"As the market is so competitive in advanced imaging modalities, vendors couldn't afford to increase prices and risk losing customers. A 25 percent tariff, though, is a big cost to ingest, meaning vendors will need to be very smart in how they rejigger operations to limit impact on customers. Higher-priced, better-featured systems are generally still U.S. or non-China manufactured, apart from perhaps some specific components. These systems also tend to be "marquee" or flagship installs, often combined in long-term managed service deals (decades often) with large and mid-sized providers. I would expect the leading vendors would try to limit any price rises in this segment, or risk losing their core business to competitors."

Specific impacts, according to Holloway, could include greater consolidation, a slower "trickle down" effect on new technology, with providers retaining their older equipment for longer periods of time, and a limitation in the availability of imaging equipment.


Those in lower-end markets, such as X-ray or ultrasound, could especially feel the impact with large multinational enterprises facing risks of pulling out, raising prices to offset the impact of the tariff, or competing with shrinking markets. Smaller providers could become less price-competitive as they face limited choices by Chinese vendors selling into the U.S.

"If the tariff stays in place, the market could well see lengthening replacement cycles, more bulk purchasing (which usually favors the largest vendors, but squeezes margins and sometimes stifles innovation)," said Holloway. "A less competitive market with fewer vendors is also possible, as some of the mid-sized imaging vendors in X-ray and ultrasound will find it difficult to ingest the tariffs while maintaining profitability, or be able to meet the bundled bulk purchasing the new market landscape will demand, tipping the balance toward their larger peers. The U.S. will become less attractive as a result."

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