Exploring Asian Medical Device Markets: An International Conversation with Anurag Mairal and Karl Im

AnuragAnurag Mairal and Karl Im, two contributors to the international medical device community, recently joined our Biodesign Alumni Group for its first International Tableside Chat in which over 40 participants from the US, India, and Singapore were connected by a video link to provide a truly interactive forum for discussion of the opportunities and challenges with device development in Asia. Both helped provide key insights into why East Asian (China, Japan, Singapore…) and South Asian (India) markets are important but still in the early stages of being developed.  (See bios below.)

Why Asia?

The potential of Asian markets was certainly a draw for the audience, and Karl helped to pin down exactly why it has garnered so much buzz. Quite simply, Asian countries represent close to 50% of the world’s population but only consume 13% of healthcare dollars spent each year, highlighting the growth opportunity of the region.

Opportunities… (and Challenges)

Throughout of the course of the conversation, it became apparent that there is clear opportunity for the entrepreneurially minded because many larger medical device manufacturers based outside of Asia are running into adaptability issues when entering Asian markets where in many respects they are focused on protecting their core revenue generating technologies. While there is a high view of Western developed products in Asia, tailoring products to meet local needs and pricing can be a challenge for established companies familiar with a set ways of doing business. Understanding the local environments will be critical for success in these different regions.

Regionally, opportunities further present differently. As Karl noted, Singapore is an excellent hub for manufacturing and device development because of the technical capabilities of its workforce, the critical respect for IP protection, and proximity to the rest of the region. Still the ability to sell into neighboring markets is not always clear cut.

In China, the government is focused heavily on internal growth and development as highlighted by initiatives such as the 1000 scholars program which serves to foster homegrown development through seed grants. Opportunity, yes, but accessibility to foreigners less so, highlighting the need to partner with locals in order to successfully navigate the Chinese market. While CE marked and Western developed products still are viewed as high value products, the need to continually reinvent and innovate is no more apparent than in China where their internal development efforts and technical prowess have been making leaps and bounds. This is further compounded in certain situations by more favorable reimbursement for Chinese devices which pressures foreign manufacturers.

The experience in China stands in contrast to India where government support is focused on bigger more established local companies. According to Anurag, seed funding support is typically harder to come by and suggests that a cultural shift may be necessary to enable a med tech start up environment.

What about Japan? It is a real market opportunity, but hard to enter given cultural predilections and long regulatory processes.

Are these markets real?

Throughout the course of our conversation, it became apparent that the devil’s in the details. While Asia represents a large potential market overall, entry into these markets requires ground level involvement likely with local representatives to help navigate each country’s particularities.

Given the challenges which seemed to outweigh the benefits, the question remained: Why go to Asia? When should you go?

Market potential is one answer. Establishing sales in Asia can ultimately help grow the valuation of your company (recall that 50% of the world’s population is here).

But, perhaps put most aptly by our panelists when asked is these markets are truly real:

“China is more real than India.”

“Tread carefully with your eyes open.”


Anurag Mairal, PhD, MBA is a Co-founder and Executive Vice President of Orbees Medical, a consulting firm serving medical device industry in the U.S., Europe, and Asia. He is also the Director, Global Exchange Programs, Stanford University where he is responsible for developing an extensive network of partners from industry, academia, regulatory bodies, and investors in Asia and the U.S. to foster these Asia-focused programs. Prior to this, Dr. Mairal was a Product Director at Cordis and a Development Director, Business Development at Nitinol Devices and Components, both Johnson and Johnson companies. He is also a co-founder of South Asian MBA Association (SAMBAA), a global network of MBAs with interest in South Asia. He received his PhD from the University of Colorado at Boulder and MBA from the Haas School of Business at University of California, Berkeley

Karl Im, MBA, is the founder of Venture Manufacturing Group (VMG) and a serial entrepreneur. VMG incubates medical device technologies by providing start up support along with its turnkey engineering, manufacturing, quality and regulatory services. While managing VMG, Karl co-founded two companies: Guided Delivery Systems and Indigo Orb. GDS is developing a solution for percutaneous mitral repair and Indigo Orb is developing tools for better delivery of pain management treatments. Karl also founded Parklin Medical Pte. Ltd, a medical device manufacturing company, both in US and in Singapore. Karl earned his BS degree in Mechanical Engineering from University of California, Santa Barbara. He then completed his MBA at Pepperdine University. Karl began his career working in aerospace industry and transitioned to medical device industry working at Guidant/Origin Medsystems.


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