As we commented earlier , the Chinese medtech market is gaining considerable attention among major medical device manufacturers because of a rapidly expanding economy and fast procedure growth. But, it is worth noting that in many markets much of this growth stems from a small procedure base, which makes the growth numbers somewhat inflated. So when will China and the other BRIC countries actually reach a point to make a dent in the revenues of large international medtech companies.

According to recent MRG research, the answer is very soon. Take the interventional cardiology (IC) device market, for example. By 2015, the BRIC countries will generate nearly 43% of global revenues (global in this case including revenues generated in France, Germany, Italy, the UK, the US, Japan, plus the BRIC countries), while the US the next largest market will generate under 39% of the total market. In 2011, China accounted for over 65% of the total revenues generated in the BRIC countries. On top of that, growth is still anticipated to be stronger than in the US beyond the forecast period, although that is a little harder to judge for certain. There is no doubt, however, that companies that ignore the potential of the BRIC countries particularly China will fall behind.

The BRIC countries do, however, come with their own sets of pitfalls. The Chinese market is characterized by a large number of local competitors able to substantially undercut pricing. In India which is poised to surpass China's working-age population by 2035 poverty and a lack of access to health care continue to plague a large chunk of the population despite efforts to improve health standards. In Brazil, a similar problem exists because of rapid urbanization resulting in inadequate quality and timeliness of care. Meanwhile, in Russia, corruption continues to plague the health care system, with some patients needing to bribe hospital staff to receive basic services.

Additionally, many of these countries have approval systems that are difficult to navigate and small rural health care centers that are harder to access, particularly for smaller companies. As a result, working through local distributors currently tends to be norm for foreign companies.

Nonetheless, companies that focus on the maturing US and European markets will likely see their global market shares decline as the BRIC governments work to address these issues. This is particularly of interest given that these markets have traditionally been much more recession-proof, which may help companies offset financial challenges as the US and Europe teeter on the brink of another economic crisis.

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