People who make a living creating innovative medical devices—whether it’s an ultrasound diagnostic tool, a stent to prop open clogged arteries, or an MRI machine—are an unhappy bunch these days.
Let us count the ways, as described in the second annual medical device industry analysis being released today by Ernst & Young. Because unemployment is up, people are losing their employer-sponsored health insurance. That means patients are postponing elective medical procedures, and hospitals and government payers are tightening their budgets. A powerful U.S. Senator, Max Baucus, wants to raise $40 billion in taxes on the medical device industry; healthcare reformers like President Obama are talking about comparative effectiveness studies that would add time and expense to device development; and lawmakers are considering whether to require companies to disclose all gifts and payments to doctors who help develop and buy their products.
Those are the megatrends medical device companies have to deal with in this recession, but what does the data say about how they’re being affected? Here are some highlights that caught my eye in this 60-page report:
—Despite the recession, revenues of publicly traded medical technology companies in the U.S. and Europe actually climbed 11 percent to $289 billion (although the growth was only about half that much when factoring out foreign-exchange rate fluctuations and acquisitions).
—While Johnson & Johnson, Medtronic, and Boston Scientific appear to be performing fine, that’s not so much the case for the smaller players that create most of the innovations the big boys acquire to keep growing. U.S. and European medical technology companies saw total industry financing drop 38 percent in 2008—although when E&Y subtracted two big European deals, the numbers looked a lot worse, with financing down 44 percent in Europe and 53 percent in the U.S. “One area where the growing chasm between medtech’s haves and have-nots is most visible is in fundraising,” the report says.
—Mergers and acquisitions, which are usually the only way medical device startups can make returns for their investors, showed a big-time decline in 2008. There were just 79 deals in 2008, down about 41 percent from the prior year.
—The IPO market was basically flat-lining, with medical device companies raising a puny $135 million through initial public stock offerings, out of $9.2 billion in total financing for the industry. A shocking 16 medical device companies withdrew their IPO statements during 2008, and IPO financing dropped 93 percent from the prior year, according to the report.
It’s little wonder why some of the nation’s pioneering medical device executives and entrepreneurs are fuming about what’s happening to their industry. Boston Scientific CEO Ray Elliott has been quoted as saying Sen. Max Baucus’ proposal for a $40 billion tax on medical device companies is “nonsensical.” David Auth, the prominent Seattle area inventor who once sold a company to Boston Scientific for more than $500 million, told me last month that things have gotten so bad that he has almost stopped investing in the medical device sector. Auth says he can’t imagine how startups can generate returns anymore.
The Ernst & Young report mentions most of these factors, but still tried to paint a somewhat rosier picture. It cited the usual market forces of an aging population, large demand from patients with unmet needs, and economic growth in emerging markets. “As a society, we are certain to need medtech innovation,” the report states.
Since medical devices are an important part of the local innovation clusters Xconomy covers in Boston, Seattle and San Diego, I was especially keen to look for any regional data from Ernst & Young. There wasn’t nearly as much here as E&Y usually gathers on the biopharmaceutical clusters around the country, but there were still some interesting factoids.
—Geography matters. Of the 969 public and venture-backed medical device companies in the U.S., more than half (52 percent) were in California, Massachusetts, and Minnesota. Drilling down a little more specifically, the standout hotspots for medical devices are the San Francisco Bay Area, Orange County, CA, San Diego, Boston, and Minneapolis-St. Paul. (The report’s authors didn’t share the love for Seattle, which some locals like to call the “Silicon Valley of ultrasound.”
—The thriving hubs tended to have a few critical factors in common, according to the report. They all have a population of skilled scientists and managers; strong access to capital in terms of venture backing and banking; and a robust network of support institutions like hospitals, universities, and suppliers.
—In terms of the numbers, Northern California has the biggest concentration of medical device makers by far, with 186 venture-backed companies and 33 public companies. Southern California (a combination of Orange County and San Diego in this report) had 82 venture-backed companies and 41 public firms. Third place went to Massachusetts with 66 venture-backed device makers and 39 public companies. My home state of Washington ranked way down the list in tenth place, with 24 venture-backed companies and five public companies. I guess the problem with ultrasound is that most people can’t hear it.
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