GLOBAL MEDICAL DEVICE MARKET OUTLOOK, 2018 - PRESENTED AT AUSMEDTECH MAY 2018 - SQUARESPACE

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GLOBAL MEDICAL DEVICE MARKET OUTLOOK, 2018 - PRESENTED AT AUSMEDTECH MAY 2018 - SQUARESPACE
Global Medical Device Market
                  Outlook, 2018
                 Presented at AusMedTech

May 2018
GLOBAL MEDICAL DEVICE MARKET OUTLOOK, 2018 - PRESENTED AT AUSMEDTECH MAY 2018 - SQUARESPACE
Global Healthcare Revenue by Sector in 2017 and 2018
                               Total Healthcare Industry: Revenue Forecast by Sector, Global, 2017 and 2018
                                                                                                                                                          2017
                           1,500
                                                       1,246                                                                                              2018
                                          1,195
     Revenue ($ Billion)

                           1,000

                             500                                371    390

                                                                                                                65       72                108        115
                                                                                   29        31
                                0
                                          Pharma and             Medical         Medical Imaging                  In-Vitro                Healthcare IT
Sector
                                            Biotech            Technologies        Equipment                    Diagnostics
Growth Rate
                                              4.3%                5.2%               4.4%                         10.0%                        6.4%
(2017–2018)
                                                                         2017                         2018                              Growth Rate
                           Total Healthcare Industry
                                                                      1,768.61                       1,853.83                              4.82%
                                   ($ Billion)

                                                                                     Note: All figures are rounded. The base year is 2017. Source: Frost & Sullivan
GLOBAL MEDICAL DEVICE MARKET OUTLOOK, 2018 - PRESENTED AT AUSMEDTECH MAY 2018 - SQUARESPACE
Global Healthcare Revenue by Region in 2017 and 2018
               Total Healthcare Industry: Revenue Forecast by Region, Global, 2017–2018
   North                                                                           Asia-Pacific
                                           Europe
  America                                  22.8%                                 (excluding Japan)
   38.5%                                                                               18.5%
 714.52 Bn                               422.04 Bn
                                            1.0%                                    342.39 Bn
    3.1%                                                                               11.1%

                                                                                                                              Japan
                                                                                                                               9.4%
               Latin
                                                                                                                            174.40 Bn
              America
                7.4%                                                                                                           2.3%
                                                                  Row
             137.08 Bn                                            3.4%
               10.9%                                            63.40 Bn
                                                                 13.8%
2018 Percent of total global share   Projected 2018 market size in $Billion        2018 Projected Growth Rate
                                                                 Note: All figures are rounded. The base year is 2017. Source: Frost & Sullivan
GLOBAL MEDICAL DEVICE MARKET OUTLOOK, 2018 - PRESENTED AT AUSMEDTECH MAY 2018 - SQUARESPACE
Global Medical Device Industry Market Snapshot, 2017–
2018
               Medical Device Industry: Revenue Forecast, Global,                    Medical Device Industry: Percent Sales by Segment, Global,
                                  2017–2018                                                                     2018Aesthetics, 1.9%
                                                                                                        Neuro,
                                                                                 Respiratory - Anesthesia, Uro-Gyno, 1.9%              Robotics-Navigation, 1.9%
                            Growth Rate: 5.2%                                                                     2.8%
                                                                                           4.7%
                                                                                                    Audiology, 4.7%
  Revenue ($

                                                                                                                                             Others*, 28.1%
   Billion)

                $370.8 B                                  $390.1 B                      Patient Monitoring, 5.5%
                                                                                              Wound Care, 5.7%

                                                                                                                                             Ortho, 13.2%
                                                                                             Ophthalmology, 8.5%

                                                                                                             Cardio, 9.5%
                                                                                                                     Minimally Invasive, 11.6%
                                                                                         Medical Device Industry: Percent Sales by Region, Global,
                                                                                          Brazil India
                                                                                                       ROW         2018
                                                                                                             19.8%                         United States
                                                                                           1.1% 1.2%
                                                                                                                                              39.0%
                                                                                            Spain
                           2017                         2018                                2.0%
                                                                                              Russia
                                                                                               2.1% France
                                                                                                     4.0%
                                                                                                     UK       China
                                                                                                    4.0%      8.1% Germany Japan
*Others include durable medical equipment, hospital supplies, consumables, and                                       9.9%      8.9%
sterilization and decontamination equipment.                                        Note: All figures are rounded. The base year is 2017. Source: Frost & Sullivan
   4
GLOBAL MEDICAL DEVICE MARKET OUTLOOK, 2018 - PRESENTED AT AUSMEDTECH MAY 2018 - SQUARESPACE
Global Medical Device Industry—Top 3 Segments
Snapshot, 2017–2018
    Medical Device Industry: Top 3 Segments Revenue and Growth                       Medical Device Industry: Revenue Split by Segments and
                     Forecast, Global, 2017–2018                                                     Growth Potential, 2018
         80.0
                                                                                                           Equipment/      Consumables/Acc
         60.0
Revenue ($

                                                                                                                                                 Services
                                                                                                            Implants           essories
 Billion)

         40.0                                                                         Revenue Split           60%                35%               >5%

         20.0                                                                         Growth Rate             2-5%               4-8%             10-15%
                   49.0 51.3             42.0 45.3           35.0 36.9
             0.0
                   Orthopedic           Endoscopy             Cardiac
                                    2017        2018
                                                                                                          Services                                 Analytics
Medical Device Industry: Top 3 Segments Revenue Share By Region,
                           Global, 2018                                                                   Incremen                                   Data
                                                                                                              tal                                 Management
                           Orthopaedic           Endoscopy               Cardiac                          Products

   United States                62.5%                44.7%               40.1%
                                                                                       Product            Product               Product             Product
   Europe                       22.5%                23.8%               28.1%

   Asia Pacific                 11.0%                19.5%               24.0%

   Rest of World                4.0%                 12.0%                7.8%          Product            Service                Product            Solution
                                                                                        Supplier           Provider               Supplier           Provider

                                                                                   Note: All figures are rounded. The base year is 2017. Source: Frost & Sullivan
 5
GLOBAL MEDICAL DEVICE MARKET OUTLOOK, 2018 - PRESENTED AT AUSMEDTECH MAY 2018 - SQUARESPACE
Analysis of M&A Deals in Global Medical Device Industry,
2017
Where are Companies Placing Their Bets?
 •   Business expansion, increasing market share, market consolidation, and technology expansion to leverage first-mover
     advantage are the main reasons driving the acquisitions for tier-1 companies.
 •   Growth by acquisition is still a medical device company’s go-to strategy, one trend that is expected to remain stable over the
     next 3 to 5 years. In-house R&D investments have declined in 2017, globally.

        Notable Consolidation                                Mega Merger                                 Notable Company

          In the recent years five               M&A in 2017 in Top 10 medical                    Most notable is Essilor's merger
          out of the top 30                      device companies was driven by                   with Luxottica Group, owner of
          companies have been                    Product portfolio strengthening.                 the Ray-Ban and Oakley brands,
          acquired hence                         Abbott acquiring St Jude medical to              in a $49 billion deal that would
          consolidating the top 10               strengthen its Cardiac portfolio and             create a giant in the eyewear
          players with 30- 40 percent            Medtronic acquiring Crospon to                   industry
          of the global medical                  strengthen its Endoscopy portfolio
          device market.
GLOBAL MEDICAL DEVICE MARKET OUTLOOK, 2018 - PRESENTED AT AUSMEDTECH MAY 2018 - SQUARESPACE
Transformation in the Medical Device Industry Ecosystem—2018
Growth Stars
         Key Areas of Activity in 2018

     On Body                In-Home        Community               In-Clinic                  In-Hospital

                          Home Medical       Mobility                   Lab-on-a Chip              Connected
    Wearables
                          Devices                                                                  Equipment
    Smart                 Consulting/        Supply Chain               Ambulatory                 Smart OR
    Devices               Coaching           Logistics                  Therapies
                          Activity           Emergency                 Handheld                    Real-time
    Peripherals
                          Monitoring         Response                  Medical                     Location System
                                             Intelligence              Technologies
    Next                  Digital            Automated                  Care Co-                   Patient
    generation            Assistants         Kiosks                     ordination                 Surveillance
    Implants                                                            Technologies
                        Storage/
     Analytics/         Database          Cyber-            Machine               Inter-             Decision
    Informatics        Management        Security           Learning            operability          Support

                                                                                              Source: Frost & Sullivan
GLOBAL MEDICAL DEVICE MARKET OUTLOOK, 2018 - PRESENTED AT AUSMEDTECH MAY 2018 - SQUARESPACE
Key Trends Driving MedTech Business Model Shift

 Factors Driving Business
                                 From                   To                                                     Objective
  Model Transformation

                                                                        Growing importance of performance metrics tied to reimbursement
                            Fee for Service       Outcome Based         • Opportunities to support providers in extending care across the continuum and
     Contract Model
                              (Volume)                (Value)              population health management (PHM)
                                                                        • Increased focus on patient/consumer and patient satisfaction

                                                                        Increasing centralization of hospital purchasing process
                                                 Physician-led GPOs
                               Physician                                • Hospital consolidation - Shift to fewer decision makers
    Target Customer                            (Clinical and Economic
                            (Clinical Value)                            • More standardization and increasing importance of administrators and economic
                                                        Value)
                                                                            buyers

                                                                        Increasing demand for solutions versus stand-alone products
    Portfolio Strategy        Diversified            Targeted           • Growing provider desire for fewer and deeper partnerships
                                                                        • Shifting market focus from medical devices to end-to-end digital health solutions

                                                                        Shifting patient mix from inpatient to outpatient
                                                                        • Technologies (e.g. mHealth, RPM, Homecare) and reimbursement promoting lower
                               Inpatient            Outpatient
      Care Delivery                                                         acuity care settings
                                 Care           (Pre and Post Care)
                                                                        • Providers and payers need to manage cost and justify value across the care
                                                                            continuum
                                                                                                                                        Source: Frost & Sullivan
GLOBAL MEDICAL DEVICE MARKET OUTLOOK, 2018 - PRESENTED AT AUSMEDTECH MAY 2018 - SQUARESPACE
Medical Technologies Market—Key Growth
  Opportunities

          Connected Devices                  Hospital Patient Monitoring                   Digitizing Cancer Intervention
• Connected devices and those              • Analytics and real-time monitoring        •    "Precision in Care" would be the
  enabling healthy living and aging are      capabilities would be the value                focus for cancer therapy
  set for double digit growth and            proposition of patient monitoring              manufacturers with investments in
  increased global adoption in 2018.         companies, moving forward.                     digitization of therapies, improving
                                                                                            visualization and surgical
• The cardiac sector will lead the way     • Hospital-centric patient monitoring
                                                                                            techniques, and workflow
  in the adoption of connected devices       will be driven by the shift to wireless
                                                                                            integration solutions.
  to support the care continuum.             real-time monitoring, enabling the
                                             clinical community to drive greater
                                             efficiencies.

Image Source: Thinkstock, Frost Database                                                                        Source: Frost & Sullivan
GLOBAL MEDICAL DEVICE MARKET OUTLOOK, 2018 - PRESENTED AT AUSMEDTECH MAY 2018 - SQUARESPACE
Medical Imaging Equipment Market—Key Growth
  Opportunities

                    AI in                        Portable and Handheld                          Digital
                  Imaging                             Ultrasound                             Tomosynthesis
• AI will move mainstream in the            • High growth opportunities in the    •   Digital Tomosynthesis continues to
  imaging diagnostics segment,                ultrasound imaging category with        evolve as a more effective diagnostic tool
  leveraging advanced/ deep learning          capabilities beyond established         in breast imaging and digital x-ray
  capabilities to improve screening           clinical segments.                      technologies, and is expected to spur
                                                                                      market growth in the next 2-3 years.
  outcomes.                                 • Key areas of growth include: POC,
                                                                                  •   With x-ray technologies, Digital Chest
• Operationalizing AI platforms across        primary care, musculoskeletal,
                                                                                      Tomosynthesis (DCT) is also proving to
  medical imaging workflows would             emergency medicine, anesthesia,         be more effective at guiding clinical
  result in 10–15% productivity gains         pain management, and fusion             decision making around detecting lung
  for radiologists in the next 2-3 years.     imaging.                                nodules.

Image Source: Thinkstock, Frost Database                                                                    Source: Frost & Sullivan
2018 Healthcare IT Market—Key Growth Opportunities

          Cloud Solutions for                                     Cognitive                                           Care
              Healthcare                                          Computing                                        Management
 • Increasing volume and complexity of             • Meaningful cognitive solutions have an           •   Solutions that allow management,
   healthcare data underscore the potential          estimated revenue potential of over $40              integration and analytics of genomics,
   to develop new and innovative solutions           billion by 2025. While the benefits                  medical records and population health
   that leverage cloud platforms.                    accrued by various healthcare industry               data will enable Precision Medicine.
                                                     stakeholders through cognitive
 • Adoption of cloud-based clinical                                                                   •   Precision Medicine solutions will play a
                                                     computing could be well over $150
   applications including EMRs, HIE, PHM                                                                  pivotal role in not just drug discovery
                                                     billion by that time.
   solutions and teleradiology will peak in                                                               but, also, improvements in care quality,
   the next 3-5 years but the game-                • The data deluge in healthcare is paving              outcomes and chronic disease
   changer will be real-world data.                  the way towards analyzing information                management.
   collaborations.                                   and deriving “value” for stakeholders.

Note: EMR—Electronic Medical Record, HIE—Health Information Exchange, PHM—Population Health Management.
Image Source: Thinkstock, Frost Database                                                                                       Source: Frost & Sullivan
Medical Technologies Sector Companies to Watch—
2018
      Abbott Laboratories                                    Abiomed
Continuous Glucose Monitoring                      Miniaturized Circulatory                      Digital Wound Management
                                                      Support Devices                                     Solution
Brief Summary:                               Brief Summary:                                Brief Summary:
Provides a continuous flash glucose          With the FDA approval of Impella RP® for      The company’s advanced wound care
monitoring system called Libre, at 1/4 the   Right Heart Failure in 2017 and with its      business, comprising 26% of its 2016
cost of existing systems, FDA approved in    Impella series of heart pumps, Abiomed is     revenue of $4.7 billion, has been stagnating
September 2017 and received                  the only solution provider of percutaneous    over the last 5 years. Smith & Nephew
reimbursement approval in most European      temporary ventricular support devices for     acquired worldwide distribution rights for
countries and Japan at the end of 2016       right heart failure and cardiogenic shock     MolecuLight i:X, an innovative digital wound
and 2017.                                    therapy.                                      assessment device.
                                                                                           Unique Value Proposition:
Unique Value Proposition:                                                                  MolecuLight i:X expands the company’s
Approval in CE and Japan generated           Unique Value Proposition:                     footprint from wound therapeutics into the
hundred thousands of unit sales, primarily   With the expansion of product sales to        digital wound imaging and diagnostics space.
with out-of-pocket expenditure. FDA          international markets, the company is         Unmatched product synergies across the
approval and reimbursement coverage          expected to grow at a higher rate and         wound care continuum offers healthcare cost
across many countries is likely to double    FY2018 revenues are projected to grow by      savings and high topline growth opportunities.
unit sales in the next 2 years.              more than 25%, making it one of the fastest   It is a win-win value proposition, offering
                                             growing cardiovascular device companies in    significant scale and faster growth potential for
                                             the last 5 years.                             MolecuLight.

                                                                                                                        Source: Frost & Sullivan
Medical Imaging Sector Companies to Watch—2018

           Artificial Intelligence                        Portable/Hand-held Ultrasound                                    Digital Tomosynthesis
Brief Summary:                                          Brief Summary:                                         Brief Summary:
Arterys uses deep learning in it’s cardio AI, lung AI   Butterfly Networks ushers in a new era of high-        As an OEM dedicated to women’s care, Hologic
and liver AI platforms in order to improve the          performance, hand-held ultrasound systems. It          continues to build on its product portfolio to address
imaging accuracy of its cardiac MRI scans, provide      has developed the world's first Ultrasound-on-         the continuum of breast care through early
single click automated volumetric segmentation of       a-Chip based imaging system (Butterfly iQ® for         detection, diagnosis, surgical treatment planning,
lung nodules and automated segmentation of liver        iPhone) by combining almost 10,000 sensors,            and image-guided procedures.
lesions. Arterys received FDA approval for its          covering across 13 clinical applications, with a       In ECR’17, Hologic introduced its new dedicated
cloud-based Cardio DL platform in January 2017.         single transducer probe.                               prone stereotactic biopsy system, ‘Affirm’ which
                                                                                                               delivers the capability of performing both 2D and 3D
                                                                                                               tomosynthesis-guided procedures on a single
Unique Value Proposition:
                                                        Unique Value Proposition:                              platform.
GE Healthcare’s Vios Works solution is powered
by Arterys. The company has also entered into a         A unique blend of affordability (at less than $2k),
partnership with Siemens Healthineers. In               diagnostic versatility, and assistive intelligence     Unique Value Proposition: Transformation from
November 2017, the company raised USD 30                makes the Butterfly iQ® the next ‘in’ stethoscope      product-centric to ‘customer-centric’, together with
million in Series B funding. Artery’s portfolio also    in daily practices. It is expected to play a pivotal   an established sales and distribution network for
includes the FDA approved MICA platform, an AI          role in the diagnosis of pneumonia and women’s         women's health, as well as extensive relationships
platform for medical imaging analytics, which           health during child birth.                             with clinical labs and OB/GYN channels, will
includes Arterys’ PHI Service for data security.                                                               accelerate Hologic’s customer penetration and
                                                                                                               retention.

                                                                                                                                               Source: Frost & Sullivan
Healthcare IT Sector Companies to Watch—2018

                                                           IBM Watson
   Technology Platforms & Services                    Cognitive Intelligence Platform                          Internet Conglomerate

Brief Summary: The online retail                     Brief Summary: Despite some negative              Brief Summary: In Dec 2017, Alphabet
and services giant announced a                       publicity, IBM Watson continued to see growth     announced a number of
$14 billion acquisition of Whole                     in revenues and client base from the healthcare   new services from various subsidiaries
Foods and a partnership with Cerner to enter         industry. Watson for Oncology is expected to      (DeepMind, Verily and Google) to be launched in
the PHM market, while Amazon Web                     end the year with over 120 hospital clients,      the near future. Combined with recent
services continues to be a leader in the             while partnerships with other market              investments in start-ups throughout 2017, the
healthcare cloud computing market.                   participants like Sanofi, Medtronic and CDC       company promises to expand its play in
                                                     developed further.                                healthcare in 2018.
Unique Value Proposition: Amazon’s products
and technologies have a strong consumer-                                                               Unique Value Proposition: Google’s consumer
centric market presence. Its cloud platforms         Unique Value Proposition: Cloud+Cognitive is      penetration of over a billion users globally and
and e-commerce business models have the              an integrated value proposition that IBM is       Alphabet’s technical brilliance across all its
potential to create truly patient-centric clinical   bringing to every client engagement. The          businesses has the power to create disruptive
and non-clinical health services, ranging from       powerful combination promises to deliver          healthcare IT solutions such as, for instance, the
wellness advisory and disease management to          optimum ROIs on the latest technologies,          highly accurate, open source platform for gene
retail sales and clinical intervention.              including IoT and blockchain for clients.         sequencing, DeepVariant.

                                                                                                                                     Source: Frost & Sullivan
Top 6 Transformational Shifts Impacting the Medical Device Industry
 in 2018
 “Patient Centricity” will be the key driving force for the growth of medical devices in 2018 and beyond.
                                            6                                1         6 out of 10 new products
       Risk sharing, ecommerce and                                                     positioned today to hospitals
    product digitization are business                                                  are a solution that improves
          model to drive double digit                                                  outcomes or efficiency
                       growth in 2018

80% of the Top 25
Medical Device                                                                            2          Fem tech and Women’s
companies have some         5                                                                        Health would witness
form of service portfolio                                                                            great investments and
and have strengthened                                                                                open markets in the US
the same to grow                                                                                     and Europe.
significantly from 2018.

                                                                                          2018 will witness immense
                                                                                          growth in the secondary
       Increase in corporate                                                              portfolios of the top 10 Med
       wellness is likely to provide    4                                          3      tech companies, due to
       newer opportunities for                                                            stabilization and successful
       Payors and OEMs                                                                    integration of their M&As
                                                                                          since 2016.

                                                                                           Source: ORC International, Frost & Sullivan
Concluding Thoughts
                 What opportunities lie within the incorporation of advanced technologies,
                 such as artificial intelligence, Big Data analytics, and cloud computing?

                       How do Smart Hospitals affect traditional healthcare vendors? What is
                       the size of the growth opportunities for vendors until 2025?

 2018 Global
 Healthcare                What are the keys to monetizing unmet healthcare needs? What
   Market                  are the opportunities tied to X-as-a-Service business models?
   Outlook

                       What are the current trends related to cybersecurity for medical
                       technologies? Which devices and systems are most vulnerable?

               How does the new ecosystem of digital solution providers look like for remote
               or virtual clinical trials?
                                                                                Source: Frost & Sullivan
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