R&D licenses in the medical technology industry in the U.S. 2020-2026, by size

Number of R&D licenses in the medical technology industry in the United States from 2020 to Q1 2026, by upfront size

The number of research and development licensing deals in the medical technology industry in the United States reached about 72 in 2025, the most in years, up from about 52 in 2020. The great majority carry small or undisclosed upfront payments. Licensing is one of the quieter but increasingly important ways the medical technology industry renews itself, allowing large companies to gain access to promising early-stage technology without the cost and risk of building it from scratch. On the latest figures, the number of medtech R&D licensing deals in the United States rose to about 72 in 2025, up from about 52 in 2020, with about 18 completed in the first quarter of 2026 alone. In an industry where the cost of developing new technology keeps rising, licensing offers the large medtech companies a way to place many small bets on promising ideas, paying most of the price only if and when those ideas succeed.

Licensing is a central way medtech companies gain access to new technology, alongside acquisitions. The picture sits within our exciting healthcare technology and medtech M&A coverage.

Small deals dominate: undisclosed and sub-10 million dollar deals make up the great majority of US medtech R&D licenses every year, with large deals a small minority.

Most deals carry undisclosed or small upfront payments, with only a handful exceeding 100 million dollars, themes our medical technology industry and medtech industry data coverage explores.

A note on the data. The figures show the number of R&D licensing deals in the medical technology industry in the United States from 2020 to the first quarter of 2026, by upfront payment size. Figures are estimates and the 2026 figure covers the first quarter only. Because licensing data is compiled from deal databases and company filings, and because so many upfront payments are never disclosed, the figures should be read as careful estimates that capture the shape and direction of the market rather than a precise census. R&D licensing here refers to agreements in which a medtech company licenses the rights to develop or commercialise technology from another party, categorised by the size of the upfront payment made at signing.

Medtech R&D Licenses by Size

The table shows the number of medtech R&D licensing deals in the United States by year and upfront size. It shows deals with undisclosed upfronts making up the largest group throughout, followed by those under 10 million dollars. Reading across the table shows undisclosed deals consistently the largest group at around 44 percent, followed by deals under 10 million dollars, with the largest deals above 100 million dollars a tiny fraction of the total. Because so many upfronts are undisclosed and the figures are compiled from multiple sources, the totals are best read as a consistent series showing the scale and direction of licensing rather than a precise count. The most instructive way to read the table is to follow the undisclosed column, which remains the largest throughout, a constant reminder of how much of the licensing market stays hidden from public view.

How Many R&D Licenses Are Signed?

The number of medtech R&D licensing deals in the United States has risen over the period, from about 52 in 2020 to about 72 in 2025, with a dip in the quieter years of 2022 and 2023. The first quarter of 2026 saw about 18 deals. The rising number of medtech licensing deals is a signal worth watching, since it tracks the industry appetite for buying in innovation and, more broadly, the flow of new technology from start-ups and universities into the hands of the giants. The number of deals rose from about 52 in 2020 to about 68 in 2021, dipped to about 61 in 2022 and 55 in 2023, then recovered to about 64 in 2024 and 72 in 2025, with about 18 in the first quarter of 2026. The count of licensing deals is one of the better barometers of innovation flowing into the industry, since each deal marks a moment when a larger company judged an outside technology worth backing with its money and its name, and the steady rise in that count is among the clearest signs of a healthy pipeline of new ideas reaching the market.

The rise in licensing reflects the growing importance of buying in innovation rather than building it, especially in fast-moving areas such as artificial intelligence and digital health, a shift our AI market size coverage frames.

Rising activity: the number of US medtech R&D licenses rose from about 52 in 2020 to about 72 in 2025, with a dip in the quieter years of 2022 and 2023.

Licensing activity tracks the broader appetite for dealmaking, rising when confidence and funding are strong and falling when they are not, a cycle that mirrors the mergers and acquisitions market in the same period. The dip in licensing during 2022 and 2023 mirrored the wider slowdown in medtech dealmaking as interest rates rose and funding tightened, and the subsequent recovery has tracked the return of confidence to the sector. Looking across the whole period, licensing activity has proved more resilient than outright acquisition, since the lower cost and risk of a licence make it an attractive option even when confidence and funding are subdued. The resilience of licensing through the downturn of 2022 and 2023, compared with the sharper swings in outright acquisition, illustrates why licensing appeals to companies in uncertain times as a lower-cost, lower-commitment path to new technology.

What Size Are Most Licensing Deals?

Most medtech R&D licensing deals carry small or undisclosed upfront payments. About 44 percent have undisclosed upfronts, about 25 percent are under 10 million dollars, and only a small share exceed 50 million dollars. The distribution of licensing deals by upfront size is one of the most revealing features of the market, showing an industry where most deals are modest and speculative, with the real value deferred to future milestones and royalties. About 44 percent of deals carry undisclosed upfronts, about 25 percent are under 10 million dollars, about 19 percent are between 10 and 50 million, about 8 percent between 50 and 100 million, and only about 3 percent above 100 million. The heavy skew of the size distribution toward the small and the undisclosed is the single most important fact about medtech licensing, and it reflects the speculative, milestone-driven economics that govern most early-stage deals.

The prevalence of small and undisclosed upfronts reflects the early-stage nature of most licensed technology, where the value lies in future milestones and royalties rather than large upfront sums, a structure our medical technology market coverage frames.

Undisclosed leads: about 44 percent of medtech licenses carry undisclosed upfronts, about 25 percent are under 10 million dollars, and only 3 percent exceed 100 million.

Small deals dominate: undisclosed deals and those under 10 million dollars together make up about 70 percent of US medtech R&D licenses in 2025.

The largest deals, those with upfronts above 100 million dollars, are rare, numbering only two or three a year, and typically involve late-stage technology or platforms with proven commercial potential. The concentration of deals at the small and undisclosed end of the scale is a structural feature of licensing rather than a passing phase, reflecting the early-stage nature of most licensed technology and the deferred way its value is realised. Looking ahead, the balance of deal sizes seems likely to hold, with small and undisclosed deals continuing to dominate even as the occasional large, headline-grabbing licence draws most of the attention. The persistence of the small-deal, milestone-driven model, even as the overall market grows, suggests that the fundamental economics of early-stage licensing are unlikely to change, however large the occasional headline deal becomes.

Why Are So Many Deals Undisclosed?

Undisclosed upfronts are the largest single category of medtech licensing deals, accounting for about 44 percent of the total. Their prevalence reflects the confidential nature of many early-stage licensing agreements. The dominance of undisclosed upfronts is one of the defining and frustrating features of the licensing market, keeping much of its true value hidden and making it far harder to measure than the more transparent world of acquisitions. The sheer prevalence of undisclosed upfronts is a constant challenge for anyone trying to measure the licensing market, and it means the true flow of money through medtech licensing is considerably larger than the disclosed figures alone suggest. For researchers and investors alike, the veil over upfront terms means the licensing market must be read through indirect signals, the count of deals, the disclosed minority and the occasional headline transaction, rather than a clean public ledger.

The high share of undisclosed deals makes the licensing market harder to measure than the mergers and acquisitions market, where deal values are more often public, a contrast our biggest companies by market value coverage frames.

A steady 44 percent: the share of medtech licenses with undisclosed upfronts has held broadly steady, reflecting the confidential nature of early-stage deals.

The share of undisclosed deals has held broadly steady over the period, suggesting that the confidentiality of early-stage licensing is a structural feature of the market rather than a passing trend. The steadiness of the undisclosed share over the years suggests that confidentiality is fundamental to how early-stage licensing works, and is unlikely to change even as the overall market grows.

How Big Are the Largest Deals?

Large licensing deals, those with upfront payments above 100 million dollars, are rare in medtech. Only about two or three are signed in a typical year, and they usually involve late-stage technology or established platforms. The rarity of large upfront licensing deals in medtech is one of the clearest ways the industry differs from pharmaceuticals, and it reflects the more incremental, hardware-led nature of medical technology innovation. Deals above 100 million dollars number only about two or three a year, against roughly 30 undisclosed and 18 under 10 million dollars, underlining how rare large upfront licensing deals are in medtech. The handful of very large licensing deals each year attract most of the attention, but they are wholly unrepresentative of a market whose typical transaction is small, speculative and often entirely confidential. The economics that keep large upfronts rare in medtech, where value accrues gradually through adoption rather than in a single blockbuster launch, are precisely what distinguish it from the pharmaceutical licensing market it is often compared with.

The scarcity of large upfront deals reflects the difference between medtech and pharmaceuticals, where blockbuster licensing deals with huge upfronts are more common, a contrast our global pharmaceutical industry coverage frames.

Rare and steady: only about two or three US medtech licensing deals a year carry upfront payments above 100 million dollars.

When large medtech licensing deals do occur, they tend to cluster in the fastest-growing areas, from surgical robotics to molecular diagnostics to artificial intelligence, where proven technology commands a premium. The clustering of the rare large deals in the fastest-growing areas of medtech, from robotics to molecular diagnostics to AI, is a useful signal of where the industry sees the greatest and most proven commercial potential. The tendency of the largest deals to cluster in the hottest areas of medtech offers a real-time signal of where the industry sees the greatest commercial promise, from robotic surgery to genetic testing to clinical artificial intelligence.

The Average Upfront Payment

The average upfront payment in medtech R&D licensing has risen modestly, from about 22 million dollars in 2020 to about 30 million by early 2026, among deals where the upfront is disclosed. Most deals remain far below that average. The average upfront payment, though a useful measure, must be read with care, since it is pulled sharply upward by a handful of very large deals and says little about the typical, far smaller licensing agreement. The average disclosed upfront rose from about 22 million dollars in 2020 to about 26 million in 2021, and has climbed gradually to about 30 million by the first quarter of 2026, among the minority of deals with disclosed terms. The average upfront payment is a seductive but treacherous measure, since it blends a mass of tiny deals with a few enormous ones, and its slow rise says more about the occasional blockbuster than about the typical agreement.

The rising average reflects a shift toward later-stage licensing and larger platform deals, a trend our medical devices revenue coverage frames through the technologies being licensed.

Creeping upward: the average disclosed upfront payment has risen from about 22 million dollars in 2020 to about 30 million by early 2026.

The average is skewed by a small number of very large deals, and the typical or median licensing deal carries a far smaller upfront, often in the low single-digit millions or undisclosed entirely. The gap between the average and the typical deal is one of the most important things to understand about the licensing market, since headline averages can give a misleading impression of a market dominated by small, speculative agreements. The wide gap between the mean and the median upfront is a caution against reading too much into headline averages, which can suggest a market of large, confident deals when the reality is a long tail of small, speculative ones.

Which Areas See the Most Licensing?

Medtech R&D licensing spans the whole industry, from devices to diagnostics to digital health. Devices account for the largest share of deals, followed by diagnostics and a fast-growing group in digital health and artificial intelligence. The spread of licensing across the industry, from devices to diagnostics to digital health, mirrors the structure of medtech itself, while the fast growth of software and AI licensing points to where the industry believes its future lies. The spread of licensing across devices, diagnostics and digital health offers a useful map of where the industry is placing its bets, and the rapid rise of software and AI licensing points clearly to where it sees its future, as hardware makers race to secure the algorithms that will run inside their next generation of products.

The concentration of licensing in devices mirrors the structure of the industry, where devices make up the bulk of revenue, a split our medtech market by segment coverage frames.

Small deals dominate: about 69 percent of US medtech licenses in 2025 were undisclosed or under 10 million dollars, with large deals a small minority.

Digital health and artificial intelligence are the fastest-growing areas for licensing, as established medtech companies race to add software and algorithms to their hardware, often through licensing rather than in-house development. The rapid growth of digital health and AI licensing is perhaps the single most important trend in the data, capturing the scramble among established medtech companies to add the software capability they increasingly cannot do without. The scramble to license software and artificial intelligence capability marks a genuine shift in the industry, as hardware-focused medtech companies confront the reality that their future products will be defined as much by code as by components.

The Rise of Licensing

The trend in medtech licensing is toward more deals, larger average upfronts and a growing focus on software and artificial intelligence. Licensing has become a central part of how the industry gains access to new technology. The broad trend in medtech licensing is unmistakable, toward more deals, larger average upfronts and an ever-greater focus on the software and artificial intelligence that the industry increasingly sees as central to its future. The steady rise of licensing over the period reflects a deeper shift in how the medtech industry innovates, moving away from a reliance on in-house development toward a more open model of buying in ideas from wherever they emerge.

The growing role of licensing reflects the rising cost and risk of developing new technology in-house, which pushes companies to buy in innovation instead, a shift our in vitro diagnostics coverage frames through the diagnostics being licensed.

A recent rise: US medtech R&D licensing activity peaked at about 72 deals in 2025, the most in the period, after a dip in 2022 and 2023.

Broad-based growth: between 2020 and 2025 the number of licenses grew across every size bucket, led by undisclosed and small deals.

As licensing grows, it increasingly complements acquisitions as a way for the largest companies to keep their technology pipelines full, offering a lower-cost, lower-risk route to new capability than outright purchase. The growing complementarity of licensing and acquisition, with licensing offering a lower-cost and lower-risk route to new capability, is reshaping how the largest medtech companies think about filling their technology pipelines.

Where Is Licensing Concentrated?

Medtech R&D licensing is heavily concentrated in the United States, home to most of the world largest device makers and its deepest pool of research. The country accounts for the great majority of global medtech licensing activity. The concentration of licensing in the United States is among the starkest of any measure in medtech, reflecting the unmatched depth of its research base, its venture funding and its cluster of the world largest device makers. The United States accounts for the great majority of global medtech R&D licensing, reflecting its roughly 37 percent share of the medical technology market and its far larger share of early-stage research and venture funding. The dominance of the United States in medtech licensing is a direct consequence of its outsized role in early-stage research, where its universities, start-ups and venture funds generate a stream of technology that the industry then licenses. The concentration of licensing in a single country also concentrates its risks and rewards, tying the flow of new medtech ideas closely to the health of the American research and venture ecosystem that produces so many of them.

The American dominance of licensing reflects the depth of its research base and venture funding, which produce the early-stage technology that larger companies then license, a concentration our medtech market by area coverage frames.

Outside the United States, Europe is the main centre of medtech licensing, while Asia-Pacific is growing quickly as its research base deepens and its companies seek access to Western technology. The slow rise of licensing activity outside the United States, in Europe and increasingly in Asia-Pacific, is a sign of the gradual globalisation of medtech innovation, though the American lead remains commanding.

Medtech R&D Licensing in Numbers

A few numbers capture the market. The number of medtech R&D licensing deals in the United States was about 72 in 2025, up from 52 in 2020, about 44 percent carry undisclosed upfronts, and only two or three a year exceed 100 million dollars. These figures together map a licensing market that is growing steadily, dominated by small and undisclosed deals, and increasingly focused on the software and artificial intelligence reshaping the whole industry. Taken as a whole, the licensing numbers describe a market that is quietly central to how the medtech industry renews itself, growing steadily and tilting ever more toward the software and AI that will define its next chapter. The steady climb in deal counts, the persistence of small and undisclosed transactions and the unmistakable pull toward software all point in the same direction, an industry increasingly comfortable licensing its way to the future.

The figures matter because licensing is a key way the medtech industry gains access to new technology, and its growth signals the rising importance of buying in innovation, a link our medtech market worldwide coverage explores.

Together these figures show a growing licensing market, dominated by small and undisclosed deals, concentrated in the United States, and increasingly focused on software and artificial intelligence. For now, medtech R&D licensing stands as a growing and increasingly important, if discreet, part of how the industry gains access to the new technology on which its future depends, a market that rewards patient attention to its many small and often hidden deals rather than its rare headline transactions.

Medtech R&D Licensing: The Big Picture

Taken together, medtech R&D licensing in the United States from 2020 to 2026 maps a growing but discreet market, where most deals are small or undisclosed, a story our Nasdaq stock market coverage sets against the listed companies behind them.

Whether licensing keeps growing will depend on the flow of new technology from start-ups and universities, but for now it has become a central part of how the medtech industry renews itself, alongside the demographics in our US population overview.

Frequently Asked Questions: Medtech R&D Licensing