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Navigating Medtech Hardware Investments: Key Considerations

Cortex Content
Cortex Content January 05, 2024 • 0 min read

As the healthcare sector rebounds from the pandemic, providers and medtech manufacturers encounter a transformed economic landscape. For over a decade, hardware investments consistently outperformed S&P rates. Despite a recent COVID-19-induced slowdown, the medtech hardware sector – resilient and poised for disruption – once again holds significant value for investors.

Context and Industry Trends in Medtech Hardware

According to a report by McKinsey, the medtech hardware sector was affected by the dramatic drop in elective medical procedures, many of which were postponed or canceled to ensure hospitals could focus resources on treating COVID-19 patients. This resulted in a 60% decline in elective procedures in the second quarter of 2020 for Europe and the United States, with an additional 50% decline in the third quarter. Thus, the impact of COVID-19 has been a pivotal factor, causing a temporary slowdown in an otherwise thriving sector. Legacy players, accustomed to dominating the innovation landscape, have found themselves grappling with unprecedented challenges.

New Entrants and Paradigm Shift

Amidst these challenges, a wave of new entrants is gearing up to bring about a paradigm shift. Over the next five years, these disruptors are positioned to revolutionize areas such as diagnosis, intervention, remote monitoring, and wearables, as indicated by industry analysts. Consider the following examples:


Companies like Butterfly Network are revolutionizing ultrasound technology with handheld, pocket-sized devices that offer portability and accessibility previously unseen in traditional ultrasound machines. This transformative approach enables healthcare practitioners to conduct diagnostics at the point of care, enhancing efficiency and patient outcomes.


For intervention, companies like Vicarious Surgical are leveraging robotics and virtual reality to redefine minimally invasive surgery. Their innovative technologies provide surgeons with enhanced precision and control, ultimately minimizing patient trauma and accelerating recovery times. This represents a paradigm shift in surgical approaches, with potential implications for various medical procedures.

Remote Monitoring

In the realm of remote monitoring, startups like Current Health are utilizing advanced sensors and artificial intelligence to enable continuous health monitoring outside traditional healthcare settings. Their wearable devices track vital signs and health metrics in real-time, allowing for proactive and personalized healthcare interventions. This not only empowers individuals to actively manage their health but also offers valuable data for healthcare providers to deliver more personalized care.


Wearables, a burgeoning field within medtech, sees companies like AliveCor pushing boundaries with their KardiaMobile device. This pocket-sized electrocardiogram (ECG) monitor allows users to take medical-grade ECG readings anytime, anywhere, facilitating early detection of potential cardiac issues. Such innovations in wearables contribute to a paradigm shift in preventive healthcare, empowering individuals to monitor and manage their health proactively.

These startups, and others like them, are strategically positioned to transform traditional healthcare practices in the coming years. By addressing critical areas such as diagnosis, intervention, remote monitoring, and wearables, these disruptors exemplify the potential for significant advancements in patient care and overall healthcare efficiency.

Debunking the Myth of Medtech Hardware Investments

Despite the prevailing anecdotal opinion amongst VC firms that investing in hardware medtech is harder and riskier with lower returns, the data suggests the opposite. Compare the 25% success rate of US-based hardware medtech startups with the 2% success rate of software medtech startups. That’s a staggering percentage difference of 12,500%.

The numbers aren’t accidental. Investing in medtech hardware creates unique value. For example, when you invest in hardware-based companies, you invest in tangible assets that appreciate in value over time. Intuitive Surgical – the creator of the da Vinci Surgical System – has seen its stock price rise due to the increasing demand for minimally invasive surgical solutions. Intuitive’s innovative hardware has both transformed the field of surgery and delivered substantial returns for its investors, year after year.

Moreover, hardware medtech devices typically have longer life spans than software solutions, which are sensitive to the fast-paced nature of software-based technologies. This extended product life provides a consistent revenue stream for investors over longer periods. Medtronic’s pacemakers and insulin pumps have delivered strong returns to its investors over the years, without needing significant upgrades or changes to the hardware since being released. This longevity and durability are hallmarks of successful hardware medtech investments.

Innovative Startups and Investment Trends

Over the past five years, the medtech investment ecosystem has been marked by transformative innovations across various sectors. Artificial Intelligence (AI) has been a focal point, with companies like Tempus utilizing AI-driven analytics for personalized cancer care. Investors have witnessed substantial returns as these technologies enhance treatment efficacy and efficiency, pushing the boundaries of healthcare capabilities.

Virtual Reality (VR) in medtech has gained traction, with companies like Touch Surgery employing VR for surgical training. This immersive approach has not only attracted significant investments but also paved the way for strategic partnerships and acquisitions. The market ROI trends in VR underscore a growing recognition of its potential applications in medical education and procedural planning.

Wearables have become integral to remote patient monitoring, with examples like iRhythm Technologies specializing in wearable cardiac monitoring solutions. The market has responded favorably to wearables, reflecting both the increasing demand for continuous health monitoring and the financial viability of such innovations.

Remote technologies, encompassing a broad spectrum of solutions, have seen notable successes. ResMed, who focuses on remote respiratory care solutions, demonstrates the market’s positive response to devices addressing remote patient needs. The increasing emphasis on decentralized healthcare is reflected in the upward trajectory of returns within this sector.

Thus, the past five years have witnessed a medtech investment landscape characterized by robust growth and transformative technologies. Innovations across AI, VR, wearables, remote technologies, and robotics demonstrate not only their market viability but also the potential for substantial returns and diverse exit strategies (see below). The overarching trend underscores a dynamic and promising future for medtech investments.

Considerations for Medtech Hardware Investors

A nuanced understanding of the following factors is essential to ensuring informed and successful medtech investments:

Expertise in Technology and Engineering

A deep grasp of technology and engineering is fundamental. Successful hardware innovations often hinge on intricate engineering solutions, necessitating investors’ familiarity with the technological intricacies. Companies with strong technical foundations are better positioned to navigate challenges and deliver groundbreaking solutions.

Robust IP Coverage

Intellectual Property (IP) is the bedrock of medtech hardware investments. Robust patent portfolios not only safeguard innovations but also confer a competitive edge. Investors should scrutinize the strength and breadth of a company’s IP coverage, as it can dictate market positioning and protection against potential competitors.

Clinical and Data Use Cases

Investors should prioritize companies with well-defined clinical use cases and robust data strategies. Clear clinical applications enhance the market relevance of medtech hardware, while effective data use cases contribute to ongoing innovation, improving patient outcomes, and creating additional revenue streams.

Safety and Risk Profiles

In the medtech hardware realm, safety is paramount. Investors must assess a company’s commitment to stringent safety standards and evaluate the associated risk profiles. Understanding potential risks and mitigation strategies is crucial for navigating the complexities of hardware investments within the healthcare sector.

Understanding Regulatory Paths

The regulatory environment in healthcare is intricate, and navigating it is crucial for success. Investors should seek companies with a keen understanding of regulatory pathways, as expedited approvals can significantly impact time-to-market and overall return on investment.

Knowing the Advantages

While software investments often boast shorter development cycles and rapid scalability, the medtech hardware sector has distinct advantages. Hardware innovations frequently result in tangible, physical products, providing investors with tangible assets (as discussed above). Additionally, the critical nature of healthcare hardware solutions often results in longer-term relationships with healthcare providers, fostering a stable revenue stream.

Moreover, medtech hardware’s economic appeal lies in its potential for long-term, sustainable growth. As hardware solutions address tangible healthcare needs, they create lasting value. Unlike software, medtech hardware typically involves recurring revenue streams through consumables, maintenance, and upgrades, providing investors with continuous income avenues.

In summary, the medtech hardware sector presents a unique set of considerations for investors. By leveraging technology expertise, emphasizing IP protection, focusing on clinical use cases, prioritizing safety, and understanding regulatory pathways, investors can navigate this dynamic landscape. The compelling economics of medtech hardware business models, when compared to the software industry, reinforce the potential for substantial, long-term returns and solidify the case for strategic investment in this thriving sector.

Exit Strategies

As investors venture into the dynamic realm of medtech hardware, knowing the various exit strategies is crucial for optimizing returns and ensuring a successful investment journey.

Strategic Partnerships and Acquisitions

One prevalent exit strategy in the medtech hardware sector involves strategic partnerships or acquisitions. Larger healthcare corporations often seek to enhance their portfolios by acquiring innovative hardware solutions. Savvy investors can position their investments for an attractive buyout by fostering collaborations or showcasing the unique value proposition that their portfolio companies bring to the table.

Initial Public Offering (IPO)

For companies with substantial market traction and a solid financial track record, going public through an IPO is a viable exit strategy. While this avenue offers liquidity and increased visibility, it requires careful timing and preparation. Investors should closely monitor market conditions and the company’s readiness for public scrutiny to maximize the success of an IPO exit.

Licensing Agreements

Licensing agreements present an alternative exit route, allowing investors to monetize intellectual property or specific technologies. This approach can be particularly beneficial when a company possesses groundbreaking innovations with broad applications. Negotiating favorable licensing terms can provide ongoing revenue streams for investors while enabling the company to expand its reach through collaborative partnerships.

Secondary Sales or Private Equity Exits

Secondary sales or private equity exits offer investors a path to liquidity without the complexities of going public. Selling shares to other private equity firms or interested parties within the industry can provide a timely and lucrative exit, especially when the market conditions are favourable.

Merger and Consolidation

In the rapidly evolving medtech ecosystem, mergers and consolidations are common strategies for companies seeking to strengthen their market position. Investors can explore opportunities to merge portfolio companies with complementary offerings, creating synergies that enhance overall valuation and market competitiveness.

Guiding Informed Exit Strategy Decisions

Making informed exit strategy decisions in the medtech hardware sector requires a deep understanding of the unique characteristics of healthcare technologies. Investors should assess the competitive landscape, potential acquirers, market demand, and regulatory considerations. Additionally, staying attuned to technological advancements and industry trends is essential for optimal timing and positioning within the market.

By carefully considering these exit strategies and aligning them with the specific circumstances of their investments, medtech hardware investors can navigate the complexities with confidence. Each exit option comes with its own set of benefits and challenges; tailoring the strategy to the individual characteristics of the invested companies ensures that investors maximize their returns while contributing to the continued innovation and growth of the medtech industry.

Key Takeaways

Our exploration of the medtech hardware sector reveals a field poised for transformative growth and innovation. Global initiatives, like India’s AMTZ (Andhra Pradesh MedTech Zone), underscore the industry’s vast potential and the strategic focus on medtech manufacturing. This inflection point in the medtech industry presents knowledgeable investors with a unique opportunity to shape the future of healthcare technology.

The key considerations outlined for medtech hardware investments, from technology expertise to strategic exit planning, provide a comprehensive guide for investors looking to navigate this dynamic sector successfully. Dispelling the myth of excessive risk and low returns, we’ve highlighted the compelling economics of medtech hardware business models, showcasing the tangible benefits and lasting impact these investments can have on healthcare.

As we chart the course forward, it is evident that the medtech hardware sector offers more than just financial returns; it provides a chance for investors to contribute to the resilience and innovation of healthcare. By taking the actionable steps presented here, knowledgeable medtech investors have the tools to capitalize on the untapped potential within this domain. The medtech hardware sector isn’t merely an investment opportunity; it’s a gateway for those who seek to be the architects of change in the future of healthcare technology.

To learn more about hardware medtech investment opportunities, don’t hesitate to reach out to Cortex Design. We can provide you with valuable insights and potential investment options tailored to your interests and goals. 

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