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U.S. map image from Flickr from image map U.S. The Top 10

Medtech States

Brian Buntz and We’ve all heard the stereotypes: California is a medtech hotbed. Chris Newmarker Massachusetts has cutting-edge research and Yankee ingenuity. And Minnesotans wake up earlier and work longer hours than everyone.

A substantial proportion of While the rankings for the top five companies are fairly

the medical device industry is straightforward, there is no single state that can confidently claim to be the clustered in a handful of best spot for all medical device firms. Orthopedic firms, for instance, will find states, although the number many advantages in Indiana while digital health companies would likely of U.S. medtech hubs is growing. fare better in a state like California or Massachusetts.

In the following rankings, we take a look at the most recent data available, We ranked the states based weighing everything from business friendliness to overall medical device on medical device employment in each state. Interestingly, the top three states score poorly in employment, patents, NIH funding, VC medical device terms of business environment but score better than all of the other states on funding, and business the list in nearly every other category. friendliness. Read on to discover major data for 10 top medical device states in the United States. 1. California

Sure, California has its problems. peripheral equipment Important Statistics: But the state is still unparalleled manufacturing, which employed when it comes to sheer size, 340,000, according to PwC. Medical Device Manufacturing Employment, 2013: boasting more medical device Orange County has long been one 63,307 companies and workers—by far— Medical Device Patents, 2009–2013: of the biggest medical device 10,061 than any other. The state’s device clusters in the country. The hub Medtech VC Investing, 2014: industry is considerably bigger than $1.2B there may be the biggest in the NIH Funding, 2014: that of and state and is definitely the largest in $3.4B Massachusetts. Medical Device Establishments: Southern California, according to a 1039 Best States for Business Ranking: In fact, California has multiple big report published by Biocom in 32 device hubs—Orange County, Los 2013. Employers in Orange County Chief Executive State Ranking: 50 Angeles, San Diego County, Silicon are also handsomely rewarded, Valley. Looking at it differently, all according to the report. An Major OEM headquarters: of Southern California from the average medical device worker in Varian Medical Systems (Cardiovascular Div.) coast to the Arizona state line is a Orange County makes an average Edwards Lifesciences life hub, as is the entire of $120,687, according to Biocom’s Intuitive Surgical Bay Area coupled with report. Sacramento. The medical device industry in Throughout the state, an average Orange County was responsible for employee in the broader life more economic activity than sciences industry in California earns Riverside, San Diego, and Imperial in excess of $97,000, according to counties combined. In all, the OC’s the PwC 2014 California medical device industry was Biomedical Industry Report. responsible for $5.3 billion of annual economic activity out of $9.5 billion While the state may be well known generated by the greater four- for its motion picture and high tech county region. industries, the combined life industry in California employed more people—267,000 in 2012—than all other industries in the state apart from computer and (continued) 2 The Top Ten Medtech States California Is Still on Top

To the south, San Diego is emerging as a leader when it comes to wireless California has more medical technologies and biotech. life science VC Silicon Valley has its own advantages, too, leading the nation when it funding than the comes to venture capital funding. In recent months, Apple and Google, both of which are based in Silicon Valley, have shown increased interest other nine states in in medical . In December 2015, Google debuted a new this list combined. name for its life science business—Verily.

Among the top 10 medical device states, California pulls in substantially more venture capital investment for medtech than any other state on the list—in 2014, there was $1.2 billion invested in medical device technology—more than the other nine states in list combined. In 2013, California pulled in roughly 45% of all of the venture capital funding in the United States within the life sciences sector—nearly $3 billion total.

The state saw the number of employees in the life sciences industry rise by 2% during the recession from 2008–2012, while other states like Massachusetts, Minnesota, Pennsylvania, Indiana, and New Jersey saw their life science employment numbers decline. According to PwC, only the state of North Carolina grew at a quicker rate (8.3%) in this time span. While a number of medtech companies are leaving the state, looking for greener pastures, the talented workforce present and strong life sciences infrastructure in the state will likely secure it as the U.S. leader for some time.

3 The Top Ten Medtech States Much of the medtech industry is based around St. Paul (shown here) and .

2. Minnesota

Minnesota's history in medtech officials reportedly told the ImportantImportant Statistics Statistics: : stretches back to the middle of the governor that the company

Medical Device Manufacturing last century. The roots of the state’s planned to keep their Minnesota Medical Device Manufacturing Employment, 2013: Employment, 2013: Medical Alley are even highlighted operations intact and that, rather 28,141 63,307 Medical Device Patents, 2009–2013: in a Smithsonian exhibit. than laying off employees in the Medical Device Patents, 2009–2013: 4269 10,061 state, it had plans to hire more in Medtech VC Investing, 2014: Medtech VC Investing, 2014: The state is presently home to the $234M the future. $1.2B NIH Funding, 2014: likes of Medtronic (which still has its NIH Funding, 2014: $497M $3.4B operational headquarters there), Twin Cities Business magazine Medical Device Establishments: Medical Device Establishments: named Medtronic’s CEO Omar 308 St. Jude Medical, 3M, and Mayo 1039 Best States for Business Ranking: Best States for Business Ranking: . has a large Ishrak as its 2015 Person of the Year. 13 32 And the Minneapolis/St. Paul Chief Executive State Ranking: Twin Cities presence, and medical

31 device OEMs ranging from Business Journal has named Ishrak Major OEM headquarters: Olympus to Coloplast also have its 2016 Executive of the Year in the MajorVarian OEMMedical headquarters Systems : Medtronic (Cardiovascular Div.) Medtronic (Operational HQ) operations there. According to Twin Cities, noting that Medtronic Edwards Lifesciences St. Jude Medical Intuitive Surgical Newsweek in 2010, 22% of has already added 350 jobs to the 3M

Coloplast employees in the greater Twin North Star State. Cities area work in the medical The manufacturing conglomerate technology sector. That figure 3M is an even bigger employer in represents a larger percentage the Twin Cities than Medtronic. The than tech workers in the Bay Area company, which is at once a (21%). medical device maker and a Although Medtronic is now officially supplier to the industry, was ranked headquartered in , Ireland, 205 in Forbes’ listing of the world’s after its $50 billion acquisition of biggest companies. By contrast, , the company is still a Medtronic was listed at 249. powerhouse in the Twin Cities, employing some 8000 employees there.

Upon first disclosing to Governor Mark Dayton its plans to move its headquarters to Ireland, company (continued) 4 The Top Ten Medtech States Under Ishrak’s tenure, Medtronic Minnesota Wins the Most PMAs has become one of the top two medical device companies in the California may be the largest medtech state, but it is not at the top of the world. list when it comes to U.S. FDA approvals for the toughest type of medical device applications. The state has a history of clinicians Chris Newmarker who have been involved in

medical device development. The It turns out that when it comes to getting premarket approvals from FDA, Minnesota state also has a strong network of remains the leader and has even grown its lead over California during the Great Recession, according to EvaluateMedTech data relayed by LifeScience Alley. suppliers, including Digi-Key, one of Over more than 50 years of PMAs, a third of them—more than 9000—involved the largest distributors of electronic devices created by Minnesota applicants. California only had 28%, or nearly 8000. And LifeScience Alley reports the difference has been even more stark in recent parts. Other major Twin Cities– years. based contract manufacturers The next states in the running—Massachusetts, Texas, and New Jersey—only had a include Proto Labs (Maple Plain), fraction of the pie. Heraeus Medical Components (St. Minnesota’s accomplishment is even more remarkable considering that California Paul), Minnetronix (St. Paul), and Sil- easily wins out when it comes to number of medtech workers (about 63,207 to Pro (Delano). Minnesota’s 28,141, as of 2013) and venture capital funding ($1.01 billion to Minnesota’s $165 million, as of 2013).

The state also boasts a strong California is home to more medical device companies than any other U.S. state, infrastructure of suppliers to the with a dense network of high-tech firms and a talented workforce. But some of the most life-saving (as well as most highly regulated) devices have been created in medical device industry and strong Minnesota. support from state politicians.

On a more critical note, the state lacks the funding climate that has historically benefited medtech startups in places like California and Massachusetts. Still, there is plenty of focus in the region through trade group LifeScience Alley and others when it comes to preserving and even enhancing this important medical device industry hub. The state of Minnesota is also in the process of spending $455 million to support infrastructure around the Mayo Clinic—more than 80 miles to the southeast of Minneapolis, in Rochester, MN.

Trade organization Life Science Alley released this infographic showing the state’s leadership in obtaining PMAs.

5 The Top Ten Medtech States 3. Massachusetts

Much of Massachussetts’ medical device industry is based in around Boston.

Massachusetts boasts one of the drawing investors to help spread Important Statistics: densest medical device clusters in their solutions around the country, and the industry has the world. Case in point is Robert Medical Device Manufacturing Employment, 2013: strong government support. Former Langer, ScD. The MIT professor in 14,719 Gov. Deval Patrick in 2008 signed recent decades has made Medical Device Patents, 2009–2013: 2481 into law a $1 billion package to chemical relevant to Medtech VC Investing, 2014: support the life sciences industry the life sciences, helping develop $339M NIH Funding, 2014: over a ten-year period. The state is treatments for cancer, , $2.4B also home to the country's largest heart , and schizophrenia. Medical Device Establishments: 289 biotechnology cluster. The state The field of -delivery has Best States for Business Ranking: has a highly educated populace especially benefitted from his 18 Chief Executive State Ranking: and has world-renowned research contributions. Langer has worked 46 institutions including MIT and with others at MIT, its teaching

Major OEM headquarters: Harvard that help attract affiliate Brigham and Women’s Boston Scientific (Marlborough) substantial R&D funding to the city. , and other institutions to Hologic (Marlborough) Massachusetts received $2.4 billion launch 29 companies. He has 1080 in NIH funding in 2014, less than patents issued or pending. California but about five times Among the launches is SQZ BioTech what Minnesota received. (Boston), which Langer described Medical devices are the biggest as “a company that can get export for the state, making up 13% anything into a cell by squeezing it of its international trade. Two major appropriately.” The firm’s tech uses OEMs—Boston Scientific and a “CellSqueeze” chip, mounted Hologic—are headquartered in onto an interface with reservoirs, to Marlborough. Nevertheless, the hold cells before and after state does have a high cost of squeezing. living and scores relatively poorly in terms of business friendliness.

On the other hand, the state’s medtech labs and incubators are (continued) 6 The Top Ten Medtech States Along with Silicon Valley, the The company boasts that the

Boston area is one of the most Form 2’s stereolithography innovative areas in the country. 3-D printing technology allows for Materials scientist John A. Rogers unprecedented accuracy and may have pioneered flexible precision at a price point that electronic circuits at the University almost everyone can afford. Such of at Urbana-Champaign, technology has run in the tens of employing them for purposes thousands of dollars in the past. including harvesting energy off Only four years old, Formlabs’ beating hearts. But the company technology was exciting enough commercializing much of the MIT that it raised nearly $3 million in a alumnus’ work, MC10, is based in Kickstarter campaign. Lexington, MA. MIT professor Robert Langer and The Massachusetts Medical MDEA Lifetime Achievement The 2015 Minnesota Medtech Device Industry Council Award Winner Robert Langer is Week Innovation Prize winner was (MassMEDIC) is an important one of the most influential researchers active in medtech. Formlabs (Somerville), which has a booster of the medtech industry in Image: MIT professional grade 3-D printer the state. called the Form 2 that costs $3499.

Image from Wikipedia

4. Florida

Miami from the water

Florida is home to more than 1000 In terms of medical device Important Statistics: companies active in the life investment, the state is not as sciences, according to Enterprise competitive, coming in near Medical Device Manufacturing Florida. The state is home to a the bottom of this list. Employment, 2013: range of life science companies 21,855 ranging from Arthrex and Bristol- Florida certainly has a business Medical Device Patents, 2009–2013: Myers Squibb to Noven. friendly environment, however. 1439 Forbes ranked Florida in slot 20 Medtech VC Investing, 2014: According to Enterprise Florida, in its Be st States for Business $23M the state ranks second in the Ranking while the readers of NIH Funding, 2014: nation in terms of FDA-registered Chief Executive magazine $473M medical device manufacturing voted Florida as the second Medical Device Establishments: facilities. best state in the country to do 620 business. Best States for Business Ranking: Enterprise Florida says that 620 20 medical device manufacturers The state has no income tax for Chief Executive State Ranking: had operations in the state as of individuals. The state is 2 2014. Among them are Johnson & aggressive in recruiting new Johnson and Medtronic Surgical businesses to relocate there, and offers them handsome Major OEM headquarters: Technologies, which have facilities in Jacksonville, and Johnson & economic incentives to do so. Arthrex (Naples) Johnson Vision Care, which is also In addition, Scripps Research Vistakon/Acuvue (Jacksonville) based there. Institute has its Scripps Florida MAKO Surgical Corp. / Stryker nonprofit biomedical research subsidiary (Davie) Recently, Zimmer Biomet facility located in Jupiter. expanded its facilities in Palm Beach Gardens. Each year, more than $1 billion is invested in life-science In terms of employment of related projects by the state’s medical device professionals, universities. Florida ranks third overall in the country—trailing California and The state also attracts Minnesota. considerable NIH funding—$473 million in 2014, which was nearly In all, the state’s healthcare as much as the $497 brought in ecosystem employs some 700,000 by Minnesota, which is home to workers. the prestigious Mayo Clinic, which, incidentally, also has a The state also ranks well in terms of facility in Florida—in medical device patents granted. Jacksonville. From 2009 to 2013, the state had 1439 such patents—behind only California, Minnesota, and Massachusetts.

There is a statewide association of medtech companies, the Florida Medical Manufacturers Consortium (FMMC) based in Tallahassee.

8 The Top Ten Medtech States 5. Indiana

Indiana’s Capitol.

A town in Indiana, Warsaw, has the terms of its business environment. Important Statistics: distinction of being the orthopedic The state offers companies relatively capital of the world. Ortho giant low taxes and operating costs. In Medical Device Manufacturing Employment, 2013: Zimmer Biomet has its headquarters terms of top medtech 17,956 there and DePuy Synthes operates manufacturing states, only Texas Medical Device Patents, 2009–2013: 1219 its joint reconstruction business out and Florida score higher. Medtech VC Investing, 2014: of the town. In addition, heavy- (not available) The state doesn’t score as well in NIH Funding, 2014: hitters like Medtronic, Paragon terms of venture capital investment, $208M Medical, Symmetry Medical, and Medical Device Establishments: however. In fact, the state was the 155 others also have a presence in the only in the top ten for which we Best States for Business Ranking: area. 8 could find no data on VC Chief Executive State Ranking: 6 The state’s medtech industry is not investment. A report from BioIntellex all about orthopedics, however, finds: “Indiana, like many other Major OEM headquarters: and medical device companies Midwest states, faces a Zimmer Biomet (Warsaw) Cook Medical (Bloomington) are spread throughout most of the considerable challenge in securing Hill-Rom (Batesville) state. Other common product private venture capital which is vital types made in Indiana include to small, young life sciences firms cardiovascular, diagnostic, and through their first months and urological devices. Big-name firms years.” based in Indiana include Cook The funding climate, however, is Medical and Roche Diagnostics. gradually improving. From 2003 to Boston Scientific, DePuy, and 2013, angel investor funding was Medtronic also have operations in $18.8 million and early stage the state. funding totalled $59 million, The state’s combined life sciences according to BioCrossroads. industry is responsible for $59 billion Between 2003 and 2013, life science of “economic impact,” according VC investment in the state leapt to BioCrossroads. 336% over the prior decade.

The state scores well in most indices of business friendliness. Chief Executive magazine readers ranked the state as the sixth best in

9 The Top Ten Medtech States 6. Pennsylvania

Philadelphia

As Pennsylvania's traditional coal example, the company’s diabetes Important Statistics: mines, oil fields, steel mills, and management Animas Corp. and

apparel factories have faded Medical Device Manufacturing Synthes, part of DePuy Synthes, both Employment, 2013: away, they have been replaced have headquarters in West Chester. 16,525 by modern manufacturing facilities. Medical Device Patents, 2009–2013: The group Select Greater 1210 Boasting a strong medtech Medtech VC Investing, 2014: Philadelphia boasts that there are industry, the state is benefiting from $63M more than 2000 medtech NIH Funding, 2014: a quickly growing population $1.5B companies located in Pennsylvania, eager for technical work. Best States for Business Ranking: New Jersey, and Delaware, with the 36 Chief Executive State Ranking: Pennsylvania’s east has been City of Brotherly Love right in the 35 becoming one of the country’s center of the region.

Major OEM headquarters: leading medical device The state may not rank as highly for Dentsply International Inc. (York) manufacturing centers, although Teleflex Inc. (Wayne) business friendliness. But there are the industry throughout the state is deals to be had. Lab space goes for growing, too. an average $13.80 per square foot In 2013, Pennsylvania was ranked in Philadelphia, while it is $47.40 per sixth among U.S. states for medical square foot in Boston, according to device employment. a life science industry trends report from JLL. Besides having a major medtech

OEM, Dentsply International Inc., Entities including Ben Franklin based in York, the state also Technology Partners, Pennsylvania maintains a strong backbone of State University’s Small Business medtech contract manufacturers. Development Center, and The B. Braun OEM Division of B. Pennsylvania Bio are all seeking to Braun Medical Inc., for example, is further grow Pennsylvania as a based in Bethlehem. medical device state.

Johnson & Johnson, headquarters over the Delaware River in New Jersey, has a large medtech presence in the region, too. For

10 The Top Ten Medtech States 7. New York

New York doesn't get as much between the New York Genome Important Statistics: attention in medtech as its New Center and the University of

Jersey neighbor, but the state is Buffalo’s Center for Medical Device Manufacturing Employment, 2013: vigorously working to boost its Computational Research. If the 16,544 presence in life sciences. New York plan works as anticipated, it will Medical Device Patents, 2009–2013: 1160 City is even vying to become a help drive progress in biomedical Medtech VC Investing, 2014: tech hub similar to San Francisco. research and drive growth in the $16.7M NIH Funding, 2014: state’s burgeoning genomic It's telling that digital health $2.1B industry. The plan will Best States for Business Ranking: incubator Rock Health, 29 also tie the New York City headquartered in San Francisco, Chief Executive State Ranking: university medical community to 49 now has an office in New York City. the emerging Buffalo medical And IBM Watson global Major OEM headquarters: technology corridor. Sirona Dental Systems Inc. headquarters opened in 2014 at 51 (Long Island) Astor Place in New York City's With nine major academic Silicon Alley. medical centers, New York City also boasts the world’s largest Boston may be the biggest hub on concentration of academic the East Coast for medical institutions, including Columbia technology innovation. But New University, Weill Cornell Medical York City is hoping to give it a run College, NYU, Albert Einstein for its money. At present, the two College of Medicine, and the cities appear to be neck-and- Rockefeller University. The $2.1 neck. A late 2015 funding report billion in NIH funding that New York from Rock Health found that New researchers received in 2014 is York City attracted nearly as much nearly as much as the $2.4 billion VC cash for digital health funding received by their counterparts in as Boston. New York attracted Massachusetts. more than $500M in deals in 2015.

In early 2014, Governor Andrew Cuomo pledged more than $100 million for the New York Genomic Medicine Network, a partnership

11 The Top Ten Medtech States 8. Texas

The Texas Capitol

When Canadian wound clamp nation. And there is specific support company Innovative Trauma Care for life sciences. Important Statistics: was searching for a U.S.

headquarters in 2012, it did not turn It also helps that the largest medical Medical Device Manufacturing to the usual suspects such as center in the world, the Texas Employment, 2013: Minneapolis, Boston, or California. Medical Center, is based in 13,967 Houston. The Texas Medical Center Medical Device Patents, 2009–2013: Instead, the company’s co-founder even announced last year that 1137 and president Dennis Filips settled Johnson & Johnson Innovation was Medtech VC Investing, 2014: on San Antonio—for good reason, opening a JLABS@TMC incubator $63.2M too. The home of the Alamo also for new companies. NIH Funding, 2014: has the San Antonio Military Medical $972M Center, the U.S. Department of Many of the biggest medtech Best States for Business Ranking: Defense’s only stateside Level I– players, including more than a 6 trauma center, and a niche cluster dozen Fortune 500 medtech Chief Executive State Ranking: of wound care device companies companies, have manufacturing 1 including Vidacare Corp. and facilities or significant operations in

Kinetic Concepts Inc. the state. These include Abbott Major OEM headquarters: Laboratories, Johnson & Johnson, Greatbatch Inc. (Frisco) “There was already a pool of talent Medtronic, GE, Stryker, Cardinal Cyberonics Inc. (Houston) down there. ... If we had gone to Health, St. Jude Medical, and San Diego or Boston, it probably Becton Dickinson. would have taken longer to make the right connections,” Filips says. It Texas’ rise is far from complete also helped that the city of San though. InCube’s Imran thinks the Antonio made a $300,000 equity three major U.S. medical device investment in Innovative Trauma industry hubs—California, Care, and there were eager angel Minnesota, and Massachusetts— investors and a few venture capital have three major things going for outfits such as medtech innovator them: a plethora of groundbreaking Mir Imran’s InCube Labs with a ideas produced inside and outside presence in the Lone Star State. of universities, a large community of The story of San Antonio’s medtech entrepreneurs who can identify growth involves a cluster focused on fruitful ideas and cultivate them into a specific niche, in this case trauma promising companies, and a large care; the willingness of public and pool of risk capital to pay for private sources to pony up some medical device development. money; and a lower cost of doing business. It is a situation that is While Texas can’t quite compete repeating itself across Texas in other with the upper-tier medtech hubs cities including Austin and Houston, now, it’s certainly gaining ground. and a reason why the medtech landscape is shifting ever so slightly in the Southwest. The medical device industry in Texas has been gaining strength in large part because of the state's famed business friendliness. Chief Executive magazine pegged the state’s business climate as the best in the

12 The Top Ten Medtech States 9. New Jersey

Important Statistics: Perhaps New Jersey should do a up to $5 million, are available to better job marketing itself as a eligible technology and life

medtech hub. Home to one of the science businesses locating in Medical Device Manufacturing densest concentrations of medical these zones. Employment, 2013: device companies in the country— 13,575 not to mention New Brunswick, NJ– Camden’s Innovation Zone Medical Device Patents, 2009–2013: based Johnson & Johnson—the includes the Waterfront 1145 state gets relatively little credit for Technology Center, a 100,000-sq-ft Medtech VC Investing, 2014: its contributions. facility designed to help $82M established businesses and NIH Funding, 2014: Twelve of world’s top 20 medtech startups in the biosciences and $228M companies maintain a significant other high-tech and life sciences Best States for Business Ranking: presence in New Jersey, according fields. 41 to the HealthCare Institute of New Chief Executive State Ranking: Jersey (HINJ), which provides a Located in the Bioscience Cluster 47 voice for the life sciences industry between Rutgers and Princeton

in the state. Besides its Universities is the Technology Major OEM headquarters: headquarters in New Brunswick, Centre of New Jersey (North Johnson & Johnson J&J’s medical presence in the Brunswick). With approximately (New Brunswick) Garden State includes Ethicon in 325,000 sq-ft of laboratory, Becton, Dickinson and Co. Somerville and Janssen in Titusville. production, and office space and (Franklin Lakes) Becton, Dickinson and Co. is more than $100 million invested in C.R. Bard (Murray Hill) headquartered in Franklin Lakes, facilities and improvements, the and C.R. Bard is based in Murray Tech Centre was designed to Hill. meet the needs of research and development companies in the While the state’s medtech industry bioscience and other high-tech is strong, its biotech and pharma industries and to accommodate industries are stronger. According modern cleanrooms and wet labs. to a report from the New Jersey Department of Labor and Twelve of world’s top 20 medtech Workforce Development, nearly firms maintain a significant 75% of the state’s workers in life presence here, according to the sciences are in either pharma or HealthCare Institute of New biotech while the remainder works Jersey. for the medtech industry. When it comes to business New Jersey’s Economic environment, however, the state Development Authority has does not excel. Case in point: established three Innovation Zones, Forbes’ “Best States” business areas within the cities of Camden, ranking was slightly more upbeat, Newark, and the Greater New pegging the state in slot 41 in the Brunswick area that encompass nation. state universities, research institutions, and related businesses. These zones are designed to encourage the rapid transfer of discoveries from the laboratory to the marketplace. Enhanced financial incentives, including loans

13 The Top Ten Medtech States Utah has one of the fastest-growing medtech industries in the U.S. Shown here: its capitol building. 10. Utah

Important Statistics: Even with names such as Edwards employment outlook. The Utah Lifesciences, Merit Medical Technology Council (UTC)—the

Systems, and Nelson Laboratories state's professional association for Medical Device Manufacturing among the state's employers, it more than 6000 high tech, clean Employment, 2013: may be a surprise to learn that, on tech and life science companies— 9504 a per-capita basis, Utah is actually touts other proofs of the state Medical Device Patents, 2009–2013: first in the nation in medical device being good for business, including 648 manufacturing, according to 2012 Gallup Daily Tracking listing Salt Medtech VC Investing, 2014: numbers published in Economic Lake City as the top job-creating $16.9M Review by the Economic U.S. metro area and CBS News NIH Funding, 2014: Development Corporation of Utah. ranking Provo and Orem first in a $165M Much of the industry is centered new index of the nation's 150 most Best States for Business Ranking: around Salt Lake City, where the dynamic labor markets. 1 University of Utah hospital and Chief Executive State Ranking: are known for The state-funded Utah Science 15 medical device innovation, and Technology and Research

particularly in orthopedics and Initiative (USTAR) has recruited Major OEM headquarters: cardiovascular devices. scientists from MIT, Harvard Merit Medical Systems Inc. University, UCLA, Case Western, (South Jordan) Major OEMs with a presence in the University of Arizona, and Oak state include Edwards, Becton Ridge National Laboratory to move Dickinson, Boston Scientific, to Utah research universities such Medical Care and C.R. as the University of Utah and Utah Bard. State University, according to the 2014 State Tech and Science Index Still, when looking at the most report by the Milken Institute’s recently available employment California Center. numbers, Utah trails the other states on this list by a significant margin. USTAR partners with the research The same is also true when universities to continually spin out comparing the volume of medical new medical device companies, device patents filed in Utah from as many as a dozen each year. between 2009 to 2013 to the other states in this roundup.

The Beehive State is also noted for its business friendliness. Utah has been No. 1 in Forbes’ Best States for Business rankings for five of the past six years, with Forbes recently praising the state for its robust labor force, low energy costs, and

14 The Top Ten Medtech States Top 10 Medical Medical Medtech VC NIH Funding, Chief Major Hubs Medical Device Mfg. Device Investing, 2014 Executive Device Employment, Patents, 2014 Magazine States 2013 2009–2013 Ranking

1. CA 63,307 10,061 $1,200,000,000 $3,400,000,000 50 Orange County, Silicon Valley, and San Diego 2. MN 28,141 4269 $234,000,000 $497,000,000 31 Twin Cities 3. MA 14,719 2481 $339,000,000 $2,400,000,000 46 Boston/Cambridge 4. FL 21,855 1439 $23,000,000 $473,000,000 2 Jacksonville and Tampa 5. IN 17,956 1219 Not available $208,000,000 6 Warsaw and Indianapolis 6. PA 16,525 1210 $63,000,000 $1,500,000,000 35 Philadelphia and Lehigh Valley 7. NY 16,544 1160 $16,700,000 $2,100,000,000 49 New York City and Westchester County 8. TX 13,967 1137 $63,200,000 $972,000,000 1 Houston, Austin, and Dallas 9. NJ 13,575 1145 $82,000,000 $228,000,000 47 Middlesex County 10. UT 9504 648 $16,900,000 $165,000,000 15 Salt Lake City

Methodology: In ranking the states in this roundup, we looked closely at overall medical device employment numbers and patents filed, making special considerations for states with exceptionally high venture capital or NIH funding amounts (such as Massachusetts). We also weighed the business climate of each state, using it, for instance, to position Pennsylvania ahead of New York state. While business friendliness is certainly an important consideration, we didn’t think twice about our choice to position California, Minnesota, and Massachusetts as the top three states because those three generally led by wide margins in other categories.

Medical device industry employment and patents filed data came from the Minnesota Department of Employment and Economic Development’s Compare Minnesota tool, venture capital funding numbers were from the PricewaterhouseCoopers/National Venture Capital Association UBM MoneyTree Report, and NIH funding was from NIH’s website. Business 2901 28th Street, Suite 100 friendliness rankings came from Forbes' Best States for Business (2015) and Santa Monica, CA 90405 Chief Executive magazine’s Best & Worst States for Business (2015). 310-445-4200

15 The Top Ten Medtech States