As cross-border trade expands, U.S.-based healthcare providers are increasingly finding customers around the globe.

Source: Abbott Labs 2014 Annual Report

In the United States, healthcare spending is a whopping 18% of GDP. On the other hand, in emerging economies healthcare makes up only 6% of GDP. A growing middle class in developing nations means that number is rising. Companies focusing overseas are going to grow faster than U.S.-focused counterparts. Here are three companies following the growth around the world:

Abbott Laboratories (NYSE: ABT)
Abbott is a global provider of branded pharmaceuticals and other healthcare products. It operates in more than 100 countries and generates close to 70% of its revenue outside the United States. Asia represents Abbott’s fastest-growing region.

#-ad_banner-#The Asia-Pacific region’s healthcare spending is expected to grow at a rate of 7.1 percent from 2013 to 2017, according to The Economist. China is one of the firm’s major markets, where Abbott Labs is excelling  despite a complex regulatory environment. The firm has grown sales in the country 24% per year since 2012, and China is now the company’s second-largest market behind the United States.

Its third-largest market is India. Sales in the country aren’t growing as quickly, at 5% per year, but the company has billions invested in the country. This includes a new manufacturing facility that opened in India last year. There’s evidence that sales may be picking up in the country, too. CEO Miles White announced on the most recent conference call that the company’s Indian division saw double digit sales growth in the first quarter.

Becton, Dickinson And Co. (NYSE: BDX)
BDX is a leader in the medical devices space and earns two-thirds of its revenue from outside the United States. Revenue in the United States grew only 2% since 2013, while international revenue grew 7% despite an unfavorable foreign exchange translation impact of 0.6%.

Becton Dickinson is showing tremendous growth in its Asia division, which includes China and India, with 13% annualized growth since 2012. Although its recent acquisition of CareFusion indicates that Becton Dickinson remains squarely focused on the United States, it has upped its investment in the Asian region by $100 million since 2012.

Stryker Corp. (NYSE: SYK) is the largest “pure-play” surgical implant company in the world, with a $33 billion market capitalization. Though it earns most of its revenue in the United States, it doubled international sales to more than $3 billion in 2014.

Stryker doesn’t break out sales by country, but CEO Kevin Lobo recognizes the importance of China and India in its long-term plans. On the fourth quarter conference call he said, “…within emerging markets, China and India are going to be two areas that we’re going to focus very heavily on and that’s from a position of strength.”

Of course, as investors, we’re buying every aspect of the business, not just the foreign growth. And while all three of these companies are great candidates for long-term investment, Becton Dickinson is the best candidate for investment today. The company is expected to grow revenue over 20% this year, has a more diversified product line (thanks to a shrewd purchase of CareFusion) and is a dividend aristocrat with a 10-year dividend growth rate of over 10%.

Risks To Consider: The strength of the dollar is negatively impacting Abbott Labs and Becton Dickinson. Although the dollar is relatively strong now, it can continue to strengthen as central banks around the world have shown little inclination to back off the easy money policy.

Action To Take –> Becton-Dickinson is trading at more than 30 times its expected 2015 earnings per share, which looks expensive. However, currency effects are expected to negatively impact earnings by a whopping $1.60 per share in 2015. Adjusting for this effect equates to a 23 price-to-earnings multiple, a fair price for a fast-growing, well-run company that will make patient shareholders rich for decades.

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