This image is the 2023 logo of the Medical Design & Outsourcing Medtech Big 100 Report about the world's largest medical device companies.Of the 100 largest medical device companies, these 10 firms have spent the largest portion of their revenues on research and development.

Each year, Medical Design & Outsourcing compiles a list of the 100 largest medtech companies around the world and ranks them based on annual revenue for the most recently reported fiscal year. We also consider research and development spending because it can indicate where innovation occurs in the industry.

According to this year’s Big 100 analysis, the ranking of the companies that spent the biggest percentage of their revenue on R&D was mixed. While companies with the highest sales spent the most on R&D in previous years, that was not the case this year. Companies that are in the bottom 50 of our Big 100 list dedicated a greater portion of revenue to research.

Only one company on the R&D spenders list was ranked among the top 25 on the Big 100 – Edwards Lifesciences.

Read on to discover the 10 medtech companies spending the largest portion of their budget on R&D and what the businesses did in their most recent fiscal years. Sort the table below to your preference.

Microport

2023 Big 100 rank: 77
Revenue ($USD): $840,831,000
Headquarters: Shanghai, China

MicroPort’s cardiac rhythm management subsidiary — MicroPort CRM — announced in May that it received FDA approval for its Alizea and Celea implantable pacemakers. Microport said its newly approved devices are the longest-lasting pacemakers for their size on the market today. They offer a volume of just 11 cc and a projected longevity of 13 years. –CN

Novocure

2023 Big 100 rank: 85
Revenue ($USD): $537,840,000
Headquarters: Root, Switzerland

Novocure specializes in developing therapies for difficult-to-treat tumors. The oncology company's tumor treating fields technology (“TTFields”) is FDA-approved for recurrent and newly diagnosed glioblastoma and mesothelioma. In June 2023, the company said a phase 3 clinical trial found TTFields with standard therapies improved survival for non-small cell lung cancer patients. The company is also studying ovarian, brain and pancreatic cancer. –JH

Applied Medical Resources

2023 Big 100 rank: 79
Revenue ($USD): $800,000,000
Headquarters: Rancho Santa Margarita, California

Founded in 1987, privately held Applied Medical Resources provides technologies for minimally invasive and general surgery, as well as cardiac, vascular, urologic, colorectal, bariatric, obstetric and gynecologic specialties. This year, it made headlines when it filed an antitrust lawsuit against Medtronic in U.S. District Court in Central California. In July, the Federal Trade Commission sought court permission to file an amicus brief that would “correct some of Medtronic’s erroneous assertions and mistaken legal points” the medtech giant made in its argument for dismissal. –CN

Inari Medical

2023 Big 100 rank: 96
Revenue ($USD): $383,471,000
Headquarters: Irvine, California

Inari Medical focuses on the treatment of venous diseases such as venous thromboembolism, crafting devices to extract blood clots safely and effectively. Its FlowTriever device employs both mechanical and aspiration methods in a single session. The company invests aggressively in R&D. In the first half of 2023, Inari grew significantly through new product launches, expansion into global markets and increased adoption of its equipment in medical procedures. Inari this year launched RevCore and T16 Curve, both designed to treat venous thromboembolism, clots in the leg that are often undiagnosed. –BB

Edwards Lifesciences

2023 Big 100 rank: 24
Revenue ($USD): $5,382,400,000
Headquarters: Irvine, California

Strong transcatheter aortic valve replacement (TAVR) sales backed 10% year-over-year revenue growth for Edwards Lifesciences during the first half of 2023. In the U.S., improved hospital staffing levels aided TAVR sales, as did the launch of the Sapien 3 Ultra Resilia. The company has upped its full-year sales guidance to between $5.9 billion and $6.1 billion. “Looking beyond 2023, we remain confident that our foundation of innovative therapies along with a differentiated technology pipeline positions us well for continued longer-term success,” said Bernard Zovighian, who took over as CEO for Michael Mussallem in May 2023. –CN

AtriCure

2023 Big 100 rank: 99
Revenue ($USD): $330,379,000
Headquarters: Mason, Ohio

When it comes to treating AFib and related conditions, AtriCure has carved out a strong niche for itself when it comes to devices delivered via surgery. Its Isolator Synergy ablation clamp is the only device — catheter-delivered or surgical — that is FDA-approved for the treatment of persistent and long-standing persistent AFib. AtriCure’s Hybrid AF therapy is a minimally invasive procedure for persistent AFib patients, while its cryoablation technology blocks pain in cardiac and thoracic procedures. In addition, AtriCure’s AtriClip left atrial appendage (LAA) exclusion products provide an option for surgeons to reduce stroke risk after heart operations. Even with Medtronic launching its competing Penditure left atrial appendage (LAA) exclusion device, AtriCure officials have told analysts that they don't see health providers significantly transitioning away from AtriClip. –CN

Inspire Medical Systems

2023 Big 100 rank: 94
Revenue ($USD): $407,856,000
Headquarters: Golden Valley, Minnesota

Inspire Medical Systems revenue grew more than 60% year-over-year during the first nine months of 2023, with the implantable sleep apnea device company expecting full-year growth in the 49% to 50% range. Inspire’s pacemaker-like device that provides an alternative therapy to CPAPs has benefited from the Philips recall. Earlier this year, Inspire hired former Medtronic VP and Spine & Biologics GM Carlton Weatherby as its chief strategy officer and former Applied VR executive Dr. Charisse Sparks as chief medical officer. –CN

Shockwave Medical

2023 Big 100 rank: 88
Revenue ($USD): $489,733,000
Headquarters: Santa Clara, California

Shockwave Medical’s proprietary intravascular lithotripsy (IVL) tech delivers local sonic pressure waves to treat calcified plaque. The company says the technology safely modifies calcium while significantly reducing the risk of complications. The company announced a $500 million private offering to continue its growth. Major medical device companies reportedly saw Shockwave as an acquisition target this year, but Shockwave Medical is a buyer, too. In April, it paid $147 million for Neovasc and its Reducer system for addressing refractory angina. –CN and SW

Dexcom

2023 Big 100 rank: 38
Revenue ($USD): $2,909,800,000
Headquarters: San Diego, California

Dexcom, a developer of continuous glucose monitoring (CGM) technology, continued its rapid growth in 2023 with the launch of its next-generation G7. Soon after, a new Medicare guideline implemented in April increased the addressable market for the company’s CGM. The San Diego-based company is now shifting its focus toward using its technology beyond diabetes management, with eyes on bringing its sensors to even more users. –SW

Carl Zeiss Meditec

2023 Big 100 rank: 53
Revenue ($USD): $1,997,977,800
Headquarters: Jena, Germany

Carl Zeiss Meditec products and workflow solutions support the diagnosis and treatment of eye diseases. It also provides technology for visualizing minimally invasive surgical treatments in neurosurgery, ENT, spine, pathology, oncology and dentistry. –CN

Executive Editor Chris Newmarker, Managing Editor Jim Hammerand, Associate Editor Sean Whooley and Pharma Editor Brian Buntz contributed to this article.