The Journal of the American Medical Association – Neurology (JAMA Neurology) has indicated it will publish the results of the landmark stroke diagnostic study – VERiTAS (Vertebrobasilar Flow Evaluation and Risk of Transient Ischaemic Attack and Stroke study (VERiTAS).  Acceptance by this highly prestigious and influential peer-reviewed journal is a significant reflection of the importance of the study and the wide-ranging implications of the NOVA blood flow non-invasive MRI-based, objective stroke diagnostic system.

Key factors “shaping” the aesthetic surgery market and healthcare M&A activity in it are:

Large and Growing Market
15.6 million cosmetic procedures, including both minimally-invasive and surgical, were performed in the US in 2014, an increase of 3% since 2013. Additionally, 5.8 million reconstructive surgery procedures were performed last year, up 1%.

The deal provides Allergan with AqueSys’s minimally invasive glaucoma surgery (MIGS) device called the XEN45 Gel Stent.  MIGS devices are alternatives to glaucoma medication and more invasive surgical techniques.  The leader in the MIGS area is Glaukos, which closed an IPO in June 2015 and now has a market cap of over $1b.  Its iStent is FDA-approved for moderate to severe glaucoma while the AqueSys device is for mild to moderate patients.

The Walden Group advised JoViPak Corporation and arranged for its sale to BSN Medical GmbH & Co. KG,, a $850m manufacturer of products for wound care, vascular disease, lymphology and non-invasive orthopaedic conditions.  JoViPak pioneered the market for night-time lymphedema garments to manage lymphatic disorders, an underserved, yet rapidly growing market. JoViPak’s products simulate the dynamic massaging action of an expert lymphedema therapist in gently releasing trapped fluid so that it properly drains via the lymph system.  

The recent $3.2b healthcare M&A purchase of Synageva BioPharma Corp. by Alexion Pharmaceuticals again put the spotlight on the high cost of specialty drugs. Synageva’s lead candidate, Kanuma, is designed to treat lysosomal acid lipase deficiency, a genetic disease in which people do not produce enough of a certain enzyme. Infants with the disease often die within months. It can also cause liver damage and other problems in children and adults. So-called orphan drugs like Kanuma are now among the …

After several years of government reimbursement pressure, headwinds are beginning to abate.  Given the aging population, the significant positive impact in vitro diagnostics have on the medical care and controlling costs, the diagnostics market is expect to grow.   This is especially the case in regard to molecular diagnostics and genetic testing, which enable more personalized and targeted therapeutic approaches.   See accompanying chart.

In June 2015, the Supreme Court of the United States affirmed the Affordable Care Act in King v. Burwell.  While the Republicans may continue to try to change some provisions, the Court clarified much of the uncertainty surrounding the fate of the ACA.  The ACA provides for a major expansion in the number individuals entitled to insurance coverage, and higher burdens on insurers to cover pre-existing conditions and other pathologies, among other requirements which make for more costly insurer requirements.

Composition
The U.S. clinical testing industry consists of two segments: (a) hospital inpatient and outpatient testing (40%) and (b) commercial clinical laboratories, physician-office laboratories and other locations, as well as hospital outreach testing (60%).Hospital-based and affiliated laboratories account for ~60% of the total industry; commercial clinical laboratories approximately 33%;and physician-office laboratories and other locations account for 7%.See adjacent chart.

Healthcare M&A in 2014 was characterized by seismic changes.  More than 40 deals were announced or closed with a value over $1 billion – 8 were over $10 billion. Here are the key factors that shaped the environment for healthcare mergers and acquisitions and healthcare investment banking.

In Q3 2014. big deals continued to dominate the healthcare M&A headlines, with transformative divestitures and restructurings also reshaping the landscape. Large scale M&A activity is how large companies are adapting to the new healthcare environment.  In the new environment, tight government and hospital budgets loom large and cost has become an enormous part of the equation. Lower reimbursements, more challenging and expensive regulatory pathways, and a tougher gauntlet to get products…