HealthCareMandA www.healthcaremanda.com Health Care M&A NEWS Volume 19, Issue 5 May 2014 INSIDE THE HEALTH CARE M&A MARKET $21 billion. Bayer (XE: BAYN) agreed to buy Merck’s (NYSE: MRK) over- the-counter drug products for $14.2 billion. Then there’s the $45.7 bil- lion surprise hostile bid from Valeant Pharmaceuticals (NYSE: VRX) and private equity firm Pershing Square for Allergan (NYSE: AGN), which promptly adopted a poison pill and started rumors flying that it could be looking for an acquisition of its own, with Irish drug maker Shire plc (NAS- DAQ: SHPG) as one potential target. Pharma mergers and acquisitions were big business in 2009, with 138 deals totaling $147 billion, and they IN THIS ISSUE Big Drug Deals Are Back Pfizer’s now-$106 billion bid for AstraZeneca has the business world buzzing. The deal has taken a hostile turn and the competition is watching. Could this spark a pharma feeding frenzy? Page 1 The Orthopedic Device Market’s Got Legs The Medical Device sector saw a drop in transactions and VC interest in the wake of the 2013 excise tax implementation. But a few big deals in the orthopedic sector have given the sector a jump start in 2014, and could signal the start of something big. Page 1 April M&A Activity Deal volume wasn’t the real story last month. Deal making stayed fairly steady. It was the dollar volumes that made April a stand-out month, so we’ve spelled it out in detail, by sector. Page 19 ... Departments Technology Deal Summaries Page 4 Additional Transactions Page 8 Health Care Technology Page 10 Services Deal Summaries Page 12 Additional Transactions Page 14 Health Care Services Page 17 BIG PHARMA IS BACK IN THE GAME DEAL MAKERS LOOK READY TO PARTY LIKE IT’S 2009 MED DEVICE MARKET SURGES MEGA-MERGER PUTS THE SPOTLIGHT ON ORTHOPEDICS (continued on page 10) (continued on page 2) T he medical device market got a shot in the arm in April, as Zimmer Holdings, Inc. (NYSE: ZMH) announced its acquisi- tion of Biomet, Inc., a privately-held neighbor in Warsaw, Indiana, the self- described “Orthopedic Capital of the World.” The total price of the transac- tion is $13.35 billion, with $10.35 in cash and $3 billion in Zimmer stock. The price of this single deal sur- passes the combined total spending in the Medical Device category in 2013, which came to approximately $11.9 billion. In the five years between 2009 and 2013, deal volume and value peaked with a high of 185 deals in 2010, and a healthy $65.8 billion in spending recorded in 2011. (See chart on page 2.) In the first four months of 2014, preliminary data show there have been 32 deals announced in the Medical Device sector, compared with 33 in the same period the year before. Thanks to the Zimmer-Biomet transaction, 2014’s four-month combined deal total stands at approximately $16.8 billion, versus just $2.7 billion in the 2013 time frame. Still, removing the Zimmer- Y ou’d have to be living under a rock not to have heard the news that, late last month, Pfizer Inc. (NYSE: PFE) made a $98 billion offer for AstraZeneca plc (NYSE: AZN), and then topped it with another offer of $106 billion when the first was rebuffed. The second was also rejected, and the game continues. If consummated, it would be the largest pharmaceutical deal since 2009, when Pfizer paid $68 billion for Wyeth, Inc. Two days earlier, GlaxoSmith- Kline (NYSE: GSK) and Novartis (NYSE: NVS) announced they were trading business units, in a transaction with a combined total of approximately
Transcript
HealthCareMandA www.healthcaremanda.com
Health Care M&ANEWS
Volume 19, Issue 5May 2014
InsIde the health Care M&a Market
$21 billion. Bayer (XE: BAYN) agreed to buy Merck’s (NYSE: MRK) over-the-counter drug products for $14.2 billion. Then there’s the $45.7 bil-lion surprise hostile bid from Valeant Pharmaceuticals (NYSE: VRX) and private equity firm Pershing Square for Allergan (NYSE: AGN), which promptly adopted a poison pill and started rumors flying that it could be looking for an acquisition of its own, with Irish drug maker Shire plc (NAS-DAQ: SHPG) as one potential target.
Pharma mergers and acquisitions were big business in 2009, with 138 deals totaling $147 billion, and they
IN THIS ISSUEBig Drug Deals Are Back
Pfizer’s now-$106 billion bid for AstraZeneca has the business world buzzing. The deal has taken a hostile turn and the competition is watching. Could this spark a pharma feeding frenzy? Page 1
The Orthopedic Device Market’s Got Legs
The Medical Device sector saw a drop in transactions and VC interest in the wake of the 2013 excise tax implementation. But a few big deals in the orthopedic sector have given the sector a jump start in 2014, and could signal the start of something big. Page 1
April M&A Activity
Deal volume wasn’t the real story last month. Deal making stayed fairly steady. It was the dollar volumes that made April a stand-out month, so we’ve spelled it out in detail, by sector. Page 19
Big Pharma is Back in the gameDeal Makers look reaDy to Party like it’s 2009
med device market surgesMega-Merger Puts the sPotlight on orthoPeDics
(continued on page 10)
(continued on page 2)
The medical device market got a shot in the arm in April, as Zimmer Holdings, Inc.
(NYSE: ZMH) announced its acquisi-tion of Biomet, Inc., a privately-held neighbor in Warsaw, Indiana, the self-described “Orthopedic Capital of the World.” The total price of the transac-tion is $13.35 billion, with $10.35 in cash and $3 billion in Zimmer stock.
The price of this single deal sur-passes the combined total spending in the Medical Device category in 2013, which came to approximately $11.9 billion. In the five years between
2009 and 2013, deal volume and value peaked with a high of 185 deals in 2010, and a healthy $65.8 billion in spending recorded in 2011. (See chart on page 2.)
In the first four months of 2014, preliminary data show there have been 32 deals announced in the Medical Device sector, compared with 33 in the same period the year before. Thanks to the Zimmer-Biomet transaction, 2014’s four-month combined deal total stands at approximately $16.8 billion, versus just $2.7 billion in the 2013 time frame. Still, removing the Zimmer-
You’d have to be living under a rock not to have heard the news that, late last month,
Pfizer Inc. (NYSE: PFE) made a $98 billion offer for AstraZeneca plc (NYSE: AZN), and then topped it with another offer of $106 billion when the first was rebuffed. The second was also rejected, and the game continues. If consummated, it would be the largest pharmaceutical deal since 2009, when Pfizer paid $68 billion for Wyeth, Inc.
Two days earlier, GlaxoSmith-Kline (NYSE: GSK) and Novartis (NYSE: NVS) announced they were trading business units, in a transaction with a combined total of approximately
This publication is not a complete analysis of every material fact regarding any company, industry or security. Opinions expressed are subject to change without notice. Statements of fact have been obtained from sources considered reliable but no representation is made as to their completeness or accuracy. POSTMASTER: Please send address changes to Health Care M&A News, 268-1/2 Main Avenue, Norwalk, CT 06851.
Biomet deal from the equation leaves a total of $3.4 billion, which bests the four-month total seen in 2013.
Most industry observers credit the 2.3% excise tax on medical device companies as the cause of the M&A slowdown. But with the Zimmer-Biomet mega-merger, things could be turning around, at least in the orthopedic device segment, where those companies compete with the likes of Smith & Nephew plc (NYSE: SNN), Stryker Corporation (NYSE: SYK), Johnson & Johnson’s Synthes (NYSE: JNJ) and Wright Medical Group, Inc. (NASDAQ: WMGI). While more mergers among these rivals are unlikely, M&A in the orthopedic category could pick up in the wake of this billion-dollar deal.
“We’re going to see a continuation of acquisitions of smaller to mid-sized companies, with anywhere from under $500 million in revenues or a $2 billion market cap,” said Paul Teitelbaum, a managing director at Me-sirow Financial. “Wright Medical could potentially be an
acquisition candidate, though probably not at the current prices. It’s trading at a very high valuation, so it’s probably one of the reasons it hasn’t been bought.”
Wright Medical, which currently has a market cap around $1.5 billion, has been on its own acquisition trail. In January the company announced two deals simultane-ously, for global ortho company Solana Surgical, LLC (for $90 million) and the smaller foot-and-ankle product manufacturer OrthoPro, LLC (for $32.5 million). In Oc-tober 2013, it paid $75 million for Biotech International, a French manufacturer of surgical implants.
It’s the larger companies that have been making large purchases. Depending on their timing, they are probably not looking for more purchases, or may be looking to get back in action. Smith & Nephew is likely in the former category, since it made a $1.7 billion deal in February for ArthroCare Corp. (NASDAQ: ATRC). While that’s not a mega-deal, it will take some time to digest. In the latter category is Synthes, which was acquired in April 2011 for $21.3 billion by Johnson & Johnson.
Then there’s Stryker, with a market cap of $29.5 billion, which has been a serial acquirer in recent years. So far this year it has announced two deals: one for Pivot Medical, a U.S. device maker focused on hip arthroscopy procedures, for an undisclosed price; and one for German operating room equipment maker Berchtold Holding, AG for $172 million. In 2013, its four announced acquisi-tions totaled nearly $1.9 billion, including $1.65 billion for MAKO Surgical Corp. (NASDAQ: MAKO).
“In the next few years, Stryker is definitely going to be one that buys,” Teitelbaum said. “Smith & Nephew will be another one. Zimmer, too, although that probably won’t be in the next year, because the press release said the integration with Biomet is going to take until the first quarter of 2015. I wouldn’t be surprised if the integration
Medical Device M&A(continued from page 1)
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takes well into the second half of next year.”
What they’ll Be targeting
Their targets will be the smaller orthopedic compa-nies, particularly ones that fill in the holes left after the major acquisitions have been integrated. In the case of the Zimmer-Biomet deal, Teitelbaum said, “Together, I think they’re going to be a leader in the large bones, the large joints, trauma, fixation and reconstruction. But where they’re going to have a big hole is extremities. That’s one of the areas where the highest growth is, in orthopedics, because historically, it’s been underserved.”
Currently, the foot-and-ankle space is hot, and com-manding high multiples, he said, citing Wright’s purchase of OrthoPro and Stryker’s 2011 deal for Memometal Technology SA which, for $162 million, represented 5.4x revenue.
Other growth areas are in devices for the shoulder, hand-and-wrist and elbows. “There are lots of interesting companies in those areas that are still hanging out there, that are growing fairly well and have a bright future,” Teitelbaum added. Then there’s the private equity quotient. Biomet was
acquired in 2007 by Blackstone Group, KKR & Co., TPG and Goldman Sachs Group for about $11.3 billion. It was on its way to an initial public offering early this year when Zimmer stepped in. As The Wall Street Journal noted, in 2007 each of the PE companies pitched in $1.3 billion in cash, with the remainder covered with new debt, of which some $3 billion remained on its balance sheet.
There are many more orthopedic companies still out there that received “a ton of venture capital investment over the last 10 to 15 years,” Teitelbaum noted, that have produced some innovative and transformative products and procedures, such as total disk replacement and novel approaches to arthroplasty.
Some of those investors could be heading for the exit in the near future. One example was the May 2013 sale of Knee Creations, LLC, owned by one of the leading orthopedic PE firms, Viscogliosi Brothers, LLC, to Zim-mer for an undisclosed price.
This could be a better year for Medical Device trans-actions, if the first few months are any indication. It’s too early to say the market’s got legs. But there sure are a lot of feet and ankles to be tended to.
Page 4 May 2014Health Care M&A News
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deal summaries—technology Biotechnology
TARGET LISTING ACQUIRER LISTING DATE PRICEChatham Therapeutics, LLC Private Baxter International Inc. NYSE: BAX 4/2/2014 $70,000,000Chapel Hill, North Carolina Deerfield, Illinois
in Brief: Chatham is a clinical development-stage biotech company focused on novel gene therapy-mediated treatment for hemophilia. Bax-ter’s BioScience division is acquiring the company after a May 2012 collaboration to evaluate Chatham’s Biological Nano Particle platform.
in Brief: Shape Pharmaceuticals develops suberohydroxamic acid phenyl ester (SHAPE), a novel tissue-targeted HDAC inhibitor in a topical gel formulation to treat early-stage lymphoma. TetraLogic focuses on small-molecule therapeutics in oncology and infectious diseases.
California Stem Cell, Inc. Private NeoStem, Inc. AMEX: NBS 4/14/2014 $34,112,000Irvine, California New York, New York
in Brief: California Stem Cell has developed proprietary methods for the scalable product of high-purity human stem cells and their deriva-tives. NeoStem is working on stem cell-based therapies for anti-aging initiatives and building a network of adult stem cell collection centers.
in Brief: SCRA Technology Ventures is selling Selah Genomics, which provides advanced molecular and genomic diagnostic services to healthcare providers and the pharma industry. EKF designs, manufactures and sells diagnostic instruments and more in Europe and Ireland.
Sanofi CTRM business NYSE: SNY Aastrom Biosciences, Inc. NASDAQ: 4/21/2014 $6,500,000Bridgewater, New Jersey Ann Arbor, Michigan ASTM
in Brief: Sanofi is selling its cell therapy and regenerative medicine (CTRM) business to Aastrom, which develops multi-cellular therapies for patients with severe, chronic cardiovascular diseases. It gets the global commercial rights to three autologous cell therapy products.
Novartis global vaccine biz NYSE: NVS GlaxoSmithKline plc NYSE: GSK 4/22/2014 $5,250,000,000East Hanover, New Jersey Brentford, England
in Brief: NVS’ portfolio and pipeline products includes Bexcero, a new vaccine for the prevention of meningitis B, but excludes influenza vac-cines. The acquisition significantly expands GSK’s vaccine portfolio and pipeline, specifically in meningitis.
Andromeda Biotech Ltd. TASE: CBI Hyperion Therapeutics, Inc. NASDAQ: 4/24/2014 $20,350,000Israel South San Francisco, California
in Brief: Andromeda is a subsidiary of Clal Biotechnology Industries, Ltd. and is focused on the development of DiaPep277, an immune inter-vention therapy for new onset Type 1 diabetes, an orphan indication.
iPerian, Inc. Private Bristol-Myers Squibb NYSE: BMY 4/29/2014 $175,000,000South San Francisco, California New York, New York
in Brief: BMY is acquiring iPerian to gain full rights to its lead asset, IPN007, an innovative preclinical monoclonal antibody that represents a new approach to treat progressive supranuclear palsy and other Taupathies, a class of neuro-degenerative diseases.
deal summaries—technology medical devices
TARGET LISTING ACQUIRER LISTING DATE PRICEAccessClosure, Inc. Private Cardinal Health Inc. NYSE: CAH 4/2/2014 $320,000,000Santa Clara, California Dublin, Ohio
in Brief: AccessClosure makes and distributes the Mynx product line of vascular closure devices. This acquisition gives Cardinal Health entry in the U.S. interventional cardiology area, and expands its portfolio of preferred items for its physicians.
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deal summaries—technology Pharmaceuticals
TARGET LISTING ACQUIRER LISTING DATE PRICESilom Medical Company, Ltd. Private Actavis plc NYSE: ACT 4/1/2014 $100,000,000Phaya Thai, Thailand Parsippany, New Jersey
in Brief: Silom Medical is one of Thailand’s leading generic pharmaceutical companies. The acquisition elevates Actavis into a top-five posi-tion in the Thai generic market, with leading positions in the ophthalmic and respiratory categories and a strong cardiovascular franchise.
in Brief: Questcor focuses on treatments for patients with serious, difficult-to-treat autoimmune and inflammatory disorders. Shareholders will receive $30.00 in cash and 0.897 Mallinckrodt shares, for a total consideration of $86.10 per share.
Ranbaxy Laboratories Ltd. Private Sun Pharma BSE: 524715 4/7/2014 $4,000,000,000New Delhi, India Mumbai, India
in Brief: Ranbaxy Laboratories is a generic drug manufacturer whose largest shareholder, Japan’s Daiichi Sankyo Co. agreed to an all-stock transaction from Sun Pharma. Ranbaxy has been plagued by factory quality problems that got its drugs barred from the United States market.
Topotarget A/S NASDAQ: BioAlliance Pharma SA Paris: BIO 4/16/2014 $108,000,000Copenhagen, Denmark TOPO Paris, France
in Brief: Topotarget develops oncology products. Its lead drug candidate, belinostat, has shown positive results in the treatment of hematologi-cal malignancies and solid tumors. Once the deal is completed, TOPO shareholders will own one-third of the shares of the merged company.
in Brief: Under terms of the agreement, Epirus will merge with a wholly-owned subsidiary of Zalicus in an all-stock transaction, after which Zalicus will be renamed Epirus Biopharmaceuticals, Inc.
GSK’s oncology business NYSE: GSK Novartis Corporation NYSE: NVS 4/22/2014 $16,000,000,000Brentford, England East Hanover, New Jersey
in Brief: GlaxoSmithKline is selling the rights to its currently marketed oncology portfolio, related R&D activities and its AKT inhibitor still in development, as well as preferred partner rights for future commercialization of GSK oncology products.
Rights to migraine treatment Private Endo Health Solutions Inc. NASDAQ: 4/24/2014 $85,000,000San Diego, California Malvern, Pennsylvania ENDP
in Brief: Zogenix, Inc. is selling the worldwide rights to its needle-free delivery system for sumatriptan. With this acquisition, ENDP enhances its portfolio of branded products for the treatment of pain and migraine headaches.
deal summaries—technology medical devices (cont’D)
TARGET LISTING ACQUIRER LISTING DATE PRICEBiomet, Inc. Private Zimmer Holdings, Inc. NYSE: ZMH 4/24/2014 $13,350,000,000Warsaw, Indiana Warsaw, Indiana
in Brief: Biomet designs, manufactures and markets surgical and non-surgical products used primarily by orthopedic surgeons and other mus-coloskeletal medical specialists. The acquisition is expected to add double-digit accretion to Zimmer’s adjusted diluted earnings in the first year.
Aïmago SA Private Novadaq Techologies, Inc. TSX: NDQ 4/24/2014 $10,000,000Lausanne, Switzerland Mississauga, Ontario
in Brief: Aïmago’s lead product is designed for pre-diagnostic uses, able to provide perfusion imaging on the skin’s surface without adminis-tering an imaging agent. It complements Novadaq’s technology, which provides detailed quantitative vascular blood flow capabilities.
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additional transactions—technology SECTOR TARGET ACQUIRER DATEBIOTECHNOLOGY Rights to Fleximer technology Millennium Pharmaceuticals, Inc. 4/7/2014 GnuBIO Bio-Rad Laboratories, Inc. 4/11/2014 Shanghai PrimeGene Bio-Tech Co. Techne Corporation 4/15/2014 BriaCell Therapeutics Corp. Ansell Capital Corp. 4/17/2014
eHEALTH Assets of TransEngen Inc. ZirMed 4/3/2014 Dynamic Vault, LLC Lightbeam Health Solutions, LLC 4/7/2014 CHCA Computer Systems Inc. GE Healthcare IT and Performance 4/15/2014 MDdatacor, Inc. Symphony Technology Group 4/16/2014 konciergeMD Accolade 4/28/2014 MEDICAL DEVICES License to fiber optic sensors Abiomed, Inc. 4/15/2014 Intelligent Hospital Systems Van Humbeck family 4/16/2014 Inspiro Medical Ltd. OPKO Health, Inc. 4/17/2014 Technologies from Gleveigh Medical Clinical Innovations, LLC 4/22/2014
PHARMACEUTICALS Alvogen Pamplona Capital Management LLP 4/2/2014 ChondroCelect Swedish Orphan Biovitrum AB 4/3/2014 Rights to Zertane Vyrix Pharmaceuticals 4/10/2014 Rights to oral formulation Moberg Pharma AB 4/14/2014 4 products from Akorn, Inc. Actavis plc 4/17/2014 License agreement with Agenus Inc. Merck 4/28/2014 Grupo Farmaceutico Somar Endo Health Solutions Inc. 4/29/2014
deal summaries—technology Pharmaceuticals (cont’D)TARGET LISTING ACQUIRER LISTING DATE PRICE Global rights agreement Private Celgene Corporation NASDAQ: 4/24/2014 $710,000,000Dublin, Ireland Summit, New Jersey CELG
in Brief: Nogra Pharma Limited and Celgene have entered into a global license agreement to develop and commercialize GED-0301, a drug candidate to treat moderate-to-severe Crohn’s disease and other indications.
Insight Pharmaceuticals, LLC Private Prestige Brands Holdings NYSE: PBH 4/25/2014 $650,000,000Trevose, Pennsylvania Tarrytown, New York
in Brief: Insight Pharmaceuticals markets and distributes feminine care and OTC healthcare brands. Prestige is paying $750 million in cash, and will acquire tax attributes with a present value of $100 million, resulting in an effective purchase price of $650 million.
Furiex Pharmaceuticals, Inc. NASDAQ: Forest Laboratories, Inc. NYSE: FRX 4/28/2014 $1,100,000,000Morrisville, North Carolina FURX New York, New York
in Brief: Forest Labs will pay $95 per share, approximately $1.1 billion in cash, and up to $30 per share, approximately $360 million in aggre-gate, in a Contingent Right Value that may be payable based on the status of Furiex’ lead drug candidate, eluxadoline, following approval.
think revista for real estate information
The first real estate database for medical office buildings (MOBs), hospitals and other health care real estate properties will be launched this month with its Northeast property online database, followed by a full national launch.
If you want to know the affiliation of a hospital, the total square feet of an MOB, the last time it sold or where it is located, www.revistamed.com is the place to
go. And the best news is that it is free, thanks to founding partners Healthcare Trust of America (NYSE: HTA), Health Care REIT, Inc. (NYSE: HCN), Raymond James Financial, Inc. (NYSE: RJF) and Surface Logic.
Revista will be doing much more in the future, in-cluding seminars, conferences, webcasts as well as metro and regional market reports. In fact, their first event is the Northeast Data Launch & Networking Roundtable, in Boston on May 20. The Revista National Launch Event will be held in Chicago in November.
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1/23 Build or Join an ACO—Don’t Let This Opportunity Pass You By!
2/13 Continuing Care At Home: A Way To Broaden Your Reach
Health Care Technology NewsCalling April an active month in mergers and acqui-
sitions would hardly do it justice, from the Technology segment’s point of view. Three of the four sectors had at least one billion-dollar transaction, and Pharma had four multi-billion-dollar deals. The laggard was the eHealth sector, which is seeing consolidation among smaller, pri-vate companies that do not disclose prices, typically. And with the federal government’s stunning postponement of the implementation of the ICD-10 coding system until October 2015, we’re not expecting a lot of action in this sector in the near future.
Biotechnology
The big news in this sector is the nearly $5.3 billion deal announced by GlaxoSmithKline plc (NYSE: GSK) for the global vaccine business of Novartis (NYSE: NVS), just one side of a multi-billion-dollar swap an-nounced by both companies on April 22. In this part of the transaction, Novartis is selling its vaccine portfolio and pipeline, including Bexcero, a new vaccine for the prevention of meningitis B. The sale excludes its influ-enza vaccines. The acquisition will significantly enhance the breadth of GSK’s vaccines portfolio and pipeline, specifically in meningitis treatments. It also strengthens GSK’s manufacturing network and reduces supply costs. Lazard and Zaoui & Co. served as advisors to GSK, as well as Citi and Arkle Associates. The transaction is expected to close in the first half of 2015.
While that deal seemed to grab the spotlight, some other interesting moves were announced. Baxter Inter-national (NYSE: BAX), which announced in March that it plans to spin off its biotech business next year, acquired Chatham Therapeutics, LLC for $70 million. Chatham, based in Chapel Hill, North Carolina, is fo-cused on developing novel, gene therapy-mediated treat-
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(continued on page 14)
Big Pharma Is Back in the Game(continued from page 1)may have taken a toll on deal volume in the following years. By 2012, M&A had plummeted to just 103 deals and $38 billion. Hindsight being 20/20, it looks like that was the Year of the Bargain Hunter.
Sure, deal making recovered in 2013, with 151 deals and $67 billion. But Big Pharma mostly stayed out of the fray as smaller specialty and generics companies changed hands. The biggest buy in the sector was Amgen’s (NAS-DAQ: AMGN) $9.7 billion deal of Onyx (NASDAQ: ONXX). Sizeable, but not on the Big Pharma scale.
Back in January 2009, Pfizer kicked off the year with that $68 billion bid for Wyeth. By March, Merck had a $41.1 billion offer on the table for Schering-Plough. The next month, GSK announced a $3.6 billion deal for privately held Stiefel Laboratories. By the time the year ended, Johnson & Johnson (NYSE: JNJ), Warner Chilcott (NASDAQ: WCRX), Dainippon Sumitomo (T: 4506), Takeda (T: 4502) and Sanofi-Aventis (NYSE: SNY) had all joined the billion-dollar bidders club. In 2014, we know two of those companies became targets themselves. Be careful what you wish for.
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Behavioral Health CareBiopharmaceuticals Biotechnologye-HealthHealth Care ServicesHome Health CareHospitalsLaboratories, MRI and DialysisLong Term CareManaged CareMedical DevicesPharmaceuticalsPhysician Medical GroupsRehabilitation... and more!
The Most Up-to-Date Health Care and Seniors Housing M&A Database with 20,000 Deals in These Key Sectors:
in Brief: Senior Rehabilitation & Skilled Nursing Center was built in 1963, expanded in 1973, and remodeled in 2001 and 2011. The license is for 199 beds, but only 165 are operational. Occupancy on those operating beds was 84% with an 80% Medicaid and 4% Medicare census.
Rose Terrace Health & Rehab NASDAQ: Rose Terrace Acq., LLC Private 4/3/2014 $16,500,000Culloden, West Virginia DVCR West Virginia
in Brief: Diversicare Healthcare Services obtained a Certificate of Need for this skilled nursing facility in June 2009 and it opened on January 1, 2012. It cost just over $7.25 million to build.
Aspen Grove Private Publicly traded chain Public 4/9/2014 $14,600,000Lambertville, Michigan
in Brief: Aspen Grove is an assisted living and memory care community that was built in 2001. Occupancy is about 88% and it is located eight miles from Toledo, Ohio, which is considered to be its market. This was the only seniors property owned by the seller, a local CPA.
Shelbourne Personal Care Private Regional operator Private 4/10/2014 $2,000,000Butler, Pennsylvania Pennsylvania
in Brief: Shelbourn is licensed for 60 beds. It was built in 1965 and renovated in the late 1990s. It has 28,277 square feet on 11.4 acres. This facility was a strategic acquisition that fit operationally with the buyer’s smaller facilities in the state.
11 senior care facilities Private American Realty Capital NASDAQ: 4/14/2014 $104,000,000Various states New York, New York HCT
in Brief: A regional owner sold its entire portfolio of 10 skilled nursing facilities with 818 SNF beds and 58 assisted living beds, plus one independent living community with 67 units. There were two each in Iowa, Missouri and West Virginia, and five in Wisconsin.
4 senior care properties Private HealthLease Properties REIT TSX: HLP.UN 4/15/2014 $49,400,000Various states Toronto, Ontario
in Brief: This portfolio includes two skilled nursing facilities with 186 beds and two assisted living facilities with 179 beds. The average age of the properties is seven years. They were operated by Saber Healthcare Group.
University Village Private BVM Management Company Nonprofit 4/23/2014 $23,000,000Tampa, FLorida Indianapolis, Indiana
in Brief: University Village is a CCRC that is comprised of 492 independent living villas and apartments, 90 assisted living villas and apartments, 20 memory care units and 120 skilled nursing beds. Occupancy is believed to be close to 75%. The $23 million price is estimated.
TARGET LISTING ACQUIRER LISTING DATE PRICEIQumm, Inc. Private Roche SIX: RO 4/7/2014 $275,000,000Marlborough, Massachusetts Basel, Switzerland
in Brief: IQumm focuses on developing point-of-care products for the molecular diagnostics market. Its Lab-in-a-tube technology is a novel biological sample testing platform.
in Brief: Hooper Holmes is selling Heritage Labs International, LLC, which tests samples and supports insurers, and Hooper Holmes Services, which provides data collection, tele-interviewing and underwriting services.
deal summaries—services long-term care
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deal summaries—services long-term care (cont’D)
deal summaries—services managed care
TARGET LISTING ACQUIRER LISTING DATE PRICE
CDMI, LLC Private Magellan Health Services NASDAQ: 4/1/2014 $205,000,000Newport, Rhode Island Avon, Connecticut MGLN
in Brief: CDMI provides a range of clinical consulting programs and negotiates and administers drug rebates for managed care organizations and other customers. In 2013, it had net revenues of approximately $43 million.
TARGET LISTING ACQUIRER LISTING DATE PRICE
Somerby of Alpharetta Private Publicly traded REIT Public 4/25/2014 $83,500,000Alpharetta, Georgia
in Brief: This retirement community opened in December 2007 and reached 93% occupancy three years later. It has 16 villas, 187 independent living units, 56 assisted living units and 23 memory care units. Occupancy today is above 95%.
Park Place campus Private Sabra Health Care REIT NASDAQ: 4/30/2014 $23,800,000Fort Wayne, Indiana Irvine, California SBRA
in Brief: The Leo Brown Group is selling Park Place, a senior housing campus with a total of 140 units, comprised of 24 independent living units, 76 assisted living units and 40 memory care units. It opened in 2011 and is currently 100% occupied.
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SECTOR TARGET ACQUIRER DATE
HOME HEALTH & HOSPICE VNA-TIP Healthcare Celtic Healthcare, Inc. 4/1/2014 Professional Nursing Services LHC Group, Inc. 4/3/2014 St. Joseph Hospital Home Health LHC Group, Inc. 4/3/2014 TriStar Home Health and Hospice Viaquest, Inc. 4/10/2014 Life’s Doors Home Health and Hospice The Ensign Group, Inc. 4/11/2014
HOSPITALS Fairmont General Hospital Alecto Healthcare Services, LLC 4/1/2014 Community Memorial Healthcenter VCU Health System 4/10/2014
MANAGED CARE QualChoice Holdings, Inc. Catholic Health Initiatives 4/2/2014 Premier Access Insurance Company The Guardian Life Insurance Co. 4/9/2014 North American Partners in Anesthesia FOAA Anesthesia Services 4/14/2014
PHYSICIAN MED GROUPS Associates in Urology USMD Holdings, Inc. 4/16/2014 Fredericksburg Anesthesia Associates MEDNAX, Inc. 4/21/2014
REHABILITATION Oncology Rehab Partners McKesson Specialty Health 4/1/2014
OTHER Health Dialog Services Corporation Rite Aid Corporation 4/1/2014 Integrated Medical Systems International STERIS Corporation 4/1/2014 Take Care Employer Solutions, LLC Water Street Healthcare Partners 4/3/2014 Synchrogenix Information Strategies Arsenal Capital Partners 4/15/2014 RediClinic Rite Aid Corporation 4/10/2014 Dynamic Clinical Systems Press Ganey 4/28/2014
additional transactions—services
ments for hemophilia, investigating programs for both hemophilia A and B. In May 2012, Baxter and Chatham collaborated to evaluate Chatham’s Biological Nano Par-ticle platform as a potential treatment for hemophilia B, known as BAX 335, which is currently in a Phase 1/2 study. Even with the divestiture looming, this deal makes sense for Baxter, which has the broadest portfolio of he-mophilia treatments in the industry. More than half of its drug unit’s approximately $6 billion in revenue last year came from its treatments for hemophilia. Which means $70 million is pocket change.
Another Big Pharma name, Bristol-Myers Squibb Company (NYSE: BMY), made a deal for a specialty biotech. BMY agreed to pay $175 million for iPierian, Inc., a San Francisco-based biotech funded by Kleiner Perkins Caufield & Byers, MPM Capital, SR One, Highland Capital and Google Ventures. iPerian’s lead asset, IPN007, is a preclinical monoclonal antibody that could begin Phase 1 trials in progressive supranuclear palsy by early 2015. BMY could pay additional develop-ment and regulatory milestone payments totaling $550 million, along with future royalties on net sales.
(continued from page 10) ehealth
Only six deals have come to light in this sector in April, but there was an abundance of news regarding the growing interest in investing here. For example, digital health funding hit $1.35 billion in the first quarter of 2014, according to StartUp Health. That’s a good start on surpassing the $2.8 billion total for all of 2013. Al-though the number of capital raises in the first quarter dropped to 133 from 144 in the same quarter of 2013, the size of the deals more than doubled, from $599 million in Q1:13 to $1.359 billion.
Also in the first quarter, Castlight Health made a splash as the largest IPO of the year so far (at least un-til the Chinese internet company Alibaba goes public in a few months). Castlight raised more than $3.2 billion on an initial valuation of $1.4 billion on its first day of trading back in March. Investors were betting on the po-tential profits to be reaped from its main product, which is cloud-based price-transparency software to help em-ployers with healthcare costs, coverage and usage, and identifies where resource efficiency could be improved.
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One deal that caught our eye was GE Healthcare IT and Performance Solutions’ (NYSE: GE) acquisi-tion of CHCA Computer Systems, Inc., a privately held company in Montreal, Canada. CHCA is an operating room management and analytics solutions provider that developed the Opera software app to increase productiv-ity and “patient satisfaction” in the OR. GE already has a portfolio of OR and Perioperative software, and this acquisition will allow it to deliver a more integrated of-fering in the OR using software, real-time data and ana-lytics.
It’s also in keeping with GE Healthcare’s shift from servicing medical devices and equipment to boosting productivity throughout a hospital’s operations. The company is moving toward more analytics-based data and software, aiming to change behaviors, improve out-comes and reduce costs, as we heard GE Healthcare Services president and CEO Mike Swinford tell attend-ees at the Mid America Healthcare Venture Forum last month. His focus is on making acquisitions in potential hospital management businesses with logistics that help hospitals and health systems work more efficiently. “Ser-vices is the obvious area to drive down healthcare inef-ficiency and cost,” Swinford said in his keynote address. This is only the beginning, it seems.
medical devices
Yes, there was that $13 billion-plus deal between Zimmer (NYSE: ZMH) and Biomet, but this sector saw some other sizable deals last month. Cardinal Health (NYSE: CAH) shelled out $320 million for AccessClo-sure, Inc., a privately held manufacturer and distribu-tor of a line of vascular closure devices under the Mynx brand name. The deal gives Cardinal Health an entrance into the interventional cardiology market in the United States. AccessClosure is also the exclusive U.S. distribu-tor of the Flash Ostial System dual balloon angioplasty catheter. It had sales of $80 million in 2013.
OPKO Health, Inc. (NYSE: OPK) hasn’t been in the M&A news since April 2013. The multinational phar-ma company announced last month that it will acquire Inspiro Medical Ltd., an Israeli medical device compa-ny developing a new platform to deliver small molecule drugs such as corticosteroids and beta agonists or larger molecules to treat respiratory diseases. Its chief product is an easy-to-use dry powder inhaler to treat respiratory disorders. It operated within the Misgav Venture Accel-erator, with the Trendlines Group as its largest share-holder. Financial terms were not disclosed.
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Thursday, June 5, 2014, at 1:00 p.m. (Eastern)
Home Health & Hospice M&A: Consolidation Is In The Air
Pharmaceuticals
And now for the details on the other half of that GlaxoSmithKline/Novartis swap. While GSK paid $5 billion for Novartis’s meningitis vaccines and preclini-cal products, Novartis in turn agreed to pay $16 billion to GSK for the rights to its currently marketed oncology portfolio, related R&D activities and its AKT inhibitor now in development, as well as preferred partner rights for future commercialization of GSK oncology products. GSK retains its early-stage R&D pipeline and discovery capability, as well as certain product rights outside of oncology. Again, Lazard and Zaoui & Co. were GSK’s advisors, as well as Citi and Arkle Associates.
The billion-dollar deals kept coming, as Questcor Pharmaceuticals, Inc. (NASDAQ: QCOR) agreed to be acquired by Mallinckrodt plc (NYSE: MNK) for $5.6 billion. Questcor is a high-growth biopharma com-pany focused on patients with serious, difficult-to-treat autoimmune and inflammatory disorders. Its sharehold-ers will receive $30.00 in cash and 0.897 Mallinckrodt shares, for a total cash consideration of $86.10, which represents a 33% premium over Questcor’s trailing 20-trading-day, volume-weighted average price. After the closing, former QCOR shareholders will own 49.5% of the company. Barclays was MNK’s financial advi-
sor in the transaction, and Wachtell, Lipton, Rosen & Katz and Arthur Cox in Ireland were its legal advisors. Questcor’s financial advisor was Centerview Partners and its legal advisors were Latham & Watkins LLP and Metheson in Ireland.
Then there was Sun Pharmaceutical Industries’ (BSE: 524715) $4 billion all-stock buyout of the strug-gling Ranbaxy Laboratories Ltd. (BSE: 500359), which is majority-owned by Japan’s Daiichi Sankyo Co. (Tokyo:4568). In the transaction, Ranbaxy’s sharehold-ers will receive 0.8 share of Sun Pharma for each share. Ranbaxy’s problems with manufacturing in India got its generics banned from the U.S. market. With this acqui-sition, Sun Pharma becomes the fifth-largest specialty generics company in the world, and the largest phar-maceutical company in India. The combined entity will have operations in 65 countries, 47 manufacturing facili-ties and a significant portfolio of specialty and generic products, including 629 Abbreviated New Drug Applica-tions (ANDAs). Sun expects to realize revenue and op-erating synergies of $250 million, primarily from topline growth, procurement and supply chain efficiencies, by the third year following the closing of the transaction. Citi and Evercore are acting as financial advisors to Sun Pharma, while Shearman & Sterling LLP, Crawford Bayley & Co. and S.H. Bathiya & Associates are act-
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ing as Sun’s legal advisors. Ranbaxy’s financial advisor is ICICI Securities and its legal advisors are Luthra & Luthra Law Offices and Amarchand & Mangaldas & Suresh A. Shroff & Co. Daiichi Sankyo’s financial ad-visor is Goldman Sachs and its legal advisors are Davis Polk & Wardwell LLP and Amerchand & Mangaldas & Suresh A. Shroff & Co.
Forest Laboratories (NYSE: FRX), which is in line to be acquired by Actavis plc (NYSE: ACT) for $25 billion, last month announced an acquisition of its own—and its second this year. This one involves Furiex Pharmaceuticals, Inc. (NASDAQ: FURZ), a drug de-velopment collaboration company, which was reportedly looking for a buyer in March, with the help of Bank of America. Bloomberg suggested its gastrointestinal drugs would be a good fit for Salix Pharmaceuticals. Obvi-ously, that rumor didn’t pan out.
Forest will pay $95 per share, or approximately $1.1 billion. In addition, Furiex shareholders could receive up to $30 per share in a Contingent Value Right (approxi-mately $360 million in aggregate), that may be payable based on the status of eluxadoline, Furiex’s lead prod-uct, as a controlled drug following approval. At the same time, Forest announced that it has entered into an agree-ment with Royalty Pharma, the spurned hostile bidder in last year’s battle for Elan Corporation, to sell Fu-riex’s royalties on alogliptin and Priligy for approximate-ly $415 million upon successful completion of the Furiex acquisition. Forest’s deal for Furiex is not contingent on its agreement with Royalty Pharma. Covington & Bur-ling LLP served as Forest’s legal counsel. Furiex was advised by Kirkland & Ellis LLP and Wyrick Robbins Yates & Ponton LLP, and Royalty Pharma was advised by Goodwin Procter LLP. BofA Merrill Lynch and Credit Suisse acted as financial advisors to Furiex.
And Actavis, which seems to announce at least one transaction per month, isn’t sitting around waiting for the Forest deal to clear. It announced its expansion into Southeast Asia with the $100 million acquisition of Si-lom Medical Company, Ltd., a leading generic pharma-ceutical company in Thailand. The acquisition elevates Actavis to the top-five tier in this generic drug market.
It also paid an undisclosed amount for four products from Akorn, Inc., although the closing is contingent on the consummation of Akorn’s $640 million acquisition of Hi-Tech Pharmacal Co., announced in August 2013.
Health Care Services NewsDeal making dried up last month. We’ve recorded
just 32 announcements in April, compared with 48 in March and 47 in April 2013. The largest factor is the sudden slowdown in Long-Term Care transactions, with only nine announcements last month compared with 25 in the previous month. That’s not a great surprise, given the record-breaking fourth quarter and still-hot first quar-ter of this year for M&A in the sector. It was time for investors to stop and take a deep breath, apparently.
laBoratories, mri & dialysis
Roche (SIX: RO) paid $275 million for IQuum, Inc., a privately held company that has developed a sys-tem aptly named Lab-in-a-tube, a novel biological sample testing platform. The moat around IQuum’s castle is its focus on point-of-care offerings for the molecular diag-nostics market. Once the transaction is complete, IQuum will be integrated into Roche Molecular Diagnostics.
long-term care
The largest transaction announced in this sector was a mere $104 million, a paltry sum following the billion-
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The Month in M&A at a Glance:Health Care Services, April 2014
Sector Deal Volume Combined PriceLong-Term Care 9 $324,340,000Labs, MRI & Dialysis 3 278,700,000Managed Care 3 205,000,000Behavioral Health Care 0 —Home Health & Hospice 5 —Hospitals 1 —Physician Medical Groups 1 —Rehabilitation 0 —Other 6 —Total 28 $808,040,000
dollar sums recorded in previous months. American Realty Capital Healthcare Trust (NASDAQ: HCT), which became a publicly traded REIT on April 7, ac-quired 11 senior care facilities across Iowa, Missouri, West Virginia and Wisconsin. The portfolio consists of 10 skilled nursing facilities with 818 SNF beds and 58 assisted living beds, and one independent living com-munity with 67 units. ARC purchased these assets and has leased them to Illinois-based Platinum Health Care. Occupancy of the portfolio is about 82%, with 20% of the revenues from Medicare, 25% from private pay and the rest primarily from Medicaid.
HealthLease Properties REIT (TSX: HLP.UN) also made a multi-location deal for four senior care prop-erties in North Carolina, Pennsylvania and Virginia, for $49.4 million. The portfolio includes two skilled nursing facilities with 186 beds and two assisted living facilities with 179 beds. The average age of the properties is seven years. The seller was Virginia-based Smith Packett.
managed care
With three deals announced in this sector last month, we could say it’s positively jumping. Magellan Health Services (NASDAQ: MGLN) paid $205 million for
CDMI, LLC, which offers a range of clinical consulting programs as well as negotiates and administers drug re-bates for managed care organizations and other custom-ers. Catholic Health Initiatives, through its subsidiary Collab Health, executed a stock-purchase agreement with QualChoice Holdings, parent company of HMO QCA Health Plan, Inc. and QualChoice Life and Health Insurance Company. Separately, Guardian Life Insurance Company paid an undisclosed amount for dental insurer Premier Access Insurance Company. The deal strengthens its existing Dental PPO and Dental HMO plans.
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aPril is the cruelest monthtechnology Deals rack uP Big Dollars as services Deals sliDe
April deal volume was about on par with the pre-vious month, when there were at least 73 deals announced, by our preliminary total. That’s only
off by 6% compared with 78 deals reported in March 2014, and about 1% better than the 72 deals in April 2013.
The dollar values are another story, however, and that is why we decided to share them with you this month, rather than the usual deal volume. Last month’s total of $48.5 billion was more than 1000% better than the previous month’s total of $4.2 billion, and still 138% better than April a year ago.
Service transaction values tanked, to just $808 mil-lion, largely due to the collapse of M&A activity in the Long-Term Care sector. Deal volume in LTC has been scorching in the last two quarters, with 65 deals in Q4:13,
Deal Value, April vs. March 2014 and April 2013 Apr-14 Mar-14 Apr-13 $$ $$ Change $$ ChangeServices Behavioral Health Care $0 $0 $91,800,000 Home Health & Hospice $0 $0 $34,425,000 Hospitals $0 $0 $1,186,500,000 Labs, MRI & Dialysis $278,700,000 $3,600,000 7642% $0 Long-Term Care $324,340,000 $1,841,879,000 -82% $429,375,000 -24%Managed Care $205,000,000 $0 $0 Physician Medical Groups $0 $2,400,000 -100% $0 Rehabilitation $0 $0 $1,188,900 -100%Other $0 $363,500,000 -100% $1,000,000,000 -100%Services subtotal $808,040,000 $2,211,379,000 -63% $2,743,288,900 -71%Technology Biotechnology $5,608,962,000 $823,500,000 581% $15,580,000,000 -64%eHealth $0 $8,650,000 -100% $105,000,000 -100%Medical Devices $13,681,500,000 $2,300,000 594748% $1,344,700,000 917%Pharmaceuticals $28,384,652,000 $1,206,540,608 2253% $590,600,000 4706%Technology subtotal $47,675,114,000 $2,040,990,608 2236% $17,620,300,000 171%Grand total $48,483,154,000 $4,252,369,608 1040% $20,363,588,900 138%Source: Health Care M&A News, May 2014
and 60 deals in Q1:14. Deal makers were understand-ably played out by April, when just nine LTC deals were announced. The Hospital sector was hot in April 2013, although its $1.2 billion total was due to a single deal, when Catholic Health Initiatives acquired St. Luke’s Episcopal Health System.
Pharma deals played a major role in boosting last month’s total, thanks to Novartis’ (NYSE: NVS) offer of $16 billion for GlaxoSmithKline’s (NYSE: GSK) on-cology business, as well as three other billion-dollar-plus deals in the sector. There’s more to come, if you believe that Pfizer (NYSE: PFE) will succeed with its now-hos-tile stalking of AstraZeneca (NYSE: AZN) and Aller-gan (NYSE: AGN) trying to evade Valeant’s (NYSE: VRX) clutches. It’s getting so you can’t tell the players without a program these days.
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