The global Elastomeric Infusion Pumps Market size was valued at USD 1,102.5 Million in 2022 and is projected to attain USD 3,038.9 Million by 2032 mounting at a CAGR of 10.9% from 2023 to 2032.
Elastomeric Infusion Pumps Market Highlights
- Global elastomeric infusion pumps market revenue is poised to garner USD 3,038.9 million by 2032 with a CAGR of 10.9% from 2023 to 2032
- North America elastomeric infusion pumps market value occupied around USD 397 million in 2022
- Asia-Pacific elastomeric infusion pumps market growth will record a CAGR of more than 11% from 2023 to 2032
- Among type, the continuous rate elastomeric pump sub-segment occupied over US$ 606.3 million revenue in 2022
- Based on application, the pain management sub-segment gathered around 54% share in 2022
- Collaborations of private and public organizations for product innovation is a popular elastomeric infusion pumps market trend that drives the industry demand
Elastomeric infusion pumps are medical devices that provide drugs and fluids to patients in a regulated and continuous manner. These devices are intended to provide a dependable and portable option for long-term administration of pharmaceuticals such as antibiotics, pain relievers, chemotherapeutic agents, and other therapeutic chemicals. In contrast to typical IV bags and electronic infusion pumps, which require power sources and extensive programming, elastomeric infusion pumps work on a more basic and mechanical foundation.
Elastomeric pumps are built of elastomeric material and have a flexible, balloon-like reservoir that may expand and shrink. The reservoir contains the prescribed medicine or fluid and is linked to a tubing system with a flow regulator. The pressure formed within the elastomeric reservoir as it gradually compresses over time controls the flow of the material. This mechanism enables a steady and regulated infusion rate, making it appropriate for a wide range of medical procedures.
In clinical settings, these pumps have various advantages. They are portable, lightweight, and do not require electricity, making them ideal for ambulatory treatment or at home. Furthermore, elastomeric infusion pumps are easy to set up and use, lowering the chance of programming mistakes and improving patient safety. Furthermore, they are disposable, reducing the danger of contamination and infection that can occur with reusable infusion devices.
Elastomeric infusion pumps are used in a variety of medical fields, including cancer, pain treatment, and home healthcare, when long-term, continuous medicine delivery is required. Because of their ease of use and dependability, they are a vital tool for healthcare providers, leading to better patient outcomes and quality of life.
Global Elastomeric Infusion Pumps Market Dynamics
Market Drivers
- Growing demand for home healthcare
- Rising prevalence of chronic diseases
- Technological advancements in pump design
- Aging population requiring long-term therapy
Market Restraints
- Stringent regulatory requirements
- High cost of elastomeric pumps
- Competition from electronic infusion systems
- Limited drug compatibility
Market Opportunities
- Expansion in emerging markets
- Increasing adoption of ambulatory care
- Development of novel elastomeric pump materials
Elastomeric Infusion Pumps Market Report Coverage
Market |
Elastomeric Infusion Pumps Market
|
Elastomeric Infusion Pumps Market Size 2022 |
USD 1,102.5 Million |
Elastomeric Infusion Pumps Market Forecast 2032 |
USD 3,038.9 Million |
Elastomeric Infusion Pumps Market CAGR During 2023 - 2032 |
10.9% |
Elastomeric Infusion Pumps Market Analysis Period |
2020 - 2032 |
Elastomeric Infusion Pumps Market Base Year
|
2022 |
Elastomeric Infusion Pumps Market Forecast Data |
2023 - 2032 |
Segments Covered |
By Type, By Application, By End-User, And By Geography
|
Regional Scope |
North America, Europe, Asia Pacific, Latin America, and Middle East & Africa |
Key Companies Profiled |
Baxter International Inc., B. Braun SE, Fresenius SE and Co. KGaA, Medline Industries LP, Vygon SAS, Smiths Group Plc, Owens & Minor Inc., Nipro Corp., Ambu AS, Avanos Medical Inc., MicroPort Scientific Corp., and Mindray Bio-Medical Electronics Co. Ltd.
|
Report Coverage
|
Market Trends, Drivers, Restraints, Competitive Analysis, Player Profiling, Covid-19 Analysis, Regulation Analysis |
Elastomeric Infusion Pumps Market Insights
The elastomer infusion pumps market dynamics exhibit a complex interplay of elements that affect the industry's growth and evolution. The growing demand for home healthcare solutions is one of the primary forces moving the market ahead. Patients are increasingly looking for therapies that allow them to take medication at home, and elastomeric pumps, with their mobility and ease of use, meet this need. This need is fueled further by an ageing population that frequently requires long-term therapy for chronic illnesses.
The market, however, is not without its difficulties. Stringent regulatory regulations and quality standards are a major impediment. To assure the safety and efficacy of their goods, manufacturers must follow tight criteria, which can add time and expense to the development process. Furthermore, the high cost of elastomeric pumps may restrict their availability, especially in resource-constrained healthcare settings.
Another aspect at work is competition, with electronic infusion systems offering an alternative to elastomeric pumps. While electronic systems provide enhanced capabilities and programmability, elastomeric pumps remain popular owing to their ease of use and dependability. Drug compatibility is still an issue, since not all drugs can be supplied by elastomeric pumps, limiting their value in some therapeutic areas.
Despite these obstacles, the elastomer infusion pump industry offers several prospects for expansion. As healthcare infrastructure improves and demand for cost-effective infusion solutions develops, expanding into emerging nations provides a big potential. Furthermore, the use of ambulatory care settings, in which patients are treated outside of typical hospital settings, offers a favorable environment for elastomeric pumps. Manufacturers are also investing in the research of new materials and technologies to improve the performance and compatibility of these pumps, while industry partnerships drive innovation in product design and functionality. These forces will influence the future of the elastomeric infusion pump market as it adapts to changing healthcare requirements and technological improvements.
Elastomeric Infusion Pumps Market Segmentation
The worldwide market for elastomeric infusion pumps is split based on type, application, end-user, and geography.
Elastomeric Infusion Pumps Types
- Continuous Rate Elastomeric Pump
- Variable Rate Elastomeric Pump
As per the elastomeric infusion pumps industry analysis, continuous rate elastomeric pumps is the leading type in the market. Continuous rate elastomeric pumps were frequently used for drugs and fluids that required a regular and continuous infusion rate over a long period of time. These pumps were commonly employed in situations when a steady medicine concentration was necessary, such as pain control, antibiotic treatment, or certain chemotherapy regimens.
Variable rate elastomeric pumps, on the other hand, provided flexibility in regulating the infusion rate based on the patient's changing demands. When treatments required periodic changes or drugs needed to be supplied at different rates over time, these pumps were recommended.
Elastomeric Infusion Pumps Applications
- Pain Management
- Antibiotic or Antiviral
- Chemotherapy
- Others
According to our elastomeric infusion pumps market analysis, the pain management application will have the most market share in 2022. In pain treatment applications, elastomeric infusion pumps were extensively employed. These pumps enabled the regulated and continuous administration of pain drugs, making them especially useful in post-surgical treatment and chronic pain management.
Antibiotic and antiviral medications are frequently administered on a continuous and long-term basis. Elastomeric pumps were widely used in these applications to ensure patients got the correct dosage over an extended period of time, particularly when intravenous antibiotic treatment was required.
Elastomeric infusion pumps were crucial in chemotherapy treatments. They enabled the regulated continuous administration of chemotherapy medications, making them suited for outpatient or home-based chemotherapy regimens.
The others category included a diverse variety of medical applications requiring regulated and continuous medication or fluid delivery. Hydration therapy, immunoglobulin therapy, and other specialised therapies may fall under this category.
Elastomeric Infusion Pumps End-Users
- Hospitals
- Ambulatory Service Centers
- Clinics
- Others
According to the elastomeric infusion pumps market forecast, hospital end-user is expected to gain significant traction from 2023 to 2032. Hospitals have traditionally accounted for a sizable portion of the elastomeric infusion pump industry. Elastomeric pumps were extensively utilised at these healthcare institutions for a variety of applications, including post-surgical care, pain management, chemotherapy, and antibiotic delivery.
Elastomeric infusion pumps were rapidly being used in ambulatory care centres, commonly known as outpatient clinics or day surgery centres. These centres provided a convenient and cost-effective alternative to regular hospital settings for delivering certain medical services. Elastomeric infusion pumps were also used in clinics, including specialised and general care clinics, for specific therapies. They were especially useful for pain treatment, cancer, and infectious disease management clinics.
Furthermore. others included a wide range of healthcare settings, such as home healthcare and long-term care institutions. Elastomeric pumps have become more popular in home healthcare settings, allowing patients to receive continuous medicine or fluid treatment while remaining in the comfort of their own homes.
Elastomeric Infusion Pumps Market Regional Segmentation
North America
Europe
- U.K.
- Germany
- France
- Spain
- Rest of Europe
Asia-Pacific
- India
- Japan
- China
- Australia
- South Korea
- Rest of Asia-Pacific
Latin America
- Brazil
- Mexico
- Rest of Latin America
The Middle East & Africa
- South Africa
- GCC Countries
- Rest of the Middle East & Africa (ME&A)
Elastomeric Infusion Pumps Market Regional Analysis
North America, notably the United States and Canada, accounted for a sizable portion of the elastomeric infusion pump industry. The region's sophisticated healthcare infrastructure, the high prevalence of chronic illnesses, and a strong emphasis on home treatment all contributed to market expansion. Because of its vast population and high healthcare spending, the United States was a big contributor to the industry.
Another important market for elastomeric infusion pumps was Europe. Germany, France, and the United Kingdom were significant donors. The market in this region benefited from a well-established healthcare system, an aging population, and the adoption of cost-effective home-based therapies.
The Asia-Pacific area, which includes China, Japan, and India, was witnessing rapid expansion in the elastomer infusion pump market. APAC market expansion was driven by factors such as a growing middle-class population, more healthcare awareness, and increased access to healthcare services. Furthermore, the rising frequency of chronic illnesses in this region has increased demand for infusion pumps.
Elastomeric Infusion Pumps Market Players
Some of the top elastomeric infusion pumps companies offered in our report includes Baxter International Inc., B. Braun SE, Fresenius SE and Co. KGaA, Medline Industries LP, Vygon SAS, Smiths Group Plc, Owens & Minor Inc., Nipro Corp., Ambu AS, Avanos Medical Inc., MicroPort Scientific Corp., and Mindray Bio-Medical Electronics Co. Ltd.
CHAPTER 1. Industry Overview of Elastomeric Infusion Pumps Market
1.1. Definition and Scope
1.1.1. Definition of Elastomeric Infusion Pumps
1.1.2. Market Segmentation
1.1.3. Years Considered for the Study
1.1.4. Assumptions and Acronyms Used
1.1.4.1. Market Assumptions and Market Forecast
1.1.4.2. Acronyms Used in Global Elastomeric Infusion Pumps Market
1.2. Summary
1.2.1. Executive Summary
1.2.2. Elastomeric Infusion Pumps Market By Type
1.2.3. Elastomeric Infusion Pumps Market By Application
1.2.4. Elastomeric Infusion Pumps Market By End-User
1.2.5. Elastomeric Infusion Pumps Market By Region
CHAPTER 2. Research Approach
2.1. Methodology
2.1.1. Research Programs
2.1.2. Market Size Estimation
2.1.3. Market Breakdown and Data Triangulation
2.2. Data Source
2.2.1. Secondary Sources
2.2.2. Primary Sources
CHAPTER 3. Market Dynamics And Competition Analysis
3.1. Market Drivers
3.1.1. Driver 1
3.1.2. Driver 2
3.2. Restraints and Challenges
3.2.1. Restraint 1
3.2.2. Restraint 2
3.3. Growth Opportunities
3.3.1. Opportunity 1
3.3.2. Opportunity 2
3.4. Porter’s Five Forces Analysis
3.4.1. Bargaining Power of Suppliers
3.4.2. Bargaining Power of Buyers
3.4.3. Threat of Substitute
3.4.4. Threat of New Entrants
3.4.5. Degree of Competition
3.5. Market Concentration Ratio and Market Maturity Analysis of Elastomeric Infusion Pumps Market
3.5.1. Go To Market Strategy
3.5.1.1. Introduction
3.5.1.2. Growth
3.5.1.3. Maturity
3.5.1.4. Saturation
3.5.1.5. Possible Development
3.6. Technological Roadmap for Elastomeric Infusion Pumps Market
3.7. Value Chain Analysis
3.7.1. List of Key Manufacturers
3.7.2. List of Customers
3.7.3. Level of Integration
3.8. Regulatory Compliance
3.9. Competitive Landscape, 2022
3.9.1. Player Positioning Analysis
3.9.2. Key Strategies Adopted By Leading Players
CHAPTER 4. Elastomeric Infusion Pumps Market By Type
4.1. Introduction
4.2. Elastomeric Infusion Pumps Market Revenue By Type
4.2.1. Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast, By Type, 2020-2032
4.2.2. Variable Rate Elastomeric Pump
4.2.2.1. Variable Rate Elastomeric Pump Market Revenue (USD Million) and Growth Rate (%), 2020-2032
4.2.3. Continuous Rate Elastomeric Pump
4.2.3.1. Continuous Rate Elastomeric Pump Market Revenue (USD Million) and Growth Rate (%), 2020-2032
CHAPTER 5. Elastomeric Infusion Pumps Market By Application
5.1. Introduction
5.2. Elastomeric Infusion Pumps Market Revenue By Application
5.2.1. Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast, By Application, 2020-2032
5.2.2. Pain Management
5.2.2.1. Pain Management Market Revenue (USD Million) and Growth Rate (%), 2020-2032
5.2.3. Antibiotic or Antiviral
5.2.3.1. Antibiotic or Antiviral Market Revenue (USD Million) and Growth Rate (%), 2020-2032
5.2.4. Chemotherapy
5.2.4.1. Chemotherapy Market Revenue (USD Million) and Growth Rate (%), 2020-2032
5.2.5. Others
5.2.5.1. Others Market Revenue (USD Million) and Growth Rate (%), 2020-2032
CHAPTER 6. Elastomeric Infusion Pumps Market By End-User
6.1. Introduction
6.2. Elastomeric Infusion Pumps Market Revenue By End-User
6.2.1. Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast, By End-User, 2020-2032
6.2.2. Hospitals
6.2.2.1. Hospitals Market Revenue (USD Million) and Growth Rate (%), 2020-2032
6.2.3. Ambulatory Service Centers
6.2.3.1. Ambulatory Service Centers Market Revenue (USD Million) and Growth Rate (%), 2020-2032
6.2.4. Clinics
6.2.4.1. Clinics Market Revenue (USD Million) and Growth Rate (%), 2020-2032
6.2.5. Others
6.2.5.1. Others Market Revenue (USD Million) and Growth Rate (%), 2020-2032
CHAPTER 7. North America Elastomeric Infusion Pumps Market By Country
7.1. North America Elastomeric Infusion Pumps Market Overview
7.2. U.S.
7.2.1. U.S. Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
7.2.2. U.S. Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
7.2.3. U.S. Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
7.3. Canada
7.3.1. Canada Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
7.3.2. Canada Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
7.3.3. Canada Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
7.4. North America PEST Analysis
CHAPTER 8. Europe Elastomeric Infusion Pumps Market By Country
8.1. Europe Elastomeric Infusion Pumps Market Overview
8.2. U.K.
8.2.1. U.K. Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
8.2.2. U.K. Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
8.2.3. U.K. Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
8.3. Germany
8.3.1. Germany Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
8.3.2. Germany Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
8.3.3. Germany Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
8.4. France
8.4.1. France Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
8.4.2. France Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
8.4.3. France Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
8.5. Spain
8.5.1. Spain Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
8.5.2. Spain Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
8.5.3. Spain Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
8.6. Rest of Europe
8.6.1. Rest of Europe Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
8.6.2. Rest of Europe Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
8.6.3. Rest of Europe Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
8.7. Europe PEST Analysis
CHAPTER 9. Asia Pacific Elastomeric Infusion Pumps Market By Country
9.1. Asia Pacific Elastomeric Infusion Pumps Market Overview
9.2. China
9.2.1. China Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
9.2.2. China Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
9.2.3. China Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
9.3. Japan
9.3.1. Japan Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
9.3.2. Japan Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
9.3.3. Japan Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
9.4. India
9.4.1. India Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
9.4.2. India Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
9.4.3. India Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
9.5. Australia
9.5.1. Australia Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
9.5.2. Australia Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
9.5.3. Australia Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
9.6. South Korea
9.6.1. South Korea Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
9.6.2. South Korea Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
9.6.3. South Korea Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
9.7. Rest of Asia-Pacific
9.7.1. Rest of Asia-Pacific Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
9.7.2. Rest of Asia-Pacific Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
9.7.3. Rest of Asia-Pacific Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
9.8. Asia Pacific PEST Analysis
CHAPTER 10. Latin America Elastomeric Infusion Pumps Market By Country
10.1. Latin America Elastomeric Infusion Pumps Market Overview
10.2. Brazil
10.2.1. Brazil Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
10.2.2. Brazil Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
10.2.3. Brazil Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
10.3. Mexico
10.3.1. Mexico Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
10.3.2. Mexico Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
10.3.3. Mexico Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
10.4. Rest of Latin America
10.4.1. Rest of Latin America Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
10.4.2. Rest of Latin America Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
10.4.3. Rest of Latin America Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
10.5. Latin America PEST Analysis
CHAPTER 11. Middle East & Africa Elastomeric Infusion Pumps Market By Country
11.1. Middle East & Africa Elastomeric Infusion Pumps Market Overview
11.2. GCC
11.2.1. GCC Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
11.2.2. GCC Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
11.2.3. GCC Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
11.3. South Africa
11.3.1. South Africa Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
11.3.2. South Africa Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
11.3.3. South Africa Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
11.4. Rest of Middle East & Africa
11.4.1. Rest of Middle East & Africa Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Type, 2020-2032
11.4.2. Rest of Middle East & Africa Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By Application, 2020-2032
11.4.3. Rest of Middle East & Africa Elastomeric Infusion Pumps Market Revenue (USD Million) and Forecast By End-User, 2020-2032
11.5. Middle East & Africa PEST Analysis
CHAPTER 12. Player Analysis Of Elastomeric Infusion Pumps Market
12.1. Elastomeric Infusion Pumps Market Company Share Analysis
12.2. Competition Matrix
12.2.1. Competitive Benchmarking of key players by price, presence, market share, and R&D investment
12.2.2. New Product Launches and Product Enhancements
12.2.3. Mergers And Acquisition In Global Elastomeric Infusion Pumps Market
12.2.4. Partnership, Joint Ventures and Strategic Alliances/ Sales Agreements
CHAPTER 13. Company Profile
13.1. Baxter International Inc.
13.1.1. Company Snapshot
13.1.2. Business Overview
13.1.3. Financial Overview
13.1.3.1. Revenue (USD Million), 2022
13.1.3.2. Baxter International Inc. 2022 Elastomeric Infusion Pumps Business Regional Distribution
13.1.4. Product /Service and Specification
13.1.5. Recent Developments & Business Strategy
13.2. B. Braun SE
13.3. Fresenius SE and Co. KGaA
13.4. Medline Industries LP
13.5. Vygon SAS
13.6. Smiths Group Plc
13.7. Owens & Minor Inc.
13.8. Nipro Corp.
13.9. Ambu AS
13.10. Avanos Medical Inc.
13.11. MicroPort Scientific Corp.
13.12. Mindray Bio-Medical Electronics Co. Ltd.