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The consolidation trend that’s dominated the medical device industry for the past few years only seemed to accelerate in 2018, according to our annual look at the world’s largest medtech operations, The Big 100.

Even as the bar to making the list is continuously dropping, collectively this roster put up higher sales this year than in last year’s issue. Although last year’s revenue cut-off was $40.2 million (EDAP), this year Ra Medical Systems made the list at $6.2 million. But Big 100 companies in total brought in a little more than $397.5 billion in revenues, up about $13.4 billion (3.5%) over the previous year.

Once again acquisitions played a lead role: • 3M’s takeout of wound care giant Acelity for $6.7 billion • Boston Scientific’s $4 billion acquisition of BTG • Johnson & Johnson’s buyout of Auris Health for $3.6 billion • Fresenius (finally) closing the $2 billion buy of NxStage Medical • Medtronic acquiring Mazor Robotics for $1.7 billion • Boston Scientific buying Vertiflex for $465 million • Stryker acquiring OrthoSpace for $220 million

Here’s another trend that stuck out: IPOs are back and, combined with the accelerated consolidation trend, added a clutch of companies to the list that included Ambu, Brainsway, Endologix, Glaukos, Inspire Medical, Nevro, Si- Bone and TransEnterix.

Finally, this year we added a new aspect, examining revenues earned per employee as a proxy measure for efficiency. The results were surprising – turn to page 100 for the results.

Some notes on our methodology: We begin the process of compiling companies’ annual reports early each year, as soon as the prior year’s financials begin to trickle in. We compile the listings and rank the companies according to annual revenues, then R&D spending and number of employees. Once the numbers are collected, we attempt to contact each of the 100 companies to confirm our findings.

Using data from the most recent fiscal year, we turn to our own archives, corporate documents and public regulatory filings. For companies with non-medical device businesses, we exclude those divisions’ results from our calculations. For currency conversions, we use the average exchange rates from the previous year as set by the U.S. Federal Reserve.

Once the results are in we take a closer look at the top 20 firms on the list, providing a brief review of their news from the past year. We take a deeper dive into the numbers, looking at R&D spends, workforce counts and revenues per employee.

Danielle Kirsh
Associate Editor
Medical Design & Outsourcing
dkirsh@wtwhmedia.com