Summary of China Healthcare Conference Call Industry Overview - **Industry**: China Healthcare - **Survey**: AlphaWise survey conducted with 80 hospital executives in November 2025, focusing on hospital capital expenditures (capex), procedure volumes, and brand preferences for 2026 [1][26] Key Findings Hospital Capex Outlook - **Cautiously Optimistic**: 59% of hospital executives expect higher capex in 2026, up from 43% in 2025, but still below 85% in 2024 [3][51] - **Expected Growth**: Average capex growth projected at 4.7% YoY for 2026, compared to 3.0% for 2025 [3][51] - **Actual Growth in 2025**: Estimated capex growth for 2025 was 5.8% YoY, indicating better-than-expected performance [3][51] - **Key Drivers**: Hospital surplus (69%), patient demand (50%), and local fiscal budgets (44%) are primary factors influencing capex decisions [31] Equipment Spending Trends - **Top Equipment Categories**: Surgical and soft endoscopes expected to see the highest unit growth at 26% and 16% respectively, followed by CT, ultrasound, and CLIA analyzers with high-teens growth [32][93] - **AI and Digitization**: AI, digitization, and cloud capabilities are the top investment priorities, with 84% of executives planning to increase spending in these areas [33][78] Brand Preferences and Market Dynamics - **Domestic Brands**: Mindray and United Imaging maintain strong positions in brand preference, with Mindray expected to gain share in surgical endoscopes and ultrasound [36][38] - **Foreign Brands**: Siemens Healthineers, GE Healthcare, and Philips show mixed performance, with potential share losses due to domestic competition [17][19][20] - **Market Shifts**: United Imaging is expected to gain significant share in CT and MR equipment, while Mindray is anticipated to strengthen its position in various categories [38] Pricing and Procurement - **Pricing Pressures**: Continuous pricing pressure expected in clinical testing, negatively impacting the IVD segment [10][42] - **Procurement Changes**: Increased expectations for centralized procurement and shorter tender cycles, which could lead to downward pricing pressures [30][61][62] Procedure Volume Expectations - **Moderating Growth**: Only 17% of executives expect growth in procedure volumes, down from 31% in the previous year, primarily due to budget constraints [39] - **Specialty Procedures**: Expected growth across major specialties is clustered in the mid-single-digit range, indicating stable demand [40] Stock Implications - **Positive Outlook for Certain Companies**: - **Mindray**: Expected to recover to positive revenue growth in 2026 due to stable capex environment [11] - **United Imaging**: Positioned to benefit from high-end imaging demand [12] - **APT Medical**: Anticipated to capture growth in cardiac ablation procedures [14][15] - **Zylox-Tonbridge**: Expected to see growth in neuro and peripheral intervention procedures [16] Risks and Challenges - **Market Uncertainty**: Hospital executives express caution regarding capex decisions, with procurement timing expected to be back-loaded into the second half of 2026 [68] - **Regulatory Pressures**: Ongoing regulatory scrutiny and tighter budgets continue to pose challenges for lower-tier hospitals [56] Conclusion The 2026 outlook for the China healthcare sector is cautiously optimistic, with expected growth in hospital capex and a focus on advanced medical technologies. However, challenges such as pricing pressures and market competition from domestic players remain significant factors influencing the landscape.