Friday Five - The medtech week in review

M&A, M&A and more M&As as Merit, Smith & Nephew, Alcon and Apollo wheel and deal; Mobidiag aims for China; Medtronic’s latest SNM innovation; and FDA welcomes new deputy commissioner in new year.

[Note from the editor: This is the last Friday Five of 2018; the next edition of Friday Five will be published on January 4, 2019. The team at FirstWord MedTech would like to wish all our readers Happy Holidays and a prosperous new year!]


The holiday season may bring a period of rest and relaxation to many but the final weeks of the year has always promised a hectic news flow from industry and the last week has proved no different. Several M&A deals were forged and completed, with transactions across various sectors.  

Interventional technologies specialist Merit Medical Systems expanded its peripheral vascular portfolio and entered a new market segment with the acquisition of Vascular Insights, developer of the ClariVein varicose vein treatment system. The ClariVein device is already CE-marked and  FDA-cleared, and used in over 120 000 cases. This is Merit Medical’s second acquisition this year, and it coincidentally comes a month after two of the company’s key rival in interventional oncology, BTG, agreed to enter the folds of Boston Scientific, another Merit rival though more in the cardio- and peripheral vascular sectors. Taking into account that BTG - and soon Boston Scientific - had a varicose vein platform and Merit Medical previously hadn’t, could the addition of Clarivein level out the playing field?


[See The Wider View: Is Merit Medical bringing in ClariVein to ease its FOLO pain?]


Other significant M&A deals announced this week include Smith & Nephew’s agreement to buy Ceterix Orthopaedics for up to $105 million. While Smith & Nephew is the world’s third largest reconstructive implant maker, this acquisition benefits its sports medicine portfolio with the addition of meniscal repair technology.

Eye care technology giant Alcon, which is in the midst of a spin-out from its parent company Novartis, also bagged a bolt-on in an ophthalmic area which it believes has significant growth opportunity, dry eye. Alcon has acquired Tear Film Innovations, which has developed and is commercialising the iLux device for treating meibomian gland dysfunction, a leading cause of dry eye. The company had highlighted at a November investor meeting this particular disease area as a key growth opportunity that it wanted to tap into.  

And in the area of obesity management, two players did some creative wheeling and dealing. Apollo Endosurgery agreed to sell the Lap-Band gastric banding system, which it had acquired from Allergan five years ago, to ReShape Medical, a bariatric therapy rival. Apollo had planned to revitalise sales of Lap-band, but it has been going a bit pear-shaped with sales of the device declining in the US and flat in other geographies. ReShape believes it can get value out of Lap-Band, which it is acquiring for $10 million upfront, a snip, considering Apollo had paid Allergan $75 million upfront. Apollo has also gained, as part of ReShape’s payment, the latter’s intragastric balloon line, Apollo already has its own intragastric balloon product, Orbera, and said while it will make available ReShape balloon in the near term, it will focus commercial efforts exclusively on Orbera.


Another interesting deal signed and sealed this week came from emerging molecular diagnostics player Mobidiag. The Finnish company is setting up a joint venture with Chinese IVD firm, Autobio Diagnostics; the JV will be dedicated to commercialising Mobidiag’s infectious disease tests that run on its Novodiag rapid, high-plex platform. Setting up a JV with a local partner is not an unusual move for companies looking to access a big market like China. What’s interesting is that Mobidiag has not wasted anytime in targeting this country, even though Novodiag is a relatively new offering and the firm has not been selling it for very long in Europe. But China is a lucrative IVD market growing at double-digit rates and the Novodiag platform offers a key advantage - cost - which could drive healthy uptake of its technology by Chinese customers that are looking for fast, accurate and low-cost tests for infectious diseases.

[See The Wider View: Mobidiag's cost advantage plays to China's value demands]



Speaking of innovations, the medical device industry’s numero uno Medtronic got FDA approval for a new smart programmer designed to enhance its InterStim sacral neuromodulation therapy for overactive bladder (OAB) and faecal incontinence (FI). InterStim has to date treated around 300 000 cases and while it is not Medtronic’s biggest cash cows, the market opportunity for OAB/FI is substantial with tens of millions of sufferers in the US alone.

Medtronic has monopolised the SNM for OAB/FI market in the US for nearly 20 years, but it could soon see a new competitor arrive on the scene next year; Axonics has submitted a PMA application for its r-SNM system and if all goes well, it could be launched in the US in H2 2019.

The r-SNM has certain advantages over InterStim, so would Medtronic’s latest efforts to upgrade its existing InterStim technology be sufficient to keep its leading position in the US SNM market?


[See The Wider View: Can Medtronic’s souped-up Interstim hold off incoming new rival?]



Medtronic might be seeing a new SNM rival in the new year, but the FDA will be seeing a more welcomed new addition to its staff in 2019. The US watchdog has appointed Amy Abernethy, the current chief medical officer of Flatiron Health, as principal deputy commissioner.

The choice of candidate to fill the agency’s top non-political role highlights the FDA’s conviction of the importance of real-world evidence in the future healthcare ecosystem, driving precision medicine and the development of better therapies, as well as informing regulatory decision-making.    

Abernethy brings to her new role a solid track record - both at Flatiron and in her previous roles at Duke University - of building systems that use the ever-growing flow of health data to generate real-world evidence that can be used by different healthcare stakeholders.


[See The Wider View: Why Flatiron’s Abernethy got the second-top position at FDA]

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