Healthcare Investments and Exits Mid-Year 2016 Report

Healthcare Investments and Exits Mid-Year 2016 Report

Paul Schuber Valuations Associate SVB Analytics

Written by: Jonathan Norris Managing Director Silicon Valley Bank

Table of Contents

Healthcare Investments and Exits, Mid-Year 2016 Report 2

Key Highlights 1H 2016 3

Healthcare Investments and Fundraising 4

Top 15 Crossover Investors 12

Healthcare Big Exit M&A and IPO 15

Glossary 26

About the Authors 27

Cover Photo: Cytotoxic T lymphocytes attacking cancer cell

Key Highlights 1H 2016: New Patterns Emerge as Investor Confidence Drives Deals Like investing and exits overall, healthcare experienced a bumpy start in 2016 — but also had some surprising highlights.

• Venture fundraising declines, but Series A investment is up in all sectors.

• We expect healthcare investment to reach $9B-$9.5B for full-year 2016, down slightly from 2015.

• Crossover investment slows, but newly raised funds, corporate venture and family offices are largely filling the gap. Crossover investors are instead focusing on getting biopharma portfolio companies to an IPO.

• Potential distributions are on pace to reach $15B-$17B for the full-year 2016.

• Biopharma round sizes are skyrocketing, while exits focus on early-stage companies.

• Device remains healthy, as M&A big exits are on pace to meet full-year 2015.

• Diagnostics (dx) has experienced exit pullback due to regulatory and reimbursement uncertainty. However, investment has picked up and M&A activity should increase.



Healthcare Investments and Fundraising: Series A Activity Booms

With very healthy funding over the last few years, we continue to see strong investment into companies and expect it to continue for at least the next two years.

Based on Q1 2016 data, we think investment into companies will reach $9-$9.5B for the full year, down slightly from 2015. This reflects less crossover activity.

Fundraising in 1H 2016 is down compared to 1H 2015, driven primarily by the closing of three big funds ($2.75B total) in 2015. But we continue to see LP interest in investing into healthcare.

Investors See Strong Future in Healthcare


U.S. Healthcare: Capital Invested and VC Dollars Raised

Capital Flow Ratio 127% 368% 207% 189% 175% 149% 141%

HC $ Invested into Companies HC VC $ Fundraised Gap in Funding

0123456789

1011

2009 2010 2011 2012 2013 2014 2015

$ Bi

llion

s

Source: PricewaterhouseCoopers, Thomson Reuters and SVB proprietary data

$7.5B

$10.5B

Series A Activity Is Strong across All Sectors


Total Series A ($M) $1,107 $862 $1,843 $994 CVC Deals % / # 28% / 17 27% / 20 26% / 23 33% / 19

BIOPHARMA

Biopharma is on pace in 2016 for 100+ Series A deals (up 30% over 2015) with $2B in invested capital. Both would be record highs, if investment velocity continues.

• Significant pre-clinical focus, especially in platform, oncology, anti-infective, neurology and orphan/rare disease companies

Device deals already have eclipsed 2015 totals, driven by angel activity.

• Significant investment activity in neurology, cardiovascular and surgical companies

Dx/tools deals and dollars in 1H 2016 have exceeded 2015 totals, despite an M&A pullback.

• Grail raised $125M in Series A, accounting for almost half of dollars raised in 1H 2016

DEVICE

DX/TOOLS

Total Series A ($M) $227 $337 $92 $104 CVC Deals % / # 18% / 7 14% / 6 22% / 4 4% / 1

Total Series A ($M) $234 $252 $165 $263 CVC Deals % / # 10% / 4 12% / 4 24% / 4 21% / 5

60 75 87 58

0

40

80

1202013 2014 2015 1H 2016

# of

Dea

ls

38 42 18 24

0

40

80

120

# of

Dea

ls

39 34 17 24

0

40

80

120

# of

Dea

ls

Source: CB Insights, PitchBook, press releases and SVB proprietary data

U.S. Company Formation: Deals and Investments in Series A

Venture and Corporate Investors Keep Active


Trends suggest the number of deals by the most active investors will increase 30% over 2015.

Pfizer, a corporate investor, leads all investors with 9 new deals in 1H 2016.

The majority of the most active VCs in 1H 2016 have raised new funds between January 2015 and June 2016.

Active crossover investors include Deerfield Management (7), Fidelity Investors (4) and Cormorant Asset Management (4). See page 13.

Top 2015 VC+CVC Biopharma

INVESTOR DEALS TYPE

OrbiMed Advisors 16 VC

New Enterprise Associates 9 VC

Novartis Venture Funds 9 Corporate

ARCH Venture Partners 8 VC

Sofinnova Ventures 8 VC

Novo 7 VC

Pfizer Venture Investments 7 Corporate

Versant Ventures 7 VC

Celgene 6 Corporate

Johnson & Johnson Innovation 6 Corporate

SR One 6 Corporate

Top 1H 2016 VC+CVC Biopharma

INVESTOR DEALS TYPE

Pfizer Venture Investments 9 Corporate

OrbiMed Advisors 8 VC

Frazier Healthcare 6 VC

Novo 6 VC

AbbVie Biotech Ventures 5 Corporate

ARCH Venture Partners 5 VC

New Enterprise Associates 5 VC

Canaan Partners 4 VC

MPM Capital 4 VC

Johnson & Johnson Innovation 3 Corporate

Roche Venture Fund 3 Corporate

Most Active* New Investors in Biopharma 2015 versus 1H 2016

*Most active is defined as top 60 investors based on new investments. Source: CB Insights, PitchBook, press releases and SVB proprietary data

Oncology Leads New Biopharma Investments


Oncology has almost three times the number of deals compared to any other category.

Anti-infective, ranked ninth in number of deals in our 2014 analysis, is now tied for second.

Platform, orphan/rare disease and neurology continue to receive significant investment.

Oncology 62 deals $2,419M

Anti-Infective 22 deals $686M

Platform 22 deals $914M

Neurology 22 deals $816M

Orphan/Rare Disease 19 deals $749M

Auto-Immune 6 deals $232M

Metabolic 9 deals $243M

Cardiovascular 5 deals $109M

Gastrointestinal 6 deals $128M

Respiratory 4 deals $155M

Ophthalmology 5 deals $201M

Most Active* New VC Investments in Biopharma by Indication 2015–1H 2016

*Most active is defined as top 60 investors based on new investments. Source: CB Insights, PitchBook, press releases and SVB proprietary data

Biopharma Deal Size Increases


Median investment round size from most active investors has increased 40% over 2015.

The median deal size has almost tripled since 2013.

Recent larger equity raises in biopharma could compress M&A multiples down the road, especially as IPO optionality declines.

$15.3

$23.0

$30.0

$42.8

$0

$5

$10

$15

$20

$25

$30

$35

$40

$45

2013 2014 2015 1H 2016

Med

ian

Deal

Siz

e ($

Mill

ions

)


Median Deal Size by Top 60 VC and Corporate Investors

Device Gains Traction in Large Late-Stage Deals

Active* Investors

INVESTOR TYPE INVESTOR TYPE

Action Potential Venture Capital Corporate Lightstone Ventures VC

Aisling Capital VC Longitude Capital VC

BioStar Ventures VC Medtronic Corporate

Deerfield Management Crossover New Enterprise Associates VC

Edwards Lifesciences Corporate OrbiMed Advisors VC

Endeavour Vision VC Sante Ventures VC

GE Ventures Corporate Sofinnova Partners VC

HealthQuest Capital VC SV Life Sciences Advisers VC

Johnson & Johnson Innovation Corporate Venrock VC

KCK Group Family Office Vertex Healthcare VC


Analysis of the top 10 1H 2016 device deals:

• The median deal size jumped to $46M in Q2 2016 — the largest median round size in two years.

• The increased deal sizes underscore the funding of late-stage pivotal trial and/or commercialization rounds.

• Cardiovascular received the most investments in 1H 2016; this indication requires significant clinical trial investment. We also saw recent big exit M&A activity in this indication, with 8 of 17 device big exits in 2015.

Active* Investors in Device 1H 2016

*Active defined as investors that are actively investing or actively looking at deals. Source: CB Insights, PitchBook, press releases and SVB proprietary data

Top Dx/Tools Round Sizes Increase


Analysis of the top 10 1H 2016 dx/tools deals:

• Dx/tools deal size surged to a median of $41M in Q2, nearly tripling the 2015 median. Half of these investments were either Series A or B.

• The deals were equally split between dx and tools.

The number of investments by the Top 15 Crossover Investors in 1H 2016 equaled all of 2015.

Active* Investors

INVESTOR TYPE INVESTOR TYPE

ARCH Venture Partners VC OrbiMed Advisors VC

Arboretum Ventures VC Paladin Capital Group VC

Baird Capital VC Pfizer Venture Investments Corporate

Cormorant Asset Management Crossover Qiagen Corporate

Fidelity Investments Crossover Roche Venture Fund Corporate

Foresite Capital Management Crossover Sequoia Capital VC

Gilde Investment Management VC Venrock VC

Illumina Ventures Corporate Wuxi Venture Fund VC

Active* Investors in Dx/Tools 1H 2016

*Active defined as investors that are actively investing or actively looking at deals. Source: CB Insights, PitchBook, press releases and SVB proprietary data


Top 15 Crossover Investors: Investments Decline as Crossovers Focus on IPOs

Top 15 Crossover Investors: Investments in Biopharma Decline Rapidly


2013 2014 Q1 2015 Q2 2015 Q3 2015 Q4 2015 Q1 2016 Q2 2016 Total PRIVATE

INVESTMENTS 15 68 27 46 68 22 16 13 275

MOST ACTIVE CROSSOVER INVESTORS 1H 2016

INVESTOR DEALS

Deerfield Management 7

Fidelity Investments 4

Cormorant Asset Management 4

Sectoral Asset Management 3

Crossover investment deals dropped almost 70% from 2H 2015. However, we still see crossover investor activity, and this group continues to be an important part of the biopharma ecosystem.

In 1H 2016, 70% of crossover deals were in Series A and B.

Something to consider: Will crossover investors continue to support portfolio companies that need to raise another private round?

Top 15 Crossover Investors: Adage Capital Management, Casdin Capital, Cormorant Asset Management, Deerfield Management, EcoR1 Capital, Fidelity Investments, Foresite Capital Management, Jennison Associates, Perceptive Advisors, RA Capital Management, Redmile Group, Rock Springs Capital, Sectoral Asset Management, Wellington Management, Woodford Investment Management


Top 15 Crossover Investors: Investors Push for Biopharma IPOs


Crossover IPOs as Percentage of Exits

IPO / Total Exits (M&A + IPO) 55/61 (90%)

Our analysis shows that biopharma companies with a Top 15 Crossover Investor are much more likely to exit through an IPO. Greater than 45% of these companies have exited since 2013, and 90% of those exits have been IPOs.

In 1H 2016, 11 of 15 VC-backed biopharma IPOs had a Top 15 Crossover as a private investor. The number of Top 15 Crossover IPOs is on pace to match 2015, which is remarkable in a declining IPO market.

The challenge ahead: 55% of the portfolios of Top 15 Crossover Investors are still private. This suggests that their focus in 2H 2016 will be on helping companies go public instead of making new private investments.

Private Company Backlog

Still Private / Total Deals 74/135 (55%)

*Estimate based on 1H 2016 IPOs

2

8

23 22

32

58

19

8

0

10

20

30

40

50

60

70

2013 2014 2015 2016*

# of

IPO

s

Top 15 Crossover

Other Investors


Top 15 Crossover Investors: Adage Capital Management, Casdin Capital, Cormorant Asset Management, Deerfield Management, EcoR1 Capital, Fidelity Investments, Foresite Capital Management, Jennison Associates, Perceptive Advisors, RA Capital Management, Redmile Group, Rock Springs Capital, Sectoral Asset Management, Wellington Management, Woodford Investment Management


Healthcare Big Exit M&A and IPO: Robust M&A Activity Continues as IPOs Slow

Large Stemcentrx Deal Propels Overall Distributions


Biopharma 64% 80% 69% 69% 85%

Device 27% 12% 21% 23% 13%

Dx/Tools 9% 8% 10% 8% 2%

Pre-Money IPO Value Big Exit Milestones to be Earned Big Exit Upfront Payments

Potential Distributions* from VC-backed IPOs and Big Exit M&A 2012–1H 2016 One deal, Stemcentrx’s acquisition

by AbbVie, contributed almost half of all 1H 2016 total potential distributions.

Barring another multibillion-dollar exit in 2H 2016, full-year potential distributions are on pace to reach $15B-$17B.

While below the record high in 2015, this signals another good year for investors.

*Potential distributions are calculated assuming 75% venture ownership for upfront payments. IPOs are based on the pre-money valuation assuming 75% venture ownership. M&A milestone payments are discounted to 25%.

02468

1012141618202224

2012 2013 2014 2015 1H 2016

Tota

l Val

ue ($

Bill

ions

)


Strong Biopharma Big Exit M&A Continues, while IPO Market Slows

Q1 Q2 Q3 Q4 Total

2013 IPO 3 10 13 8 34

M&A 3 3 3 3 12

2014 IPO 24 12 17 13 66

M&A 3 4 6 1 14

2015 IPO 11 12 9 10 42

M&A 7 4 6 4 21

2016 IPO 7 8 15

M&A 5 4 9

Healthcare Investments and Exits, Mid-Year 2016 Report 17 Source: CB Insights, PitchBook, press releases and SVB proprietary data

VC-backed Biopharma Exits by Quarter 2013–1H 2016 Full-year 2016 biopharma IPOs are estimated to come close to the 2013 total.

Of the 15 IPOs in 1H 2016, 7 companies were trading above their IPO price and 8 trading below at the end of the first half of 2016.

We anticipate M&A big exits to pick up in 2H 2016 and exceed the 2015 total.

Early-Stage Companies Dominate Biopharma IPOs


Stage 2012 2013 2014 2015 1H 2016

Pre-Clinical / Phase I 1 9 29 18 9

Total Biopharma IPOs 10 34 66 41 15

% Early-Stage IPOs 10% 26% 44% 44% 60%

Biopharma IPOs were focused predominantly on early-stage companies in 1H 2016.

In 1H 2016, median IPO dollars raised was $53M, down from $75M in 2H 2015. Median pre-money valuation in 1H 2016 of $176M is healthy, but below the 2H 2015 median of $233M.

Following a strong 2015 for neurology and anti-infective IPOs, these indications had none in 1H 2016. This may be related to recent clinical setbacks at newly public companies.


VC-backed Biopharma IPOs by Stage 2012–1H 2016

Biopharma M&A Big Exit Multiples Surge; Early-Stage Focus Continues

Healthcare Investments and Exits, Mid-Year 2016 Report

Pre-Clinical Phase I Phase II Phase III Commercial

19

0

2

4

6

8

10

12

14

16

18

20

2012 2013 2014 2015 1H 2016

# of

Big

Exi

ts


VC-backed Biopharma Big Exit M&A by Stage 2012–1H 2016 Biopharma deals in 1H 2016 had a strong median upfront multiple of 4.7X. Even more impressive, the median all-in multiple reached 14X, up significantly from 2014 and 2015.

7 of 9 M&A big exits were pre-clinical or Phase I:

• Pre-clinical deals were in neurology, auto-immune and orphan/rare disease.

• Phase I deals were in oncology (2 deals), metabolic and aesthetics/dermatology.

Early-Stage Biopharma M&A Remains Strong, while Exit Time Decreases

Healthcare Investments and Exits, Mid-Year 2016 Report 20 Source: CB Insights, PitchBook, press releases and SVB proprietary data

$325M

$500M $413M

$600M $600M

5.0 4.1

5.3 5.6 4.7

2012 2013 2014 2015 1H 2016

Median Total Deal Size and Time to Exit (Pre-Clinical & Phase I)

Median Total Deal Size Median Time to Exit (years)

n=5 n=3 n=8 n=11 n=7

31.8% 51.7%

74.0%

36.9% 51.2%

68.2% 48.3%

26.0%

63.1% 48.8%

2012 2013 2014 2015 1H 2016

Median Total Deal Size (Pre-Clinical & Phase I)

Upfront % Milestone %

$325M $500M $413M $600M $600M

M&A median total deal size remains at record high, even as IPO optionality is decreasing.

This suggests competition among acquirers, which is leading them to pay more at deal close to acquire early-stage assets.

Biopharma M&A continues to show a quick time to exit.

Device Big Exit M&A Charges On as IPOs Disappear


Q1 Q2 Q3 Q4 Total

2013 IPO 0 0 0 2 2

M&A 2 2 6 2 12

2014 IPO 1 5 1 3 10

M&A 2 9 5 2 18

2015 IPO 3 4 3 1 11

M&A 0 4 9 4 17

2016 IPO 0 0 0

M&A 5 4 9


VC-backed Device Exits by Quarter 2013–1H 2016 In 1H 2016 there were no device IPOs, but we did see some reverse merger activity.

At the same time, there were 9 M&A big exits — on pace to match the 2015 total.

In each of the past five quarters, there have been at least four M&A device big exits.

Device Big Exit M&A Trends to Later Stage

Non-Approved CE Mark U.S. Commercial

Represents # of IPOs Represents Big Exits


0

2

4

6

8

10

12

14

16

18

2012 2013 2014 2015 1H 2016

# of

Big

Exi

ts

1 2

7

1

2

8

1

2


The orthopedic indication leads with three deals in 1H 2016.

There were no Medtronic venture-backed acquisitions in 1H 2016 (13 big exit acquisitions in 2014-2015). However, we expect Medtronic activity in 2H 2016. Discussions with investors suggest that the next flurry of early stage acquisitions could focus on atrial fibrillation, heart failure, stroke or neurostimulation.

VC-backed Device Big Exit M&A by Stage 2012–1H 2016

Device Big Exit M&A Propels Higher Median Values


Median Upfront ($M) $95 $127 $180 $150 $120

Median Total Deal ($M) $195 $175 $185 $219 $300

Median Years to Exit 7.0 6.6 6.9 5.5 9.2

# of Structured Deals # of All-In Deals

0

2

4

6

8

10

12

14

16

18

20

2012 2013 2014 2015 1H 2016

# of

Big

Exi

ts


In 1H 2016, 7 of 9 M&A device big exits were structured. There have never been more than 50% structured deals in any year.

Looking at regulatory pathways in 1H 2016, the majority of deals (6 of 9) are 510k pathway. These companies typically require revenue ramp-up prior to acquisition. This helps to explain the longer time to exit and later-stage focus.

VC-backed Device Big Exit M&A Deal Structure 2012–1H 2016

Dx/Tools Faces Exit Slowdown


2015*

While there have been multiple dx/tools acquisitions of public companies in 1H 2016, there have been only two private M&A big exits. Both deals were tools companies focused on drug discovery.

Dx/tools IPOs in 2015 performed poorly, and there were none in 1H 2016.

Q1 Q2 Q3 Q4 Total

2013 IPO 1 0 2 1 4

M&A 1 1 1 0 3

2014 IPO 2 2 3 0 7

M&A 2 3 0 5 10

2015 IPO 1 2 1 1 5

M&A 3 0 2 1 6

2016 IPO 0 0 0

M&A 1 1 2


VC-backed Dx/Tools Exits by Quarter 2013–1H 2016

Dx/Tools Hits Big Exit M&A Slump


Median Upfront ($M) $127 $350 $133 $184 $108

Median Total Deal ($M) $127 $450 $239 $189 $108

Median Years to Exit 5.6 8.2 6.0 4.5 6.1

# of Structured Deals # of All-In Deals

The two 1H 2016 deals were commercial-stage tools companies with no milestones. A third tools deal was announced in early Q3 2016. Revenue traction is likely the main predictor of M&A success.

In the dx space, uncertainty existed for most of 1H 2016. This was due to Medicare lab test pricing and FDA regulation of lab-developed tests. With more clarity on the horizon, activity should increase.


0

1

2

3

4

5

6

7

8

9

10

2012 2013 2014 2015 1H 2016

# of

Big

Exi

ts

VC-backed Dx/Tools Big Exit M&A Deal Structure 2012–1H 2016

Glossary

Big Exit

Big Exits are defined as private, venture-backed merger and acquisition transactions in which the upfront payment is $75 million or more for biopharma deals and $50 million or more for device and dx/tools deals.

Initial Public Offering

IPO is defined as a venture-backed company raising IPO proceeds more than $25 million.

Deal Descriptions

Structured Deal This is a pay-for-performance system that pays some of the consideration upfront, but sets milestones in development that must be achieved before the full value of the transaction will be realized.

All-in Deal All consideration for the deal is paid when the deal closes.

Big Exit Upfront Payments The upfront payment refers to payments in a structured deal that are made at the close of the deal; it does not include milestones.

Big Exit Milestones to be Earned The milestones to be earned refer to payments in a structured deal that are made after the pre-determined goals are met.

Total Deal Value The total deal value of a structured deal includes both the upfront payment and the milestones to be earned.

Regulatory Definitions

Non-approved Non-approved refers to a device company that has no regulatory approval for its product.

CE Mark CE Mark refers to a device company that has a CE Mark-only product. CE Mark is a European Union designation that is less difficult to obtain than FDA approval, and the approval process typically has a faster timeline.

U.S. Commercial Commercial refers to a device company that has an FDA-approved product, and typically is in commercial stage.

Series A Series A companies are defined as U.S. companies raising their first round greater than $2 million in equity or backed by institutional or corporate venture capital.

Indication Definition

Neurology CNS, pain, and psychology comprise neurology.


About the Authors

27

Jonathan Norris Jonathan Norris is a managing director for SVB's Life Science and Healthcare practice. Norris oversees business development efforts for banking and lending opportunities as well as spearheading strategic relationships with many healthcare venture capital firms. He also helps SVB Capital through sourcing and advising on limited partnership allocations. In addition, he speaks at major investor and industry conferences and authors widely cited analyses of healthcare venture capital trends. Norris has more than sixteen years of banking experience working with healthcare companies and venture capital firms. Norris earned a bachelor's degree in business administration from the University of California, Riverside and a juris doctorate from Santa Clara University.

Managing Director Silicon Valley Bank [email protected]

Paul Schuber Paul Schuber is an associate with SVB Analytics leading valuation engagements and specializing in the life sciences. Prior to SVB Analytics, Schuber facilitated clinical trials on behalf of pharmaceutical sponsors and pre-clinical trials to advance medical school research, which included writing and implementing IRB and IACUC protocols. Schuber’s healthcare experience also consists of working as an emergency medical technician and an electrocardiogram technician. He has a background in technology as well, working in many roles, including chief technology officer of an e-commerce company. Schuber earned a master’s degree in the business of bioscience from Keck Graduate Institute of Applied Life Sciences while also studying at Claremont McKenna College at the Robert Day School of Economics and Finance.

Valuations Associate SVB Analytics [email protected]


mailto:[email protected]

mailto:[email protected]

About Silicon Valley Bank For more than 30 years, Silicon Valley Bank has helped innovative companies and their investors move bold ideas forward, fast. SVB provides targeted financial services and expertise through its offices in innovation centers around the world. With commercial, international and private banking services, SVB helps address the unique needs of innovators.

28

This material, including without limitation to the statistical information herein, is provided for informational purposes only. The material is based in part on information from third-party sources that we believe to be reliable, but which have not been independently verified by us and for this reason we do not represent that the information is accurate or complete. The information should not be viewed as tax, investment, legal or other advice nor is it to be relied on in making an investment or other decision. You should obtain relevant and specific professional advice before making any investment decision. Nothing relating to the material should be construed as a solicitation, offer or recommendation to acquire or dispose of any investment or to engage in any other transaction. SVB Analytics is a member of SVB Financial Group and a non-bank affiliate of Silicon Valley Bank. Products and services offered by SVB Analytics are not FDIC insured and are not deposits or other obligations of Silicon Valley Bank. SVB Analytics does not provide investment, tax, or legal advice. Please consult your investment, tax, or legal advisors for such guidance. ©2016 SVB Financial Group. All rights reserved. Silicon Valley Bank is a member of FDIC and Federal Reserve System. SVB>, SVB Financial Group, and Silicon Valley Bank are registered trademarks. 0716-160

About SVB Analytics SVB Analytics, a non-bank affiliate of Silicon Valley Bank, serves the strategic business needs of entrepreneurs, corporates and investors in the global innovation economy. For more than a decade, SVB Analytics has helped global business leaders make informed decisions by providing market intelligence, research, and consulting services. Powered by proprietary data, SVB Analytics has a unique view into the technology and life science sectors.


Documents

Healthcare Investments and Exits Mid-Year 2016 Report