Michael Barbella, Managing Editor02.17.16
To celebrate its 80th birthday in September 1931, The New York Times asked Henry Ford and seven other American trailblazers to envision life eight decades into the future.
Some of the prophecies were quite amusing. Ford speculated that Americans would focus more on the intangibles of life than material goods (wishful thinking, perhaps), while physicist and Nobel laureate Arthur Compton predicted the blurring of national boundaries, opining, “With better communication, national boundaries will gradually cease to have their present importance. Because of racial differences, a world union cannot be expected within eighty years. The best adjustment that we can hope for to this certain change would seem to be the voluntary union of neighboring nations under a centralized government of continental size.”
Certainly, globalization has made the world a more cozy place in which to live, but the planet is still far from evolving into an orb of peaceful mega-nations under common rule.
Sociologist William Ogburn also weighed in, forecasting a more nervous and mentally unstable U.S. populous of 160 million kept in line by “mental hygienists with the upper hand.”
Interesting, to say the least.
Dr. Willis R. Whitney, considered the dean of American directors of industrial research, foresaw a future free of moths, mice, and burglars (utopia, at last!), whereas physicist/chemist Michael Pupin was equally as idealistic with his corporate profit-sharing forecast: “This civilization is the greatest material achievement of applied science ... Its power for creating wealth was never equaled in human history. But it lacks the wisdom of distributing equitably the wealth which it creates. One can safely prophesy that during the next eighty years, this civilization will correct this deficiency by creating an industrial democracy which will guarantee to the worker an equitable share...produced by his work.”
A modern-day industrial democracy is about as realistic as self-lacing shoes, flying cars, and holographic movies (all courtesy of 1989’s “Back to the Future II” augurs). More often than not, prognostications turn out to be wrong, yet homo sapiens refuses to abandon the practice for fear of the unknown.
Indeed, uncertainty can be a frightening sensibility. Knowledge—even when incomplete—begets feelings of power, security, and control, all of which are reassuring to the human psyche. Without it, we are prone to fear and insecurity.
Thus explains all the soothsaying and forward-thinking that accompanies the start of any new year. Futurism, in effect, has become the new holiday custom of late, replacing that time-honored (yet somewhat hokey) tradition of resolution-making.
There is no shortage of crystal ball gazers either. Professionals from all walks of life have entertained the masses with their bizarre peeks into future worlds. Medtech gurus have had a decent track record, save for a few major missteps along the way. (Sir John Eric Ericson’s 1873 notion of the chest, abdomen, and brain being off-limits to surgeons is a prime example.)
Mike Darwin and Steven B. Harris, M.D., contrarily, weren’t too far off with their 1988 vision of laparoscopic and less-invasive surgery within 20 years. They also portended “fine-tuned repair of heart valves and blood vessels” as well as good synthetic bone and skin, and gene therapy.
Financial forecasting has been a bit trickier, particularly in the medical technology sector where insurance coverage, U.S. Food and Drug Administration (FDA) regulations, pricing pressures, economics, and healthcare reform can easily impact a company’s bottom line. Last year was a transformational one for the industry with scale-driven mergers and acquisitions that helped major players like Medtronic plc, Zimmer, Becton Dickinson and Company, Cyberonics Inc., Danaher, and Thermo Fisher Scientific Inc. (among others) gain vertical integration and greater supply chain synergies. The deals also raised the stakes for surviving a changed healthcare landscape, where future success likely will be achieved from tactical growth that delivers greater access, improved outcomes, and lower costs.
With industry alignment leaving fewer dominant players, the pressure to differentiate in the market surely will mount in 2016. Of course, it’s nearly impossible at this point to anticipate the impact of this differentiation on medtech finance over the next 12 months. The path to demarcation might be blazed through further consolidation or initial public offerings. Then again, it might be spearheaded by renewed venture capital funding (the odds are against this particular prediction, however).
The odds are also against this year’s class of financial fortune-tellers. In spite of their best efforts, most will be off target with their device industry forecasts but they’re nevertheless undaunted in their desire/need to read the industry’s proverbial tea leaves. Nevertheless, their ensuing predictions—compiled from blogs, reports, and live interviews—make for some rather interesting reading.
Brian Chapman, Principal,nZS Associates
In a mid-December blog on the sales/marketing consulting and technology firm’s website, Chapman envisioned a rough road for pharmaceutical pricing and a “medtech purchase” from big pharma.
“In 2016, we will have set aside our preoccupation with complaining about the device tax and calculating its calamitous effects. Now that the political establishment has turned its collective sights on pharmaceutical pricing (thank you, Mr. Shkreli), there will be heat, smoke, and fire aimed at pharmacos,” Chapman wrote in his blog. “An election year will bring scrutiny, criticism, and eventually even increasing intervention for pharma drug pricing. Medtech, on the other hand, will continue to invert to lower U.S. tax bills, acquire startups to launch compelling therapies, and innovate to address quality measures. In 2016, I believe that government interventions will focus on quality and outcomes, favoring what medtech offers, while punishing pharma. It’ll be a good year to be a medtech CEO.”
That certainly would be a welcome change. For CEOs anyway.
“M&A will continue but at a slightly slower pace. The more interesting speculation is what will happen next among the bigs: Medtronic has a ton of cash, Johnson & Johnson has sold a couple of businesses and hasn’t really bought much since Synthes, and Baxter needs to consider what the split from Baxalta means for its portfolio strategy,” Chapman continued. “Will Edwards remain stand-alone? So many interesting questions.”
“I also predict at least one medtech purchase from big pharma—and a deal in which the acquiring company is strategically seeking entry into the medtech space, rather than Pfizer’s “packaged deal” entry into medtech via its purchase of Hospira or Allergan...I think that we’ll see something happen here.”
Evaluate Ltd.
In its EvaluateMedTech World Preview report released in October 2015, the United Kingdom-based life science market intelligence firm forecasts global medical technology sales to jump 5.2 percent this year to $387.8 billion and research/development spending to rise 4.2 percent to $24.9 billion.
Evaluate also expects the percentage of worldwide medtech sales dedicated to R&D spending to slip 0.1 percent to 6.4 percent in 2016.
Venkat Rajan, Industry Manager—Medical Devices, Frost & Sullivan
During an interview with Orthopedic Design & Technology, Rajan mused on potential fallout from the now-suspended device tax and portended M&A activity from companies outside the healthcare realm.
“It will be an interesting year. With the [medical device tax] reprieve, it will be interesting to see if that frees up some cash for certain big device companies to go out and make some additional purchases that they might not have been willing to do in the past,” he said. “I think we’re going to see a lot of big M&As in 2016. We saw a lot of big deals over the last couple of years between Medtronic and Covidien, Becton Dickinson and Carefusion, and Zimmer-Biomet. But we also saw a lot of other big companies that didn’t do anything over the last two years—some of the companies that come to mind are J&J and Abbott. I think potentially they could be making certain types of moves in the coming year. I think a lot of the deals we are going to see will be more focused on trying to get a better alignment with the idea of outcomes-based compensation, value-based reimbursement...trying to better align with population-based health management.
“The volume of M&A deals might slow down a bit this year simply because of consolidation and all the other deals that we’ve seen. There are fewer companies out there to make acquisitions. I think the interesting theme that we will see in acquisitions is outside companies from healthcare coming into healthcare by way of M&A or spinoffs, like the deal between Google and J&J with Verb and the surgical robotics company they spun out of Google Labs. About a month or so back, someone asked Tim Cook if Apple would ever consider seeking FDA approval for the Apple watch to be used as a healthcare device. He said not the watch but Apple definitely would consider developing a peripheral device that could be connected through the watch that could be an FDA-regulated technology. It will be curious to see if that kind of positioning takes place this year.”
Joanne Wuensch, Managing Director, BMO Capital Markets
Wuensch predicts the spine market will experience some consolidation, noting that many of the biggest companies in the sector have gaps in their portfolios that could very well drive M&A.
“Once a high-flying market, delivering growth in the double-digits, spine now is a stable market with volumes up mid- to high-single digits, offset by pricing down by low to mid-single digits,” Wuensch wrote in her 2016 Outlook report for medtech.
Wuensch might want to consider a second career as a clairvoyant; less than a week into the new year, NuVasive Inc. granted her prophesy, purchasing skeletal specialist Ellipse Technologies Inc. for $380 million in cash.
Based in Aliso Viejo, Calif., Ellipse specializes in implantable rods that can be lengthened magnetically to help correct spinal and complex skeletal deformities in children. The non-invasive technology enables kids with early onset scoliosis or shortened leg bones avoid repeated surgeries as they grow.
The acquisition expands NuVasive’s core expertise in spinal surgical products with highly differentiated technology that NuVasive plans to extend into new areas, such as degenerative spine disease. CEO Greg Lucier said the deal represents “a very beneficial financial fit.”
Some of the prophecies were quite amusing. Ford speculated that Americans would focus more on the intangibles of life than material goods (wishful thinking, perhaps), while physicist and Nobel laureate Arthur Compton predicted the blurring of national boundaries, opining, “With better communication, national boundaries will gradually cease to have their present importance. Because of racial differences, a world union cannot be expected within eighty years. The best adjustment that we can hope for to this certain change would seem to be the voluntary union of neighboring nations under a centralized government of continental size.”
Certainly, globalization has made the world a more cozy place in which to live, but the planet is still far from evolving into an orb of peaceful mega-nations under common rule.
Sociologist William Ogburn also weighed in, forecasting a more nervous and mentally unstable U.S. populous of 160 million kept in line by “mental hygienists with the upper hand.”
Interesting, to say the least.
Dr. Willis R. Whitney, considered the dean of American directors of industrial research, foresaw a future free of moths, mice, and burglars (utopia, at last!), whereas physicist/chemist Michael Pupin was equally as idealistic with his corporate profit-sharing forecast: “This civilization is the greatest material achievement of applied science ... Its power for creating wealth was never equaled in human history. But it lacks the wisdom of distributing equitably the wealth which it creates. One can safely prophesy that during the next eighty years, this civilization will correct this deficiency by creating an industrial democracy which will guarantee to the worker an equitable share...produced by his work.”
A modern-day industrial democracy is about as realistic as self-lacing shoes, flying cars, and holographic movies (all courtesy of 1989’s “Back to the Future II” augurs). More often than not, prognostications turn out to be wrong, yet homo sapiens refuses to abandon the practice for fear of the unknown.
Indeed, uncertainty can be a frightening sensibility. Knowledge—even when incomplete—begets feelings of power, security, and control, all of which are reassuring to the human psyche. Without it, we are prone to fear and insecurity.
Thus explains all the soothsaying and forward-thinking that accompanies the start of any new year. Futurism, in effect, has become the new holiday custom of late, replacing that time-honored (yet somewhat hokey) tradition of resolution-making.
There is no shortage of crystal ball gazers either. Professionals from all walks of life have entertained the masses with their bizarre peeks into future worlds. Medtech gurus have had a decent track record, save for a few major missteps along the way. (Sir John Eric Ericson’s 1873 notion of the chest, abdomen, and brain being off-limits to surgeons is a prime example.)
Mike Darwin and Steven B. Harris, M.D., contrarily, weren’t too far off with their 1988 vision of laparoscopic and less-invasive surgery within 20 years. They also portended “fine-tuned repair of heart valves and blood vessels” as well as good synthetic bone and skin, and gene therapy.
Financial forecasting has been a bit trickier, particularly in the medical technology sector where insurance coverage, U.S. Food and Drug Administration (FDA) regulations, pricing pressures, economics, and healthcare reform can easily impact a company’s bottom line. Last year was a transformational one for the industry with scale-driven mergers and acquisitions that helped major players like Medtronic plc, Zimmer, Becton Dickinson and Company, Cyberonics Inc., Danaher, and Thermo Fisher Scientific Inc. (among others) gain vertical integration and greater supply chain synergies. The deals also raised the stakes for surviving a changed healthcare landscape, where future success likely will be achieved from tactical growth that delivers greater access, improved outcomes, and lower costs.
With industry alignment leaving fewer dominant players, the pressure to differentiate in the market surely will mount in 2016. Of course, it’s nearly impossible at this point to anticipate the impact of this differentiation on medtech finance over the next 12 months. The path to demarcation might be blazed through further consolidation or initial public offerings. Then again, it might be spearheaded by renewed venture capital funding (the odds are against this particular prediction, however).
The odds are also against this year’s class of financial fortune-tellers. In spite of their best efforts, most will be off target with their device industry forecasts but they’re nevertheless undaunted in their desire/need to read the industry’s proverbial tea leaves. Nevertheless, their ensuing predictions—compiled from blogs, reports, and live interviews—make for some rather interesting reading.
Brian Chapman, Principal,nZS Associates
In a mid-December blog on the sales/marketing consulting and technology firm’s website, Chapman envisioned a rough road for pharmaceutical pricing and a “medtech purchase” from big pharma.
“In 2016, we will have set aside our preoccupation with complaining about the device tax and calculating its calamitous effects. Now that the political establishment has turned its collective sights on pharmaceutical pricing (thank you, Mr. Shkreli), there will be heat, smoke, and fire aimed at pharmacos,” Chapman wrote in his blog. “An election year will bring scrutiny, criticism, and eventually even increasing intervention for pharma drug pricing. Medtech, on the other hand, will continue to invert to lower U.S. tax bills, acquire startups to launch compelling therapies, and innovate to address quality measures. In 2016, I believe that government interventions will focus on quality and outcomes, favoring what medtech offers, while punishing pharma. It’ll be a good year to be a medtech CEO.”
That certainly would be a welcome change. For CEOs anyway.
“M&A will continue but at a slightly slower pace. The more interesting speculation is what will happen next among the bigs: Medtronic has a ton of cash, Johnson & Johnson has sold a couple of businesses and hasn’t really bought much since Synthes, and Baxter needs to consider what the split from Baxalta means for its portfolio strategy,” Chapman continued. “Will Edwards remain stand-alone? So many interesting questions.”
“I also predict at least one medtech purchase from big pharma—and a deal in which the acquiring company is strategically seeking entry into the medtech space, rather than Pfizer’s “packaged deal” entry into medtech via its purchase of Hospira or Allergan...I think that we’ll see something happen here.”
Evaluate Ltd.
In its EvaluateMedTech World Preview report released in October 2015, the United Kingdom-based life science market intelligence firm forecasts global medical technology sales to jump 5.2 percent this year to $387.8 billion and research/development spending to rise 4.2 percent to $24.9 billion.
Evaluate also expects the percentage of worldwide medtech sales dedicated to R&D spending to slip 0.1 percent to 6.4 percent in 2016.
Venkat Rajan, Industry Manager—Medical Devices, Frost & Sullivan
During an interview with Orthopedic Design & Technology, Rajan mused on potential fallout from the now-suspended device tax and portended M&A activity from companies outside the healthcare realm.
“It will be an interesting year. With the [medical device tax] reprieve, it will be interesting to see if that frees up some cash for certain big device companies to go out and make some additional purchases that they might not have been willing to do in the past,” he said. “I think we’re going to see a lot of big M&As in 2016. We saw a lot of big deals over the last couple of years between Medtronic and Covidien, Becton Dickinson and Carefusion, and Zimmer-Biomet. But we also saw a lot of other big companies that didn’t do anything over the last two years—some of the companies that come to mind are J&J and Abbott. I think potentially they could be making certain types of moves in the coming year. I think a lot of the deals we are going to see will be more focused on trying to get a better alignment with the idea of outcomes-based compensation, value-based reimbursement...trying to better align with population-based health management.
“The volume of M&A deals might slow down a bit this year simply because of consolidation and all the other deals that we’ve seen. There are fewer companies out there to make acquisitions. I think the interesting theme that we will see in acquisitions is outside companies from healthcare coming into healthcare by way of M&A or spinoffs, like the deal between Google and J&J with Verb and the surgical robotics company they spun out of Google Labs. About a month or so back, someone asked Tim Cook if Apple would ever consider seeking FDA approval for the Apple watch to be used as a healthcare device. He said not the watch but Apple definitely would consider developing a peripheral device that could be connected through the watch that could be an FDA-regulated technology. It will be curious to see if that kind of positioning takes place this year.”
Joanne Wuensch, Managing Director, BMO Capital Markets
Wuensch predicts the spine market will experience some consolidation, noting that many of the biggest companies in the sector have gaps in their portfolios that could very well drive M&A.
“Once a high-flying market, delivering growth in the double-digits, spine now is a stable market with volumes up mid- to high-single digits, offset by pricing down by low to mid-single digits,” Wuensch wrote in her 2016 Outlook report for medtech.
Wuensch might want to consider a second career as a clairvoyant; less than a week into the new year, NuVasive Inc. granted her prophesy, purchasing skeletal specialist Ellipse Technologies Inc. for $380 million in cash.
Based in Aliso Viejo, Calif., Ellipse specializes in implantable rods that can be lengthened magnetically to help correct spinal and complex skeletal deformities in children. The non-invasive technology enables kids with early onset scoliosis or shortened leg bones avoid repeated surgeries as they grow.
The acquisition expands NuVasive’s core expertise in spinal surgical products with highly differentiated technology that NuVasive plans to extend into new areas, such as degenerative spine disease. CEO Greg Lucier said the deal represents “a very beneficial financial fit.”