Short Bowel Syndrome Market Size & Share Analysis - Growth Trends & Forecasts (2025 - 2030)

Global Short Bowel Syndrome Market Trends and Insights

Rising Prevalence of SBS & Complex GI Surgeries

Neonatal surgical advances have lifted survival in very low birth-weight infants, yet they have also pushed neonatal SBS incidence to 22.1 per 1,000 NICU admissions in recent cohorts ^{[1] Journal of Pediatric Surgery Editorial Board, “Short Bowel Syndrome Epidemiology,” sciencedirect.com}. Adult incidence is rising for similar reasons: oncologic and inflammatory bowel resections are now more radical, preserving life but shortening bowel length. CMS coding changes in 2023 created visibility for these additional cases, encouraging earlier referrals and stimulating demand for novel therapeutics. 

Accelerated Approvals & Uptake of GLP-2 Analogs

The FDA expanded teduglutide to children aged ≥1 year and granted fast-track status to newer molecules such as apraglutide and sonefpeglutide, creating a virtuous cycle of innovation and access. Takeda’s Gattex/Revestive posted JPY 119.3 billion sales in fiscal 2024, up 28.1% year over year ^{[2]Takeda Pharmaceutical Company Limited, “FY 2024 Full-Year Results,” takeda.com}. Conversely, Zealand Pharma’s glepaglutide received a Complete Response Letter in December 2024, highlighting the market’s regulatory volatility. 

Orphan-Drug Incentives & Favorable Reimbursement

U.S. Medicare covers home PN under Part B when strict criteria are met, and advocacy groups are working to update the three-decade-old policy to widen access ^{[3]Oley Foundation Advocacy Team, “Medicare Home PN Coverage,” oley.org}. In Europe, NICE endorsed teduglutide under managed-entry agreements, balancing cost effectiveness with patient need. These incentives enable premium pricing and attract continued investment even as payers demand real-world evidence of PN reduction. 

Global Patient-Registry & NGO Awareness Initiatives

Registries coordinated by ESPEN and foundations such as IFFGD generate longitudinal data on safety and quality of life, expediting regulatory filings and reimbursement reviews. Awareness initiatives in emerging markets are crucial, as clinicians historically under-diagnosed SBS because they lacked dedicated codes or training. 

Tissue-Engineered Intestine R&D Breakthroughs

Tissue-engineered small intestine constructs restored 98% weight recovery in animal models versus 76% for controls. Colonic SATB2 gene knock-out reprogrammed colon tissue toward small-intestinal function, improving nutrient uptake in preclinical studies. Stem-cell organoids now achieve 17% engraftment after 10 weeks, supporting first-in-human trials. 

High Therapy Cost & Limited Access in LMICs

Total annual therapy costs exceed USD 43,000 per patient when factoring PN, monitoring, and complication management. Many LMIC health systems lack reimbursement frameworks or the cold-chain logistics for GLP-2 analogs. Manufacturers are experimenting with tiered pricing, but infrastructure constraints persist, motivating interest in low-cost peptides or simplified PN regimens. 

Serious Long-Term Safety Concerns (e.g., Neoplasia)

GLP-2 analogs mandate baseline and regular colonoscopies because long-term exposure may elevate polyp risk. Hyperamylasemia and hyperlipasemia have also been reported, particularly in pediatric cohorts. Regulators now require extended post-marketing surveillance, raising trial costs and deterring smaller entrants. 

Segment Analysis

By Drug Class: GLP-2 Dominance Faces Innovation Pressure

GLP-2 analogs accounted for 96.14% of the Short Bowel Syndrome market in 2024, propelled by teduglutide’s robust evidence base. Growth hormone therapies, though smaller in absolute sales, are set for 8.25% CAGR through 2030 as pediatric specialists employ them to spur mucosal adaptation. Weekly and monthly GLP-2 candidates like apraglutide and sonefpeglutide seek to reduce injection burden, whereas OPKO Health and Entera Bio are developing the first oral GLP-2 peptide, a shift that could reposition the Short Bowel Syndrome market size for maintenance therapy. Competitive differentiation now centers on dosing convenience, safety, and incremental PN-reduction data to secure payer acceptance and justify premium prices. 

Future uptake will hinge on real-world evidence showing durable PN reduction and manageable colonoscopic surveillance. If next-generation molecules confirm similar efficacy with fewer polyps, the Short Bowel Syndrome market could migrate quickly, fragmenting the current GLP-2 oligopoly. Conversely, any class-wide safety signal could redirect investment toward regenerative or gene-editing modalities. 

Note: Segment shares of all individual segments available upon report purchase

By Distribution Channel: Hospital Dominance Challenged by Digital Shift

Hospital pharmacies held 56.71% revenue in 2024 because SBS management demands multidisciplinary oversight and sterile compounding. Yet online & others channels are scaling at an 8.86% CAGR as home infusion firms integrate telehealth, IoT-connected pumps, and proactive electrolyte monitoring. Studies show 86% of home PN patients own a connected device, and 63% already engage with health apps. If payers continue rewarding hospital-at-home models, the Short Bowel Syndrome market will distribute more prescriptions through specialty mail-order and digital clinics, shrinking hospital share even as volumes grow. 

Retail pharmacies focus on ancillary needs such as antidiarrheals and micronutrient supplements. Their participation could expand if oral GLP-2 formulations succeed, yet stringent cold-chain and counseling requirements still favor specialty or infusion channels today. 

By Patient Age Group: Adult Stability Contrasts Pediatric Dynamism

Adult patients made up 85.25% of 2024 revenue because oncologic resections and Crohn-related surgeries are more common in later life. This segment has well-defined protocols and centers of excellence, ensuring predictable penetration for every incremental therapy. However, pediatric cases are climbing fastest, with a 9.13% CAGR, due to improved neonatal survival of premature infants with necrotizing enterocolitis. A systematic review reported 36 children achieving enteral autonomy on teduglutide after 24 weeks, while 149 showed reduced PN needs. Pediatric formulations, weight-based dosing, and family-centric digital support platforms are poised to capture new value pools and diversify the Short Bowel Syndrome market share currently anchored in adult care. 

Long-term safety monitoring is more stringent in children, so sponsors must generate lifetime exposure data and collaborate with registries. High efficacy in growth metrics and neurodevelopmental outcomes will be decisive for caregiver adoption and payer endorsement. 

Note: Segment shares of all individual segments available upon report purchase

Geography Analysis

North America generated 42.41% of the Short Bowel Syndrome market in 2024, supported by specialized intestinal-failure centers, Medicare PN reimbursement, and early access to GLP-2 analogs. CMS coding updates and commercial coverage expansions ensure treatment visibility and financial viability, yet payer criteria remain stringent and require documentation of 12-month PN dependence in some plans. 

Europe retains critical mass through centralized care networks and harmonized guidelines. NICE’s commercial arrangement for teduglutide and ESPEN’s multidisciplinary standards provide structure and reduce therapeutic variability. EU clinical consortia also drive first-in-human tissue-engineering trials, strengthening the region’s innovation footprint. 

Asia-Pacific is the fastest-growing territory at 9.34% CAGR through 2030, driven by regulatory modernization in China and increased resection volumes tied to rising colorectal cancer incidence. China’s 2023 regulations on special-medical-purpose formula expand access to nutritionally balanced enteral feeds, complementing PN and pharmacotherapy. Japan’s inclusion in global apraglutide trials exemplifies the region’s integration into pivotal studies, accelerating time-to-approval for novel agents.