This morning, I read a good post on VentureBeat from Glenn Solomon of GGV Capital about the “hottest” fastest growing and most profitable internet companies.  No surprise – all of them are outside the US – namely Russia and China. Much of this can be explained by the fact that the domestic markets in these countries outside the US are growing dramatically faster than the US market.

Of course, this got me to thinking about growth in healthcare. Whose got it and where is it?

Here is the quick and dirty analysis – without any of the pretty pictures that Glenn  got from the bankers at Cowen in his post.

• Total publicly traded healthcare companies globally: 3983
• Those with LTM (last 12 months) revenue growth of 30% or more: 462
• Of the 462, those with LTM EBITDA margin of 30% or more: 59

Looking at the location of these companies shows us that unlike the internet, the US retains leadership in profitable and growing healthcare companies (at least by these metrics) – BUT it would be clearly foolish to discount China – which probably would not have made much of a showing on this list had I done the analysis just 5 or 7 years ago.

• US – 21
• China – 13
• Canada – 4
• India – 3
• Australia – 3
• Sweden – 3

The Top 20 in order of market cap (large to small) are:

1. Celgene
2. Alexion
3. Valeant (Canada)
4. Illumina
5. Endo
6. OJSC (Russia)
7. United Therapeutics
8. Guangxi Wuzhou (China)
9. Questcor
10. Sihuan Pharma (China)
11. DIVI Labs (India)
12. DiaSorin (Italy)
13. Jazz Pharma
14. Jiling Zixin (China)
15. Intermume
16. Viropharma
17. Biosensors (Singapore)
18. Zhonghong Holdings (China)
19. Momenta
20. AVEO

The best US healthcare companies (both public and private) have management teams who can commercialize products developed here in the US into fast growing markets like China, India.

Meanwhile, all of us as investors, operators, and managers in healthcare companies should be mindful of the fact that some of the fastest growth in the world is occurring outside of our shores – where it is unencumbered by our complex regulatory and reimbursement schemes and where access to graduates with degrees in biological sciences and medicine is growing dramatically through stated government policies.

A thriving set of healthcare companies is a major national strategic asset for the United States for many reasons – including most importantly high value job creation and an engine to drive and soak up graduates of PhD and advanced degree programs from our universities.

We should do everything as a nation to grow these companies while smartly reducing regulatory barriers that challenge this growth – always with patients and our domestic economic engine in mind.

(Note: I did not include a forward year revenue and EBITDA growth projection in this analysis like Glenn did in his post)