Overtaking the United States, China becomes Brazil’s largest import source of medical devices
cape of good hope
2026.11.11 18:29
· From overseas
Full text 5723 words
Text | Cape of Good Hope
On October 27, Florianópolis, the capital of Santa Catarina state in southern Brazil, welcomed a group of executives from Chinese medical equipment companies.
Zhang Qiang, chairman of United Imaging Medical, signed a cooperation agreement with the local government and plans to invest 535 million reais to build a factory in Joinville, about 500 kilometers away from Sao Paulo.
This factory with a planned area of approximately 8,000 square meters will produce magnetic resonance imaging and tumor radiotherapy equipment and is expected to create 200 to 500 jobs. The first phase of construction is scheduled to start in the second half of 2027.
The project site selection process took nearly a year.
The United Imaging team inspected several cities in the state of Santa Catarina, and also visited ports such as Itajai, Navegantis and Itapoa, and finally chose the Perini Industrial Park in Joinville.
A Chinese medical equipment manufacturer began looking for factories and supply chains to produce high-end medical equipment in Brazil.
Behind this investment, there is also a set of data that has just been released.
On September 22, the Brazilian Innovative Medical Industry Alliance ABIIS released the industry report for the first half of 2026. Brazil imported US$696.5 million of medical devices from China, accounting for 21% of all imports, exceeding the 20% of the United States and 12% of Germany.
Legend: Share of source countries for Brazilian medical device imports from January to June 2026. Source: ABIIS, Comex Stat.
China has become Brazil’s largest import source of medical devices.
In 2025, the United States still ranks first with a share of 17.1%, Germany is 14.9%, and China is only 12.4%, ranking third. In the first half of 2026, China's import share jumped to the top of the list.
Legend: Brazil’s source country structure of medical device imports in 2025. Source: ABIIS, Comex Stat.
However, the growth of Chinese medical equipment in Brazil has extended from disposable consumables and basic hospital equipment to imaging diagnosis, life monitoring and high-end medical equipment.
1. Brazilian hospitals began to buy more Chinese equipment
What’s happening in the Brazilian healthcare market?
ABIIS data shows that in the first half of 2026, Brazil's medical device imports totaled US$3.355 billion, a year-on-year increase of 8.2%; exports were US$456 million, a year-on-year decrease of 5.9%.
The trade deficit reached approximately US$2.9 billion in the first half of the year.
At the same time, apparent consumption of medical devices in Brazil increased by 7.5%.
Demand comes from increasing medical activity. In the first half of 2026, the Brazilian Unified Health System SUS completed approximately 3.28 million surgeries, a year-on-year increase of 4.5%; approximately 2.62 billion outpatient diagnostic examinations were performed, an increase of 3.7%.
Among them, the number of magnetic resonance diagnostic examinations increased by 16.7%.
The medical service network is also expanding.
As of the end of June, SUS had 103,193 medical service institutions, 1,959 more than the end of 2025; non-SUS medical service institutions reached 375,899, an increase of 17,251 in half a year.
More examination, surgery and diagnosis and treatment institutions mean that hospitals need to continue to purchase equipment, reagents and medical consumables.
Brazil has a population of more than 200 million, the public medical system covers the whole country, and the private hospitals and medical insurance market are also quite developed.
The two types of medical systems have created rich levels of equipment needs.
Large private hospitals have continued procurement needs for high-end imaging, life monitoring and diagnostic technologies. The public health system needs to expand examination and treatment capabilities within limited budgets.
This creates opportunities for manufacturers that can offer products in a variety of price bands.
The growth of China's medical equipment first occurred in this round of demand expansion.
According to statistics from the China Chamber of Commerce for Import and Export of Medicines and Health Products, in the first half of 2026, China's medical device exports to Brazil were approximately US$700 million, a year-on-year increase of 28.9%, an outstanding growth rate among major export markets.
Categories driving growth include disposable medical supplies, massage rehabilitation equipment and dental supplies.
The growth of China's exports to Brazil includes a large number of products with obvious manufacturing scale advantages. Injections, infusions, nursing care and basic diagnostic and treatment supplies used in hospitals still constitute an important part of China's international trade in medical devices.
But another batch of products is gradually entering the higher-value purchase list of Brazilian hospitals.
2. China has entered the imaging and monitoring system of hospitals
ABIIS's segmented import data for the first quarter of this year provides a clearer industrial structure.
In the field of medical imaging equipment and related consumables, China is Brazil's largest import source country, with an import value of approximately US$70 million, accounting for 39.6% of this category.
In the field of hospital life support and monitoring equipment, China accounts for 29.1%.
For laboratory separation, transfer and mixing equipment, China accounts for 39.3%.
For medical protective equipment and hospital furniture, China’s import share reached 66.8% and 68.6% respectively.
These types of products span different technical fields.
Medical furniture and protective equipment mainly reflect manufacturing scale, cost and supply chain efficiency.
Life support and monitoring equipment involves capabilities such as sensors, signal processing, equipment reliability, clinical operation, and hospital information system compatibility.
Medical imaging equipment places more complex demands on manufacturers.
A large-scale magnetic resonance equipment requires magnets, radio frequencies, gradient systems, image processing software, as well as installation, commissioning and long-term maintenance.
Imaging diagnostic equipment also needs to continue to adapt to clinical needs to help hospitals shorten examination time and improve diagnostic efficiency.
Chinese manufacturers have been able to offer products covering multiple technological levels.
However, there are still differences in the areas where Chinese and American companies have advantages in Brazil.
In the first quarter of this year, the United States accounted for 30.2% of in vitro diagnostic reagent imports and 28.5% of in vitro diagnostic equipment and analytical instruments.
American companies also occupy the leading import source position for cardiovascular, orthopedics, ophthalmology, and some high-end laboratory analysis equipment.
These businesses involve reagent formulations, clinical applications, patents, doctors' usage habits and long-term equipment installed base.
Especially for in vitro diagnosis, after the hospital purchases the analyzer, it also needs to purchase supporting reagents for a long time.
The customer relationship formed by equipment installation may last for many years.
It can be seen from this that ranking first in the import volume of medical devices is only a phased achievement for China’s supply chain to enter the Brazilian medical market.
Behind the share growth are both the large-scale delivery of medical consumables and technological advancements in life monitoring, ultrasound and imaging equipment.
How much profit Chinese manufacturers can earn also depends on the product mix and the services and consumables that hospitals continue to purchase.
3. Mindray and United Imaging are doing two businesses.
The financial reports of domestic medical equipment companies can further explain these changes.
In the first half of 2026, Mindray Medical achieved operating income of 17.747 billion yuan, of which international business income was 9.471 billion yuan, a year-on-year increase of approximately 13.7%, accounting for 53% of the overall revenue.
Note: Porto Grande Hospital in Amapa State, Brazil, uses Mindray A9 anesthesia workstation. Source: Amapá state government news agency.
Latin America business revenue reached 1.662 billion yuan, higher than the 1.390 billion yuan in the same period last year, a year-on-year increase of approximately 19.5%.
This group of Latin American revenue covers multiple countries, and the contribution from the single market of Brazil has not been disclosed separately.
But it shows that Chinese head medical equipment companies have established large-scale operations locally.
Mindray's products mainly cover life information and support, in vitro diagnosis and medical imaging.
Its 2026 semi-annual report shows that the life information and support business revenue was 4.811 billion yuan, the in vitro diagnostic business was 6.865 billion yuan, and the medical imaging business was 2.836 billion yuan.
The international ultrasound business continues to grow, with revenue from ultra-high-end series of ultrasound products increasing by more than 30% year-on-year.
Mindray's advantage comes from its relatively rich product portfolio.
When a hospital purchases monitors, anesthesia machines, ultrasound equipment or in vitro diagnostic products, it can obtain multiple categories of equipment and supporting services from the same supplier.
This helps reduce the complexity of procurement coordination, equipment training and maintenance management.
United Imaging Healthcare is taking a different path.
In the first half of 2026, United Imaging’s revenue was 7.052 billion yuan, a year-on-year increase of 17.22%.
Among them, overseas income was 1.765 billion yuan, a year-on-year increase of more than 50%, and the proportion of overseas income increased to 25.02%.
United Imaging's products focus on magnetic resonance, CT, molecular imaging, radiotherapy and other fields.
Caption: Magnetic resonance examination control room at Real Hospital Português, Recife. Source: Jornal do Commercio.
The stand-alone value of these equipment is higher, and the R&D investment and technical threshold are also higher.
In May this year, United Imaging demonstrated products including high-end magnetic resonance, CT and next-generation ultrasound at the Sao Paulo Radiology Congress JPR.
The company disclosed that its products have entered medical institutions such as Hospital Israelita Albert Einstein in Brazil, and have established cooperation with local imaging diagnostic institutions.
These customer cases mean that China’s high-end imaging equipment has begun to enter Brazil’s mature clinical use system.
But for medical equipment companies, selling machines is only part of their income.
After a large-scale imaging equipment is put into operation, it requires long-term maintenance, calibration, software updates and parts replacement.
When large hospitals purchase equipment, they will also examine the supplier's maintenance response time, spare parts supply capabilities and equipment availability.
United Imaging’s semi-annual report this year provides a set of data worthy of attention.
In the first half of 2026, the company's service business revenue was 980 million yuan, a year-on-year increase of 20.11%, and the gross profit margin remained above 60%.
Service revenue accounts for approximately 13.9% of overall revenue.
This set of data belongs to United Imaging's global business and includes a variety of equipment and services.
However, from the perspective of business structure, after-sales service has become a business with high profitability.
As the installed capacity of overseas equipment increases, maintenance, upgrades and long-term service contracts are expected to bring more stable income to Chinese medical equipment companies.
This is also an important reason for United Imaging to expand local operations in Brazil.
4. There are two sets of procurement logics in the Brazilian medical market.
Brazil has the largest universal public health care system in the world.
According to data from Brazil's National Complementary Medicine Agency ANS, in September 2026, private medical insurance covered approximately 53.11 million people nationwide, accounting for approximately 24.9% of the total population.
Most Brazilian residents obtain medical services mainly through the public health system SUS.
However, the distribution of high-end imaging equipment and specialized medical resources is significantly different from the population structure.
A study published in the "Brazilian Journal of Radiology" in 2024, using national data from 2015 to 2021, found that private medical institutions own the majority of CT and magnetic resonance equipment, and the equipment configuration of the public medical system has long been below the reference targets set by the government.
The atlas released by the Brazilian Society of Radiology in 2025 also reflects this regional difference.
There are 13.18 radiologists per 100,000 people in southeastern Brazil and less than 5 in the north.
High-end medical resources are concentrated in economically developed cities.
Brazilian hospitals therefore face two different procurement environments.
One category is large private hospitals and imaging diagnostic groups.
They need to consider patient volume, examination efficiency, equipment utilization, maintenance costs and clinical quality. Equipment purchases often come with multi-year service contracts.
The other category is the public medical system and medical service institutions that receive public funding support.
These agencies need to consider procurement budgets, coverage populations, regional medical needs, and government-mandated procurement procedures.
What’s even more interesting is that there are business connections between the two systems.
In July 2026, the Brazilian Ministry of Health expanded the imaging examination projects of the "Agora Tem Especialistas" program.
Private and charitable medical institutions can provide CT, magnetic resonance, ultrasound and other examinations to SUS patients, and obtain financial credits that can be deducted from federal taxes in accordance with policy regulations.
The payment standards for some inspection items have increased by more than 300% compared with the original standards.
This makes the equipment operation of private hospitals more closely linked to the inspection needs of the public medical system.
For imaging equipment manufacturers, the business logic of buyers has also changed.
A private diagnostic center purchasing MRIs may need to calculate how many tests it can perform per day and how much revenue it will generate from public health payments and private insurance.
The price of the equipment, inspection efficiency, maintenance time and long-term service costs will all affect the return on investment.
This also explains why Brazil's high-end medical equipment market has high customer entry barriers.
Chinese companies need to prove that their equipment can meet clinical requirements and establish a service system that meets local hospital operating conditions.
In areas with relatively insufficient medical resources, equipment investment also faces restrictions on doctors, technicians, supporting facilities and capital investment.
For manufacturers, the Brazilian medical market has great growth potential, but different regions and different payment systems correspond to completely different sales conditions.
5. After an enterprise establishes a factory, there are still three thresholds
On October 27, United Imaging announced an investment of 535 million reais in Brazil.
这项投资可以放进巴西医疗产业政策的变化中理解。
今年7月，巴西通过立法，将医疗健康产业的本地研发、制造和技术转移确立为长期产业政策。
政府希望利用SUS庞大的采购需求，推动医疗设备、药品和其他医疗技术在本国生产。
其中一个重要工具，是政府采购中的本地制造偏好。
巴西工业与贸易部披露，在指定的PAC项目医疗设备采购中，符合条件的本地制造设备可以享有10%的价格优惠幅度。
对于同时满足本地研发条件的产品，还可以获得额外10个百分点的优惠。
这项措施适用于规定的产品和采购范围。
由此，医疗设备制造商需要回答一道更加复杂的投资题。
如果继续从中国出口，可以利用国内成熟的产业链和生产规模。
如果转向巴西本地制造，则需要增加固定资产投入、招聘当地员工、建立供应链并管理生产成本。
采购竞争还在加剧。
11月10日，巴西卫生部披露，Novo PAC Saúde通过项目标准化和集中采购，预计可以节约33.7亿雷亚尔。
其中，设备及车辆采购环节的预计节约额达到20.7亿雷亚尔。
对医疗设备企业，这意味着更大规模的采购机会，也意味着政府可以通过集中采购争取更有利的价格。
本地化有助于企业进入采购体系，规模采购则可能压缩设备销售利润。
监管构成第二道门槛。
巴西国家卫生监督局ANVISA按照风险等级管理医疗器械。
根据RDC 751/2022，医疗器械分为四个风险等级。I类、II类采用通知制度，III类、IV类需要产品注册。
高风险产品注册还涉及质量体系、生产企业合规等要求；部分医用电气设备需要取得巴西认可的产品符合性认证。
外国制造商也需要通过在巴西依法设立的责任主体办理相关监管手续。
这意味着，一家中国医疗设备企业即使已经取得其他国家的产品认证，进入巴西市场仍需要完成当地合规程序。
产品种类越多，注册、技术资料、质量管理与后续维护的复杂度也会提高。
第三道门槛，是医院的长期使用成本。
大型影像设备采购涉及医生、医院管理部门和工程技术人员。
对于医院，设备运行期间的检查量、停机时间、维修响应和服务费用，直接影响长期收益。
大型跨国医疗设备企业在巴西经营多年，拥有客户关系、设备装机基础和成熟的售后网络。
中国企业扩大市场份额，需要持续提高临床认可度，并逐步积累服务记录和客户复购。
联影在巴西建厂，可以改善部分生产和服务条件。
但一家工厂能够带来多少收入，最终仍取决于设备订单、产能利用率、服务合同以及当地经营成本。
这些数字有待企业在工厂投产后逐步披露。
六、进口额第一之后，利润留在哪里？
2026年上半年，中国占巴西医疗器械进口额20.8%，美国占19.9%。
中国已经处在这个市场主要供应来源的位置。
但两国厂商的产品结构，仍然存在差异。
中国企业在医用防护用品、医院基础设备、部分影像和监护产品领域具有较强竞争力。
美国企业则在体外诊断试剂、部分分析仪器，以及高端医疗产品领域积累了客户与技术优势。
随着中国医疗设备进入巴西更多医院，竞争还会进一步延伸到产品长期使用环节。
对于迈瑞、联影等中国企业，巴西市场提供了进入高端医院和拉美医疗体系的机会。
但进口金额的增长、产品注册的增加，以及本地工厂的建设，最终都要回到企业经营结果上。
设备卖给了哪些医院，形成了多少长期装机，售后合同贡献多少收入，本地制造能否提高投资回报，这些指标将逐渐比进口来源国排名更重要。
联影在若因维利规划的新工厂，正处在这场竞争的起点。
中国制造已经成为巴西医疗设备的重要供应力量。下一阶段的竞争，将更多取决于临床客户、政府采购和长期服务所能创造的利润。
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