According to a report by evaluatemedtech, few mergers and acquisitions were completed in the first six months of 2020. Their average size is $108 million and their total value is less than $2 billion, the lowest point in the past decade. It can even be called the biggest pigeon for medical M & A in 2020. Qiagen saw the global hot demand for diagnosis during the epidemic. Therefore, it was completely unable to satisfy its appetite for the $11.5 billion quotation given by Thermo Fisher. Qiagen did not hesitate to refuse the olive branch thrown by Thermo Fisher.

Fortunately, after June, teladoc and Siemens have injected a booster into the cold trading market, and the trading market is rejuvenated.

The following is the most important transaction of shengshida medical finishing 2020.

[01] teladoc and livongo

Teladoc's acquisition of livongo is undoubtedly the heaviest transaction event in 2020. This transaction involving US $18.5 billion is also the largest transaction in 2020.

Livongo was founded in 2008 and listed on IPO in 2019. Its main business is to use digital technology and intelligent devices to help slow patients (mainly diabetes) manage their disease and provide services to 30% of Fortune 500 companies.

Teladoc was founded in 2002 and went public with IPO in 2015. It has established a telemedicine technology platform so that patients can conduct remote consultation with doctors who join the technology platform through video. During the epidemic, teladoc's business soared, its revenue increased by 125%, and the number of virtual nursing visits tripled in the second quarter. The acquisition was completed in late October, and livongo became a subsidiary of teladoc.

The two companies suddenly announced the transaction, which surprised the market and excited the market. Whether it is worth $18.5 billion needs to be evaluated by time.

[02] Siemens and Varian

Siemens' acquisition of Varian is definitely the most sensational transaction, although the amount is not the highest. When Siemens announced its acquisition of Varian with us $16.4 billion in all cash in early August, it was clear that the domestic medical circle was boiling. Siemens and Varian were embarrassed to say that they were mixed medical circles.

Siemens is a member of GPS and has long dominated the top ten medical device companies in the world. Varian is the global leader in the field of tumor radiotherapy. Varian has installed more than 8000 sets of radiotherapy systems worldwide, accounting for more than 50% of the global radiotherapy market share. The acquisition means that Siemens will enter the tumor radiotherapy market, and the two sides will achieve strong alliance in the fields of imaging diagnosis, in vitro diagnosis and interventional therapy, so as to become a new aircraft carrier in the field of medical and health care.

Siemens and Varian businesses can form strong complementarities and form a one-stop service for tumor patients from diagnosis to treatment. At the same time, through technical integration, more advanced integrated treatment equipment may be developed. Xiaobian is as good as everyone. This transaction also looks forward to a spark between Siemens and Varian at the level of medical technology.

[03] Illumina and Grail

In September, Illumina and grail announced that they had reached a final acquisition agreement with a cash and stock consideration of $8 billion at the completion of the transaction. This transaction can be called "remarriage". Grail is a cancer screening startup separated from Illumina in 2016. Illumina has granted grail many privileges for this "remarriage", and grail will operate as an independent department in Illumina. Grail's shareholders can continue to enjoy part of the revenue from grail related businesses. Illumina can give so many privileges because of Grail's own strength (after all, the major shareholders are the same group).

The acquisition of grail aims to accelerate the commercialization process and promote the market to adopt more innovative multi cancer screening methods, which provides unlimited possibilities for early cancer screening and overall optimization of clinical results. In the future, Illumina will continue to maintain its leading position in the gene side field and push up the stock price. For major shareholders, it is the best deal to be able to enjoy dividends for many times (both fame and wealth).

[04] Shrek and Wright medical

This is a record transaction, breaking the transaction record since the establishment of Shrek. This $4.7 billion transaction enables Stryker to continue to stabilize and break through its share in the orthopaedic market, and further achieve its No.1 goal in the orthopaedic field.

Founded in 1950, Wright medical is a global medical device company focusing on limbs and biological agents. It provides surgical solutions for upper limbs (shoulder, elbow, wrist and hand), lower limbs (foot and ankle) and biological agents, which are also the three faste

st growing areas in the orthopaedic market. It was once favored by minimally invasive and obtained its "joint reconstruction business", which once made minimally invasive breathless. Fortunately, it has been digested and absorbed in recent years, and minimally invasive has regained its vitality.

Of course, it's not difficult to digest Wright medical, such as Shrek. It's rare how to 1 + 1 > 2.

Although the businesses of the two companies overlap, they are more complementary. Wright medical has the advantages of biological bone filler products, and Stryker has the expertise of surgical robots. Xiaobian is more optimistic about the realization of 1 + 1 > 2.

[05] Philips and biotelemetry

This year, Philips completed two transactions. The transaction with biotelemetry is the largest transaction since the US $5.1 billion acquisition of ventilator company Respironics. The transaction cost Philips $2.8 billion.

Biotelemetry specializes in remote cardiac diagnosis and monitoring. Its products include wearable cardiac monitors and AI based data analysis and services. It is to obtain the patient's data in real time, upload it to the cloud, analyze it in real time, and directly notify the patient's doctor if any abnormality is found. If the patient does not know it, he can get the necessary treatment and services in time.

This transaction will further expand Philips's business from hospital to family. Especially in the case of epidemic abuse, family medical treatment will become more and more urgent (after all, many hospitals and outpatients are not open), and telemedicine will be close to the dilemma of being unable to seek medical treatment. At the same time, the epidemic situation may also change people's medical concept. Some diseases do not necessarily need to go to the hospital or outpatient service, and telemedicine can also be treated. It can be said that this acquisition of Philips is in the layout of the future.

[06] exact sciences and thrive

Less than two months after Illumina acquired grail, two liquid biopsy development companies, exact sciences and thrive, announced the transaction. Exact sciences acquired thrive for us $2.15 billion. This acquisition will combine thrive's early screening and detection - cancerseek, with the scientific platform, clinical organization and commercial infrastructure of exact sciences to build a leading company in blood based multi tumor screening. So that they have the strength to continue to compete with Illumina in the field of tumor screening.

Thrive is a biotechnology company dedicated to early cancer screening through blood tests. The company's cancerseek cancer early screening blood test has conducted the first prospective intervention study involving 10000 patients in a real clinical environment. In this landmark study, using the methods of testing gene mutations and protein biomarkers, cancerseek achieved gratifying results, and detected 10 different types of cancer, including 7 cancer types without recommended screening guidelines, with very few false positives.

The main products of exact sciences include cologuard for early screening of colon cancer by testing the DNA in feces, and Oncotype DX testing that provides cancer genome information for guiding accurate medical selection by testing the genome of cancer tissue.

[07] Medtronic and digital surgery

In the largest trading field of medical devices, if you can't see Medtronic, it's always disturbing for fear that Johnson & Johnson will regain the position of first brother. Finally, I was relieved to see Medtronic's business at last.

In the field of thoracoscopic and laparoscopic surgery robots, neither Johnson & Johnson nor Medtronic has the right to speak, although they are the absolute kings in the field of thoracoscopic and laparoscopic surgery. However, original surgical is too overbearing and will never give the second person a chance to show his face.

In addition to self-reliance, Medtronic can only seek differentiated competition with the help of external forces. Digital surgery is undoubtedly a good object. After all, intuitive surgery is just getting started in the AI field.

Digital surgery is a company specializing in digital surgery solutions. It provides doctors with a surgical training platform based on clinical video data analysis based on computer vision, AI algorithm, augmented reality and other technologies.

After the acquisition of digital surgery, "touch surgery" will accelerate Medtronic's strategy of providing artificial intelligence and data in laparoscopy and robot assisted surgery, strengthen the advantages of robot assisted surgery platform, and be applicable to its wider product portfolio. Make Medtronic more confident to compete with innovative surgery.