David C. Dvorak, President & CEO
James T. Crines, Exec. VP of Finance & Chief Financial Officer
Joseph A. Cucolo, President, Americas
Kataryna Mazur-Hofsaess, M.D., Ph.D., President, Europe, Middle East and Africa
Stephen H.L. Ooi, President of Asia-Pacific
Matt Monaghan, Sr. VP, Global Hips & Reconstructive Research
Stephen E. White, Sr. VP & General Manager, Knees
Emmanuel Nyakako, Sr. VP, Global Quality, Regulatory and Clinical Affairs
Richard C. Stair, Sr. VP, Global Operations and Logistics
NO. OF EMPLOYEES: 9,500
HEADQUARTERS: Warsaw, Ind.
Linda Solomon tried almost everything to dull the pounding pain in her knees: ice packs, compression bandages, multiple medications, even cortisone injections. Nothing worked.
When the agony became unbearable, the 72-year-old Palm Coast, Fla., artist turned to Dennis Alter, M.D., as a last resort. An orthopedic surgeon at the 99-bed Florida Hospital Flagler, Alter fitted Solomon with a Persona knee from Zimmer Holdings Inc., an implant touted as the “most comprehensive, anatomically accurate and highest fidelity” replacement product ever designed.
Unveiled in March 2013, the Persona system combines personalized implants with intelligent instruments to provide surgeons with better intraoperative precision to customize the best fit for patients. Zimmer incorporated various technologies into the new system, including a Bone Resection Atlas, which helped designers and engineers precisely define anatomically accurate implant shapes and sizes; the company’s proprietary trabecular metal; and vitamin E for increased strength, ultra-low wear and oxidative stability for long-term performance.
“The Persona knee allows more options to anatomically match the patient’s knee,” said Jeffrey Keen, M.D., a colleague of Alter’s at Florida Hospital Flagler. “I am so pleased with this new knee technology.”
So is Solomon, now pain-free and leading a significantly more active life style.
Yet neither endorsement can match the satisfaction—glee, really—expressed by Zimmer executives over the Persona’s global success. Bigwigs credit the product with helping to boost net sales 3 percent last year to $4.6 billion, a considerable increase in light of 2012’s flat revenues. Operating profit benefited as well, climbing 4 percent on an adjusted basis to $1.3 billion, and diluted earnings per share rose 8 percent on an adjusted basis to $5.75.
The Americas comprised the bulk of Zimmer’s 2013 sales, accounting for $2.6 billion, or 57 percent of net revenue. The region was tops in growth as well, doubling the 3 percent gain generated in Europe ($1.2 billion) and offsetting a surprising 3 percent decline in Asia-Pacific proceeds ($791 million).
“Our 2013 results were driven by strong performances in a number of geographies and product categories,” President/CEO David C. Dvorak told shareholders in the company’s 2013 annual report.
"While new offerings, such as the Persona personalized knee system, continued to build on the strength of our joint reconstruction business, we extended our reach across the continuum of musculoskeletal care with innovative treatments and solutions to address new markets and anatomical sites. We believe that this comprehensive portfolio both defines and distinguishes Zimmer, and positions us to continue capturing global sales growth.”
The company secured some of that growth through the debuts of new extremities products like the Trabecular Metal total ankle and Trabecular Metal reverse shoulder system patient-specific instruments, as well as the acquisition of Normed Medizin-Technik GmbH, a German provider of technologies for the foot and ankle, hand and wrist reconstruction and trauma markets. The Sidus stem-free shoulder system, launched in 2012, also fueled the surge in extremities sales, which ballooned 11 percent to $194 million compared with the previous year. The gain more than compensated for the 1 percent slide in hip sales and virtually single-handedly helped reconstructive product proceeds rebound from a dismal 2012 showing.
Net reconstructive device revenue increased 3 percent to $3.4 billion, due largely to the Persona knee unveiling and rollout, along with solid growth in its existing product lines. Knee revenue jumped 4 percent to $1.9 billion, profiting from respective 5 percent increases in domestic and European sales, and solid performances from such reliable old favorites as the NexGen Complete knee solution, Unicompartmental high-flex knee, patient-specific instruments, and early intervention products.
Budgetary constraints kept hip sales from growing in Europe, while a weak Japanese yen dragged down profits by 9 percent. Hip implants slid 1 percent to $1.3 billion, though Zimmer’s M/L Taper hip prosthesis, M/L Taper hip prosthesis with Kinectiv technology, the CLS Spotorno stem and Alloclassic Zweymuller hip stem were popular with customers. Other best-sellers included the Wagner SL revision hip Stem, the Continuum acetabular system, the Trilogy IT acetabular system, the Allofit IT Alloclassic acetabular system, the Vivacit-E highly crosslinked polyethylene liners and Biolox delta heads.
Dental sales bounced back from a disappointing 2012, growing 1 percent to $239 million last year on higher demand for the company’s Tapered Screw-Vent implant system, a device with an internal hex platform design to reduce the stress on the crestal bone and resist abutment screw loosening.
Spinal product proceeds remained mired in a 5-year-old downward spiral in 2013, declining 3 percent to $202 million. It was the worst-performing product category for the second consecutive year, having failed to profit from gains in Europe and Asia-Pacific, the distribution of the APEX spine system (a set of implants and instruments to correct spinal deformities) or the launches of minimally invasive spinal surgery products (specifically, the Viewline retractor system, tube retraction system and posterior instrument set). Solid sales of the PathFinder NXT minimally invasive pedicle screw system and Trabecular Metal products partially offset weak sales of the Dynesys dynamic stabilization system, the Trinica Select anterior cervical plate system and other implants.
Though trauma systems were more susceptible to volatile foreign exchange rates than most other products, the devices still managed to post a profit in 2013 (year ended Dec. 31), growing revenue 2 percent to $316 million. Sales drivers included the Natural nail and Periarticular locking plates systems.
Surgical products bested all other product categories in gains, skyrocketing 18 percent to $432 million, or 9.3 percent of total sales. The Transposal fluid waste management System (obtained through the 2012 acquisition of Dornoch Medical Systems Inc.) contributed to the increase, as did Palacos bone cement, tourniquets and wound debridement devices.
Zimmer-Biomet Deal to Create Orthopedic Powerhouse
Biomet Inc.’s life journey is about to come full circle.
The 37-year-old company founded by two former Zimmer Holdings Inc. employees (and their friends) will reconnect with its birth mother in the next eight months as the two entities merge operations. The bittersweet reunion is costing Zimmer $13.4 billion ($10.4 billion in cash and $3 billion in stock), but the money is well spent, as the company likely will gain market share and business from longtime rivals Stryker Corp. and Johnson & Johnson’s DePuy subsidiary.
The deal—announced April 24—is the orthopedic industry’s largest since the $21.3 billion melding of DePuy and Synthes Inc. in 2012, and undoubtedly the biggest for Zimmer since its 2001 spinoff from Bristol-Myers Squibb Co. It’s also the fifth-largest medical device merger in the last decade, according to Bloomberg data.
“The bottom line is it makes a lot of sense,” Needham & Co. analyst Mike Matson told Bloomberg. “There are a lot of cost savings to be had and the scale should provide an advantage as their customers, hospitals and insurance companies go through waves of consolidation.”
The deal’s anticipated cost savings certainly are significant: $135 million in the first year and $270 million by the third year, a cache that is expected to contribute $1.15 to $1.25 per share in earnings during the first year, Zimmer Chief Financial Officer James Crines told analysts on a conference call.
Perhaps more important than the savings, however, is the potential for pricing stability. Analysts claim the Zimmer-Biomet union could help slow price cuts at hospitals by limiting their implant choices. Healthcare institutions in recent years have created central committees to limit the number of companies they work with and extract price discounts through their combined purchasing power.
Though the practice shows no signs of slowing, the addition of Biomet should make Zimmer’s products more difficult to rebuff and bolster its negotiating power. The combined Zimmer-Biomet firm is likely to gain a 39 percent market share in U.S. sales of hip and knee implants, leaving its main competitors—DePuy (JNJ) and Stryker—with 23 percent and 21 percent, respectively, according to a Goldman Sachs report.
“This will give Zimmer some leverage when they go to hospitals, and help them compete,” noted Jason McGorman, an analyst at Bloomberg Industries in Princeton, N.J. “[Also], they get a little more in terms of products in other areas, like sports medicine, extremities and trauma, where Zimmer has less exposure.”
J.P. Morgan analyst Michael Weinstein agreed.
“It further consolidates an industry that has been lacking in pricing power for the past decade,” he wrote of the Zimmer-Biomet proposal. “Zimmer is stronger as a result of the transaction—both competitively and relative to a customer base that continues to consolidate and gain leverage over the surgeon.”
Zimmer will likely have a commanding upper hand as it becomes heir apparent to the $45 billion orthopedic device industry (JNJ will remain king) and adds more comprehensive and scalable solutions to its portfolio. That expansion, no doubt, will benefit sales, contributing roughly 15 percent in additional net revenue, industry experts claim. Zimmer and Biomet are expected to generate $8.4 billion in combined sales next year, when the acquisition is expected to close.
While Zimmer stands to gain considerably from the Biomet merger, the buyout could very well backfire by inspiring more partnerships, barring antitrust issues. “This deal could put pressure on the remaining ortho players to get larger,” Wells Fargo analyst Larry Biegelsen wrote in a note.
Luckily for Zimmer, there aren’t too many large players left. Stryker briefly considered teaming up with United Kingdom-based Smith & Nephew plc, but backed down when Medtronic Inc. expressed interest in late May; Medtronic’s interest was short lived, however, as the company announced plans to acquire Smith & Nephew’s competitor, Covidien plc, several days later.
Stryker ultimately lost interest too, but also left the door open for a potential buyout. “At the request of the U.K. Takeover Panel, Stryker confirms that it does not intend to make an offer for Smith & Nephew,” the company said in a May 28 statement. “Stryker reserves the right to announce or participate in an offer or possible offer for Smith & Nephew and/or to take any other action which would otherwise be restricted...within six months after the date of this announcement.”
Stay tuned. —ODT Staff