Healthcare Sector Comment – September 2016

Increasing incidences of lifestyle related diseases like obesity and diabetes are driving growth in the devices market, especially with disorders of the eye including glaucoma, diabetic retinopathy and cataracts. Problems such as these can also be prevalent among an ageing population, hence a growing need for early intervention and detection to provide a way to control the rising costs of healthcare.

Only last week AcuFocus, Inc., the US-based developer of breakthrough, small aperture technologies for the improvement of near vision; received investment of approximately €60m in a financing round led by KKR. The investment will help commercialise these technologies which could be effective in treating the natural loss of near vision, as well as cataracts, the clouding of the eye’s natural lens.

This month alone we have seen two deals involving private equity acquiring ophthalmology device companies. The first saw GHO Capital Partners acquire the European and international commercial operations of Nicox S.A., the France-based developer of various ophthalmic products, for €26m. As well as TPG Capital’s acquisition of Beaver-Visitec International, Inc., the US-based manufacturer of a range of ophthalmic microsurgical products.

All of these follow on from a recent wave of trade acquisitions in the ophthalmic sector in the last two years:

  • Alcon’s acquisitions of WaveTec Vision Systems, Inc., the US-based manufacturer of guidance systems for cataract surgeons and ophthalmologists, for €265m; and Transcend Medical, Inc., the US-based glaucoma device developer, for €317m.
  • Bausch & Lomb’s acquisition of Doctors Allergy Formula, LLC, the US-based provider of ocular allergy diagnostic systems; and
  • Santen Pharma’s acquisition of InnFocus, Inc., the US-based developer of biocompatible biomaterials and medical devices for glaucoma surgery, for €204m.

At Clearwater International we continue to watch the ophthalmology sector with a keen eye, as incumbent players and new entrants alike strive to find novel applications for the wealth of new technologies coming to the fore.


A taste of deals in August

Medical Equipment and Supplies

Crosstex International, Inc. the US-based manufacturer of infection prevention and control products acquired Accutron, Inc., the US-based manufacturer of analgesia conscious sedation equipment and accessories for dental practitioners, for €47m.

Bio-Techne Corp., the listed US-based biotechnology reagents, instruments, and clinical diagnostic controls manufacturer acquired Advanced Cell Diagnostics, Inc., the US-based developer of cell and tissue based diagnostic tests for personalised medicine, for €294m.

Compass Health Brands Corp., the US-based general medical equipment manufacturer acquired Meridian Medical, the US-based manufacturer of gel overlays, seating/positioning cushions, lymphedema treatment products and specialty support surfaces.

Sunshine Heart, Inc., the listed US-based medical device company acquired the Aquadex FlexFlow ultrafiltration product of CHF Solutions, Inc., the US-based cardiac device developer, for €4m.

Zoetis, Inc., the listed US-based veterinary vaccine developer acquired Scandinavian Micro Biodevices ApS, the Denmark-based designer of diagnostic cartridges based on the micro-fluidic technology, for €72m.

Medtronic Plc, the US-listed Ireland-based manufacturer of medical therapies acquired the gynecology business division of Smith & Nephew Plc, the listed UK-based provider of medical technology products and services, for €310m.

Zimmer Biomet Holdings, Inc., the listed US-based provider of musculoskeletal products acquired CD Diagnostics, Inc., the US-based integrated diagnostics company with an expertise in immunoassay development.

Medtronic Plc, the US-listed Ireland-based manufacturer of medical therapies acquired HeartWare International, Inc., the US-based manufacturer of miniaturised implantable heart pumps and ventricular assist devices, for €946m.


Health and Social Care

Dermot Keogh, the individual investor acquired Keith Holland & Associates Limited, the UK-based provider of behavioural vision treatment services for children and adults with various patterns of difficulty.

Mediline Nurses & Carers Limited, the UK-based provider of support workers and nursing staff acquired North West Community Services Limited, the UK-based provider of community care and support services to disabled people.

The National Fostering Agency Limited, the UK-based fostering agency, and a portfolio company of Stirling Square Capital Partners LLP, has acquired Acorn Care and Education Limited, the UK-based provider of education and care services for children and young people with special educational needs, for €476m.

Strawberry Fields REIT Limited, the US-based real estate investment trust acquired seven nursing homes in Tennessee and one nursing home in Kentucky, for €66m.

Echo, Inc., the US-based healthcare software solutions provider acquired Morrisey Associates, Inc., the US-based developer of web-based applications related to physician credentialing and integrated care management, for €43m.

Deutsche Wohnen AG, the listed Germany-based residential property company acquired the Pegasus Care Home Portfolio of residential facilities in Germany, for €421m.

Target Healthcare REIT Limited, the listed UK-based real estate investment trust acquired two care homes in Dundee and Sandiacre, UK, for €16m.


Pharmaceuticals and Biotechnology

Amphastar UK Limited, the UK-based speciality pharmaceutical company acquired International Medication Systems (UK) Limited, the UK-based sterile injectable pharmaceuticals and drug delivery systems developer, for €7m.

Ascendis Health Limited, the listed South Africa-based provider of plant, animal and human health products acquired Remedica Holdings Public Company Limited, the Cyprus-based provider of generic pharmaceuticals, for €250m. In a related transaction they also acquired Scitec Holding BV, a US-based producer of sports nutrition products for €170m.

Nichi-Iko Pharmaceutical Co., Limited, the listed, Japan-based, generics-focused pharmaceutical company acquired Sagent Pharmaceuticals, Inc., the US-based manufacturer of injectable pharmaceuticals, for €636m.

Galenica Limited, the listed Switzerland-based healthcare service provider acquired and delisted Relypsa, Inc., the gastrointestinal tract biopharmaceutical product manufacturer, for €1.3bn.

Opko Health, Inc., the listed US-based biopharmaceutical and diagnostics company acquired and delisted Transition Therapeutics Inc., the Canada-based biopharmaceutical developer of therapeutic agents for disease indications, for €37m.