Crashing the gates of the top 10 IVD markets

per cent for Brazil in 2008. All three currencies are in good shape, and inflation is modest in each country: 3.0 per cent in China, 4.1 per cent in Brazil, and 5.2 per cent
in India.

Clinical labs and diagnostic medicine
Brazil and India are similar in that they both have long histories of stratified access to medical services. The less fortunate have endured poor services delivered by government clinics and hospitals. The public sector labs that serve these people are strapped for cash and have always been less-than-ideal customers for international IVD firms. Selling to public-sector labs has frequently involved shady practices, so international firms tended to focus on the private hospitals and commercial labs, where the self-serving decisions of on-site management are more rational.
Well before the advent of automated laboratory medical technologies during the 1960s, both India and Brazil had many private clinics and hospitals that catered to the more affluent classes. By the time the 1970s arrived, with the semiautomated batch analysers of those days, there were plenty of small-scale, mom-and-pop commercial labs. Since private medicine was always legal in Brazil and India, entrepreneurial biochemists and pathologists had the legal security to make substantial investments in capital equipment.
Today, Brazil has many highly automated commercial lab chains. India is a few years behind Brazil in this process. Private commercial labs have been around for many years in India, but only recently have chains of private labs become common in Brazil. The commercial labs in India may be every bit as well automated as the leading Brazilian commercial labs, but they are not yet running such big daily workloads.
China, however, had no tradition of private medicine in any form. Prior to 1949, there were plenty of private medical practices, but the government took over responsibility for the provision of healthcare in the early 1950s. There has never been any legal framework in China that would give the entrepreneurial Chinese biochemists and pathologists the confidence necessary to make the capital equipment purchases necessary to run a viable commercial lab.
The government medical services provided in China may have been underwhelming, but there was never any private outlet for those who could afford to pay for premium healthcare, as was the case in Brazil and India. Today, there are very few private labs in China, and these have difficulty attracting specimens away from government hospitals. There are a few private hospitals in China, but these are small and cater to the very wealthy. Once the government clarifies its position on regulation of private medicine, there should be a boom in the commercial lab business.
Chinese labs have always been owned by government entities, such as the health ministry, the armed forces, the provinces, and the municipalities. Despite the fact that they are all government owned, China’s hospital-based clinical labs are very commercially sophisticated and very protective of the revenue stream that labs provide.
They usually bring in profits for their hospitals, second only to the profits brought in by the
hospital pharmacies.
In China, Brazil, and India, there are currently very large numbers of active clinical labs (see Table I). In addition, these countries will take delivery of a huge share of the world’s new instrumentation in 2008 (see Table II).
The impact of indigenous producers
While China is a far bigger market than either Brazil or India, a far lesser share of China’s domestic market is at this point accessible to multinational firms (see Table III). China and Brazil are comparable in terms of the value of their IVD products supplied