The economy continues to have the lowest score of the MCI measures, falling to a score of -75.6 in Q3 2011 compared to -64.6 in Q2 2011. This is likely tied to both fears of a second recession in the US as well as the continuing debt crisis in the Eurozone, which has caused austerity measures to be implemented in a number of countries. The Economist indicates that the debt crisis that has been looming in Europe has lowered confidence in US banks, causing the US economy MCI score to plummet. Furthermore, the US faces its own economic troubles as the country sorts through a number of new regulations as well as continued litigation from the 2008 recession. Additionally, protests regarding the bank bailouts and wealth disparity that began in New York have become notable enough to spread to other countries across the world, further demonstrating a lack of confidence in the economy.

The MCI scores for all three therapeutic areas—cardiovascular, orthopedics, and facial aesthetics—fell from Q2 2011 to Q3 2011, a reflection of the overall decline in the MCI. The strongest decrease was noted in the cardiovascular space, likely related to the fact that cardiac rhythm management device companies in particular have noted a slump in profits; this is in turn tied to studies claiming that a large portion of implantable cardioverter defibrillators are implanted without proper evidence, resulting in a US Department of Justice investigation. As a result, cardiovascular MCI scores fell most dramatically in the US, where the score dipped from 1.5 to -16.1 between Q2 2011 and Q3 2011, ending the upward trend that began in Q1 2010. The European cardiovascular MCI score fell in Q3 2011 as well, likely partially attributed to the fact industry sources note a general decline in procedure volumes over the summer months combined with general economic unrest in the region. The Rest of World countries, however, maintained a fairly positive outlook, likely buoyed by strong cardiovascular procedure volume growth in emerging markets such as China and India.

While remaining positive, the facial aesthetics MCI fell quite a bit from Q2 2011 as well; this is likely most closely tied with the fall in confidence surrounding the economy in general because these procedures are entirely elective. Having suffered a more dramatic fall between Q1 2011 and Q2 2011, the orthopedic MCI stabilized to some extent in Q3 2011, although it still dropped slightly—likely due to continued concerns over devices such as metal-on-metal hip implants and growth factors.