Global health care spending is projected to increase at an annual rate of 5.4% to $10.059 trillion in 2018–2022, a considerable rise from the 2.9% ($7.724 trillion) in 2013–2017 representing 7% of Global GDP ($150 trillions). This increase is a result of the expansion of health care coverage in developing markets, the growing care needs of elderly populations, advances in treatments and health technologies, and rising health care labor costs. Per-person health care spending is expected to continue to vary widely, ranging from $11,674 in the United States to just $54 in Pakistan in 2022. Efforts to close this gap will be constrained by higher population growth in developing economies.

There are three main categories of medical technologies:

1. Medical devices (MDs) are products, services or solutions that prevent, diagnose, monitor, treat and care for human beings by physical means.
2. In vitro diagnostics (IVDs) are non-invasive tests used on biological samples (for example blood, urine or tissues) to determine the status of one’s health.
3. Digital health and care refers to tools and services that use information and communication technologies (ICTs) to improve prevention, diagnosis, treatment, monitoring and management of health and lifestyle.

For the MedTech market overall, we should expect 450 B$ of sales in 2019 from which 110 B$ were spent in Europe (source US International Trade Admin).

The Covid-19 pandemic magnifies the importance and acceleration of the development of this industry driven by patient needs, availability of data and value-based health-care imperatives.

The pandemic accelerates trends, spurring the switch to a digital economy and workplace with a long-lasting impact on the organization of medical labor. Furthermore, demand for health care—and, therefore, medical technology—will be continuously growing.

The massiveness and availability of data obviously has a major impact. Data and analytics are now widely used in business to solve a range of problems. In health care, the stakes are arguably much higher, but the tools are just as applicable. Increasingly, large data sets — originating from patients records, sensors, imagery and genomics or environment — and powerful analytics can be used to cut through the fog that clouds decision making, guiding physicians and clinicians toward the best diagnostic tests and care pathways — ultimately leading to better outcomes. These data are currently major enablers of the medicine of tomorrow that can be called "P5": Precise, Preventive, Predictive, Participatory, Personalized, impacting dozens of sectors like illness prevention, epidemiology, AI based diagnostics, treatment and chronic care monitoring, thus resulting in the strong development of biotech devices but also e-healthcare applications (on line bookings, telemedicine, quantified self, etc.)

Value Based healthcare as the ability for healthcare providers to improve measurable patient health outcomes is proving to be an especially important criterion in fast-growing MedTech markets to support better care episodes and pathways (hospitals dealing with pre and post-operative care, management of chronic care, etc.)

The specific needs of emerging markets — with the lack of well-developed health care infrastructures and, in particular, the absence of a critical mass of highly trained clinicians (who have been the traditional customers for MedTech products) — make it imperative for companies to develop new solutions that support the delivery of good health outcomes at a much lower cost and in a much more integrated way.

Consequently, there is a huge potential of growth and Investment opportunities in MedTech driven by reinforced vital imperatives of the planet and by current financial market trends

Maturing healthcare tech companies can be good targets for PE firms ready to apply rigorous analysis and invest in growing companies in US and European markets. Healthcare companies with a strong technology component are valued end of Q1 2020 on average at 17.4 times earnings, compared with 15 times average across the industry, with lower multiples for companies without strong technological components. For example, pharmaceuticals average 15 times and healthcare providers average 11.4 times (source Prequin). In recent years, well-managed healthcare tech companies have performed even better, with some exits at 23 to 25 times EBITDA in developed markets.

Thus, investing in healthcare tech is key for PE firms, and the fear of too low multiples is surely unfounded while there is a good rationale for high or even very high multiples. Many healthcare tech companies serve growing markets and market positions, once secured — especially as part of a platform or suite of solutions—are often defensible with strong entry barriers. Such assets are worth their higher multiples and especially given the strategic nature of human healthcare and welfare.

Opportunities are various and plentiful:

1. Large and mature businesses: Radiology equipment & software, Hospital information systems, Electronic medical records, Bio and viral tech, Pacemakers, etc.
2. Specialized companies (about 200m$): Surgery MedTech devices & robotics, Laparoscopy & endoscopy devices, Echography equipment, Anesthetic monitoring, Prostheses and orthotics, Biomarkers, etc.
3. Series B startups: AI for diagnostics, Telehealth and telemonitoring, Chronic care (self) management, 3D printing, simulation for training and education, robotics, bioelectronics, chatbots, drones, lab-on-a-chip devices, etc.

This new trendy industry calls for bold strategic investment decisions as we are in a real human “strategic bubble”

Let The New P5 Medicine criteria guide innovation & use this approach as the lens to identify corporate opportunities.

Develop a strategic vision “Invest to win”, both therapeutically as well as geographically, in remaining new opportunities and near-term roadmap to be best positioned in a MedicalTech digital market.

Reimagine by using data and analytical assets in new ways to develop proprietary insights and create competitive advantage

Win in emerging markets by carefully assessing where to play, creating the right product portfolios and distribution models, and, in many cases, finding the right deal partners.