The dynamics of the medical device innovation ecosystem, which has long been US focused, are shifting to create a more global environment. Here, PricewaterhouseCoopers introduces its Medical Technology Innovation Scorecard - to be unveiled later this fall - that evaluates the innovative capacity and capabilities of nine countries, all current or emerging leaders in medical technology, in order to track global shifts in device innovation.

Highlights from the Q4 2009 review of medical device and in vitro diagnostics/research dealmaking: Medical device financings - again led by both early- and late-stage VC money, which made up 65% of the quarter's $745mm total - experienced a decline from the previous three-month period, which brought in over $1bn. The year overall fetched just $3.1bn, slightly less than 2008's $3.3bn aggregate. The biggest M&A was Ethicon Inc.'s $785mm takeover of Acclarent Inc. in December. Although Q4 M&A was $1bn higher than Q3, 2009 on the whole was the most dismal year for medtech acquisitions in over five years. On the in vitro diagnostics/research front, the $304mm in financings disappointed as it showed a significant dip from the $821mm done during Q3. Although Vermillion Inc.'s $43mm PIPE made up 19% of the quarter's pie, early- and late-stage VC financings again dominated, together accounting for 65% of Q4's aggregate dollar volume. Becton Dickinson & Co.'s $275mm October buy of molecular diagnostics firm HandyLab Inc. capped off a less-than-outstanding quarter of M&A activity with only five transactions totaling $468mm. For the entire year, in fact, this industry segment only managed to bring in $5.1bn through 21 M&A deals, a significant decrease over 2008's $9.6bn full-year amount.

Buoyed by their success with Genomic Health, a trio of West Coast VCs have expanded their portfolios of molecular diagnostic companies, with many following similar themes. CardioDx has developed a test to distinguish between patients who should move on to cardiac imaging and those they are comfortable managing otherwise. Such a rule-out test is a challenging proposition. But if adopted, and more broadly, as molecular diagnostics move into new and broad markets like cardiology and metabolic disease, pharma could use this opportunity to its advantage in many settings, including co-marketing arrangements.

Highlights from the Q4 2009 review of start-up dealmaking: Fundraising in the biopharma, medical device, and in vitro diagnostics industries totaled $976 million, an 88% increase from the previous quarter, and a 77% jump from Q4 2008's $551 million. Of the total fundraising, 66% or $640 million went to the biopharma industry. Compared with Q3 2009, device fundraising rose by 85% (from $113 million to $209 million) and diagnostics companies raised 72% more (from $74 million to $127 million). The fourth quarter of 2009 saw eight acquisitions, all of them in the biopharma industry. Big Pharmas were busy signing deals with start-ups--Sanofi-Aventis inked three while Roche and Novartis AG each signed two.