Tai Hah 0:06
Sure Start. Okay, so I'm going to first start off with actually asking my honorable panelists to introduce themself, and I'll come back to me, since they're much more important than I am for this discussion.
Michael Wasserman 0:19
Nice to see everybody. Thank you for skipping lunch. Michael Wasserman, I am a partner with patient score capital elevage medical, which is a $12 billion healthcare focused private equity firm based in Menlo Park,
Andrew Glass 0:36
Hi, good afternoon, everybody. Andy glass, I'm the CEO of Viasure Medical. We are an Ireland based company focused on cardiovascular that is about to receive US FDA approval. As you can tell from my accent, I'm an American, and I live here in London and used to work in China, so maybe that's why they put me on the global markets panel.
Luc Marengere 0:57
Luc maragee, I'm a managing partner with TVM capital. TVM capital is co located in Munich and Montreal. We invest in therapeutics. We also invest in medical devices, usually commercial stage. And we're very happy to be here and participate in this town.
Heather Potters 1:14
And my name is Heather potters. I'm from PharmaJet I'm a co founder and a former private equity person, we have a fast, fluid, needle free injection technology where we focused on vaccines and therapeutics historically, and now we're working on a spin out for our chronic disease indications.
Tai Hah 1:31
And so last and the least, Tai Hah, I'm a investment banker. They let me in. So I'm Amir. I run City's global Medtech franchise, been a healthcare banker for boy. This is my 38th year. So seen a lot, done a lot, and because I'm a banker, I have to put a quick plug in for city. So thankfully, in the last 18 plus months, we've been number one healthcare M A right, and in med tech, we advise Stryker and Inari advise BD on the RMT into orders, right advice star on the sale into ELS. Most importantly for this topic, live sistersonix Right on a recent sale, which is a big multiple. So given the topic, growth unleashed as a very heady multiple for a very, very growthy company, as I'm sure most of you know, growth as a topic is extremely critical, both public side investors and strategics. I have clients that are growing fast, growing slow. Main topic, how do we grow better? Clearly, you have companies like Stryker, Boston Scientific, intuitive. There are the dollings that companies like Medtronic would aspire to, or Medtronic used to be that way, as you all know. And how do you get there? Well, you get there by, quite frankly, buying companies that are sitting in this conference right, that get to a certain level, right? And the price of that acquisition, whether public investor or strategic, has really gone off in the last several years. I think part of that is a scarcity factor. So to that point, I think this topic is particularly interesting and relevant, right? So with that, and look, I'm going to separate topics by questions, the investor side of the equation and the company side of the kitchen, although Heather, you're on both side of the equation, right? So maybe you start off with just providing asking my panelists to discuss what you see as the current environment, right? And what type of companies you're seeing, etc. I'll just let you go on.
Michael Wasserman 3:46
I'll take the first shot at that. So I think we've been as a firm, extraordinarily busy the last 15 or 18 months or so. They could close seven transactions in that period of time, I think is terms of the volume of growth stage businesses that continues to be robust, quality in my mind, and I'd love to hear what Luke has to say as well. Tends to be a little barbell, right? You have a company like his tosonics, which you know, even 18 months ago, when it was they were raising their last private round, there was no question that the company was going to be successful. It was a matter of how big and how fast. And as you probably know, Tae there was a lot of folks that piled into that transaction. We just invest in another company called Galvanize therapeutics, where notice Doug good shawl, the former CEO of Shockwave, has taken over as the CEO there. And similarly, you know, as a late stage transaction with with strong growth prospects, it was one of these companies that had trouble. Raising financing, trouble raising financing, and then the dam broke. And then, you know, there's the other side of the equation as well, where there's some companies that have been, you know, scratching out in the wilderness, looking for for their next financings, and maybe have a little bit more hair on them.
Tai Hah 5:17
Have you found the current environment to be easier, higher velocity of quality deals, or worse, companies more desperate, like because, you know, obviously went through a period of time where funding was much more difficult. Yeah, I'll
Michael Wasserman 5:31
take them in maybe a different order. I don't know what easier is, because, you know, the investing part, the front end is, that's the easy work, right? The hard work comes after the investment. Are there more companies out there? I don't know if it's, it's more or less. I think the, you know, the quality, there is a flight to quality, which means, you know, a little bit more competitiveness and a little faster when it comes to processes,
Luc Marengere 6:01
happy to add to this. So TVM capital, again, is venture capital firm, so on the medical device side, where we normally live, just to allow you to calibrate your GPS, as to what we do is we look at companies that are post approval, early commercial or in a pivotal trial, either to support a de novo or support a PMA process, because that's usually where we live. So everything I'm going to say is kind of biased to that slice of med tech companies certainly agree that there, I always tell companies, because we raise funds as well. So we certainly do know fundraising, there is no fun in fundraising. It is a it's a note the grindstone. Even if you've got a differentiated sort of story, you got a great story, still a financing is not going to be all that, all that simple. It will take time. So we do see a little bit of a flight to quality look. I mean, there have been companies in the last six months that have raised 80 100 $125 million so what? What do these companies tend to have in common? Right? So they have a highly, highly differentiated product. They either have great pivotal data and or their product is bit more of a platform they have clear commercial success, clear visibility towards a cat one if, if cat three to cat one conversion is relevant for their type of product, okay? And one other thing that they usually have is a certain visibility towards an exit right? Venture capitalists, we covered that in the prior panel. We need to see capital recycled, right? So investing in companies that will reimburse with with a multiple, obviously your capital in a reasonable amount of time that allows funds to then go and raise another fund. Okay? And it's good. And so it goes, right? It's good for the entire landscape. So flight to quality definitely expect delays is all right, so, but quality products do get financed at the end of the day, they do get financed. Interesting.
Tai Hah 8:24
And so in that context, right quality and right flight to quality, when I look at the data on sort of macro level, and maybe the data is not as good as the information out of the Bureau of Labor sticks on employment, but like the amount of funding that's gone into late stage, companies have held fairly consistent for the last two, three years. I said, let's say close 3 billion for Adam. So does that mean that there are a bunch of companies that are simply not getting funded period? Because if that one was same and more or less going to high quality companies. And I've, I've noticed a big fund raises, right? Or we're not that involved in private capital raises. I mean, is that what you see happening that you feel,
Luc Marengere 9:12
well, I think there's a delay in some of these companies raising money, but it's the same thing on the therapeutic side, right? You need a story to go and raise and raise money. Companies in our portfolio that need to raise capital, we try to package them that before you go and raise capital, you don't have a story to tell, right? So maybe reach a clinical milestone or reach a commercial milestone. Reach some miles, put that out as a press release, right? And then, and then go and leverage this to raise, to raise capital, right? This is but this is nothing new, right? Those of us who have been in in the business since the 1990s I remember when things fell down. In 2000 they got back up. I remember when things fell down in 2007 they got back up, right? Well, guess what? Things will get back up, right? But when things are hard, you try to become more resourceful. You stretch your dollars, you do an internal round. So 2025, with your banking right? 2025, was supposed to be the the M and a bonanza year, right? The head of the FCC was already rolling down. Pennsylvania, Haven you, JP Morgan, Morgan, Stanley stock price in January went up 20% All right, so everyone was was rubbing their hands together, going, man, is this going to be an amazing year for m and a right? Well, not quite right. But then be resourceful. What can you do to so it's turned out to be a bit more of an internal round a year, right? But that doesn't mean that you're not building value. You'll realize it at some point.
Tai Hah 11:03
And so, I guess, to the group. So from a quality perspective, or things that are attractive or versus maybe more challenging, would you make a differentiation between companies that are more present US versus Europe? How do you think about that? Since we were in London, it was a fair question.
Luc Marengere 11:22
Who else would like to understand? But I can definitely speak to this. But Andy, what's what's yours?
Andrew Glass 11:29
Well, yeah, as a CEO of a European based company, and having spent a fair amount of time in the US, I don't think there's that much differentiation. I think I would say, 15 years ago, the idea of a US firm coming to Europe was unheard of, you know, to make investments. I think there's more open to it, openness to it. Now, I think when you talk about quality, what you're really talking about, in my view, is risk, right? Because I think you see a lot of early stage funding that up to 1 million, you can find that out there quite easy, but then it's a lot of the other CEOs are struggling with, trying to get that A, round B, round C, round to where they can get to the point where they can, you know, have a pivotal and someone like you can come in with a big raise. But I think those are the rounds where a lot of the investors are taking the find the risk, and they find the timelines long, and then it's hard to get past that stage. So I think that's where, regardless if it's in Europe or United States, that a lot of companies are struggling now, in terms of, how can they de risk themselves to be like, Okay, now it's the commercial product, and someone can come put in 20, 3040, 50 million or 100 million, whatever it is, and really drive the sales. I think that's where there's a struggle. And even the strategics don't want to jump in and in those stages either, because they're taking on a lot of risk as well, because they want it to be de risked when they jump in. So there is a bit of, I think, kind of a dumbbell in terms of, you know, as you go out there and try and find funds as a company, because if you've already run your pivotal and you're successful, then, yeah, it's a different challenge of commercializing moving forward, because it's been de risked by so much, right? But it's in those, those middle stages where I think it's still quite challenging. I look at the history of the last five years. I mean, if you know 2020 if you put digital in front of the name of your company, you got funding. I mean, that, you know, we were trying to raise money then, and they like, Look traditional medical products, we're not interested in. And so then we had the dynamic of, we were actually trying to raise money in Asia. And we had four term sheets from Asia, because there's a lot of money in China in particular that was looking for opportunities. But that kind of dried up a bit over time. And then, you know, in the last few years, when you would go to some of these firms, and they say, Look, you know, our LPs are overweighted to healthcare already overweighted in this space, so they're kind of slowing down, which means our investing is going to slow down, and we're going to nurture our our pieces. So I think you're starting to see in the last year or so, a bit of more normality that was created, actually, from covid in terms of those kind of, you know, B, C, D, rounds as people go out to look for investing and but I do think, as you come back to the original question, you know, both for firms and for investors, I think is becoming more global, but there still is a bias that's out there. Like, you know, if it's something in my backyard, I understand it better.
Michael Wasserman 14:21
Can I turn the question around on you, please? Yeah. So you're representing a strategic a buyer company's got $100 million of revenue, and it's 50 million in Europe, 50 million in the US. You getting credit for that European revenue? As much credit, absolutely.
Tai Hah 14:41
Right. So look, you know, by the way, is, I can't think of an example of a company with that profile, yeah,
Michael Wasserman 14:49
you're right. You're right. So let's say, let's ever, let's say 2080,
Tai Hah 14:54
you know, I think right, as long as the company has. A critical mass scale revenue in the US market, in my opinion, right then, I think you get counted for those revenues globally. One caveat is, maybe you look at China a little differently today, there's a point in time when China revenues were giving a multiple like for the growth opportunity today, it's, it's in the other direction, right? The other thing I'd add is that, is that the, and this is tricky, because right? And I had hoped for part of the robust 25 was also betting on improvement of the anti trust regulatory environment, right? And it's a little different, little better, right, I think. But you know, it's not the way I think we all predicted it would be, because things are a little volatile, so the reactions are not entirely predictable, or the little better, because I thought man a Khan was was anti business, but that's my opinion. So I hope no one's recording this. I may get canceled. But so from a right, from a regulatory perspective, question is, do those revenues have issues for the strategic choir? Right? So they highly in the last three to four years, they become highly attuned to looking at situation, even if it makes strategic sense, right? And like, to get them to spend time, I gotta walk through the antitrust assessment, which is really interesting, right? Yes, like, that's not really my job, right? That it's sort of, you know, above my ski, or I'm leaning on the skis, but, but something that they got to think about. And that factor, you know, is going to be here for a little bit. And the other problem is that one thing that Lana kan did a really good job was exporting, was exporting her views into the UK CMA. So if those revenues, and not to get a Lionel, but or detail, those revenues, that 20, let's say, in Europe is sitting in the UK, and UK has a voice in that, right? That's a that becomes a little red flag, yeah.
Heather Potters 17:10
Can I offer a different perspective? Because I know that some people were here to talk about growth, and as investors, we're always worried about the exit and where we're going to go, but I think for some of the companies that may be early stage looking for money, it's always about what you're doing today that will prepare for somebody else to own your business tomorrow. Whenever tomorrow is could be a year from now, could be two years from now. So we've adopted an untraditional approach, where, on a lip through basis, our technology is essentially married with vaccines and therapeutics that are being developed by other companies, and we do that all over the world. So we are borderless and agnostic. And because of the combination product process we get on a look through basis, their balance sheet, their risk, not at our risk. We get some revenue. We get some exposure, and at commercial stage, we get a piece of the economics, and in some cases, and particularly nucleic acid, they don't work with needles, they work with our technology. And so we go down a transom for, you know, a decade plus, at least, and have some of their economics. So we're always worried about growth, but we're also preparing for what may be next. And so those companies are looking for acquisition and by flow through. It's helpful for us to position that way. And essentially, the world of medicine says a lot of risk. So early stage development. What is it? 2% or something? Make it all the way? It depends on the category. But if you're able to diversify into other markets that are untraditional, if a market crashes, I think it's really helpful to have broader exposure. And even though a lot of the spend is in the United States, and that's where technologies end up being used more in volume, and there are complications with the MDR and things like that in Europe right now, if you have the opportunity to just expand a little bit further and not remain myopic, I think that managing through to the growth for your business. Still get some points along the way, and we have exposure to volume use in really untraditional markets, places like Afghanistan Pakistan, for immunization programs all the way through to promising things for the next cancer therapy that are going to come to market. So ultimately, there's not one size fits all. But in the end, what you want to do is work with these guys so that you can prepare for essentially, being owned by somebody with a bigger balance sheet that you can take, that can take you a long time into the future.
Tai Hah 19:36
So interesting. So on that theme. So if you are making investment decisions or operational decision on how to spend your valuable capital and human resources, and your choice is okay. This is my core market, clinically and you. Graphically. Let's get this done, unless you're prepping for IP or sale or, I think, depending on which category, decision might be a little different, right? But in that context, what you know, What's your general leaning, is it be smaller focused in the category, or be more diverse? Because I think, right, you mentioned Afghanistan. I've never buys a company with Afghanistan revenues. I think
Heather Potters 20:24
it depends, obviously, on the product. So we are ubiquitously available to deliver fluid injection alternative to needle, which means that our universe is huge, or something like 16 billion shots in the world. And we're not going to steal all those away from the needle companies. But, you know, focus is everything. On one hand, if you're too diversified and you lose that focus, if you have a more hyper concentrated kind of, you know, singular area, I think that's mission critical. And then when the world kind of retrenches, there is capital. Sometimes you don't like the terms, sometimes you can put certain things on hold, or sometimes you can maybe, on a look through basis, rely on partners. I think you have to approach it that way all the time, from the entrepreneurial perspective, that's what we have to worry about. We have to worry about that we're never going to hit the wall, we're never going to run out of money, right? But the same time, if we have great investors on our board that are prompting us to consider how we, you know, develop our businesses, to be able to position them to be owned by somebody bigger. That's also an important thing, you know, never to forget,
Luc Marengere 21:33
yeah, yeah, I would up to that. So the approach that we take, I'm sure others do as well, is that when we, when we look at a company that that is early commercial, one, two, $3 million in in revenues, right, elements, such as manufacturing, scale up automation, if that's actually relevant for that particular product, right? This is something you need to spend a lot of time on up front. Then, yes, you're approved. Yes, you're early, commercial, clinical, clinical, clinical, right? How much more clinical data do you need to produce? The answer to that is usually a lot more, right? They don't always have to be RC, TAs, but investigator LED type of clinical trials. You can develop your you can explore other verticals for your product as well, but you got to coordinate that as well advocacy groups. Now, all of that feeds into the value proposition. I Because clinical work will will help define that value proposition. So what's the value proposition to the patients? What's the value proposition to the healthcare providers? Now that you've generated clinical data, that starts to frame the value proposition well, that that feeds into reimbursement conversations and so on, right? And all of this eventually builds towards a cohesive message for strategic buyer, right? Because all that clinical development and all the reimbursement arguments you're making that all goes into the marketing department of the strategic that go by, you're giving them the template as to how to market your product post acquisition, right? So sometimes I do get a bit of a giggle. Some European companies that want to go to the United States, they want to go to the United States, they're going to do a 510, K and then there you go. That's the end of the rainbow. We've now found the pot of gold. I think that that is a bit of a naive approach. You will need to generate clinical data, clinical support kill Well, support in the United States. The same is true in the other direction, of course, going to Europe, right? So to the to the idea of on a global perspective, building growth, unleashing growth, right? So you have to take that kind of a global view. Your product in the US. You want to go to Europe, well, then you have to build clinical package to support it, and vice versa. And I like your your your your comment as well, about always trying to figure out, you know, how do we how do we build stronger, more diverse, different arguments that frame the differentiation of our product and why people should use it? Absolutely key.
Michael Wasserman 24:34
Luke, remember back in the day when we used to have which decade? Well, the question will reveal it. When we used to look at a med tech company and we'd say, oh, you know what? We're going to take them to Europe, get a CE mark and commercialize in Europe, while going through it quickly, quickly, while going through the regulatory process in the US, if you saw a company that looked like that today, do you consider that a commercial. Stage Company.
Luc Marengere 25:02
Well, of course, thanks for teeing that up. So now with the MDR business, right? And then Europe. Is Europe, Pan Europe, or is Europe first France or Germany, then France or Germany, then UK, you know, so, so there's a there's an order, yeah, to things, right? And so, so yes and no is really the answer? The answer to that, yeah,
Andrew Glass 25:29
I would be hard pressed. I mean, like, if you don't have a US strategies and Medical Products Company, I think people are going to start to raise eyebrows. Like, really, that's, you know, it have to be very unique product. So I think it's focused on the US. Is kind of like, what is your strategy for the US, and then where to go? It's a more predictable market. It's easier to get growth there. But I do think there is a comment to be made about, don't forget these other markets, right? So as we were trying to sell our company, you know, you would get into meetings and be okay, what's your plan for Japan? And we kind of had this moment where we had to look at each other, like, we don't have one, you know. But like now we are getting the filing ready for, you know, PMBA, which is very healthy market, wonderful pricing, but we don't have legal entity in Japan. So whoever acquire US, it's, they're going to fire it whenever that happens. But then you get more, you know, like, what about Canada? That was kind of a question. Like, well, ran thought about that. Or Australia, New Zealand, or Brazil, two year regulatory process when you got to start that. So you, you know, I don't, I think you need to have a plan for these other markets and be aware of it. But the other comment you made about MDR, I mean, we were fully MD R certified and been through, but each of the markets, as you mentioned, is very different. France is, you know, great potential. But then, you know, the fun of hiring French employees and trying to get pharmacy money Germany, you know, huge volume, but the pricing is terrible, right? Like, you know, how do you, how do you manage this dynamic and get going? It's more like an A 380 taking off, kind of rumbling, and you make certain wins along the ways and get a bit of revenue is possible. But the beast that everyone talks about is, you know, what's your plan for the US? When are you going to go there? Because that's where strategics investors think of of you know, that's the market now.
Tai Hah 27:14
So I picked up on a theme here, which and when we had a pre call, I picked it up from you look, which is the exit it feels like most of you think about is M and A versus an IPO
Michael Wasserman 27:27
Pat, we get our money faster, really, speed. Well, you know, you know this better than certainly I do, but it's cleaner depending on what the structure of the M and A is. But obviously, with an IPO, you've got volatility associated to it. You got a lock up associated with it. If I can, if I have a company where I can get an M and A for a billion dollars, or take it public at a billion dollar valuation, unless I'm, you know, really think that it's being undervalued from an M A perspective, it's certainly cleaner.
Tai Hah 28:05
How would you make your investment decisions or operational, strategic decisions, knowing that that's your like goal, let's say sale path, versus if you're going to be standalone company, right? Like, were there are certain decisions that you make differently along that path. Maxeder and suggest that there ought to be right. But again, I'm not clean your seats, right? You know, I get involved much later.
Andrew Glass 28:31
So after you get past the regulatory, clinical aspect, there is this commercial conversation that comes up, right? Because if you're going to generate your first million, your first 10 million, or whatever it is in sales, you're probably going to have to invent to have to invest a million or 10 million, right? And then the investors look at you like, well, we're going to invest 10 to maybe get to 10, you know. And is that worth it, right? They would rather take that commercial aspect and give it to a strategic I think that's a becomes a big question of like, if you're going to go try and drive revenue, like, how much is enough? What's the right number for, you know, the next round, what's the night right number to get a strategic to come in and jump on us? And I think that you have to really kind of think through because, you know, particularly, if you go into the US, you're looking at a 50 million, $100 million raise to really drive sales, a significant number to get you to an IPO of a decent size. Are your investors? Is your cap table capable of taking that type of hit for the X? I think these are the things that you know, we all understand in the medical technology, but that's, that's the big inflection point in terms of because if a strategic is going to buy you, what would they do with your sales team?
Luc Marengere 29:41
Yeah, on the therapeutic side, I would have a slightly different answer to your question, right? Because we've done that successfully. CO lucid was an investment of ours in Boston, right? So we invested in the mezzanine round. The mezzanine round covered one of the phase threes. Okay? Of two. Right and in for migrate. Company went public on NASDAQ, raise more money now to cover both phase threes within, within nine months post IPO, first phase three reads out Alleluia. It's all very positive. End points are met all over the place. Now you get a premium on the stock price, because you put out a press release with positive phase three, and then, and then you drive an M and A from there. So, so you compound the premiums, I think, for med tech, that that might be aspirational to do something like this. So we focus entirely on an M and A strategy, right? So we look at things, are we going to have an anti trust issue if we invest in this company, right? So we look at that up front, right? And then we try this term we use internally is the M and A trilogy, okay? One of these things is obvious is you want to have as many potential buyers as you possibly can so create tension that way, right? But how do we finance this company so that at the time that it should become an attractive M A candidate, right? The balance sheet is going to be is going to be bolstered, right? And the the next big milestone, preferably break even on the revenue side is within reach based on the cash that's on the balance sheet, right? So any strategic looking at Target X sees the balance sheet, sees the break evens, realizes that we've got money to get there. So now, if you want to buy this company, don't waste our time. So we try to engineer our investments to sort of get there. Is, is it working according to plan perfectly all the time? We know the answer to that, but that's, that's the goal. That's the objective.
Heather Potters 32:01
I just wanted to offer. I'm not sure anybody really understands what it's like to be public unless you are at least in United States and expensive. Do you know insurance brain damage with respect to frivolous lawsuits? If you are highly predictable and you have a lot of volume grace, and if you are a biotech actually, I think you don't have those risks where you're having to meet, you know, the earnings calls and the reporting and things like that. So it might be more specifically appropriate for some kinds of companies. And then in certain cases, we have some of our partners that are quoted in various small markets around the world, where at least they have the exposure of people being able to see insightfully into their company, but without the same kind of volume issues if somebody shorting their stock and telling them that they're stupid and they are actually being positioned simply to be acquired by someone else. So I think big companies acquire little companies, and I wouldn't mind that the threat of going public offers an opportunity for a strategic investor to say, How about now we would rather own this business, or that the pricing that you may get in the right market timing helps with that process. But I think really mostly Medtech companies benefit from being owned by bigger companies.
Tai Hah 33:23
That's good to know well, so you know, in the context of that, right? So again, this is to any and all of you, right? Who do you see from your perception perspective, as my right kind of buyers for you, but for the company, for your past experiences, like, Who do you respect? Who do you see? Like, if you were to invest in a company, right? When you see a buyer down the road, like, What category would you invest in related to that particular buyer, or buyers?
Luc Marengere 33:58
So I'll draw an analogy, right? So on, on the pharma side, we invested oncology and Immunology. Why is that? Well, for the last 20 years, pick up any pharma report, year end report, highest number of deals, biggest premiums paid, oncology immunology, right? So, so invest where there's a need, of course, but invest where buyers want to buy right medical device side. Well, what are the areas in acute care facilities that that are the economic engines of acute care facilities? Interventional Cardiology is one, electrophysiology is one, operating rooms, you know. So invest in these areas. Who buys in these areas? Well, it's, it's the Boston size and so on, so on, right? So, so again, that that rationale just just builds, right? So you want to be where people are avid. Be looking to to add to their sweets and and because there's going to be high adoption, there's going to be high revenue generation, well then they're going to pay a premium for that, right? So we would not hope no Nobody here is is developing new catheters for dialysis, but we wouldn't necessarily invest in something that's capitated right as as an extreme opposite example.
Heather Potters 35:27
Okay, if I look at our business today, we have the ability to sell to medical device companies. Some pharmaceutical companies invest in devices, and some don't, and then OEMs that are supporting those businesses. Typically want to add extra volume to their businesses, so we're unusual because we have a larger market opportunity. But some of the other businesses that I've invested in, I think that they face a universe of buyers that are reasonably selective, that are kind of traditional, but most of them are actually looking outside the United States right now to ensure that if they can't be bought, they're actually going to license their technology and expand their footprint, which also implies that they have more opportunity. And then we tend to think myopically. So I live in the United States, and I think about the perspective from that area. But if I look at the vaccine and therapeutics markets, there are a number of countries, some of whom got caught out during covid that have actually put in their own capacity because they never want to get caught out again. And so I think if you look at any of the largest of the countries, you should have a look at the domestic players there, because there may well be hidden opportunities, and it may not be traditional, it may not be appropriate. But again, I think you know, forget the borders, because things change, regulatory changes, and you don't know what you don't know.
Tai Hah 37:00
So down memory lane, right? Your best investment decision you've made
Michael Wasserman 37:09
ever Well, I remember my best outcome.
Tai Hah 37:12
Okay, well, that's Nick
Michael Wasserman 37:14
but I all but I also remember at the time that we made the investment. And maybe this ties back to my earlier comment about, you know, the hard work comes after. I remember saying to my partners at the time, yeah, this we probably won't lose money on this one, but I don't think it's going to be a big home run. And it was so. And I do tell this to my junior my mid level and junior colleagues, is the correlation between outcomes and how I feel about an investment at the time of the investment totally non existent. Not sure if that makes me a good investor or bad investor, but we'll find out. Some guy, you make your own luck, maybe, maybe, yeah.
Luc Marengere 37:55
I mean, we've had, we've had very interesting stories, you know, companies, companies that have flirted with corporate depth about 12 times in its progression, and lo and behold, you know, it becomes like a multi billion dollar outcome kind of thing, right? We've also had and in in, especially on the therapeutic side, I'd be the first one to say you can do all the due diligence you want, and you can talk to all the experts you want. You're rolling the dice, and there's always a certain element of luck to this, right? So we sold two companies to Lily. 118, months after the first deal. One, nine months after the first investment, right? One gave us 18 times our capital, and 113 times our capital. These are great outcomes. They could have also very easily been both write offs, right? So clinical the human body is very funny by a lot. Biologic system you get into to humans, they work, they they don't. And then I think you had the the regret thing, and I'll offer one as well, because, yes, it's, it's a complete write off, but we kind of, you know, half, half laugh at this, and at this point, don't put money in a CRO that that has a business in clinical trials just before covid, just before a pandemic, that closes down your clinical sites or start a lab company before covid. Oh, my God, right.
Heather Potters 39:34
So I'll just offer an untraditional view, because I used to be a broad based investor. But you know, if you're making widgets that's going to be limited in in what the exit opportunity can be, versus if you're creating some Eureka, brand new discovery that's going to ultimately change an industry. So best opportunity, you know, the 10 to 15x is pretty phenomenal. I've seen. Five, I've seen zero. But I think if you look realistically at what you're developing, your goal is, frankly, just a really solid return, because the unicorns don't happen very often, and your investors will be really happy. You know, if you make that solid return and perform and execute, because it is about risk mitigation from an entrepreneurial perspective, the investors talk about all the, you know, funding and returns, because they need to raise money from investors that are interested in that. It's kind of a microcosm and the cycle of life. But I also think, you know, try and be realistic, because if you feel confident about hitting that, that's great, and if it can be better sometimes, that relates to market timing.
Tai Hah 40:45
Andy, what prison company accepted? Right? What's the best firm you've worked that in your history? I'm sorry, zand, before you join, yeah, your current firm, right? So presumably, that's great. But before that, what's your best operational stuff in your history,
Andrew Glass 41:03
in my history. So I would say my four years in China were trying, okay, the absolute, I mean, they say a year in China is like a dog years. So much happens. We had the GSK where suddenly our sales reps were being pulled in the police stations, and you had to manage through that. You sort of got called in by the police to make, you know, testimony. I mean, those are the types of experiences in China. But I think it also speaks to, you know, maybe as a final comment, you know, this is about the global is that there are other markets out there. There are other opportunities out there. And if you have a product that makes a lot of sense in China or makes a lot of sense in those places, you know, pick your place Brazil, whatever the the indication is, you know, there are people there that will put up money and help you, you know. And I think is worth considering that as an opportunity. And just as a final comment, if you are to go to a place like China or Brazil or whatever, find an agent to help you. Don't go it alone, because it's it's going to be a new piece. I think we all understand the model of how to go to the US, but there are opportunities out there at other markets, so you just have to be smart about how you go after them. Wait, you're on that micro port. Were you? No, I wasn't in market or No, no,
Tai Hah 42:19
okay, that's a that's a that's another different story. Yeah, that's another panel for future. Well, look, I think we're time is up, the
Michael Wasserman 42:26
flashing red light
Tai Hah 42:28
our toe apology. Yeah, I guess we're done. I have more questions, but we're done.
Luc Marengere 42:34
Thank you for your time. Thank you.
Tai Hah 0:06
Sure Start. Okay, so I'm going to first start off with actually asking my honorable panelists to introduce themself, and I'll come back to me, since they're much more important than I am for this discussion.
Michael Wasserman 0:19
Nice to see everybody. Thank you for skipping lunch. Michael Wasserman, I am a partner with patient score capital elevage medical, which is a $12 billion healthcare focused private equity firm based in Menlo Park,
Andrew Glass 0:36
Hi, good afternoon, everybody. Andy glass, I'm the CEO of Viasure Medical. We are an Ireland based company focused on cardiovascular that is about to receive US FDA approval. As you can tell from my accent, I'm an American, and I live here in London and used to work in China, so maybe that's why they put me on the global markets panel.
Luc Marengere 0:57
Luc maragee, I'm a managing partner with TVM capital. TVM capital is co located in Munich and Montreal. We invest in therapeutics. We also invest in medical devices, usually commercial stage. And we're very happy to be here and participate in this town.
Heather Potters 1:14
And my name is Heather potters. I'm from PharmaJet I'm a co founder and a former private equity person, we have a fast, fluid, needle free injection technology where we focused on vaccines and therapeutics historically, and now we're working on a spin out for our chronic disease indications.
Tai Hah 1:31
And so last and the least, Tai Hah, I'm a investment banker. They let me in. So I'm Amir. I run City's global Medtech franchise, been a healthcare banker for boy. This is my 38th year. So seen a lot, done a lot, and because I'm a banker, I have to put a quick plug in for city. So thankfully, in the last 18 plus months, we've been number one healthcare M A right, and in med tech, we advise Stryker and Inari advise BD on the RMT into orders, right advice star on the sale into ELS. Most importantly for this topic, live sistersonix Right on a recent sale, which is a big multiple. So given the topic, growth unleashed as a very heady multiple for a very, very growthy company, as I'm sure most of you know, growth as a topic is extremely critical, both public side investors and strategics. I have clients that are growing fast, growing slow. Main topic, how do we grow better? Clearly, you have companies like Stryker, Boston Scientific, intuitive. There are the dollings that companies like Medtronic would aspire to, or Medtronic used to be that way, as you all know. And how do you get there? Well, you get there by, quite frankly, buying companies that are sitting in this conference right, that get to a certain level, right? And the price of that acquisition, whether public investor or strategic, has really gone off in the last several years. I think part of that is a scarcity factor. So to that point, I think this topic is particularly interesting and relevant, right? So with that, and look, I'm going to separate topics by questions, the investor side of the equation and the company side of the kitchen, although Heather, you're on both side of the equation, right? So maybe you start off with just providing asking my panelists to discuss what you see as the current environment, right? And what type of companies you're seeing, etc. I'll just let you go on.
Michael Wasserman 3:46
I'll take the first shot at that. So I think we've been as a firm, extraordinarily busy the last 15 or 18 months or so. They could close seven transactions in that period of time, I think is terms of the volume of growth stage businesses that continues to be robust, quality in my mind, and I'd love to hear what Luke has to say as well. Tends to be a little barbell, right? You have a company like his tosonics, which you know, even 18 months ago, when it was they were raising their last private round, there was no question that the company was going to be successful. It was a matter of how big and how fast. And as you probably know, Tae there was a lot of folks that piled into that transaction. We just invest in another company called Galvanize therapeutics, where notice Doug good shawl, the former CEO of Shockwave, has taken over as the CEO there. And similarly, you know, as a late stage transaction with with strong growth prospects, it was one of these companies that had trouble. Raising financing, trouble raising financing, and then the dam broke. And then, you know, there's the other side of the equation as well, where there's some companies that have been, you know, scratching out in the wilderness, looking for for their next financings, and maybe have a little bit more hair on them.
Tai Hah 5:17
Have you found the current environment to be easier, higher velocity of quality deals, or worse, companies more desperate, like because, you know, obviously went through a period of time where funding was much more difficult. Yeah, I'll
Michael Wasserman 5:31
take them in maybe a different order. I don't know what easier is, because, you know, the investing part, the front end is, that's the easy work, right? The hard work comes after the investment. Are there more companies out there? I don't know if it's, it's more or less. I think the, you know, the quality, there is a flight to quality, which means, you know, a little bit more competitiveness and a little faster when it comes to processes,
Luc Marengere 6:01
happy to add to this. So TVM capital, again, is venture capital firm, so on the medical device side, where we normally live, just to allow you to calibrate your GPS, as to what we do is we look at companies that are post approval, early commercial or in a pivotal trial, either to support a de novo or support a PMA process, because that's usually where we live. So everything I'm going to say is kind of biased to that slice of med tech companies certainly agree that there, I always tell companies, because we raise funds as well. So we certainly do know fundraising, there is no fun in fundraising. It is a it's a note the grindstone. Even if you've got a differentiated sort of story, you got a great story, still a financing is not going to be all that, all that simple. It will take time. So we do see a little bit of a flight to quality look. I mean, there have been companies in the last six months that have raised 80 100 $125 million so what? What do these companies tend to have in common? Right? So they have a highly, highly differentiated product. They either have great pivotal data and or their product is bit more of a platform they have clear commercial success, clear visibility towards a cat one if, if cat three to cat one conversion is relevant for their type of product, okay? And one other thing that they usually have is a certain visibility towards an exit right? Venture capitalists, we covered that in the prior panel. We need to see capital recycled, right? So investing in companies that will reimburse with with a multiple, obviously your capital in a reasonable amount of time that allows funds to then go and raise another fund. Okay? And it's good. And so it goes, right? It's good for the entire landscape. So flight to quality definitely expect delays is all right, so, but quality products do get financed at the end of the day, they do get financed. Interesting.
Tai Hah 8:24
And so in that context, right quality and right flight to quality, when I look at the data on sort of macro level, and maybe the data is not as good as the information out of the Bureau of Labor sticks on employment, but like the amount of funding that's gone into late stage, companies have held fairly consistent for the last two, three years. I said, let's say close 3 billion for Adam. So does that mean that there are a bunch of companies that are simply not getting funded period? Because if that one was same and more or less going to high quality companies. And I've, I've noticed a big fund raises, right? Or we're not that involved in private capital raises. I mean, is that what you see happening that you feel,
Luc Marengere 9:12
well, I think there's a delay in some of these companies raising money, but it's the same thing on the therapeutic side, right? You need a story to go and raise and raise money. Companies in our portfolio that need to raise capital, we try to package them that before you go and raise capital, you don't have a story to tell, right? So maybe reach a clinical milestone or reach a commercial milestone. Reach some miles, put that out as a press release, right? And then, and then go and leverage this to raise, to raise capital, right? This is but this is nothing new, right? Those of us who have been in in the business since the 1990s I remember when things fell down. In 2000 they got back up. I remember when things fell down in 2007 they got back up, right? Well, guess what? Things will get back up, right? But when things are hard, you try to become more resourceful. You stretch your dollars, you do an internal round. So 2025, with your banking right? 2025, was supposed to be the the M and a bonanza year, right? The head of the FCC was already rolling down. Pennsylvania, Haven you, JP Morgan, Morgan, Stanley stock price in January went up 20% All right, so everyone was was rubbing their hands together, going, man, is this going to be an amazing year for m and a right? Well, not quite right. But then be resourceful. What can you do to so it's turned out to be a bit more of an internal round a year, right? But that doesn't mean that you're not building value. You'll realize it at some point.
Tai Hah 11:03
And so, I guess, to the group. So from a quality perspective, or things that are attractive or versus maybe more challenging, would you make a differentiation between companies that are more present US versus Europe? How do you think about that? Since we were in London, it was a fair question.
Luc Marengere 11:22
Who else would like to understand? But I can definitely speak to this. But Andy, what's what's yours?
Andrew Glass 11:29
Well, yeah, as a CEO of a European based company, and having spent a fair amount of time in the US, I don't think there's that much differentiation. I think I would say, 15 years ago, the idea of a US firm coming to Europe was unheard of, you know, to make investments. I think there's more open to it, openness to it. Now, I think when you talk about quality, what you're really talking about, in my view, is risk, right? Because I think you see a lot of early stage funding that up to 1 million, you can find that out there quite easy, but then it's a lot of the other CEOs are struggling with, trying to get that A, round B, round C, round to where they can get to the point where they can, you know, have a pivotal and someone like you can come in with a big raise. But I think those are the rounds where a lot of the investors are taking the find the risk, and they find the timelines long, and then it's hard to get past that stage. So I think that's where, regardless if it's in Europe or United States, that a lot of companies are struggling now, in terms of, how can they de risk themselves to be like, Okay, now it's the commercial product, and someone can come put in 20, 3040, 50 million or 100 million, whatever it is, and really drive the sales. I think that's where there's a struggle. And even the strategics don't want to jump in and in those stages either, because they're taking on a lot of risk as well, because they want it to be de risked when they jump in. So there is a bit of, I think, kind of a dumbbell in terms of, you know, as you go out there and try and find funds as a company, because if you've already run your pivotal and you're successful, then, yeah, it's a different challenge of commercializing moving forward, because it's been de risked by so much, right? But it's in those, those middle stages where I think it's still quite challenging. I look at the history of the last five years. I mean, if you know 2020 if you put digital in front of the name of your company, you got funding. I mean, that, you know, we were trying to raise money then, and they like, Look traditional medical products, we're not interested in. And so then we had the dynamic of, we were actually trying to raise money in Asia. And we had four term sheets from Asia, because there's a lot of money in China in particular that was looking for opportunities. But that kind of dried up a bit over time. And then, you know, in the last few years, when you would go to some of these firms, and they say, Look, you know, our LPs are overweighted to healthcare already overweighted in this space, so they're kind of slowing down, which means our investing is going to slow down, and we're going to nurture our our pieces. So I think you're starting to see in the last year or so, a bit of more normality that was created, actually, from covid in terms of those kind of, you know, B, C, D, rounds as people go out to look for investing and but I do think, as you come back to the original question, you know, both for firms and for investors, I think is becoming more global, but there still is a bias that's out there. Like, you know, if it's something in my backyard, I understand it better.
Michael Wasserman 14:21
Can I turn the question around on you, please? Yeah. So you're representing a strategic a buyer company's got $100 million of revenue, and it's 50 million in Europe, 50 million in the US. You getting credit for that European revenue? As much credit, absolutely.
Tai Hah 14:41
Right. So look, you know, by the way, is, I can't think of an example of a company with that profile, yeah,
Michael Wasserman 14:49
you're right. You're right. So let's say, let's ever, let's say 2080,
Tai Hah 14:54
you know, I think right, as long as the company has. A critical mass scale revenue in the US market, in my opinion, right then, I think you get counted for those revenues globally. One caveat is, maybe you look at China a little differently today, there's a point in time when China revenues were giving a multiple like for the growth opportunity today, it's, it's in the other direction, right? The other thing I'd add is that, is that the, and this is tricky, because right? And I had hoped for part of the robust 25 was also betting on improvement of the anti trust regulatory environment, right? And it's a little different, little better, right, I think. But you know, it's not the way I think we all predicted it would be, because things are a little volatile, so the reactions are not entirely predictable, or the little better, because I thought man a Khan was was anti business, but that's my opinion. So I hope no one's recording this. I may get canceled. But so from a right, from a regulatory perspective, question is, do those revenues have issues for the strategic choir? Right? So they highly in the last three to four years, they become highly attuned to looking at situation, even if it makes strategic sense, right? And like, to get them to spend time, I gotta walk through the antitrust assessment, which is really interesting, right? Yes, like, that's not really my job, right? That it's sort of, you know, above my ski, or I'm leaning on the skis, but, but something that they got to think about. And that factor, you know, is going to be here for a little bit. And the other problem is that one thing that Lana kan did a really good job was exporting, was exporting her views into the UK CMA. So if those revenues, and not to get a Lionel, but or detail, those revenues, that 20, let's say, in Europe is sitting in the UK, and UK has a voice in that, right? That's a that becomes a little red flag, yeah.
Heather Potters 17:10
Can I offer a different perspective? Because I know that some people were here to talk about growth, and as investors, we're always worried about the exit and where we're going to go, but I think for some of the companies that may be early stage looking for money, it's always about what you're doing today that will prepare for somebody else to own your business tomorrow. Whenever tomorrow is could be a year from now, could be two years from now. So we've adopted an untraditional approach, where, on a lip through basis, our technology is essentially married with vaccines and therapeutics that are being developed by other companies, and we do that all over the world. So we are borderless and agnostic. And because of the combination product process we get on a look through basis, their balance sheet, their risk, not at our risk. We get some revenue. We get some exposure, and at commercial stage, we get a piece of the economics, and in some cases, and particularly nucleic acid, they don't work with needles, they work with our technology. And so we go down a transom for, you know, a decade plus, at least, and have some of their economics. So we're always worried about growth, but we're also preparing for what may be next. And so those companies are looking for acquisition and by flow through. It's helpful for us to position that way. And essentially, the world of medicine says a lot of risk. So early stage development. What is it? 2% or something? Make it all the way? It depends on the category. But if you're able to diversify into other markets that are untraditional, if a market crashes, I think it's really helpful to have broader exposure. And even though a lot of the spend is in the United States, and that's where technologies end up being used more in volume, and there are complications with the MDR and things like that in Europe right now, if you have the opportunity to just expand a little bit further and not remain myopic, I think that managing through to the growth for your business. Still get some points along the way, and we have exposure to volume use in really untraditional markets, places like Afghanistan Pakistan, for immunization programs all the way through to promising things for the next cancer therapy that are going to come to market. So ultimately, there's not one size fits all. But in the end, what you want to do is work with these guys so that you can prepare for essentially, being owned by somebody with a bigger balance sheet that you can take, that can take you a long time into the future.
Tai Hah 19:36
So interesting. So on that theme. So if you are making investment decisions or operational decision on how to spend your valuable capital and human resources, and your choice is okay. This is my core market, clinically and you. Graphically. Let's get this done, unless you're prepping for IP or sale or, I think, depending on which category, decision might be a little different, right? But in that context, what you know, What's your general leaning, is it be smaller focused in the category, or be more diverse? Because I think, right, you mentioned Afghanistan. I've never buys a company with Afghanistan revenues. I think
Heather Potters 20:24
it depends, obviously, on the product. So we are ubiquitously available to deliver fluid injection alternative to needle, which means that our universe is huge, or something like 16 billion shots in the world. And we're not going to steal all those away from the needle companies. But, you know, focus is everything. On one hand, if you're too diversified and you lose that focus, if you have a more hyper concentrated kind of, you know, singular area, I think that's mission critical. And then when the world kind of retrenches, there is capital. Sometimes you don't like the terms, sometimes you can put certain things on hold, or sometimes you can maybe, on a look through basis, rely on partners. I think you have to approach it that way all the time, from the entrepreneurial perspective, that's what we have to worry about. We have to worry about that we're never going to hit the wall, we're never going to run out of money, right? But the same time, if we have great investors on our board that are prompting us to consider how we, you know, develop our businesses, to be able to position them to be owned by somebody bigger. That's also an important thing, you know, never to forget,
Luc Marengere 21:33
yeah, yeah, I would up to that. So the approach that we take, I'm sure others do as well, is that when we, when we look at a company that that is early commercial, one, two, $3 million in in revenues, right, elements, such as manufacturing, scale up automation, if that's actually relevant for that particular product, right? This is something you need to spend a lot of time on up front. Then, yes, you're approved. Yes, you're early, commercial, clinical, clinical, clinical, right? How much more clinical data do you need to produce? The answer to that is usually a lot more, right? They don't always have to be RC, TAs, but investigator LED type of clinical trials. You can develop your you can explore other verticals for your product as well, but you got to coordinate that as well advocacy groups. Now, all of that feeds into the value proposition. I Because clinical work will will help define that value proposition. So what's the value proposition to the patients? What's the value proposition to the healthcare providers? Now that you've generated clinical data, that starts to frame the value proposition well, that that feeds into reimbursement conversations and so on, right? And all of this eventually builds towards a cohesive message for strategic buyer, right? Because all that clinical development and all the reimbursement arguments you're making that all goes into the marketing department of the strategic that go by, you're giving them the template as to how to market your product post acquisition, right? So sometimes I do get a bit of a giggle. Some European companies that want to go to the United States, they want to go to the United States, they're going to do a 510, K and then there you go. That's the end of the rainbow. We've now found the pot of gold. I think that that is a bit of a naive approach. You will need to generate clinical data, clinical support kill Well, support in the United States. The same is true in the other direction, of course, going to Europe, right? So to the to the idea of on a global perspective, building growth, unleashing growth, right? So you have to take that kind of a global view. Your product in the US. You want to go to Europe, well, then you have to build clinical package to support it, and vice versa. And I like your your your your comment as well, about always trying to figure out, you know, how do we how do we build stronger, more diverse, different arguments that frame the differentiation of our product and why people should use it? Absolutely key.
Michael Wasserman 24:34
Luke, remember back in the day when we used to have which decade? Well, the question will reveal it. When we used to look at a med tech company and we'd say, oh, you know what? We're going to take them to Europe, get a CE mark and commercialize in Europe, while going through it quickly, quickly, while going through the regulatory process in the US, if you saw a company that looked like that today, do you consider that a commercial. Stage Company.
Luc Marengere 25:02
Well, of course, thanks for teeing that up. So now with the MDR business, right? And then Europe. Is Europe, Pan Europe, or is Europe first France or Germany, then France or Germany, then UK, you know, so, so there's a there's an order, yeah, to things, right? And so, so yes and no is really the answer? The answer to that, yeah,
Andrew Glass 25:29
I would be hard pressed. I mean, like, if you don't have a US strategies and Medical Products Company, I think people are going to start to raise eyebrows. Like, really, that's, you know, it have to be very unique product. So I think it's focused on the US. Is kind of like, what is your strategy for the US, and then where to go? It's a more predictable market. It's easier to get growth there. But I do think there is a comment to be made about, don't forget these other markets, right? So as we were trying to sell our company, you know, you would get into meetings and be okay, what's your plan for Japan? And we kind of had this moment where we had to look at each other, like, we don't have one, you know. But like now we are getting the filing ready for, you know, PMBA, which is very healthy market, wonderful pricing, but we don't have legal entity in Japan. So whoever acquire US, it's, they're going to fire it whenever that happens. But then you get more, you know, like, what about Canada? That was kind of a question. Like, well, ran thought about that. Or Australia, New Zealand, or Brazil, two year regulatory process when you got to start that. So you, you know, I don't, I think you need to have a plan for these other markets and be aware of it. But the other comment you made about MDR, I mean, we were fully MD R certified and been through, but each of the markets, as you mentioned, is very different. France is, you know, great potential. But then, you know, the fun of hiring French employees and trying to get pharmacy money Germany, you know, huge volume, but the pricing is terrible, right? Like, you know, how do you, how do you manage this dynamic and get going? It's more like an A 380 taking off, kind of rumbling, and you make certain wins along the ways and get a bit of revenue is possible. But the beast that everyone talks about is, you know, what's your plan for the US? When are you going to go there? Because that's where strategics investors think of of you know, that's the market now.
Tai Hah 27:14
So I picked up on a theme here, which and when we had a pre call, I picked it up from you look, which is the exit it feels like most of you think about is M and A versus an IPO
Michael Wasserman 27:27
Pat, we get our money faster, really, speed. Well, you know, you know this better than certainly I do, but it's cleaner depending on what the structure of the M and A is. But obviously, with an IPO, you've got volatility associated to it. You got a lock up associated with it. If I can, if I have a company where I can get an M and A for a billion dollars, or take it public at a billion dollar valuation, unless I'm, you know, really think that it's being undervalued from an M A perspective, it's certainly cleaner.
Tai Hah 28:05
How would you make your investment decisions or operational, strategic decisions, knowing that that's your like goal, let's say sale path, versus if you're going to be standalone company, right? Like, were there are certain decisions that you make differently along that path. Maxeder and suggest that there ought to be right. But again, I'm not clean your seats, right? You know, I get involved much later.
Andrew Glass 28:31
So after you get past the regulatory, clinical aspect, there is this commercial conversation that comes up, right? Because if you're going to generate your first million, your first 10 million, or whatever it is in sales, you're probably going to have to invent to have to invest a million or 10 million, right? And then the investors look at you like, well, we're going to invest 10 to maybe get to 10, you know. And is that worth it, right? They would rather take that commercial aspect and give it to a strategic I think that's a becomes a big question of like, if you're going to go try and drive revenue, like, how much is enough? What's the right number for, you know, the next round, what's the night right number to get a strategic to come in and jump on us? And I think that you have to really kind of think through because, you know, particularly, if you go into the US, you're looking at a 50 million, $100 million raise to really drive sales, a significant number to get you to an IPO of a decent size. Are your investors? Is your cap table capable of taking that type of hit for the X? I think these are the things that you know, we all understand in the medical technology, but that's, that's the big inflection point in terms of because if a strategic is going to buy you, what would they do with your sales team?
Luc Marengere 29:41
Yeah, on the therapeutic side, I would have a slightly different answer to your question, right? Because we've done that successfully. CO lucid was an investment of ours in Boston, right? So we invested in the mezzanine round. The mezzanine round covered one of the phase threes. Okay? Of two. Right and in for migrate. Company went public on NASDAQ, raise more money now to cover both phase threes within, within nine months post IPO, first phase three reads out Alleluia. It's all very positive. End points are met all over the place. Now you get a premium on the stock price, because you put out a press release with positive phase three, and then, and then you drive an M and A from there. So, so you compound the premiums, I think, for med tech, that that might be aspirational to do something like this. So we focus entirely on an M and A strategy, right? So we look at things, are we going to have an anti trust issue if we invest in this company, right? So we look at that up front, right? And then we try this term we use internally is the M and A trilogy, okay? One of these things is obvious is you want to have as many potential buyers as you possibly can so create tension that way, right? But how do we finance this company so that at the time that it should become an attractive M A candidate, right? The balance sheet is going to be is going to be bolstered, right? And the the next big milestone, preferably break even on the revenue side is within reach based on the cash that's on the balance sheet, right? So any strategic looking at Target X sees the balance sheet, sees the break evens, realizes that we've got money to get there. So now, if you want to buy this company, don't waste our time. So we try to engineer our investments to sort of get there. Is, is it working according to plan perfectly all the time? We know the answer to that, but that's, that's the goal. That's the objective.
Heather Potters 32:01
I just wanted to offer. I'm not sure anybody really understands what it's like to be public unless you are at least in United States and expensive. Do you know insurance brain damage with respect to frivolous lawsuits? If you are highly predictable and you have a lot of volume grace, and if you are a biotech actually, I think you don't have those risks where you're having to meet, you know, the earnings calls and the reporting and things like that. So it might be more specifically appropriate for some kinds of companies. And then in certain cases, we have some of our partners that are quoted in various small markets around the world, where at least they have the exposure of people being able to see insightfully into their company, but without the same kind of volume issues if somebody shorting their stock and telling them that they're stupid and they are actually being positioned simply to be acquired by someone else. So I think big companies acquire little companies, and I wouldn't mind that the threat of going public offers an opportunity for a strategic investor to say, How about now we would rather own this business, or that the pricing that you may get in the right market timing helps with that process. But I think really mostly Medtech companies benefit from being owned by bigger companies.
Tai Hah 33:23
That's good to know well, so you know, in the context of that, right? So again, this is to any and all of you, right? Who do you see from your perception perspective, as my right kind of buyers for you, but for the company, for your past experiences, like, Who do you respect? Who do you see? Like, if you were to invest in a company, right? When you see a buyer down the road, like, What category would you invest in related to that particular buyer, or buyers?
Luc Marengere 33:58
So I'll draw an analogy, right? So on, on the pharma side, we invested oncology and Immunology. Why is that? Well, for the last 20 years, pick up any pharma report, year end report, highest number of deals, biggest premiums paid, oncology immunology, right? So, so invest where there's a need, of course, but invest where buyers want to buy right medical device side. Well, what are the areas in acute care facilities that that are the economic engines of acute care facilities? Interventional Cardiology is one, electrophysiology is one, operating rooms, you know. So invest in these areas. Who buys in these areas? Well, it's, it's the Boston size and so on, so on, right? So, so again, that that rationale just just builds, right? So you want to be where people are avid. Be looking to to add to their sweets and and because there's going to be high adoption, there's going to be high revenue generation, well then they're going to pay a premium for that, right? So we would not hope no Nobody here is is developing new catheters for dialysis, but we wouldn't necessarily invest in something that's capitated right as as an extreme opposite example.
Heather Potters 35:27
Okay, if I look at our business today, we have the ability to sell to medical device companies. Some pharmaceutical companies invest in devices, and some don't, and then OEMs that are supporting those businesses. Typically want to add extra volume to their businesses, so we're unusual because we have a larger market opportunity. But some of the other businesses that I've invested in, I think that they face a universe of buyers that are reasonably selective, that are kind of traditional, but most of them are actually looking outside the United States right now to ensure that if they can't be bought, they're actually going to license their technology and expand their footprint, which also implies that they have more opportunity. And then we tend to think myopically. So I live in the United States, and I think about the perspective from that area. But if I look at the vaccine and therapeutics markets, there are a number of countries, some of whom got caught out during covid that have actually put in their own capacity because they never want to get caught out again. And so I think if you look at any of the largest of the countries, you should have a look at the domestic players there, because there may well be hidden opportunities, and it may not be traditional, it may not be appropriate. But again, I think you know, forget the borders, because things change, regulatory changes, and you don't know what you don't know.
Tai Hah 37:00
So down memory lane, right? Your best investment decision you've made
Michael Wasserman 37:09
ever Well, I remember my best outcome.
Tai Hah 37:12
Okay, well, that's Nick
Michael Wasserman 37:14
but I all but I also remember at the time that we made the investment. And maybe this ties back to my earlier comment about, you know, the hard work comes after. I remember saying to my partners at the time, yeah, this we probably won't lose money on this one, but I don't think it's going to be a big home run. And it was so. And I do tell this to my junior my mid level and junior colleagues, is the correlation between outcomes and how I feel about an investment at the time of the investment totally non existent. Not sure if that makes me a good investor or bad investor, but we'll find out. Some guy, you make your own luck, maybe, maybe, yeah.
Luc Marengere 37:55
I mean, we've had, we've had very interesting stories, you know, companies, companies that have flirted with corporate depth about 12 times in its progression, and lo and behold, you know, it becomes like a multi billion dollar outcome kind of thing, right? We've also had and in in, especially on the therapeutic side, I'd be the first one to say you can do all the due diligence you want, and you can talk to all the experts you want. You're rolling the dice, and there's always a certain element of luck to this, right? So we sold two companies to Lily. 118, months after the first deal. One, nine months after the first investment, right? One gave us 18 times our capital, and 113 times our capital. These are great outcomes. They could have also very easily been both write offs, right? So clinical the human body is very funny by a lot. Biologic system you get into to humans, they work, they they don't. And then I think you had the the regret thing, and I'll offer one as well, because, yes, it's, it's a complete write off, but we kind of, you know, half, half laugh at this, and at this point, don't put money in a CRO that that has a business in clinical trials just before covid, just before a pandemic, that closes down your clinical sites or start a lab company before covid. Oh, my God, right.
Heather Potters 39:34
So I'll just offer an untraditional view, because I used to be a broad based investor. But you know, if you're making widgets that's going to be limited in in what the exit opportunity can be, versus if you're creating some Eureka, brand new discovery that's going to ultimately change an industry. So best opportunity, you know, the 10 to 15x is pretty phenomenal. I've seen. Five, I've seen zero. But I think if you look realistically at what you're developing, your goal is, frankly, just a really solid return, because the unicorns don't happen very often, and your investors will be really happy. You know, if you make that solid return and perform and execute, because it is about risk mitigation from an entrepreneurial perspective, the investors talk about all the, you know, funding and returns, because they need to raise money from investors that are interested in that. It's kind of a microcosm and the cycle of life. But I also think, you know, try and be realistic, because if you feel confident about hitting that, that's great, and if it can be better sometimes, that relates to market timing.
Tai Hah 40:45
Andy, what prison company accepted? Right? What's the best firm you've worked that in your history? I'm sorry, zand, before you join, yeah, your current firm, right? So presumably, that's great. But before that, what's your best operational stuff in your history,
Andrew Glass 41:03
in my history. So I would say my four years in China were trying, okay, the absolute, I mean, they say a year in China is like a dog years. So much happens. We had the GSK where suddenly our sales reps were being pulled in the police stations, and you had to manage through that. You sort of got called in by the police to make, you know, testimony. I mean, those are the types of experiences in China. But I think it also speaks to, you know, maybe as a final comment, you know, this is about the global is that there are other markets out there. There are other opportunities out there. And if you have a product that makes a lot of sense in China or makes a lot of sense in those places, you know, pick your place Brazil, whatever the the indication is, you know, there are people there that will put up money and help you, you know. And I think is worth considering that as an opportunity. And just as a final comment, if you are to go to a place like China or Brazil or whatever, find an agent to help you. Don't go it alone, because it's it's going to be a new piece. I think we all understand the model of how to go to the US, but there are opportunities out there at other markets, so you just have to be smart about how you go after them. Wait, you're on that micro port. Were you? No, I wasn't in market or No, no,
Tai Hah 42:19
okay, that's a that's a that's another different story. Yeah, that's another panel for future. Well, look, I think we're time is up, the
Michael Wasserman 42:26
flashing red light
Tai Hah 42:28
our toe apology. Yeah, I guess we're done. I have more questions, but we're done.
Luc Marengere 42:34
Thank you for your time. Thank you.
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