WHEN THE COVID-19 pandemic struck India in 2020, U.S.-based Amphenol, a global leader in interconnect products for medical and healthcare devices, got a call from the Andhra Pradesh Medtech Zone (AMTZ), a medical device manufacturing park in Visakhapatnam that was barely four years old and had 25-odd units.

The AMTZ wanted Amphenol Advanced Sensors, part of the Amphenol Group (2023 sales: $12.6 billion), to set up a unit to produce sensors for oxygen concentrators, pulse oximeters, and ventilators. India had been importing these critical items before the pandemic sent demand soaring and also cut global supply lines, boosting the case for local manufacture.

Asif Gavandi, Amphenol Advanced Sensors’ account manager for India, says, “Within one discussion, we decided to set up the plant. Ours was one among the first units to come up in AMTZ.” As the pandemic peaked, companies in the AMTZ were churning out over 100 ventilators, 500 oxygen concentrators, and 1 million RT-PCR kits every day. AMTZ continues to attract companies, both foreign and Indian, and today has over 100 units that manufacture medical devices or support their production by making parts. Amphenol is preparing a second plant for sensor assembly at the AMTZ to serve its customers within the park and beyond.

Jitendra Sharma, the founder and CEO of AMTZ, says his team is going all out to attract global leaders in component manufacturing to make life easier for manufacturers of medical devices here, whether they are units of multinationals, Indian firms, or startups. “Instead of only attracting the finished goods manufacturers, we also get the value chain providers into our park. For example, radiology companies will not come if a key component, such as a detector, is unavailable. You can say a ₹7,000-crore radiology industry depends upon this ₹700-crore critical component segment,” says Sharma.

Today, AMTZ has Varex Imaging, which makes components for X-ray imaging systems, such as X-ray tubes and flat-panel detectors, and Spellman High Voltage Electronics Corp., which makes X-ray generators. Apart from these two U.S. companies, several others provide critical components for the medtech sector.

While the pandemic sparked a rush to produce medtech in India, it also signalled the confidence of MNC medtech players in India’s growth potential as a market and manufacturing base for medical devices and diagnostic equipment.

Call this the second wave: multinationals are no strangers in India’s medtech and diagnostic device space. They have defined and dominated India’s medtech and diagnostic market even before Independence. Germany’s Siemens brought X-ray imaging to India in 1927 and started making X-ray machines here in 1959 at a plant in Worli. Today, Siemens Healthineers, one of the top MNCs by India revenues, is leading in AI-driven diagnostic innovations, with over 7,000 employees, two manufacturing facilities (Vadodara and Bengaluru), a robust nationwide service network, and an R&D ecosystem.

The U.S.-based GE HealthCare, which began its journey in India in 1990 as a division of GE and became a standalone unit in 2023, has its largest R&D centre globally in Bengaluru. The Healthcare Technology Centre India (HTCI), a joint venture (JV) between GE Precision Healthcare LLC, U.S.A., and Wipro Enterprises Ltd, is one of the most successful and longest-running JVs in the Indian medtech sector with three manufacturing facilities. GE has a fourth manufacturing unit, a JV with the government-owned Bharat Electronics Ltd.

Switzerland’s Roche Diagnostics, in India since 2002, has a lab automation footprint across 30 centres in 15 cities, serving over 6 million patients. Roche is behind the AIIMS Smart Lab at the government’s All India Institute of Medical Sciences in Delhi, as well as the private-sector Apollo Hospitals Group’s DigiSmart Lab in Chennai. U.S.-based Boston Scientific set up its local corporate unit in 2011 and its first research and development centre in 2014 in Gurugram, followed by a second at Pune in 2022, to sell its coronary stents and other products. Today, it has commercial operations, R&D, digital capabilities, training, and global support functions in India.

Nadeem Anam, associate director of the Medical Technology Association of India (MTaI), an industry body, says global medtech firms have helped build many of the clinical markets, with deep, long-term investments in ecosystem development, including training healthcare professionals to use complex technologies safely and effectively. “Global companies have also made some of India’s largest investments in medtech manufacturing, research and development, and global capability centres, bringing leading-edge technologies and quality systems while transferring know-how,” says Anam.

MTaI member companies alone have over 20 manufacturing plants, 26 R&D centres, and 18 global capability centres (GCCs) in India. The MTaI counts as its members over 65 leading names, such as Roche, Medtronic, Becton Dickinson, Thermo Fisher Scientific, Boston Scientific, and Baxter.

The significance of MNCs in the Indian medtech sector is evident from the import figures. According to a recent report on the sector by NATHEALTH or the Health Federation of India, and PwC, Indian medtech imports grew from $5.1 billion to $9 billion, at a CAGR of about 12% between 2018 and 2023. An earlier focussed market study done by Deloitte Touche Tohmatsu India LLP for the Competition Commission of India, on the sub-sector of diagnostic medical imaging equipment industry (especially MRI and CT scan machines), had pointed out that the market value for medical imaging equipment may touch ₹20,968 crore by 2026, at a CAGR of 9.8% from 2022 to 2026. Again, 80% of these are imported devices.

The study had noted, “Despite efforts to boost domestic medical device production, imported devices tend to be high-value but low-volume, whereas local production is geared towards low-value, high-volume diagnostic tools.” Chaitanya Sarawate, MD, Wipro GE Healthcare, says India’s medtech sector is at an inflexion point. “With deep manufacturing capabilities and world-class engineering talent, India is poised to emerge as a global medtech leader. At Wipro GE Healthcare, we are proud to be a trusted partner in advancing India’s localisation agenda; designing and manufacturing products that reflect our commitment to ‘Make in India, for India and the world,’” says Sarawate, who is also president & CEO, GE HealthCare South Asia.

In 2022, Wipro GE Healthcare launched a medical device manufacturing (MDM) facility in Bengaluru under the production-linked incentive (PLI) scheme. The ₹100-crore facility produces CT scanners, MRI machines, cathlabs, ultrasound systems, and patient monitoring solutions. Wipro GE Healthcare has invested over $4 billion in India since its incorporation in 1990, the year before India’s economic reforms. In 2024, Wipro GE Healthcare announced an investment of over ₹8,000 crore in manufacturing and local R&D over the next five years. As a part of this investment, the Wipro GE Healthcare’s ‘Made in India’ PET CT Discovery IQ will be exported to 15 countries. It will also make the Revolution Aspire CT, Revolution ACT and MRI breast coils under the ‘In India for the World’ project.

Roche is focussing on patient access software: its products are used in over 3,000 centres in 400+ cities, says Rishubh Gupta, MD, Roche Diagnostics, India and neighbouring markets. “Through faster turnaround times and high-volume testing led by integrated automation and digital intelligence, we are empowering labs and clinicians to deliver improved patient outcomes,” says Gupta. “Platforms such as Navify power interoperable workflows, processing results for up to 100,000 patients daily across networks in India’s leading diagnostics chains, accelerating clinical decision-making at scale.”

He says Roche’s patient-first innovations are expanding access to life-saving diagnostics. These include the HPV DNA self-sampling test for cervical cancer prevention and Anti-Müllerian Hormone (AMH) Plus that aids PCOS detection. Roche also offers HCV Duo screening for Hepatitis C and CSF-based Alzheimer’s testing. Near-patient testing through LumiraDx brings diagnostics closer to patients, improving accessibility and care. “Roche’s innovations break barriers of geography, cost and stigma — extending trusted diagnostics to underserved communities,” Gupta says.

For Boston Scientific, says Madan R. Krishnan, its vice president & MD for APAC growth markets, India is no longer just a destination for global innovation. India has become an active contributor to it in the last decade or so. Boston Scientific’s evolution, from market entry to deeper ecosystem partnership, capability building, and value creation, can be seen across the spectrum. “Research-based international companies such as Boston Scientific have an important role to play in India’s healthcare ecosystem — not just as suppliers of technology, but as partners in innovation and capability building. We can support India becoming a meaningful contributor to the global medtech value chain, while helping address the growing burden of chronic disease through better access, productivity, and outcomes,” says Krishnan. Multinational medtech companies are also riding the tide of government policies that aim to have tertiary hospitals in every corner, beyond Tier I cities. The growth of hospitals will give medtech companies economies of scale. The prospects of these markets are attracting players from China and Southeast Asia who can beat western manufacturers on the pricing front and some have won government procurement contracts through their local partners.

MTaI’s Anam says that over the next five years, India’s medtech market will expand strongly, driven by rising non-communicable diseases, an ageing population, increased healthcare utilisation, wider insurance coverage, expanding hospital capacity beyond metros, and continued policy focus on domestic capability-building.

Anam says growth is likely to be led by segments that combine high disease burden with technology, particularly diagnostics, imaging, orthopaedics and implants, consumables and homecare, and digital/connected technology, where devices converge with software, data and AI to enable remote monitoring and more continuous care. Western MNCs have no intention of missing out. Roche aims to transform how care is delivered to patients. Roche’s Gupta says, “We will deepen lab automation to strengthen quality, consistency, and clinical confidence across diagnostic laboratories. Through near-patient diagnostics, we will bring timely care closer to patients.”

Roche’s to-do list: early cervical cancer screening, to shift healthcare from treatment to prevention; blood safety as a public health imperative; and precision oncology that supports more targeted, timely treatment decisions. Roche is working on partnerships that will create diagnostic ecosystems for India and neighbouring countries.

MTaI’s Anam says medtech MNCs are filling gaps, not just those left by the absence of domestic capability, but also in areas where India is still building depth in complex technology, global-grade quality systems, and advanced clinical capability. “In several high-end categories, such as sophisticated imaging and radiotherapy platforms, implantable and interventional therapies, critical care technologies, and next-generation diagnostics, MNCs have helped accelerate access to innovation and supported localisation where feasible through manufacturing, supplier development and engineering in India,” he says.