Daniel P. Florin, Interim CEO, Sr. VP, and CFO
Tony W. Collins, VP, Corporate Controller, and Chief Accounting Officer
Robert D. Delp, President, Americas
Adam R. Johnson, Group President, Spine, Dental, CMF, and Thoracic
David A. Nolan Jr., Group President, Biologics, Extremities, Sports Medicine, Surgical, Trauma, Foot & Ankle, Office Based Technologies, and Signature Solutions
Daniel E. Williamson, Group President, Joint Reconstruction
NUMBER OF EMPLOYEES: 18,500
GLOBAL HEADQUARTERS: Warsaw, Ind.
Scientists generally agree that the continued use of non-renewable fossil fuels will have a detrimental effect on the planet’s climate. For this reason, most developed nations have a “green energy” initiative in place in order to minimize their carbon footprint and use as many renewable resources as possible.
Zimmer Biomet announced in September 2016 that its Warsaw, Ind.-based headquarters will be completely powered by renewable, green energy, in compliance with the U.S. Environmental Protection Agency’s (EPA) Green Power Partnership program. The headquarters will receive its green power from Northern Indiana Public Service Company (NIPSCO), an authorized provider of green power for the EPA’s Green power program—which permits homes and businesses to designate a portion (or all) of their monthly electric usage to energy generated from renewable sources.
“We are proud to partner with the EPA and NIPSCO to lead the green power revolution in Indiana by converting 100 percent of our headquarters’ power consumption to renewable energy sources,” Robin T. Barney, Zimmer Biomet’s senior vice president of global operations and logistics, said in a company press release detailing the EPA recognition. “Sustainably and responsibly sourcing our electric power is a critical milestone in advancing Zimmer Biomet’s longstanding commitment to sustainability, and we hope our efforts inspire local area businesses and residents to join the EPA’s Green Power Program to collectively reduce our region’s environmental footprint.”
Fiscal 2016 (ended Dec. 31) marked the first full year of Zimmer Biomet’s operating results as a combined company. Their landmark merger closed on June 24, 2015, and now that all integration efforts have come to a close, the company is finally seeing the windfall it was hoping for. Zimmer Biomet’s 2016 revenue rose a staggering 28 percent to $7.7 billion, primarily as a result of Biomet product lines’ full assimilation and the accompanying sales gains. Double-digit percentage growth (and then some) spread across all regions—Zimmer Biomet’s Americas revenue ballooned 32 percent from the year prior, Europe’s sales skyrocketed 25 percent, and the Asia Pacific region was boosted by 22 percent.
The company’s Knees business continued to be the largest moneymaker in 2016, ascending 21 percent from the year prior to $2.8 billion. The double-digit growth was chiefly driven by recent product introductions like the Persona Personalized Knee System, cross-sell opportunities, and continued strong performance in the Asia Pacific region. Two implant technologies to support the Persona Knee System and Vanguard 360 Revision System released in March also invigorated the Knees business, and the latest addition to the Vanguard portfolio, the first-of-its-kind Vanguard Individualized Design (ID) knee replacement, was released in September. The Hips business followed suit in terms of double-digit growth, surging 22 percent to $1.9 billion. The introduction of the G7 Acetabular system spurred strong performance in this area, as well as three Hip portfolio products launched in March. (Editor’s note: See sidebar on page 42 for details on last year’s product launches.)
The Sports Medicine, Extremities, and Trauma (S.E.T.) business grew 35 percent to $1.6 billion in 2016. This was mainly stimulated by a growing emphasis on sales force specialization and strong performance by key brands in the portfolio. The May acquisition of Cayenne Medical—which produces soft tissue repair and reconstruction solutions for knee, shoulder, and extremities—also brought gains to this segment in 2016. And while the Dental business’ 2015 sales were threatened by a second half supply disruption related to a voluntary field action in response to a packaging issue that the company was not able to remediate until 2016, Dental revenue held fast with a 27 percent rise to $428 million.
ANALYST INSIGHTS: Zimmer Biomet continues to reinforce its market position created by the famous Zimmer and Biomet combination through both organic and M&A investments. Surprisingly, it has been able to afford $1.5 billion of acquisitions since the merger. Critical to its upcoming success will be the ability to respond to increasing pricing pressure in the joint markets—a key stated reason for the Zimmer Biomet merger.
—Dave Sheppard, Co-Founder and Principal, MedWorld Advisors
The Spine and CMF (craniomaxillofacial) business segment once again proved to be strongest in terms of percentage growth, surging 64 percent to $662 million in 2016 sales.
(This segment’s profits have more than tripled since fiscal 2014.) The $1 billion June purchase of LDR Holding Corporation was the main driver for this impressive growth, adding several offerings to support lumbar and cervical fusion procedures; it also helped establish the company as a force to be reckoned with in the cervical disc replacement (CDR) market and greatly expanded the company’s Spine business. Continued strong performance of CMF products also contributed to the increase.
The remainder of Zimmer Biomet’s revenue takes shape in its “Other” category, which rose 41 percent to $329 million in sales in 2016. The July release of Signature Solutions, a suite of clinical services and technologies to help hospitals and medical practices transition into Comprehensive Care for Joint Replacement (CJR)-mandated value-based outcomes, drove growth in this area.
Of all the medical device sectors, orthopedics is perhaps the most difficult for a large company to expand and diversify beyond its core competency because each section of anatomy requires its own set of considerations. For example, companies with large portfolios of knee or hip products have some difficulty moving into extremities, because the clinical research, device materials, and manufacturing methods required for smaller bone and joint products differ so strongly from large joints. To explore an unfamiliar product segment, large companies must either drum up the funds, personnel, and equipment necessary to expand, or else acquire a company with all of that already in place. Zimmer Biomet is certainly no stranger to M&A activity, and the trend continued in 2016. Even after the landmark merger was completed, the combined company continued to grab companies that would augment existing businesses or create entirely new ones.
In March, Zimmer Biomet purchased Colorado-based Ortho Transmission—which includes the company’s transcutaneous osseous integrated skeletal technology developed by a military surgeon—for an undisclosed amount. This complemented Zimmer Biomet’s ongoing partnership with the U.S. Department of Defense to develop a transcutaneous system to anchor prosthetic limbs to restore mobility to amputee patients. Transcutaneous systems (as opposed to those with a traditional skin-to-socket interface) avoid the common prosthetic complications of soft tissue irritation, sores, infections, and joint pain, and reduce the extra energy expenditure required for patients to walk.
The acquisition of Arizona-based Cayenne Medical was completed in May for an amount not revealed. Cayenne brought a portfolio of technically advanced soft tissue repair and reconstruction solutions for knee, shoulder, and extremities. The acquisition strengthens Zimmer Biomet’s sports medicine capabilities to address the $18 million S.E.T. (Sports Medicine, Extremities, and Trauma) market.
For a natural expansion of Zimmer Biomet’s Spine business, the company bought LDR Holding Corporation, which develops novel surgical technologies for those suffering from spine disorders, for $1 billion in June. LDR’s purchase brought with it the Mobi-C Cervical Disc Prosthesis and MIVo portfolio to support lumbar and cervical fusion procedures. The move attempted to position Zimmer Biomet as a global force in the cervical disc replacement (CDR) market, which represents the fastest-growing segment within the $10 billion spine industry. LDR’s Mobi-C CDR device was well received in the market, as the first and only device approved by the U.S. Food and Drug Administration (FDA) to treat both one- and two-level adjacent damaged cervical discs.
Zimmer Biomet grabbed French surgical robotics company Medtech SA in July. Medtech SA brings two FDA-approved, CE marked robots for minimally invasive brain and spine procedures to the company’s portfolio, giving Zimmer Biomet the potential to identify additional applications for the robots across other anatomical sites.
CD Diagnostics, which initially partnered with Zimmer Biomet in 2012 to co-develop and market diagnostics, was acquired in August for an undisclosed amount. The Delaware-based company develops immunoassays and biomarker testing for various clinical conditions in synovial fluid.
“Our acquisition of CD Diagnostics cements our leadership and competitive advantage in musculoskeletal diagnostics, strengthens our Signature Solutions offering, and advances our mission to provide comprehensive musculoskeletal healthcare,” Dan Williamson, group president of joint reconstruction for Zimmer Biomet, said in a press release. “As value-based healthcare replaces fee-for-service models, there will be a growing need for diagnostics that can either prevent or minimize costly complications, or personalize the course of treatment to speed up recovery time and optimize the patient experience and, ultimately, the patient’s outcome.”
Clinical Graphics, which specializes in 3D range-of-motion simulation technology to inform treatment decisions for common hip conditions requiring early intervention, was nabbed in September. Clinical Graphics’ imaging platform was integrated in order to reinforce its hip preservation portfolio. The technology provides 3D interactive range-of-motion simulation reports for femoroacetabular impingement and dysplasia, and physicians rely on its technology to characterize the physiology of a patient’s pain and direct treatment approaches.
Zimmer Biomet’s Signature Solutions platform was enhanced by the December acquisition of the RespondWell Telerehabilitation Platform, a comprehensive, at-home telerehabilitation platform to enhance patient compliance with physical therapy and improve the quality of recovery.
“The new value-based reimbursement environment compels hospitals and providers to assume responsibility for patient outcomes well after discharge and through the critical rehabilitation period,” David Nolan, group president of biologics, extremities, sports medicine, surgical, trauma, foot and ankle, and office-based technologies, said in a press release. “Integrating an innovative and comprehensive telerehabilitation program into our Zimmer Biomet Signature Solutions offering addresses the emerging need for healthcare providers to oversee and optimize post-surgical recovery outcomes in order to maximize value across the entire episode of care.”
According to the company, Zimmer Biomet deployed about $1.5 billion in strategic acquisitions in 2016.
In addition to a bevy of platforms acquired through purchase, Zimmer Biomet maintains a comprehensive portfolio of orthopedic products by releasing a number of new offerings throughout the year. 2016 was no different, as the orthopedic giant was granted U.S. Food and Drug Administration (FDA) clearance for and launched a sizeable lot of new technologies, spending $365 million on research and development activities. Although the company introduced 50 new products last year, the most noteworthy are listed here.
Adding to the multinational’s extremities portfolio, February brought FDA 510(k) clearance to the Unite3D Bridge Fixation System. An alternative to traditional surgical plates, screws, and staples, the 3D-printed technology provides stability in foot and ankle joint fusion surgery through an osteoconductive matrix for biological incorporation.
Three new hip portfolio products were launched in March. The Echo Bi-Metric Microplasty Stem, a metaphyseal loading, fit-and-fill femoral prosthesis implanted through a broach-only technique, is 30 percent shorter than the full-length stem, conserving natural bone. The G7 Dual Mobility Construct provides dislocation resistance without the need to constrain the femoral head and expands the company’s shell, fixation, and bearing options. The Arcos One-Piece Femoral Revision System features three fully porous, titanium stem options with a range of sizes to address small femora.
Two implant technologies to support the Persona Knee System and Vanguard 360 Revision System were also released in March. Combining ultracongruent designs with personalized femoral components, the Persona Medial Congruent Bearing recreates more natural knee motion by maximizing knee joint stability throughout the range of motion. OsseoTi Tibial Sleeves address a range of cavitary defects experienced in knee revision procedures with porous metal technology, designed to distribute the load through biologic fixation from the tibial plateau and stem to loads closer to the joint. March also saw FDA 510(k) clearance for compatibility of the Nexel Total Elbow System with the company’s Comprehensive Segmental Revision System, streamlining elbow replacement.
June saw a bunch of enhancements to the OSS Orthopedic Salvage set of joint reconstruction prostheses. These include modern implant designs for the distal femur and diaphysis, small diameter Splined Stems, and new implant components created with porous metal.
In July, the company unveiled Signature Solutions, a suite of clinical services and technologies to help hospitals and medical practices transition into Comprehensive Care for Joint Replacement (CJR)-mandated value-based outcomes. Included in the suite are interactive patient engagement tools to facilitate communication and patient adherence, a data mining and analysis platform, and consulting services with digital health software and patient-specific technologies.
In September, the first-of-its-kind Vanguard Individualized Design (ID) knee replacement stepped into the market. It’s the first total knee construct to permit a personalized fit while simplifying soft tissue preservation and balance. Vanguard ID incorporates two polyethylene bearings with different articulations on the medial and lateral sides. Due to Vanguard ID’s flexible design, surgeons can use it to mix and match bearings with different thickness and geometry to personalize their approach and preserve natural tissue.
November brought the launch of the Comprehensive Vault Reconstruction System (VRS), the first commercially available patient-matched Glenoid implant. It specifically treats patients with a severely deficient rotator cuff and considerable bone loss that precludes using a standard baseplate. VRS employs CT imaging and 3D reconstruction techniques for surgeons to personalize each patient’s implant.
December saw an addition to the biologics portfolio with the PrimaGen Advanced Allograft. PrimaGen is an autograft substitute containing a combination of demineralized cortical bone fibers with verified osteoinductivity and cancellous bone. It is indicated for use as an allogeneic bone graft substitute with viable donor cells intended for homologous use in repairing, replacing, reconstructing, or supplementing the recipient’s tissue in musculoskeletal defects.