A new study conducted by management consulting firm A.T. Kearney identifies five disruptive forces that could cost the medical device industry $34 billion over the next five years.

For the study, titled “Medical Devices: Equipped for the Future?,” A.T. Kearney more than 30 global medical device industry executives from 20 of the world’s leading medical device manufacturers that collectively represent $80 billion in revenues.

The disruptive forces identified by the study as those shaping the medical device industry are as follows:

Power shift to payers and providers Heightened regulatory scrutiny Unclear sources of innovation New healthcare delivery models Need to serve lower socioeconomic classes

In a press release about the study, Dave Powell, A.T. Kearney partner and study co-author, noted, “While the future contours of the medical device industry remain to be defined, radical change is inevitable, and the companies who embrace it will both shape the industry and profit from it.”