Start Here - Investing in Medical Devices

Table of Contents

How to Invest in Medical Devices

What Do Medical Device Companies Do?

How Do Medical Devices Get Approved?

6 Small Medical Device Companies

5 Top Medical Device Companies

8 Surgical Robotics Stocks

Medical Device ETFs: An Overview

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How to Invest in Medical Devices

The medical device market offers investors unique exposure to the overall life science space, especially in an era of fast-growing tech advancements in healthcare.

This industry covers a wide range of health and medical instruments used in the treatment, mitigation, diagnosis and prevention of diseases and physical conditions. As modern medicine is rapidly changing, medical device development must keep up.

Some examples of medical devices are neurostimulation devices, surgical implants, ultrasound imaging devices and robotic medical technology, along with insulin pumps and insulin pens for diabetes. Similar to how pharmaceutical companies seek to serve unmet needs, medical device companies do the same through their innovative technologies.

Here the Investing News Network breaks down how to invest in medical devices and gives a more in-depth look at what’s in store for the sector's future.

Invest in medical devices: What to know

Medtech companies will often seek to show investors that their products are ready to enter the market and will be in demand right away — whether it be by serving a large demographic or by targeting a specific ailment in the population that has an unmet medical need.

Much like firms following the drug approval pathway, medtech companies must conduct extensive clinical trials to bring their products to market; they have to refine their technology and confirm efficacy and safety in order to receive regulatory approvals.

Successfully completed clinical trials and product approvals are usually major catalysts for a company's share price. A medical device stock can experience a big jump when announcing positive results from a recent trial or approval from a regulatory body such as Health Canada, the US Food and Drug Administration or an equivalent agency in Europe or Asia. Poor results can have a negative impact.

Patentability also plays a big role in a medical device company’s shareholder value. Once a product has been patented, the company controls its every move and can choose to license it or make another type of deal to expand the reach of its device.

The sector is dominated by a handful of big medical device manufacturers, such as Johnson & Johnson (NYSE:JNJ), Abbott Laboratories (NYSE:ABT), Stryker (NYSE:SYK) and Medtronic (NYSE:MDT). That means investors interested in large-cap companies will have no trouble finding what they’re looking for.

Investors will also find smaller-cap companies amid the heavyweights — it's just a matter of risk tolerance. Some medical device companies in the micro-cap range include: iCAD (NASDAQ:ICAD), Neovasc (TSX:NVCN,NASDAQ:NVCN), SQI Diagnostics (TSX:SQD,OTCQB:SQIDF) and Fonar (NASDAQ:FONR).

Invest in medical devices: ETFs

For those who prefer to mitigate risk factors, exchange-traded funds (ETFs) give investors a safer way to put money into the market. With exposure to various companies, any potential decrease in one stock won't significantly drive down returns for the ETF as a whole. ETFs hold assets like stocks, commodities and bonds, and trade close to their net asset value.

Typically ETFs track an index. In the medical device arena, there are two indices that can be followed: the S&P Health Care Equipment Select Industry Index (INDEXSP:SPSIHE) and the Dow Jones US Select Medical Equipment Index (INDEXDJX:DJSMDQ).

The largest ETF in the medical devices sector is the iShares US Medical Device ETF (ARCA:IHI), which has a focus on US companies that manufacture and distribute medical devices. It also provides investors with targeted access to domestic medical device stocks.

This passive ETF tracks the Dow Jones US Select Medical Equipment Index. There are 62 holdings in the ETF; the five biggest holdings in its portfolio are Abbott Laboratories, Thermo Fisher Scientific (NYSE:TMO), Medtronic, Danaher (NYSE:DHR) and Becton Dickinson (NYSE:BDX).

The other ETF for investor consideration is the SPDR S&P Health Care Equipment ETF (ARCA:XHE), which tracks the S&P Health Care Equipment Select Industry Index. Out of 83 holdings, the top companies are Inari Medical (NASDAQ:NARI), GenMark Diagnostics (NASDAQ:GNMK), AtriCure (NASDAQ:ATRC), Penumbra (NYSE:PEN) and Alphatec Holdings (NASDAQ:ATEC).

Invest in medical devices: Market outlook

According to Precedence Research, the global medical device market is projected to grow at a compound annual growth rate (CAGR) of 5.2 percent between 2019 and 2027 to reach US$671.49 billion.

A report from BCC Research is even more optimistic, estimating that the medical technology industry will cross revenue of almost US$797 billion by 2025, growing at a CAGR of 5.6 from 2020 to 2025.

Driving that growth will be an increase in diseases, particularly cancer and diabetes, plus cardiovascular, neurological, orthopedic and respiratory diseases, which are on the rise due to age.

Chronic diseases are also growing in prevalence — the United Nations has said that by the end of 2030, the ratio of total deaths due to chronic diseases is expected to rise to around 70 percent, and the total burden of chronic diseases worldwide is expected to reach around 60 percent.

In short, with the future growth of the market anticipated to be in the billions, there are many opportunities for investing in the medical device industry.

This is an updated version of an article originally published by the Investing News Network in 2017. 

Don’t forget to follow us @INN_LifeScience for real-time news updates!

Securities Disclosure: I, Melissa Pistilli, hold no direct investment interest in any company mentioned in this article.

Additional information on Medical Device stock investing — FREE

What Do Medical Device Companies Do?

Medical device companies play a vital role in the life science industry by developing new technologies to match unmet medical needs across both established and emerging healthcare markets.

The growing prevalence of chronic diseases such as cancer and diabetes is the driving force behind increasing innovation in medical technology, from surgical instruments and orthopedics to diagnostics and medical imaging.

In 2020, 59 new medical devices were approved by the US Food and Drug Administration for the year, a big jump from the 46 approved in 2019.

Overall, the global medical device industry is expected to grow from US$447.63 billion in 2019 to US$671.49 billion by 2027. The two biggest trends in this sector are wearable medical devices and the integration of artificial intelligence.

Here the Investing News Network provides a brief overview of what medical devices companies do for those interested in investing in this niche sector of the life science market.

Medical device companies: Regulations and approval

As in the pharmaceutical industry, all new medical devices must go through clinical trials and regulatory approval with various agencies in the US, Europe and Asia. For example, a medical device product must be approved by the US Food and Drug Administration (FDA) to be available in the US market.

More specifically, the agency's Center for Devices and Radiological Health (CDRH) oversees the regulatory requirements for companies that are manufacturing, repackaging, relabeling and importing medical devices to be sold in the US.

The CDRH also regulates medical and non-medical radiation-emitting electronic medical equipment such as lasers, X-ray systems, ultrasound equipment, microwave ovens and televisions.

Medical devices are classified by the FDA into three different categories:

• Class I medical devices pose low risks and don't have many regulatory controls. These products generally do not need to submit a Premarket Notification 510(k). In other words, Class I device manufacturers don't need to show that their device is similar to an existing product to prove its safety and effectiveness. Examples include enema kits, elastic bandages and manual stethoscopes. According to the FDA, 47 percent of medical devices are considered Class I.

• Class II medical devices have the potential to be more harmful than Class I devices and therefore require a Premarket Notification 510(K). Powered wheelchairs and pregnancy test kits are considered Class II devices, as are handheld surgical instruments and infusion pumps. Class II devices make up 43 percent of all medical devices.

• Class III medical devices are the most risky because they can cause illness or injury. Class III medical devices go through a more rigorous process and must receive Premarket Approval. Companies manufacturing these devices are required to submit clinical data to the FDA for evaluation before the product can be marketed. Class III devices include implants, implantable pacemakers and diagnostic tests.

The FDA Premarket Notification 510(k) process can take up to 90 days to determine product equivalency and then file an approval to bring the medical product to market.

Being the most risky, Class III device approvals also come at a steep financial cost. A Premarket Approval can cost as much as US$94 million, compared to the US$31 million for a Premarket Notification 510(k). It takes the FDA roughly six months to review a Premarket Approval application, which is double the length of the Premarket Notification 510(k) process.

Every step of the FDA approval process represents a major catalyst for a medical device company.

Medical device companies: Growth and innovation

Medical device companies share some of the struggles faced by their counterparts in the biotechnology and pharmaceutical sectors — namely, the astronomical costs associated with research and development, as well as lengthy testing and approval processes. As a result, many of the larger medical device companies are wary of innovation, instead opting to follow existing models or technology.

Interestingly, while innovation can prove risky for bigger companies, it is the bread and butter of smaller startups aiming to get acquired by bigger players in the sector.

That being said, in order to be a long-term global leader in the space, a medical device manufacturer must incorporate new technology and innovation into its portfolio. Familiar names in the space tend to be go-to investment options. As of early 2021, some of the top companies by total revenue in the medical device industry were Medtronic (NYSE:MDT) at US$29.36 billion, Johnson & Johnson (NYSE:JNJ) at US$25.1 billion and GE Healthcare (NYSE:TMO) at US$18.3 billion.

Technologies disrupting the medical device market include smart inhalers, robotic surgery, wireless brain sensors, 3D printing, artificial organs and health wearables.

Medical device companies: Future outlook

The global medical devices market was valued at US$456.9 billion in 2020, according to a report from the Business Research Company. The market is expected to at a compound annual growth rate of 6.1 percent to reach US$603.5 billion in 2023.

The firm attributes this growth to an increase in diseases, together with a growing aging population. Notably, chronic diseases, including cardiovascular, neurological, orthopedic and respiratory conditions, continue to require the development of medical equipment and devices for diagnosis and treatment.

Other market trends that are projected to have an impact on the growth of the medical device industry are mergers and acquisitions, an increase in innovative technologies and the entry of emerging markets such as China, India and Saudi Arabia.

Investors will surely be watching the industry with a sharp eye to see how new solutions continue to shape this exciting market.

This is an updated version of an article first published by the Investing News Network in 2017.

Don’t forget to follow us @INN_LifeScience for real-time news updates!

Securities Disclosure: I, Melissa Pistilli, hold no direct investment interest in any company mentioned in this article.

Additional information on Medical Device stock investing — FREE

How Do Medical Devices Get Approved?

Life science investors are familiar with the arduous path new drugs must go through to reach the market. But how do medical devices get approved? 

In terms of devices, the same rigorous testing and inspection are required from different regulatory agencies. The US Food and Drug Administration (FDA) is the agency tasked with reviewing new devices and making amendments to already approved devices.

More specifically, medical device approval is done through the FDA's Center for Devices and Radiological Health (CDRH). The CDRH looks after the entire regulation process for companies that manufacture, repackage, relabel and import devices to the US.

Below the Investing News Network examines the FDA approval process to show investors how the agency classifies and regulates medical devices. It's critical for those interested in medical devices to understand this system, as sending a product to market is key for company profits and investor returns.

Classifying medical devices

The FDA divides medical devices into three categories based on their perceived potential to do harm. Class I medical devices are designated as low risk. These are products that don’t seem all that dangerous and generally are well established, such as enema kits, elastic bandages and manual stethoscopes. At 47 percent, nearly half of all medical devices are considered Class I.

As such, Class I medical devices are subject to the least restrictive regulatory requirements. Most, for example, do not require a Premarket Notification 510(k) — that is, a manufacturer does not need to prove that its device is "substantially equivalent" to one already on the market.

When it comes to Class II medical devices, a Premarket Notification 510(k) is one of the requirements. That’s because these devices are potentially more harmful than Class I products and therefore need to demonstrate safety. This division includes items like handheld surgical instruments and infusion pumps. These types of medical devices make up 43 percent of the market.

Then there are Class III medical devices, or products deemed to have the highest risk. Class III devices only make up 10 percent of all medical devices. Generally speaking, a lot more than a Premarket Notification 510(k) is needed to get these devices to market.

Replacement heart valves, denture adhesives, aspirators and breast implants — these products, and others like them, all require premarket approval before receiving clearance. That means more comprehensive and thorough clinical trials are required for these devices.

Medical device regulation

The procedures, trials and regulations for Class II and Class III medical device approvals are different.

In filing a Premarket Notification 510(k), manufacturers have to prove that their product is as safe and has the same effectiveness as a "predicate" — in other words, a similar device that’s already been regulated and commercialized.

The predicate and its substantially equivalent product must also have the same intended use. If the latter uses different technology, additional information needs to be submitted to be considered for clearance, showing that no patient safety concerns appear with the new device.

According to  the FDA, it takes approximately 90 days to determine substantial equivalency. Only once a product has been cleared can a company bring it to market.

On the other hand, Class III medical devices, as well as those not found to be substantially equivalent in the 510(k) process, must receive a premarket approval. In this instance, companies need to submit clinical data for the FDA to evaluate, and it takes time to first acquire those findings.

To collect clinical data, companies need to submit still another application to the FDA. An investigational device exemption allows medical device manufacturers to use their product candidates in clinical trials.

Once the studies have been completed and the premarket approval application filed, the review process takes at least 180 days. A decision is then posted publicly on the FDA’s website and anyone can petition the agency to ask it to reconsider its approval or rejection. This public review window lasts 30 days.

Future outlook

Similar to other industries within the healthcare sector, costs are extremely high when it comes to medical device research and development. This means innovation in the space may leave some companies wary, but as technology continues to evolve and advance, it is becoming increasingly difficult to ignore the impact it will — and already does — have on devices.

Technologies disrupting the space as of right now include smart inhalers, robotic surgery, wireless brain sensors, 3D printing, artificial organs and health wearables.

In short, there is plenty of evidence to show the need for this market is second to none thanks to increasing demand from hospitals and surgical centers.

Looking at recent FDA approvals, 57 medical devices were okayed in 2018, while 2019's total was slightly lower at 46. In 2020 there was a rebound, with 69 medical device approvals.

Despite some of the potential roadblocks, according to a Research and Markets medical device market report, the industry will reach US$432.6 billion by 2025, growing at a compound annual growth rate of 4.1 percent from 2020 to 2025. Fueling that growth will be healthcare spending, technology developments, the aging patient population and chronic diseases.

This is an updated version of an article first published by the Investing News Network in 2017.

Don't forget to follow us @INN_LifeScience for real-time news updates.

Securities Disclosure: I, Melissa Pistilli, hold no direct investment interest in any company mentioned in this article.

Additional information on Medical Device stock investing — FREE

6 Small Medical Device Companies

The medical device sector in Canada may be one of the country's best-kept global secrets.

According to the Canadian government, the country has a large number of medical device manufacturers working to advance product innovation. Data from 2019, the most recent year available, shows that the country brings US$7.3 billion to the medical device sector, which is 1.8 percent of the global market.

Medical devices include a plethora of items, including pacemakers, artificial heart valves, diagnostic and imaging equipment, in vitro diagnostics, dialysis equipment, hip and knee implants, synthetic skin, surgical tools, orthopedics, medical imaging and infusion pumps.

Here the Investing News Network takes a look at six small medical device companies in Canada that offer investors growth potential in this exciting segment of the life science market. Companies on this list had small market caps below C$50 million at the time of publication, with data compiled using Investing.com. The medical device firms below are listed in order of market cap size, from largest to smallest.

1. Theralase Technologies (TSXV:TLT,OTCQB:TLTFF)

Market cap: C$44.94 million

Theralase Technologies is a clinical-stage pharmaceutical company focused on the design, development, manufacturing and sale of patented laser technology platforms. The platforms support a suite of bio-stimulative and bio-destructive clinical applications for patients. The company is currently developing a photodynamic therapy for treating non-muscle-invasive bladder cancer.

Theralase Technologies was a TSX Venture 50 company in 2020.

2. Izotropic (CSE:IZO,OTCQB:IZOZF)

Market cap: C$42.01 million

Izotropic is commercializing breast computerized tomography (CT) imaging technology for the early detection of breast cancer. The company’s breast CT imaging system is a diagnostic device that produces high-resolution breast images in 3D without painful breast compression.

Preliminary studies have found that Izotropic's breast CT imaging system may be able to routinely detect small breast tumors in the 3 to 5 millimeter size range, resulting in earlier detection over mammography. In the fourth quarter of 2020, Izotropic completed a pre-submission meeting with the US Food and Drug Administration (FDA) as part of its path to commercialization; the company is in discussions with US hospitals for clinical study partners.

3. Aurora Spine (TSXV:ASG)

Market cap: C$40.29 million

Aurora Spine, another of Canada's growing medical device companies, is focused on the spinal implant market and has a portfolio of minimally invasive, regenerative spinal implant technologies designed to improve spinal surgery outcomes.

Aurora Spine has reached a number of critical milestones recently. These include the issuance of a US patent for its DEXA technology patient-matched implant technology last October, followed by the commercial launch of its proprietary SOLO ALIF standalone cage system in November of the same year. Later in 2020, Aurora commenced a major multicenter clinical study for its proprietary ZIP interspinous fixation device for relief of back pain due to symptomatic degenerative disc disease.

4. Covalon Technologies (TSXV:COV)

Market cap: C$38.47 million

Founded by a group of PhDs from the University of Toronto, Covalon Technologies researches, develops and commercializes patented medical technology targeting the areas of infection control, advanced wound care and medical coatings.

Covalon leverages its patented medical technology platforms through the development of products that are sold under Covalon's name, as well as through the development and commercialization of medical products for other medical companies via development and license contracts. The company provides its products and services to major and niche specialty medical device companies, leaders in wound care, healthcare providers and individual consumers.

5. Helius Medical Technologies (TSX:HSM,NASDAQ:HSDT)

Market cap: C$37.41 million

Helius Medical Technologies is a neurotech company focused on developing, licensing and acquiring unique and non-invasive platform technologies aimed at treating illnesses of and injuries to the brain.

The company’s first commercial product is the Portable Neuromodulation Stimulator (PoNS), a non-surgical device that delivers electrical stimulation as a short-term treatment for gait deficit due to mild to moderate symptoms from multiple sclerosis, as well as for the treatment of chronic balance deficit due to mild to moderate traumatic brain injuries in conjunction with physical therapy.

PoNS is authorized for sale in Canada and recently received marketing authorization from the US FDA. PoNS is an investigational medical device in the European Union and Australia, and is currently under premarket review by Australia's Therapeutic Goods Administration.

6. Nanalysis Scientific (TSXV:NSCI,OTCQX:NSCIF)

Market cap: C$32.77 million

Last on this small medical device companies list is Nanalysis Scientific, which specializes in the production of compact and portable benchtop nuclear magnetic resonance spectroscopic instruments for a variety of applications across various industries, including biotech and pharma, polymer research, food and environmental science as well as oil and gas.

Nanalysis’ NMReady-60 product allows chemists, researchers, engineers and students to perform spectroscopy tests wherever and whenever they need, whether in the lab or in the field. In early 2020, the company won an award for best new analytical product at the Nanotech Exhibition and Conference.

This is an updated version of an article originally published by the Investing News Network in 2016.

Don’t forget to follow us @INN_LifeScience for real-time news updates!

Securities Disclosure: I, Melissa Pistilli, hold no direct investment interest in any company mentioned in this article.

Additional information on Medical Device stock investing — FREE

5 Top Medical Device Companies

The top medical device companies are a vital component of the overarching life science industry, and are a major force in treating many diseases and conditions.

The global medical device market was valued at US$605.7 billion in 2020, and is expected to grow at a compound annual growth rate of 5.6 percent to reach US$796.9 billion in 2025.

Growth in the global medical device industry is tied to the rapid rise of an aging population, increased infectious and chronic diseases, as well as technological advancements in the field of life science.

Of course, the sector's growth wouldn't be possible without top medical device companies working on the development of devices for a variety of therapeutic areas across established and emerging markets.

Here the Investing News Network looks at the five top medical device companies developing innovative medical technology and medical equipment to treat ailments. Stocks are listed in order of market cap size, with data gathered using Investing.com's stock screener. This list was compiled on June 18, 2021.

1. Abbott Laboratories (NYSE:ABT)

Market cap: US$194.74 billion

Abbott Laboratories creates a wide range of products, from diagnostics to medical devices to branded generic pharmaceuticals. It is one of the largest medical device companies in the life science sector.

In terms of the organization's medical device equipment, Abbott Laboratories develops treatment options for vascular diseases, such as coronary and carotid stents, plus catheters and vessel closure devices. This medical device manufacturer also makes medical devices for the diabetes market, including blood glucose meters that provide accurate results and make the testing process easier.

The medical device company's other areas of focus range from vision care to developing technologies for myopia, hyperopia, astigmatism, contact lens care and corneal healthcare.

2. Thermo Fisher Scientific (NYSE:TMO)

Market cap: US$191.38 billion

Thermo Fisher Scientific is one of the world’s most respected brands in healthcare, scientific research, safety and education. The medical device company’s family of global products and services represents a broad range of high-end analytical instruments, chemistry and consumable supplies, laboratory equipment and software designed primarily for medical researchers, clinicians and scientists. It has products in a variety of areas, including cellular analysis, synthetic biology and molecular biology.

In mid-2021, Thermo Fisher Scientific launched a point-of-care COVID test in India. The TaqMan Mutation Panel can test confirmed infected samples for COVID-19 variants and provide results within 30 minutes.

3. Medtronic (NYSE:MDT)

Market cap: US$166.71 billion

Naturally this list of big names in the medical device industry would not be complete without the inclusion of Medtronic, which is one of the largest global medical device manufacturing companies.

With its headquarters in Dublin, Ireland, Medtronic's devices provide solutions for relieving pain, restoring health and working to extend the lives of millions of people globally. Its primary areas of focus include cardiac and vascular care, minimally invasive therapies, restorative therapies and diabetes.

4. Intuitive Surgical (NASDAQ:ISRG)

Market cap: US$104.91 billion

Medical device manufacturer Intuitive Surgical developed the da Vinci surgical system — the first minimally invasive surgical system to receive clearance from the US Food and Drug Administration.

Intuitive Surgical's goal is to provide assistance to doctors and hospitals with its robotics-assisted platforms, including the da Vinci system. Roughly 5 million da Vinci procedures have been done, while the system is used by surgeons across 50 US states and 66 countries around the world.

5. Stryker (NYSE:SYK)

Market cap: US$96.9 billion

Stryker is another global medical technology company that is focused on medical discovery, diagnostic products and delivery of care. The company has a multi-year national partnership with Minor League Baseball as its "Official SmartRobotics Joint Replacement Partner."

The company’s offerings include products and services in orthopedics, medical and surgical and neurotechnology and spine; these are aimed at improving patient and hospital outcomes. In late 2020, Stryker acquired Wright Medical, adding a variety of foot and ankle products to its portfolio.

This is an updated version of an article originally published by the Investing News Network in 2016.

Don’t forget to follow us @INN_LifeScience for real-time news updates!

Securities Disclosure: I, Melissa Pistilli, hold no investment interest in any of the companies mentioned.

Additional information on Medical Device stock investing — FREE

8 Surgical Robotics Stocks

If surgical robotics stocks continue their rapid advancement, the days of triple-port surgical systems may soon be gone.

Robotics technology is quickly disrupting a variety of economic sectors, including the medical space, and surgical robot applications are a major component in the overall medical robots market. In fact, a Markets and Markets report projects that this industry will reach a value of US$12.7 billion by 2025, up from an estimated US$5.9 billion in 2020.

According to the firm, increased funding for medical robot research and advancements in medical robot technology are seen as the main drivers of this sector.

Surgical robotics companies are developing products for a variety of surgery types, including cardiac, spinal and endoluminal. The tools these firms provide can increase surgeons’ performance ability and can lessen scarring, incisions, blood loss and more. Other benefits of surgical robotics advances include complete control, safer surgeries and a more comfortable recovery.

Here the Investing News Network takes a closer look at surgical robotics stocks to give investors an idea of the biggest names in the industry, as well as lesser-known companies that are still working on product development. The surgical robotics stocks below were gathered using TradingView's stock screener on July 21, 2021, and are listed in order of market cap from largest to smallest.

1. Medtronic (NYSE:MDT)

Market cap: US$170.74 billion; current share price: US$125.05

First on this list of surgical robotics stocks is Ireland-based Medtronic, one of the world’s largest medical technology companies. The company’s portfolio of medical devices includes surgical, respiratory, patient monitoring, gastrointestinal and hepatology, lung health and renal care products.

The company recently announced a new robot-assisted surgery platform that it claims "is more flexible and cost-effective than systems presently on the market." The Hugo robotic-assisted surgery system was used in mid-2021 to perform a robotic prostatectomy in Santiago, Chile. The procedure heralds the launch of the Hugo robotic-assisted surgery system patient registry, which the company will use to collect clinical data to support regulatory submissions across the globe.

2. Intuitive Surgical (NASDAQ:ISRG)

Market cap: US$111.89 billion; current share price: US$944.94

Intuitive Surgical is behind the da Vinci system, making it a global leader and one of the best-known surgical robotics companies. Started in 1999, the da Vinci system is used internationally as an aid in cardiac, thoracic, urology, gynecologic, colorectal, pediatric and general surgeries.

In the second quarter of 2021, Intuitive announced a 72 percent increase in net income to US$517.2 million, compared to US$68 million in the second quarter of 2020. The big jump was attributed to the resumption of surgeries that were delayed during the height of the COVID-19 pandemic.

3. Stryker (NYSE:SYK)

Market cap: US$97.46 billion; current share price: US$258.68

Stryker has the Mako robotic arm system for joint replacement assisted surgery. The device can be used in partial knee, total hip and total knee surgeries.

Another popular choice for medical and surgical equipment, Stryker reported US$1.5 billion in orthopedics sales in the first quarter of 2021, a 21.4 percent increase compared to the first quarter of 2020. Neurotechnology and spine net sales increased 14 percent year over year to US$848 million.

4. Smith & Nephew (NYSE:SNN)

Market cap: US$18.74 billion; current share price: US$42.63

A company known for orthopedic reconstruction, advanced wound management, sports medicine and more, Smith & Nephew is on this surgical robotics stocks list because of its Navio surgical system. Navio works in both partial and total knee replacement procedures.

In July, the company launched its Real Intelligence brand of enabling technology solutions, as well as its new-generation handheld robotics platform known as the CORI surgical system. CORI has US Food and Drug Administration (FDA) 510(k) clearance and is available for sale in the US for both total and unicompartmental knee arthroplasty applications.

5. Globus Medical (NYSE:GMED)

Market cap: US$8.02 billion; current share price: US$79.96

Globus Medical develops and commercializes spinal and orthopedic implants and surgical instruments that help surgeons treat patients with musculoskeletal disorders. The company's offerings include the ExcelsiusGPS robotic navigation platform.

In July, the company announced that over 20,000 spine procedures had been performed utilizing ExcelsiusGPS. Globus said the robotic platform has been shown to increase accuracy, reduce radiation and lessen procedure time compared to conventional spine procedures.

6. Asensus Surgical (NYSE:ASXC)

Market cap: US$635.03 million; current share price: US$2.68

Next on this surgical robotics stocks list is Asensus Surgical, a medical device robotics company that is developing solutions that enhance minimally invasive, performance-guided surgery.

Its products include the Senhance surgical system, a multi-port robotic surgery system that allows up to four arms to control robotic instruments and a camera; it also has the SurgiBot system, a single-port robotically enhanced laparoscopic surgical platform.

In July 2021, Asensus Surgical filed a 510(k) submission with the FDA for an expansion of capabilities on its Intelligent surgical unit, which is used in the company’s Senhance surgical system. "The expansion of augmented intelligence capabilities is the next driver of performance in digital surgery," said Anthony Fernando, Asensus Surgical's president and CEO.

7. Titan Medical (NASDAQ:TMDI,TSX:TMD)

Market cap: US$184.01 million; current share price: US$1.68

Titan Medical is a development-stage medical device company focused on robotic single-access surgery. Based in Toronto, Ontario, it has a research and development facility in Chapel Hill, North Carolina.

The company's Enos system is being developed for single-access surgery, and aims to improve the robotic-assisted surgery experience for patients, surgeons and hospitals. Patient benefits include less trauma and faster recovery times, while positive points for surgeons and hospitals range from faster turnover to lower operating costs. The first indication for use for Enos is benign gynecologic surgery; as of August 2021, the system had been validated in more than 60 animal and human cadaver studies.

Once only listed on the TSX, Titan uplisted to the NASDAQ in mid-2018 in an effort to attract institutional investors. The company has a relationship with Medtronic, including a $10 million license agreement for instrument and camera technologies, and a $30 million co-development and license agreement.

8. Microbot Medical (NASDAQ:MBOT)

Market cap: US$52.1 million; current share price: US$7.33

Last on this surgical robotics stocks list is pre-clinical medical device company Microbot Medical. The company is focused on micro-robotic-assisted medical devices, and has also developed the LIBERTY robotic system, which it says is the world’s first fully disposable robotic system; it is used in neurovascular, cardiovascular and peripheral vascular procedures.

In mid-2021, Microbot received a notice of allowance for its One & Done guidewire technology from China. Other global jurisdictions that have given the green light include the EU, Japan and Israel. Microbot currently holds a total of 44 patents with issued/allowed status and 24 pending patent applications.

This is an updated version of an article first published by the Investing News Network in 2018.

Don’t forget to follow @INN_LifeScience for real-time updates!

Securities Disclosure: I, Melissa Pistilli, hold no direct investment interest in any company mentioned in this article.

Additional information on Medical Device stock investing — FREE

Medical Device ETFs: An Overview

Exchange-traded funds (ETFs) are a popular investment strategy, and generally contain a variety of publicly traded companies under one stock symbol, often with a focus on a specific sector.

Depending on the ETF, investors may be able to track up-and-coming companies, get exposure to top firms or a mix of both. Aside from stocks, some ETFs also track commodities or bonds.

In the healthcare industry, medical device ETFs bring together companies that go through great lengths to develop pharmaceutical-based technology that can improve the lives of patients.

To help investors make decisions when it comes to medical device ETFs, here the Investing News Network provides a brief breakdown of what ETFs are and a look at which medical device ETFs to buy.

What is an exchange-traded fund?

An ETF is similar to a mutual fund and trades like any other regular stock. ETFs are appealing because they give investors the ability to hone in on a specific market area without investing in individual stocks.

Put simply, ETFs centered on stocks reduce the risk of investing by providing a larger pool of companies — instead of going all in for one company, ETFs lets investors pick an area that interests them and suffer less financially if one company under the ETF's umbrella underperforms. In this way, ETFs allow investors to enter the market confidently and enjoy long-term capital gains.

Like many areas of the life science space, the medical device sector can be volatile, making ETFs a particularly appealing type of healthcare ETF.

For example, if a company in a medical device ETF fails a clinical trial or receives negative feedback from the US Food and Drug Administration (FDA), those who have invested in the ETF will largely be protected from any share price drop the medical device maker might have.

On the other hand, if a company in a medical device ETF sees a major gain, that increase will also be muted for ETF investors. That is why some investment professionals prefer to take their chances by adding individual stocks to their portfolios.

Medical device ETFs to consider

Investors who want to jump into medical device ETFs have only two choices, according to ETFdb.com. Here's a brief look at those ETFs.

1. iShares US Medical Devices ETF (ARCA:IHI)

The iShares US Medical Devices ETF was launched in 2006 and tracked 67 holdings as of June 25, 2021. This iShares ETF's top three constituents by weight are:

• Abbott Laboratories (NYSE:ABT): Abbott Laboratories' medical devices are geared towards vascular disease, diabetes and vision care.

• Thermo Fisher Scientific (NYSE:TMO): The company's devices are made primarily for experts such as lab workers. Thermo Fisher Scientific has products in a variety of areas, including cellular analysis, synthetic biology and molecular biology.

• Medtronic (NYSE:MDT): Medtronic's devices aim to relieve pain and restore health. The company's areas of focus include: diabetes, cardiac and vascular ailments, minimally invasive therapies and restorative therapies.

2. SPDR S&P Health Care Equipment ETF (ARCA:XHE)

Formed on January 26, 2011, the SPDR S&P Health Care Equipment ETF tracked 86 holdings as of June 25, 2021. Some of the top holdings in this fund's portfolio are:

• BioLife Solutions (NASDAQ:BLFS): Headquartered in Washington, BioLife Solutions is a leading supplier of cell and gene therapy bioproduction tools for the regenerative medicine, biobanking and drug discovery markets.

• Nevro (NYSE:NVRO): This medical device company develops and commercializes treatments for debilitating chronic pain based on a proprietary neuromodulation platform.

• ResMed (NYSE:RMD): San Diego-based ResMed is a medical equipment company that provides cloud-connectable medical devices for the treatment of sleep apnea, chronic obstructive pulmonary disease and other respiratory conditions.

This is an updated version of an article originally published by the Investing News Network in 2016.

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Securities Disclosure: I, Melissa Pistilli, hold no direct investment interest in any company mentioned in this article.