Healthcare Equipment_Global Report 2011

Healthcare Equipment & SuppliesGlobal Report 2011A Clearwater Healthcare Team Report

Clearwater_report_26_08_2011.indd 1 30/08/2011 10:53

IMAP ConSISTS of IndEPEndEnT AdvISoRy oPERATIonS woRkInG ToGETHER To ExECuTE CRoSS-boRdER M&A PRojECTS. EACH IMAP offICE IS IndEPEndEnTly ownEd And oPERATEd.

Identifying strategic M&A opportunities wherever they might be in the world takes a world-class advisor. Clearwater and its international IMAP offices can help identify the right opportunities.

The healthcare sector, breathing life into the M&A market

www.imap.com.


Page 3

The global healthcare equipment and supplies sector is valued at £184 billion. whilst the global economic crisis and the reduction in healthcare expense reimbursement have had a significant impact, the future prospects for the sector are positive, with the market anticipated to grow to £228.5 billion by 2014, driven by ageing demographic trends, increased healthcare expenditures and higher demand for quality care from developing countries.

The united States dominates the healthcare equipment and supplies market and generates sales of over £88 billion; this is followed by Europe with £61 billion and Asia-Pacific with £35 billion. The supply chains for healthcare equipment and supplies are growing in importance as manufacturers outsource products and services, some of which are moving offshore and to low cost regions. Supply chains are getting more complex so managing this going forward is critical.

In 2010, the volume of M&A transactions saw a rebound from 2009 levels, with 727 transactions recorded compared to 658 transactions in 2009. The first half of 2011 has seen some major transactions such as j&j's acquisition of Synthes. we will continue to see M&A activity across many segments of the healthcare equipment and supplies sector driven by cost pressure and new technology.

A key area of M&A interest over the next two years will be in innovative new technologies that can help reduce hospital stays, provide early diagnosis and prevention measures, and re-ablement and care for patients in the community and their own homes. The value of in vitro diagnostics testing in particular is escalating due to its importance in detecting medical conditions early. This market is expected to grow from £19.3 billion to £30.3 billion by 2016.

we also look at the latest trends, such as the market for the supply of telecare and telemedicine/telehealth technologies. As the population across western countries grows older, companies across the world are developing innovative new solutions to care for this demographic audience. The global telemedicine/telehealth market was worth £6.2 billion in 2010 and is expected to grow to £14.3 billion by 2015.

I do hope you find this report of interest.

Ramesh jassalSenior Healthcare AnalystClearwater Corporate Finance

H E A L T H C A R E E Q U I P M E N T A N D S U P P L I E S G L O B A L R E P O R T - 2 0 1 1

Contents

Industry Forecasts Strong Growth ...........................4

Summary of M&A Transactions.................................4

Industry Growth drivers............................................4

Market Segmentation.............................................6

disposable Equipment and Supplies.................6

otologic and Technical Aids.....................................7

In vitro diagnostics (Ivd)..........................................7

ophthalmic Equipment..............................................7

dental Surgery Equipment and Supplies.......8

other Equipment...........................................................8

Home Monitoring Equipment................................8

Cardiovascular and orthopaedic Implants....8

life Science Tools and Services...........................8

Hot Topics.................................................................9

nanotechnology.............................................................9

Replacement / Artificial organs...........................9

Minimally Invasive Surgery / Procedures (MIS).....9

Home Healthcare Monitoring Technology.....10

Appendix: Thumbnail Summaries of Top 30

Medical Device Companies


Page 4

Industry forecasts Strong GrowthIndustry optimistic about growthThe global healthcare equipment and supplies sector comprises disposable equipment and supplies, otologic and technical aids, ophthalmic equipment, in vitro diagnostics and other equipment. The industry is forecast to experience strong growth from £184 billion in 2009 to £228.5 billion in 2014, representing growth of 19.5% over the period.

Industry Growth driversDemographic Trends: The united States Census bureau projects that the majority of the baby boomer population will

The healthcare equipment and supplies sector is a highly regulated market and is constantly driven by technological innovation. This is one of the main reasons that smaller companies become targets for the larger firms. After the smaller firms receive fdA marketing approvals for their products they are targeted by the larger firms for acquisition.

In 2010, there were 727 M&A deals in the healthcare equipment and supplies sector valued at £34 billion, as compared to 2009, which recorded 658 deals amounting to £15.7 billion. one of the largest deals of 2010 was novartis AG’s acquisition of a 24.6% stake in Alcon. This deal was worth almost £7.5 billion. In terms of geographic segmentation, the united States recorded the highest number of deals with 274 amounting to £16.1 billion. japan recorded 52 deals, followed by China with 44 deals, uk with 39 deals, and Germany with 35 deals.

Some of the more significant transactions over the last 18 months have included:

○ june 2011, danaher Corporation acquired beckman Coulter

○ April 2011, j&j acquired Synthes

○ december 2010, Galderma acquired Q-Med

○ September 2010, boston acquired Asthmatx

○ june 2010, Covidien acquired Somanetics

○ june 2010, nordic Capital acquired Handicare

The Surgical and Medical Instruments segment recorded the highest number of M&A deals in 2010 with 134 deals. The Medical laboratories segment recorded 98 deals, followed by Electromedical and Electrotherapeutic Apparatus with 86 deals; ophthalmic Goods, optical Instruments and lenses with 83 deals; and orthopaedic, Prosthetic and Surgical supplies with 74 deals.

M&A Activities at a Glance

Summary of M&A transactions in the Healthcare Equipment and Supplies Sector

Source: Thomsonone

Source: Datamonitor

Global healthcare equipment and supplies

Market Size Y-O-Y Growth Rate

250

200

150

100

50

0

5

6

4

3

2

1

0

Rev

enue

s (£

Bill

ions

)

Gro

wth

Rat

e (%

)

4

1.3

4.1 4.4 4.7 4.9

2009 2010 2011 2012 2013 2014

2010 2009

Number of deals 727 658

Transaction value (£ m) 33,956 15,725

Average deal size* (£ m) 161 86*Average deal size is calculated on the basis of deals with disclosed transaction values.

Top 3 Regions (2010) No. of deals Value (£ m)

North America* 297 16,751

Europe 197 14,882**

Asia-Pacific 195 1162*North America includes deals across the United States and Canada.

**European transactions include two large deals, Novartis’ acquisition of a 24.6% stake in Alcon Inc. for £7.5 billion and Reckitt Benckiser’s acquisition of SSL International, for £2.3 billion.

Top 5 Countries (2010) No. of deals Value (£ m)

United States 274 16,086

Japan 52 278

China 44 215

United Kingdom 39 2,432*

Germany 35 426* Deal value for the United Kingdom is skewed due to Reckitt Benckiser’s acquisition of SSL International, for £2.3 billion.

Activity by Sub-sector (2010) No. of deals Value (£ m)

Surgical & Medical Instruments 134 8,348

Medical Laboratories 98 3,965

Electromedical & Electrotherapeutic Apparatus 86 3,274

Ophthalmic Goods, Optical Instruments & Lenses 83 9,598

Orthopaedic, Prosthetic & Surgical Supplies 74 2,363

Other 252 16,050

Note: The 252 deals within the other sub-segments of the healthcare equipment and supplies sector relate to laboratory analytical instruments, dental laboratory equipment, X-Ray apparatus & tubes & other irradiation equipment etc.


Page 5

reach the age of 65 between 2010 and 2012. The same is the case for Europe’s population. According to a report published by world Health organisation (wHo), there are more than 700 million people aged 60 or above, accounting for 11% of the world population. The united nations has further forecast that this number will increase to 22% by 2050. This is resulting in increasing demand for healthcare equipment and supplies.

Increasing Global Health Expenditure: According to wHo, global healthcare expenditure is more than £2.9 trillion and is forecast to grow worldwide. In particular, developing countries are experiencing a steady increase in the demand for healthcare equipment and supplies, due to the increase in demand for quality healthcare.

In 2009, the Chinese government announced it would spend £77.5 billion on the healthcare sector over the next three years. In India, 80% of healthcare expenditure comes from the private sector, and huge growth has been seen in developing hospitals with modern healthcare infrastructure.

Globalisation: As regional economies, societies, and cultures become integrated through communication, transportation, and cross border trade, globalisation is taking place and companies are looking to shift certain innovation and product development practices to low cost economies like brazil, Russia, India and China (bRIC). This has also helped to reduce costs of therapies in the western world and reduce manufacturing costs. Many multinational corporates (MnCs) are expanding their manufacturing facilities in China to seize the opportunity of this increasing demand for healthcare equipment in local and international markets.

Smith and nephew has completed its £62 million manufacturing plant in the beijing yizhuang Economic and development Zone. 3M has also started production of dentistry, orthodontics, epidemiology and dermatology devices in its new facility in China. India is seen as a manufacturing hub but is also recognised for its skilled engineers and technologists. Many MnCs such as GE Healthcare and Trivitron Healthcare have invested in building their R&d facilities in cities like bengaluru and Chennai. This trend will largely help north American and European MnCs bring down manufacturing costs.

Self-testing Diagnostic Devices (In Vitro Diagnostics Equipment): In vitro diagnostics (Ivd) equipment captured 10.5% share of the global healthcare equipment and supplies market in 2009. This market is forecast to grow annually by 4.3% up to £30.3 billion by 2016. The value of Ivd testing has increased due to its capability to detect medical conditions early, thus improving cost effectiveness in patient treatment. Technological advancements in these tests have also helped many patients to avoid hospitalisation and contributed to reduced stays in hospitals. Some of the top global players operating in the Ivd segment are Roche diagnostics, Siemens

Healthcare, Abbott laboratories, johnson & johnson (j&j), beckman Coulter, becton dickenson, Sysmex and bio Rad.

Digitisation: The healthcare industry is looking at maximum digitisation of patient information so that it can be accessed from various locations and productivity can be improved. Hospitals are developing internal networks that connect all the diagnostic equipment that feed patient information. This includes computed tomography (CT) scans, x-rays, positron emission tomography (PET) scans, etc. digitisation will increase healthcare productivity by enabling use of better and faster diagnostic equipment, leading to early disease diagnosis and treatment. Paperless hospitals will also increase productivity due to instant test results and records access.

Allscripts has aligned with the top technology leaders to educate 500,000 physicians in the united States on the opportunities associated with the American Recovery and Reinvestment Act (ARRA) — it details President obama’s plan to improve healthcare quality, safety and efficiency, the secure exchange of electronic health information and the adoption of Electronic Health Records (EHR) and associated technologies. The EHR Stimulus Alliance included companies like Cisco, Citrix, dell, Intel, Intuit, Microsoft and nuance and has developed the first nationwide campaign of combining healthcare and technology to help physicians explore opportunities with the ARRA. other companies, like GE Healthcare, Emerson network Power, HP, IbM and Cognizant, are already providing healthcare technology services to hospitals and clinics worldwide.


Page 6

Market Segmentation

disposable Equipment and Suppliesdisposable equipment and supplies forms the largest segment within the global healthcare equipment and supplies sector, contributing 40% of the market’s total value. Products include syringes, catheters, electrodes, sutures, bandages, implantable prostheses, orthotics and prosthetics.

Global demand for disposable equipment and supplies is forecast to increase by 5.5% to £104.8 billion in 2014. The united States is the largest market for disposable equipment and supplies, generating total revenues of £30 billion, accounting for 40% of the £73.6 billion market. Europe is the second largest market with total revenues of £25 billion. within Europe, Germany accounts for the largest share, followed by france, with Italy and uk having almost the same market size. In the developing countries the demand for disposable equipment and supplies will increase, due to the rising quality of healthcare, technological changes and increased purchasing power.

There are two main sub-segments within disposable equipment and supplies:

○ Wound Management Supplies remains the top selling segment with demand forecast to increase by 4.6% to

£18.6 billion in 2014. An increasing trend towards expanding applications in the treatment of moderate-to-severe lacerations has observed best growth in wound dressings. demand for tissue sealants composed of cyanoacrylates and bioengineered fibrins is also forecast to grow due to its superior binding qualities and fast healing advantages. Global demand for non-woven medical disposables, which primarily include fabric-based surgical products like surgical gowns, surgical drapes/drape packs, staff apparel, surgical footwear, towels and bedding, is expected to increase by 4.4% annually, amounting to £15.5 billion in 2014. The regulation for improving healthcare infection standards will also drive growth for higher-cost single-use textiles and garments during surgery and general patient care. Increasingly prevalent incontinence conditions will also boost sales of adult diapers and related goods. Companies that operate within this segment include Abbott laboratories, 3M Company, Smith and nephew, Medtronic, kimberly-Clark, boston Scientific and j&j.

○ Diagnostic and Laboratory Disposable equipment is projected to account for a global demand of approximately £14.3 billion in 2014. Health organisations have further forecast that products for self-testing and professional diagnosis of widely prevalent chronic conditions like cardiac disorders, cancer and diabetes will see the highest demand in the diagnostic and laboratory disposables market. Major players in this sub-segment include j&j, Covidien and becton dickenson. drug delivery devices, catheters and accessories, dialysis supplies and inhalation therapy products are among the other disposable products that are forecast to have an above average growth in global demand. Growth in catheters and accessories will be seen with increased use in cardiovascular, urological, general surgical and inpatient drug administration procedures. demand for dialysis disposables will also increase due to the rise in the number of chronic renal disorders, driven by the worldwide epidemic of type II diabetes. An upward trend in global sales of oxygen therapy and other inhalation device usage will increase due to prevailing chronic respiratory conditions brought on by smoking and pollution.

Global healthcare equipment and supplies – analysis by territory

Source: Datamonitor

Europe33%

Asia-Pacific19%

NorthAmerica

48%

Germany France Italy UK Spain China0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100% Ophthalmic Equipment

Dental Surgery Equipment & Supplies

In Vitro Diagnostics

Otologic & Technical Aids

Other Equipment

Disposable Equipment & Supplies

2.0

3.7

1.8 1.1 3.7

6.9

0.4

0.8

1.4

0.3

0.9

2.9

0.6

0.7

0.50.5

1.1

2.8

1.2 1.5

1.7

1.7

2.1

5.8

0.3 0.4

0.5

0.6

0.8

1.3

1.1 0.6

1.5

0.9

2.0

5.1

Segmentation of top 5 European and Chinese markets in healthcare equipment and supplies

Other Equipment 18%

Otologic & Technical Aids

11%

In Vitro Diagnostics 11%

Dental Surgery Equipment & Supplies 10%

Ophthalmic Equipment 10%

Disposable Equipment & Supplies 40%

Global healthcare equipment and supplies - analysis by product category

Source: Datamonitor

£ bi

llion


Page 7

otologic and Technical AidsThe otologic and technical aids segment covers equipment such as hearing aids and wheelchairs. It accounts for 11.5% of the healthcare equipment and supplies sector worth £21.2 billion in 2009.

According to a report published by winterGreen Research, the global wheelchairs and scooters market amounted to £2.4 billion in 2009 and is expected to grow to £4.9 billion by 2015. Some of the companies that manufacture wheelchairs and scooters are Amigo Mobility, Convaid, Convaequip, drive Medical, Sunrise, yamaha Motor, Piaggio, Patterson and Invacare.

The hearing aid market has experienced a considerable number of technological advancements, resulting in innovative, cosmetically appealing and highly efficient hearing systems. According to wHo, in 2010 there were approximately 300 million people suffering from moderate to severe hearing loss. Europe represents the largest market for hearing aids. The united Sates is the second largest market, with Asia-Pacific expecting to register more than 9% CAGR through the period from 2010 to 2015.

Certain trends, like baby boomers with unhealthy hearing habits and subsequent hearing loss, have highlighted the accelerating demand for hearing aids in the market. The increased demand for quality healthcare and rising incomes in developing economies like the bRIC nations offer new areas of growth for hearing aid manufacturers. Even though the demand for hearing aids is continuously increasing, tough economic conditions and restricted reimbursement measures have hindered the market. Major players in the hearing aids market are Advanced bionics, Cochlear, Gn ReSound, Med-El Medical Electronics, neurelec, Phonak, Siemens Audiologische Technik, Starkey laboratories, Sonic Innovations, widex and william demant.

In vitro diagnostics (Ivd)Ivd devices include devices for clinical chemistry, microbiology, immunology and genetic tests. It also includes diagnostic instruments and related reagents and test kits, such as glucose monitoring meters, and related accessories like testing strips, used in the detection and monitoring of diseases and disorders. Ivd devices captured 10.5% of the global healthcare equipment

and supplies market, amounting to £19.3 billion in 2009; and is forecast to grow to £30.3 billion by 2016.

The clinical chemistry and immune chemistry markets are considered to be the largest Ivd sub-segments, accounting for more than 60% of total revenue. Technological advancements such as next generation dnA sequencing, molecular imaging, and microfluidics-based diagnostic devices are expected to increase growth in categories such as immunochemistry and genetic testing.

According to a freedonia report published in 2010, Ivd testswill amount to 3.9 billion by 2014. This growth will directly increase the revenue earned by the diagnostics equipment segment. This growth is also due to increases in technological advances and new product introductions, which will ultimately lead to earlier disease detection, expanded drug discovery and greater medical research capabilities. The healthcare sector will expand the use of diagnostic testing to make more therapeutic decisions and thus improve the frequency of successful patient diagnosis and treatment. The growth in personal monitoring by patients themselves will also boost the demand for this equipment.

The value of Ivd testing has been escalating as a result of demand from both medical providers and insurers due to its ability to detect medical conditions early, thus resulting in greater cost effectiveness in patient treatment. Advances in these tests have eliminated the need for many cases of hospitalisation or contributed to reduced stay in hospitals.

According to a Markets and Markets report published in April 2010, the bRIC market is expected to grow from £1.8 billion in 2009 to £4.7 billion in 2014, with particularly strong growth in China.

ophthalmic EquipmentThe ophthalmic equipment sector includes eyeglasses, contact lenses and ophthalmoscopes. It accounted for £18.4 billion of the global healthcare equipment and supplies market in 2009. The united States records the largest demand for intraocular lenses (implantable lenses that replace the lens of the eyes during a cataract surgery), which includes monofocal, multifocal and accommodative lenses. The market for intraocular lenses


Page 8

is expected to grow due to the increasing demand for premium lenses.

The ophthalmic equipment sector in Europe is worth £7.7 billion, with Germany, france, uk and Italy being the major markets.

Companies like bausch and lomb, Abbott laboratories, Alcon, Cibavision, j&j and vistakon operate within the ophthalmic equipment segment.

dental Surgery Equipment and SuppliesThe dental surgery equipment and supplies segment includes devices used by dental laboratories and dentists’ offices, such as dental chairs, instrument delivery systems, hand instruments, dental impression materials and dental cements. It captured a market share of 10.2% in 2009, amounting to total revenue of £18.8 billion. The market is estimated to grow at a CAGR of 6.8% to 2014. The main reason for this growth is due to increased demand for dental biomaterials and dental implants. It is further forecast that the markets for dental biomaterials and implants will see an overall CAGR of 10.5% and 12.2% from 2009 to 2014 respectively.

The growth of the dental equipment and supplies market is mainly determined by occurrence of oral disease across the globe. The baby boomer generation in the united States and Europe forms the main consumer target market for dental devices, due to age-related oral problems. Recently, this segment has also seen an increasing demand from a younger target market for cosmetic and aesthetic dentistry procedures, in spite of the high costs and lack of insurance cover. This in turn has boosted the global dental equipment market. Technological advancement has also helped to reduce the turnaround time for dental procedures, thus improving efficiency of the dental practitioners. Improvements in dental biomaterials and tissue regenerative material have also enabled dentists to offer better and long lasting solutions. Targeting customers directly has helped dentists to raise more awareness about dental products and up-to-date technologies. The trend towards increasing cosmetic dental procedures will increase the demand for high-end dental solutions.

Global players including 3M, Aap Implante, dentatus, dentsply International, Henry Schein, Midmark, Sirona dental System and Zimmer dental, operate within the dental surgery equipment and supplies market.

other Equipmentother equipment includes devices like imaging equipment, films and devices for radiotherapy, dialysis, endoscopy, anaesthetics, etc. This segment captures the second largest market share

within the global healthcare equipment and supplies sector. In 2009, it generated £29.9 billion with a market share of 17.9%. Some of the companies that operate in this market are 3M, GE Healthcare, Philips Healthcare and Siemens Healthcare.

Some of the additional segments not mentioned before are stated below:

Home Monitoring EquipmentThis sub-segment includes equipment and devices that measure a patient’s medical state. It includes bedside and table-top monitors as well as personal, implantable and wearable monitors and it encompasses monitors for vital signs, electromyograms, electroencephalograms, sleep apnea, cerebral meters, foetal and neonate monitoring, pulse oximetry, cardiac output, blood pressure, blood glucose and cholesterol monitoring. A Swedish analyst firm, berg Insight, estimated that this booming market was worth £6.2 billion in 2010. The diabetes monitoring segment is the largest sub-segment, amounting to £5.4 billion. one of the most important trends that this sub-segment will observe is the need to network these devices wirelessly to provide better and up-to-date information to the clinicians providing care. Companies like 3M, bosch, bayer, GE Healthcare, Philips Healthcare, Abbott laboratories and Roche operate in this segment.

Cardiovascular and orthopaedic ImplantsThe cardiovascular implants sector includes various devices such as ICds, CRT devices, ICPs, pacing leads, coronary stents, peripheral stents, synthetic grafts, heart valves, ventricular-assist devices, implantable heart monitors and implant procedure packs. The market for cardio implants amounted to £17.9 billion globally in 2009 and is expected to reach £26 billion by 2013. Major players include boston Scientific, Medtronic and St jude Medical.

orthopaedic implants account for the second largest market within the medical implants segment. This segment consists of implants used to replace damaged or troubled joints, including hip, knee, shoulder and elbow implants. The orthopaedic implants market is valued at £20.5 billion and is expected to grow year on year by 7.1%. Major players include Zimmer, johnson and johnson, Stryker and Smith & nephew.

life Science Tools and ServicesThe life science tools and services segment consists of technology solutions that form the basis for drug discovery, applied market testing, and basic scientific and medical research. Such devices form the fundamental building blocks of discovery and development of biopharmaceutical therapeutics and create a breeding ground for many clinically relevant Ivd technologies. The life science tools and services sector can be divided into seven sub-segments: genomics, proteomics, cell biology, combinatorial chemistry, small animal in vivo analysis, bioinformatics, and general labware. According to the report published by Technavio Insights, the life science tools and services market is expected to grow at a CAGR of 10.1%.

Companies like ShangPharma, life Technologies, Thermo fisher Scientific, Cambrex and wuxi Pharma operate within the life science tools and services market.

2004 2009 2014

45004000350030002500200015001000500

0

No.

of I

n Vi

tro

Test

s

Source: Freedonia

Global IVD market 2004-2014

Units of In Vitro Diagnostic Tests


Page 9

nanotechnologynanotechnology is one of the hot trends in the medical devices sector. Applications in nanotechnology are currently being used in drug delivery, in vitro, in vivo diagnostics and implant technology. nanotechnology has accelerated scientific and economic activities in medical research and development, with several medical devices currently being commercialised and benefiting from it. for example, contrast agents are incorporating nanostructured materials to allow better integration in the body, such as in bone replacement material in scaffolds for regenerative medicine and in wound dressings incorporating antibacterial nanoparticles.

Scientists have emphasised the potential for nanotechnology to improve medical devices, and thus provide better patient care. nanotechnology, along with other smart healthcare applications, is expected to bring early diagnosis, more effective treatments, better prognosis and an earlier recovery for the patient. According to a report published by business Insights, the healthcare nanotechnology market in north America amounts to £2.9 billion and £2.3 billion in Europe. further, the nanotechnology drug delivery market is expected to grow at a CAGR of 21.7% for the period between 2009 and 2014, reaching circa £9.9 billion. biocompatible implants, coatings and diagnostics are some of the major applications, projected to experience high growth between 2009 and 2014.

nanotechnology has attracted much government funding in recent years. Currently there are approximately 308 nano-life science companies globally; with 52% in the united States and 21% in Germany. They have different focuses; American companies predominantly use nanotechnology for developing drug delivery and therapeutic products, while European companies are more focused on medical devices and diagnostics. Several developing economies like India, China and korea have also started investing in R&d for use of nanotechnology in the medical devices sector.

Although it has shown exceptional growth over the years, the nanotechnology sector still needs to overcome critical hurdles. Some of these hurdles are in assessing product and patient safety, regulatory legislation and compliance. There has been very little experimental proof on the toxic effects caused by nano-dispersed compounds on patients and their environments. Regulatory legislation at a worldwide level is at an early stage although developed markets like the united States, france and Germany have started drafting regulations for the nanotechnology market. developing nations like India, China and brazil are also proposing draft regulations for the sector. This puts companies investing into the sector in an uncertain position, but such hurdles will be overcome.

Some of the companies that operate in the nanotechnology healthcare equipment and supplies sector include Advanced nanotechnology limited, Advenctus life Sciences, Alnis biosciences, Evident Technologies, GE Advanced Materials, QinetiQ nanomaterials and Samsung.

Replacement/Artificial organsMany patients have lost their lives waiting for various organs to be donated. Advanced engineering of artificial organs

Hot Topics

has provided ground-breaking options for addressing life-threatening illnesses. Some of these new technological advances include fully implantable, self-contained artificial hearts, artificial pancreases and tissue engineers that will be able to grow entire live organs.

with increasing numbers of patients suffering from late stage diseases, organ failure has been responsible for the major part of medical spending. Also, the rising success rate of transplantation has been encouraging organ failure patients to opt for artificial organs. This in turn has increased the list of patients on the transplant list and the artificial organs market is expected to establish high growth rates over the years. Even though a few of these implantable devices have been approved for clinical use, several other devices are still in the clinical trial phase and are awaiting approval. The fdA and other regulatory bodies across the world have now started increasing the number of product approvals for artificial organ transplantations. Global Industry Analytics (GIA) forecast that the artificial organs market will be £9.6 billion by 2015.

Some of the main factors that will fuel this type of growth are: ageing population, increasing success rate in organ transplantation, scarcity of organ donors, and expanding waiting lists for organ transplantation.

Artificial kidneys are leading the global artificial organs market. This trend is mainly observed in the united States and Europe where, due to the increasing prevalence of renal failure, there is a growing need for dialysis. Advancements in bioengineering and technology are expected to develop an implantable artificial pancreas. This is expected to fuel exponential growth, as more than 100 million people suffer from diabetes mellitus. The artificial pancreas market is expected to see significant growth. The global market for artificial lungs is also expected to grow at a CAGR of 7.5% between 2009 and 2015.

The replacement/artificial organs market experienced some interesting M&A activity in 2010. Most of these deals took place in the Asia-Pacific region.

key players operating in the artificial organs sector include Abbott diabetes Care, Asahi kasei kuraray Medical, baxter International, f.Hoffmann-la Roche, fresenius Medical Care, Gambro, Hepalife Technologies, jarvik Heart and Medtronic.

Minimally Invasive Surgery / Procedures (MIS)MIS is performed without making any major incisions or opening the patient’s body. The major benefits of minimally invasive surgical procedures include: superior cosmetic results, reduced post-operative pain and faster recovery rates. These procedures are employed across various specialties. Currently, MIS has been applied to most of the surgical specialties, including cardiothoracic, orthopaedic, urological, vascular and neurological procedures.

MIS has room for varied types of innovation. Manufacturers are now focusing on developing these procedures in newer areas where such procedures have not yet been performed. MIS has also relieved heavy investment in healthcare budgets, as costs for performing these surgeries are much lower than for traditional open surgeries. Therefore, full reimbursement has also been provided for these procedures.


Page 10

Health), a healthcare practice supported by electronic processes and communication. According to a research2guidance’s report published in 2010, smart phone applications will enable the mHealth sector to reach out to 500 million people, out of a total of 1.4 billion smart phone users, by 2015. Currently there are 17,000 mHealth applications in major app stores; 74% of them work on the basis of a paid business model.

Many handset manufacturers have shown interest in health related applications. Google and Microsoft have also released health portals, where users can gather and analyse medical data.

The Home Healthcare Monitoring market has been divided into:

○ Telecare market includes the use of information and communication technologies to transfer medical information for the diagnosis and therapy of patients in their home. The telecare market in Europe has seen a lot of activity, especially in large markets like the uk and Germany. Governments have been investing heavily in telecare infrastructure to cater for their dependent populations and to take timely preventative measures. Currently, only first-generation telecare equipment, like the social alarm, is being used. Second generation equipment like tracking sensors, and third generation equipment like ambient assisted living, are still in the pilot programme stage and are undergoing various research activity. Some of the companies that operate in the telecare market are nokia, Qualcomm, lG, MedApps and boston Scientific.

○ Telemedicine/telehealth market provides remote monitoring of a patient’s vital signs through the use of devices customised by healthcare service providers. fundamental signs such as blood pressure levels are transmitted to a response centre of the clinician’s computer, where it will be monitored and interpreted according to the individual’s health requirements. The global telemedicine market size is forecast to grow from £6.2 billion in 2010 to £14.3 billion by 2015 at a CAGR of 18.6%. within Europe, the uk and Germany have been investing heavily into such technologies and also are the leading markets. Some of the major players that operate within the telemedicine market are Honeywell, Contec, Intel Research, AMd Global Telemedicine, GE and Philips.

Source: research2guidance

Mobile health market by 2015

1200

1000

800

1600

1400

600

400

200

0Total mHealth

1400

500

30% of total smartphone users

will have used mHealth applications

by 2015

Smartphone user base in 2015 (millions)

Services47%

Device Sales30%

Transaction8%

Advertisement1%

Paid Downloads14%

Mobile health revenue split by 2015

These mHealth users will mainly pay for services &

devices

The global market for MIS is forecast to grow from £9.6 billion in 2009 to £14.3 billion in 2014. The united States has the largest market share and is forecast to grow from £5.5 billion in 2009 to £8.4 billion by 2014. The largest application of MIS has been employed in cardiothoracic surgical procedures which represent 75% of the total MIS market. The remaining market includes orthopaedic surgery (12%), gastrointestinal surgery (10%) and gynaecology (3%).

Some of the companies that operate in this segment are Conceptus, Strada Consulting Corporation, Ethicon Endo-Surgery (part of j&j), and Intuitive Surgical.

Home Healthcare Monitoring TechnologyThe home healthcare monitoring technology sector includes equipment and devices that measure the patient’s medical state. The baby boomer generation is suffering from various age-related and lifestyle-related diseases. Companies across the world are developing innovative solutions for this demographic audience. Much of this equipment is designed to help older adults to live independently.

A Swedish analyst firm, berg Insight, estimated that this market was worth £6.2 billion in 2010. The diabetes monitoring segment is the largest sub-segment, amounting to £5.4 billion.

one of the important trends in this market is homecare monitoring equipment with wireless technologies. According to berg Insight, by the end of 2010, approximately 100 million people used home monitoring equipment with integrated connectivity. Several companies like bosch, Honeywell and Phillips have developed integrated solutions for monitoring multiple chronic conditions.

Many companies have also ventured into mHealth (Mobile


Appendix A-i

Appendix: Thumbnail Summaries of Top 30 Medical devices Companies1

1 Companies are ranked based on revenues derived from the medical device sector for the last reported fiscal year. To determine medical device revenues the segmental data reported in the company’s filings/annual reports have been used. All the numbers reported in this section are in € millions. For companies reporting in currency other than €, we have used the exchange rate as at 31 Dec 2010.

4: Fresenius Medical

Brief description

Fresenius Medical is a German-based holding company of the Fresenius Group, operating in the healthcare sector, with products and services for dialysis, hospitals and outpatient medical care. Fresenius also offers engineering and services for hospitals and other health-care facilities. It is organised in four business segments: Fresenius Medical Care, Fresenius Kabi, Fresenius Helios and Fresenius Vamed. Fresenius Medical Care focuses on extracorporeal therapies, dialysis care and manufactures products for treatment of patients with chronic kidney failure. Fresenius Kabi specialises in the production and sale of products for infusion therapy, IV generic drugs, clinical nutrition, as well as medical devices and transfusion technology. Fresenius Helios operates 62 hospitals, including five maximum care hospitals, mostly in Germany. Fresenius Vamed operates in the project and management business of healthcare facilities worldwide.

Country Germany

Business Segments

Year/Business Segments Revenues Med. Device Revenue Revenue Growth Operating Profit Operating Margin

2010 8,993.49 8,993.49 7.0% 1,435.61 16.0%

2009 8,392.09 8,392.09 9.0% 1,310.26 15.6%

2008 7,918.27 7,918.27 14.0%

1: Johnson & Johnson

Brief descriptionJohnson & Johnson (J&J), the world's leading consumer health company, is engaged in the R&D, manufacture and sale of consumer healthcare products, pharmaceuticals, medical devices and diagnostics. The brand portfolio includes many household names like Band-Aid, Tylenol, Johnson’s baby products and Neutrogena.

Country United States

Business Segments


2010 45,953.91 18,356.34 -0.5% 13,207.08 28.7%

Medical Devices & Diagnostic (39.9%) 18,356.34 18,356.34 4.4% 6,172.25 33.6%

Pharmaceutical (36.4%) 16,711.06 -0.6% 5,287.30 31.6%

Consumer (23.7%) 10,886.51 -7.7% 1,747.51 16.1%

2009 46,185.22 17,255.76 4.3% 13,059.34 27.4%

2008 47,565.62 16,219.58 14.6%

2: GE Healthcare

Brief descriptionGE Healthcare is a unit of GE Technology Infrastructure. It has a range of products in medical imaging and information technologies, diagnostics and patient monitoring. Its products also cater to the medical research, drug discovery and biopharmaceutical manufacturing areas. GE Healthcare is aligned to the early prediction and detection of diseases, patient progress monitoring and helping physicians to tailor treatment to suit individual patients.


Business Segments


2010 12,607.91 12,607.91 5.5% 2,045.23 16.2%

2009 11,949.79 11,949.79 -7.9% 1,805.71 15.1%

2008 12,977.26 12,977.26 2.3% 2,127.31 16.3%

3: Siemens

Brief descriptionSiemens is a global group involved in electronics and electrical engineering, operating primarily in the energy and healthcare sectors. It operates in about 190 countries with 15 divisions. Its healthcare division comprises three sub divisions: imaging and IT, workflow and solutions, and diagnostics.

Country Germany

Business Segments


2010 76,980.00 12,364.00 -1.0% 7,789.00 10.7%

Healthcare (16.2%) 12,364.00 12,364.00 748.00 7.5%

Industry (45.3%) 34,869.00 3,478.00 10.0%

Energy (33.5%) 25,520.00 3,362.00 14.0%

Cross Sector Business (5.0%) 4,155.00 -537.00

2009 76,651.00 11,864.00 -0.9% 7,466.00 10.3%

2008 77,327.00 6,606.00 9.3%


Appendix A-ii

8: Boston Scientific

Brief descriptionBoston Scientific is a worldwide developer, manufacturer and marketer of medical devices for application in a range of interventional medical specialties including interventional cardiology, cardiac rhythm management, peripheral interventions, electrophysiology, neurovascular intervention, endoscopy, urology, gynaecology and neuromodulation.


Business Segments


2010 5,825.37 5,825.37 -4.7% 778.36

Cardiovascular (76.1%) 4,431.34 4,431.34

Endosurgery (20.0%) 1,164.18 1,164.18

Neuromodulation (3.9%) 229.85 229.85

2009 6,110.45 6,110.45 975.37

2008 6,007.46 6,007.46 925.37

5: Medtronic

Brief description Medtronic is a medical technology company engaged in research, design, manufacture and sale of products to alleviate pain, restore health and extend life. It manufactures and sells device-based medical therapies.


Business Segments


2010 11,802.05 11,802.05 8.0% 2,961.51 25.0%

CRDM (33.3%) 3,930.78 3,930.78 5.0%

Spinal (22.1%) 2,611.56 2,611.56 3.0%

Cardiovascular (18.1%) 2,137.01 2,137.01 18.0%

Neuromodulation (9.8%) 1,164.01 1,164.01 9.0%

Diabetes (7.8%) 923.00 923.00 11.0%

Surgical Technologies (6.0%) 718.55 718.55 12.0%

Physio-Control (2.9%) 317.11 317.11 24.0%

2009 10,893.23 10,893.23 8.0% 1,820.63 16.7%

2008 10,084.39 10,084.39 2,044.48 20.2%

6: Philips

Brief descriptionKoninklijke Philips Electronics N.V. (Royal Philips Electronics), the holding company of the Philips Group, is a diversified health and well-being company. It is one of the largest electronics companies in the world. The company primarily manufactures medical systems, consumer electronics and lighting products. It operates in Europe, North America and Asia Pacific. It has 127 production sites in 29 countries, and sales and service outlets in approximately 100 countries.

Country Netherlands

Business Segments


2010 25,419.00 8,601.00 9.6% 2,065.00 8.1%

Healthcare (34.0%) 8,601.00 8,601.00 9.7% 922.00 10.7%

Consumer Lifestyle (36.0%) 8,906.00 5.2% 595.00 6.7%

Lighting (29.0%) 7,552.00 15.4% 695.00 9.2%

GM&S (1.0%) 360.00 6.8% -147.00

2009 23,189.00 7,839.00 0.1% 614.00 2.6%

2008 26,385.00 7,649.00 54.00 0.2%

7: Abbott Laboratories

Brief descriptionAbbott Laboratories, is a diversified global healthcare companies, is engaged in the discovery, development, manufacture and sale of pharmaceuticals and medical products. The company sells its products in more than 130 countries. The company operates in five segments: pharmaceutical products, nutritional products, diagnostic products, vascular products and others.


Business Segments


2010 26,240.09 7,268.26 14.3% 7,203.45 27.4%

Pharmaceuticals (54.0%) 14,844.16 5,527.57

Nutritionals (18.0%) 4,127.67 579.76

Diagnostics (12.0%) 2,830.84 2,830.84 417.10

Vascular (9.0%) 2,383.24 2,383.24 679.00

Others (7.0%) 2,054.18 2,054.18

2009 22,954.95 6,711.00 4.2% 6,205.09 27.7%

2008 22,032.69 4,339.68 13.9% 5,797.68 26.8%


Appendix A-iii

10: Becton, Dickinson & Co

Brief descriptionBecton, Dickinson & Co (BD) is a global medical technology company engaged in the development, manufacture and sale of medical devices, instrument systems and reagents. The company’s products are used by healthcare institutions, life science researchers, clinical laboratories, the pharmaceutical industry and the general public. BD’s operations consist of three business segments: BD Medical, BD Diagnostics and BD Biosciences.


Business Segments


2010 5,500.70 5,500.70 5.5% 1,251.16 23.0%

Medical (51.5%) 2,832.43 2,832.43

Diagnostics (31.5%) 1,730.35 1,730.35

Biosciences (17.0%) 937.92 937.92

2009 5,213.22 5,213.22 1.2% 1,186.16 23.0%

2008 5,146.74 5,146.74 13.0% 1,110.39 21.7%

9: Cardinal Health

Brief descriptionCardinal Health is a healthcare services company that provides products and services to pharmacies, hospitals, ambulatory surgery centers and physician offices. It distributes pharmaceutical, radiopharmaceutical and over-the-counter healthcare products as well as medical, surgical and laboratory products. The company operates primarily in the United States. The company specialises in healthcare supply chain services delivering medical products to more than 40,000 locations every day.


Business Segments


2010 73,526.85 6,528.99 3.0% 975.15 1.3%

Medical (8.9%) 6,528.99 6,528.99 7.0% 319.13 4.8%

Pharmaceuticals (91.1%) 66,997.86 2.0% 747.50 1.1%

2009 71,625.29 6,088.16 10.0% 960.61 1.3%

2008 65,220.75 5,907.14 1,038.95 1.5%

11: Baxter International

Brief descriptionBaxter International is a global diversified healthcare company with expertise in medical devices, pharmaceuticals and biotechnology. The company develops, manufactures and markets products for the treatment of complex medical conditions including hemophilia, immune disorders, kidney disease, trauma and other conditions. The company primarily operates in the United States and Europe.


Business Segments


2010 9,548.70 5,340.30 2.0% 1,410.00 14.7%

Biosciences (44.0%) 4,208.40 3.5%

Medication Delivery (37.0%) 3,557.70 3,557.70 1.0%

Renal (19.0%) 1,782.60 1,782.60 3.0%

2009 9,373.30 5,159.70 1.7% 2,040.00 21.8%

2008 9,213.60 5,123.20 9.6% 1,837.10 19.9%

12: Stryker Corporation

Brief description

Stryker Corporation is a medical technology company with a range of products in orthopaedics and other medical specialties. The company's products include implants used in joint replacement, trauma, spinal and craniomaxillofacial; surgical equipment and surgical navigation systems, endoscopic and communications systems; patient handling and emergency medical equipment, as well as other medical device products used in a variety of medical specialties. The company operates in two business segments: med/surg equipment and orthopaedic implants.


Business Segments


2010 5,461.90 5,461.90 8.9% 1,306.80 23.9%

Medical/Surgical (41.1%) 2,247.10 2,247.10 15.7%

Orthopaedic (58.9%) 3,214.80 3,214.80 4.6%

2009 5,016.50 5,016.50 0.1% 1,189.70 23.7%

2008 5,012.90 5,012.90 12.0% 1,133.40 22.6%


Appendix A-iv

15: B. Braun

Brief descriptionB. Braun is a leading manufacturer of infusion therapy and pain management products with an environmentally-friendly focus. B. Braun addresses the critical issues of infection prevention, medication safety and environmental responsibility by promoting best practices that help clinicians reduce medication errors and prevent healthcare-acquired infections.

Country Germany

Business Segments


2010 4,398.00 4,398.00 9.8% 456.20 10.3%

Hospital Care (47.5%) 2,087.00 2,087.00 9.6%

Aesculap (29.1%) 1,281.00 1,281.00 11.1%

Out Patient Market (12.6%) 555.00 555.00 5.5%

B. Braun Avitum (10.8%) 475.00 475.00 12.8%

2009 4,028.20 4,028.20 6.4% 444.50 11.0%

2008 3,786.40 3,786.40 6.0% 390.60 10.3%

14: Covidien

Brief description

Covidien is engaged in the development, manufacture and sale of healthcare products for use in clinical and home settings. The company operates through three segments: medical devices, pharmaceuticals and medical supplies. Medical devices include the development, manufacture and sale of endomechanical instruments, soft tissue repair products, energy devices, oximetry and monitoring products, airway and ventilation products, products used in vascular therapies and other medical products. Pharmaceuticals include the development, manufacture and distribution of specialty pharmaceuticals, active pharmaceutical ingredients, contrast products and radiopharmaceuticals.

Country Ireland

Business Segments


2010 7,781.70 6,296.10 1.6% 1,539.30 19.8%

Medical Devices (64.4%) 5,010.50 5,010.50 9.6%

Medical Supplies (16.5%) 1,285.60 1,285.60 5.5%

Pharmaceuticals (19.1%) 1,485.60 11.1%

2009 7,657.90 5,708.40 3.6% 1,352.80 17.7%

2008 7,394.50 5,869.90 11.4% 1,452.00 19.6%

13: Olympus Corporation

Brief description

Olympus Corporation manufactures optics and reprographic products. The company operates in four segments: imaging, medical, life sciences and information and communication. The imaging business covers products in its digital camera and IC recorder lineups. The medical systems business covers gastrointestinal endoscopes, surgical endoscopes, endotherapy devices, endoscopic ultrasound systems and medical information systems. The life sciences business is aligned with the medical research segment offering live cell imaging and bioimaging technology. Olympus also offers industrial endoscopes, ultrasonic defect detection devices and eddy current flaw detectors.

Country Japan

Business Segments


2010 6,809.30 3,896.70 -4.10% 302.10 4.2%

Imaging Systems (16.5%) 1,122.70 -25.0%

Medical Systems (44.6%) 3,035.50 3,035.50 1.3%

Life Sciences (12.6%) 861.20 861.20 -12.0%

Information & Communication (26.3%) 1,789.90 11.0%

2009 7,544.20 3,966.30 -10.0% 513.90 6.8%

2008 8,379.00 4,140.90 -13.1% 962.10 11.5%

16: St. Jude Medical

Brief descriptionSt. Jude Medical develops, manufactures and distributes cardiovascular medical devices for the global cardiac rhythm management, cardiology and cardiac surgery and atrial fibrillation therapy areas and neurostimulation medical devices for the management of chronic pain. It operates in four segments: cardiac rhythm management, cardiovascular, atrial fibrillation and neuromodulation. The company markets its products in about 100 countries across the world.


Business Segments


2010 3,853.70 3,853.70 10.3% 952.80 24.7%

Cardiac Rhythm Management (58.9%) 2,268.30 2,268.30 9.8%

Cardiovascular (20.1%) 773.50 773.50 8.7%

Atrial fibrillation (13.5%) 528.20 528.20 12.7%

Neuromodulation (7.4%) 283.70 283.70 15.0%

2009 3,492.80 3,492.80 7.3% 830.50 23.8%

2008 3,255.50 3,255.50 15.5% 488.70 15.0%


Appendix A-v

17: 3M Healthcare

Brief description

3M is a diversified technology company which operates in the following markets: industrial and transportation; healthcare; safety, security and protection services; consumer and office; display and graphics; and electro and communications. 3M Healthcare manufactures innovative products and solutions for medical, oral care, health information management, drug delivery and food safety. These products leverage 3M technology, world-class manufacturing and global reach to provide trusted products that help promote health and improve quality, cost and outcomes.



18: Zimmer Holdings

Brief description

Zimmer Holdings designs, develops, manufactures and markets orthopaedic reconstructive implants, dental implants, spinal implants, trauma products and related surgical products. It also provides other healthcare related services. The company has operations in more than 25 countries and markets its products in more than 100 countries. The company’s primary customers include orthopaedic surgeons, neurosurgeons, oral surgeons, dentists, hospitals, stocking distributers, healthcare dealers and, in their capacity as agents, healthcare purchasing organisations or buying groups.



2010 20,197.90 3,373.40 15.3% 4,415.80 22.2%

Industrial & Transportation (31.7%) 6,402.80 18.7%

Healthcare (17.0%) 3,373.40 3,373.40 5.3%

Consumer & Office (14.5%) 2,875.00 11.0%

Safety, Security & Protection (12.4%) 2,468.30 8.0%

Display & Graphics (14.4%) 2,898.10 24.0%

Electro & Communication (10.0%) 2,180.30 28.0%

2009 17,253.50 3,204.00 -8.5% 3,592.00 20.8%

2008 18,854.80 3,210.70 3.3% 3,893.50 20.6%

Business Segments

Business Segments

2010 3,148.80 3,148.80 3.1% 919.30 29.2%

Reconstructive (75.9%) 2,389.20 2,389.20 2.6%

Dental (5.2%) 163.40 163.40 6.8%

Trauma (5.8%) 183.60 183.60 4.7%

Spine (5.5%) 174.60 174.60 -7.5%

Surgical and Other (7.6%) 238.00 238.00 13.1%

2009 3,055.50 3,055.50 -0.6% 882.70 28.9%

2008 2,908.54 3,074.90 5.7% 921.50 30.0%

Business Segments

2010 2,956.30 2,956.30 5.0% 686.50 23.2%

Orthopaedics (55.0%) 1,626.00 1,626.00 1.4%

Endoscopy (22.0%) 650.40 650.40 10.0%

Advanced Wound Management (23.0%) 679.90 679.90 9.8%

2009 2,814.50 2,814.50 -0.8% 539.50 19.2%

2008 2,836.20 2,836.20 12.8% 470.10 16.6%

19: Smith & Nephew

Brief description

Smith & Nephew is a global medical devices business operating in the orthopaedics, endoscopy and advanced wound management markets. Orthopaedics consists of reconstruction, trauma and clinical therapies products. The endoscopy business develops and commercialises endoscopic techniques, educational programmes and value-added services for surgeons to treat and repair soft tissue and articulating joints. The company’s advanced wound management business offers a range of products from initial wound bed preparation through to full wound closure.

Country United Kingdom



Appendix A-vi

Business Segments

2010 2,699.60 2,699.60 4.4% 540.60 20.0%

General Hospital (47.4%) 1,279.60 1,279.60 2.2%

Catheter & Cardiovascular (43.0%) 1,160.40 1,160.40 6.9%

Blood Transfusion (7.6%) 204.60 204.60 0.3%

Home Healthcare (2.0%) 55.00 55.00 20.5%

2009 2,586.40 2,586.40 -1.2% 461.70 17.8%

2008 2,617.40 2,617.40 10.8% 571.90 21.8%

Business Segments

2010 2,733.48 2,733.48 12.3% 298.10 11.0%Clinical Diagnostics (87.6%) 2,394.53 2,394.53 Life Sciences (12.4%) 338.95 338.95 2009 2,432.93 2,432.93 5.2% 172.51 7.0%2008 2,312.28 2,312.28 212.28 9.1%

Business Segments2010 2,751.10 2,751.10 8.0% 957.38 35.0%2009 2,533.99 2,533.99 6.3% 867.58 34.3%2008 2,382.12 2,382.12 15.7% 805.96 33.8%

21: Synthes has been acquired by J&J

Brief description

Synthes is a medical device company specialising in the development, manufacturing and marketing of instruments, implants and biomaterials for the surgical fixation, correction and regeneration of the human skeleton and its soft tissues (osteosynthesis). The company focuses on three main areas: general traumatology, spinal surgery and cranio-maxillofacial surgery; and five product groups: trauma, spine, cranio-maxillofacial (CMF), biomaterials and power tools. It has affiliates and distributors across the world, including the United States, Latin America, Europe, the Middle East and Asia.



20: Terumo Corporation

Brief description

Terumo Corporation is a medical technology company engaged in the manufacture and sale of a range of medical products and equipment, including pharmaceuticals. It operates in four business segments. The general hospital products segment is engaged in the manufacture, importation and sale of hospital medical equipment, pharmaceuticals, peritoneal dialysis and diabetes related products. The cardiac and vascular products segment is involved in the manufacture, importation and sale of catheter systems, artificial heart and lungs, as well as artificial blood vessel. The blood transfusion-related products segment is engaged in the manufacture, importation and sale of blood transfusion-related products.

Country Japan


22: Beckman Coulter

Brief descriptionBeckman Coulter is engaged in the design, manufacture and marketing of biomedical testing instrument systems, tests and supplies. It operates in two segments: clinical diagnostics and life sciences. Its products are used in a range of applications, including medical research, clinical trials and drug discovery, and diagnostic laboratories in hospitals.



Business Segments

2010 9,850.81 3,053.75 18.0% 1,616.18 16.0%

Test & Measurement (22.0%) 2,167.18

Environmental (21.0%) 2,068.67

Life Sciences & Diagnostics (17.0%) 1,674.64 1,674.64

Dental (14.0%) 1,379.11 1,379.11

Industrial Technologies (24.0%) 2,364.20

Businesses contributed to theApex Joint Venture (2.0%) 197.01

2009 8,345.75 -11.9% 1,150.93 14.0%

2008 9,474.36 15.1% 1,394.92 15.0%

23: Danaher Corporation

Brief descriptionDanaher Corporation is a global diversified technology company. It designs, manufactures, and markets innovative products and services to professional, medical, industrial, and commercial customers. Danaher operates in four segments: professional instrumentation, medical technologies, industrial technologies, and tools & components.




Appendix A-vii

Business Segments

2010 5,356.69 2,402.64 10.4% 1,846.75 34.4%

Pharmaceutical (41.0%) 2,287.73 14.0%

Surgical (46.0%) 2,402.64 2,402.64 7.4%

Consumer (13.0%) 666.32 7.6%

2009 4,849.29 2,088.90 14.8% 1,687.00 34.4%

2008 4,696.33 2,072.70 1,624.00 34.5%

Business Segments

2010 1,965.07 1,965.07 7.3% 545.00 27.0%

Vascular (28.7%) 564.09 564.09 11.0%

Urology (27.3 %) 535.74 535.74 3.0%

Oncology (27.5%) 540.96 540.96 7.0%

Surgical Specialties (16.5%) 324.28 324.28 12.0%

2009 1,891.44 1,891.44 3.4% 501.00 26.2%

2008 1,829.65 1,829.65 412.40 22.5%

Business Segments

2010 2,013.14 2,013.14 7.7% 266.08 13.2%

Musculoskeletal (100.0%) 2,013.14 2,013.14 17.3%

2009 1,868.45 1,868.45 17.3% -259.88 -13.9%

2009 1,592.67 1,592.67 -498.65 -31.3%

24: Alcon

Brief description

Alcon is a research and development driven, global medical specialty company focused on eye care. It is engaged in the development, manufacture and marketing of pharmaceuticals, surgical equipment and devices, and consumer eye care products for the treatment of eye disorders. The company operates in two business segments: Alcon United States and Alcon International. Its portfolio includes three principal ophthalmic categories: pharmaceutical, surgical and consumer eye care products. The company primarily operates in the United States, Japan and Switzerland.

Country Switzerland


26: Biomet

Brief descriptionBiomet is one of the leading providers of orthopaedic products. The company manufactures and markets a range of surgical and non-surgical musculoskeletal products in four major product categories: reconstructive products, fixation devices, spinal products and other products. Its products are used primarily by orthopaedic surgeons and other musculoskeletal medical specialists. The company has operations in more than 50 locations worldwide and distribution in approximately 90 countries.



25: C. R. Bard

Brief descriptionC.R. Bard is engaged in the design, manufacture, packaging, distribution and sale of medical, surgical, diagnostic and patient care devices. The company sells a range of products worldwide to hospitals, individual healthcare professionals, extended care facilities and alternate site facilities. C. R. Bard has four product group categories: vascular, urology, oncology and surgical specialties. The company primarily operates in the United States, Japan and Europe.



27: Dentsply International

Brief description

Dentsply International is a designer, developer, manufacturer and marketer of a range of products for the dental market. The company conducts its business through four operating segments, which are aligned to three principal categories: dental consumables, dental laboratory products and dental specialty products. It offers dental prosthetics, precious metal dental alloys, dental ceramics, endodontic instruments and materials, prophylaxis paste, dental sealants, ultrasonic scalers, bone grafting materials and crown and bridge materials. It primarily operates in the United States, Switzerland and Germany.



Business Segments

2010 1,516.00 1,516.00 3.0% 283.54 17.1%Specialties (46.0%) 697.36 697.36 Chair side Consumables (35.0%) 530.60 530.60 Prosthetics (16.0%) 242.56 242.56 Non-Dental (3.0%) 45.48 45.48 2009 1,611.64 1,611.64 -1.5% 284.43 17.4%2008 1,636.86 1,636.86 283.85 17.3%


Appendix A-viii

29:Toshiba Corporation

Brief description

Toshiba Corporation is a diversified manufacturer and marketer of advanced electronic and electrical products. Its product portfolio includes information and communications equipment and systems, internet based solutions and services, electronic components and materials, power systems, industrial and social infrastructure systems, and household appliances. The company is an innovator in medical imaging technology and markets diagnostic imaging systems based on patient-focused technology and optimum system performance.

Country Japan


28: Agfa Healthcare

Brief description

Agfa Healthcare, a part of Agfa-Gevaert group, is a provider of information technology enabled healthcare imaging solutions and systems used for capturing and processing images in hospitals and healthcare facilities. The company primarily develops hospital information systems, clinical information systems, radiology information systems, cardiology information and image management systems, and picture archiving and communication systems. It also provides digitizers, ID (identification) cameras, cassettes and imaging plates, laboratory information systems, digital radiography, computed radiography, print solutions, and film and associated products.

Country Belgium


30: Hospira

Brief descriptionHospira is a pharmaceutical and medication delivery company that develops, manufactures and markets products. Its portfolio includes generic acute-care and oncology injectables, as well as integrated infusion therapy and medication management systems. These products are used by hospitals and alternate site providers, such as clinics, home healthcare providers and long-term care facilities.



Business Segments

2010 1,180.11 1,180.11 0.0% 110.50 9.3%Hardcopy (29.0%) 342.20 342.20 Classic Radiology (14.0%) 165.20 165.20 CR/Modalities (18.0%) 212.40 212.40 HIS/CIS (11.0%) 129.91 129.91 Imaging IT (28.0%) 330.40 330.40 2009 1,178.00 1,178.00 -3.7% 104.00 8.8%2008 1,223.00 1,223.00 -12.1% -90.00 -7.2%

Business Segments

2010 54,518.00 -4.0% 999.53 2.0%Digital Products (34.0%) 18,536.12 Electronics Devices (19.0%) 10,358.42 Social Infrastructure (34.0%) 18,536.12 Home Appliances (8.0%) 4,361.44 Others (5.0%) 2,725.90 2009 56,849.54 -13.1% -2,569.45 2008 65,484.93 7.7% 2,437.90 3.4%

Business Segments

2010 2,922.87 745.49 1.0% 387.40 13.0%Specialty Injectable Pharmaceuticals (60.0%) 1,753.11 Medication Management (25.0%) 745.49 745.49Other Pharma (15.0%) 424.27 2009 2,894.58 6.9% 375.24 13.0%2008 2,708.19 5.6% 386.36 14.0%


Page 19

IMAP’s Healthcare Sector Team

for a comprehensive list of IMAP advisors and to discover how IMAP can help you with your M&A transaction, go to www.imap.com

CroatiaJurgis Oniunas [email protected]

Czech RepublicMichal Misun [email protected]

DenmarkAndreas Lauth [email protected]

GermanyAlexander Bolz [email protected]

HungaryIstvan Preda [email protected]

IndiaShiraz Bugwadia [email protected]

ItalyAntonio [email protected]

Mexico Gabriel Millá[email protected]

SpainMireia Sauret [email protected]

Switzerland Christoph Bieri [email protected] [email protected]

United KingdomRamesh Jassal [email protected] Moore [email protected]

United StatesMarc [email protected] [email protected]


www.clearwatercf.com© COPYRIGHT 2010 CleaRwaTeR CORPORaTe FInanCe llP. THIS RePORT anD THe InFORMaTIOn HeReIn IS THe eXClUSIVe DOMaIn OF CleaRwaTeR anD MaY nOT Be USeD OR RePRInTeD wITHOUT PeRMISSIOn.


Healthcare Equipment_Global Report 2011

Documents

swedish analyst

baby boomer

life science

reckitt benckisers

cardiac rhythm

patients medical

global healthcare

fresenius