

Number of physician visits

Total health expenditure

World price of crude oil

Blood and tissue delivery

Life Cycle Stage

Medical CouriersAugust 2014 4

Executive Summary | Key External Drivers | Current Performance

The Medical Couriers industry transports

advancements will boost

Key External Drivers

Number of physician visits

environment, the Medical Couriers

and medical product manufacturers. In

Medical CouriersAugust 2014 5

supplies, medicine and lab samples. In

products, materials and specimens

Number of physician visits

Key External Drivers

Medical CouriersAugust 2014 6

The Medical Couriers industry has fared

Healthcare Utilization The Medical Couriers industry serves

of 1.5% to $3.8 billion, including growth

many segments of the healthcare sector,

at annualized rates of 4.3% and 2.1%,

Regulations on perishable healthcare cargo

and shipped. The responsibility falls on the

Medical CouriersAugust 2014 7

transportation, as do most vaccines,

Medical CouriersAugust 2014 8

The growth in medical courier services

offers a nationwide network of shipping

As a result of the implementation of the

Additionally, the race to create new drugs