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September 2025 issue: The MDO Medtech Big 100 ranking of the world’s largest device companies

September 10, 2025 By Jim Hammerand

The Medtech Big 100 hits a new record high, but R&D growth is stalling

The Medical Design & Outsourcing Medtech Big 100 is our biggest project of the year, and while I wish we could celebrate its completion, we found a troubling trend in our latest analysis.

Though our annual ranking of the world’s largest medical device companies once again posted a new record for cumulative revenue at nearly half a trillion dollars, and employment continues to grow, aggregate research and development spending growth isn’t keeping pace.

In fact, collective year-over-year R&D spending growth among the Medtech Big 100 companies that report this figure (the majority do) has slowed from 20% two years ago and 10% last year to around 1% this year. And we’re not the only ones worried about this.

“Companies need to invest heavily and not hold back on R&D,” former Medtronic CEO Bill George told us after we shared our findings. “… Sometimes big companies are not willing to take the risk on breakthrough ideas, [but] they should.”

Meanwhile, the Medtech Big 100 company spending the most on R&D  — Johnson & Johnson MedTech — is growing that investment by nearly 20% and appears on track to take the top spot in a future Medtech Big 100 ranking. A big driver is Shockwave Medical, which J&J acquired in a $13 billion deal. Our cover story explores how Shockwave leaders changed their approach while shopping the company and how J&J ultimately sealed the deal. We’ve also interviewed Shockwave Chief Medical Officer Dr. Nick West to learn more about their R&D efforts and where the technology is headed.

At the top of the Medtech Big 100, Medtronic is preparing to separate its diabetes business into a standalone company called MiniMed. Many questions remain about what that will mean for Medtronic and MiniMed, and we bring you answers in a feature by Senior Editor Sean Whooley. By the way, please allow me to congratulate Sean on his recent promotion!

We’ve got more coverage of Medtech Big 100 companies throughout this issue, including GE HealthCare, Boston Scientific, Intuitive Surgical, Edwards Lifesciences and more.

Make sure to join our team on Sept. 25 for a live webcast and audience Q&A where we’ll discuss top trends from the Medtech Big 100, and watch out for our Medtech Big 100 Special Report available as soon as Sept. 17.

As always, I hope you enjoy this edition of Medical Design & Outsourcing — and thanks for reading.

– Jim Hammerand, Managing Editor
Medical Design & Outsourcing
[email protected]

About The Author

Jim Hammerand

Jim Hammerand is the managing editor of Arrowfly's Medical Design & Outsourcing, where he leads coverage of medtech innovation, design, engineering and manufacturing. He also reports breaking news at Arrowfly's MassDevice and contributes to our DeviceTalks podcasts and live events. Hammerand has more than two decades of journalism experience spanning newspapers, magazines, websites, live events, radio and TV news. For nearly a decade, Hammerand reported and edited business news for American City Business Journals as a reporter and digital editor at the Minneapolis/St. Paul Business Journal and then as managing editor of the Puget Sound Business Journal in Seattle. He holds degrees in journalism and management from the University of Minnesota and has won journalism awards from the Society of Professional Journalists, American Society of Business Publication Editors, and Trade, Association, Business Publications International. Connect with him on LinkedIn or by email at [email protected].

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  • Home
  • Medical Device Business
    • Mergers & Acquisitions
    • Financial
    • Regulatory
  • Applications
    • Cardiovascular
    • Devices
    • Imaging
    • Implantables
    • Medical Equipment
    • Orthopedic
    • Surgical
  • Technologies
    • Supplies and Components Index
    • Contract Manufacturing
    • Components
    • Electronics
    • Extrusions
    • Materials
    • Motion Control
    • Prototyping
    • Pumps
    • Tubing
  • MedTech Resources
    • Medtech Events in 2026
    • The 2025 Medtech Big 100
    • Medical Device Handbook
    • MedTech 100 Index
    • Subscribe to Print Magazine
    • DeviceTalks
    • Digital Editions
    • eBooks
    • Educational Assets
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