BOOM! Mercom Capital Group published their Q4 and 2020 roundup of global digital health investment and, no surprise, the investment picture for just about anything digital health was in sharp contrast to most of the COVID-afflicted world economy.
- Global VC funding (private equity and corporate venture capital) was $14.8 bn across 637 deals. It was a 66 percent increase in funding compared to 2019’s $8.9 bn in 615 deals. The modest increase in deal number and huge increase in funding points to the acquisition of more established companies requiring Big Deals.
- Total corporate funding, including VC, debt, and public market financing, totaled $21.6 billion
In a stunning change, telemedicine was Top Of The Pops, with $4.3 bn in investment, 139 percent over 2019’s $1.8 bn. It was over double the former star categories of data analytics and mHealth apps.
The top five disclosed M&A transactions in 2020 they tracked were:
- Teladoc’s acquisition of Livongo Health for $18.5 bn
- Blackstone’s acquisition of a majority stake in Ancestry.com for $4.7 bn (despite the ‘bloom off the rose’ of consumer genetic testing)
- Philips’ acquisition of BioTelemetry in cardiac monitoring for $2.8 bn
- Invitae’s acquisition of ArcherDX for $1.4 bn
- WellSky’s acquisition of Allscripts’s CarePort Health (CarePort) for $1.35 bn
The Executive Summary is available for free download at the link in the release. The full report will set you back $599 – $999, depending on the version.
StartUp Health has slightly different numbers but in total investment tracks almost to Mercom Capital’s estimate at $21.5 bn. For telemedicine, it still triples year-over-year but StartUp’s totals are lower: 2019’s $1.1 bn to 2020’s $3.1 bn. Part of the difference may be remote monitoring, which StartUp considers separately. It doubled from $417 million to $941 million. Their deal counts were also higher: 764 in 2020 compared to 716 in 2019. Another fun fact in their tracking are their city leaders in health innovation funding: Beijing, Tel Aviv, and London, confirming that New York and the San Francisco metro no longer have money, interest, or their former attraction. A fuller list would have been interesting. More is in their Part 1 study. Part 2, to be released next week, will cover their dozen ‘health moonshots’.
BioTelemetry , a RPM company in the cardiac monitoring, population health management, and clinical trials research, quietly announced last week two agreements that once again confirm the consolidation of now the remote patient monitoring market:
- The acquisition of the On.Demand remote patient monitoring (RPM) and coaching platform, formerly owned and operated by Envolve People Care, Inc., a Centene Corporation subsidiary. The population health management platform contains real-time monitoring of biometric data with cellular- and web-based technology (including Alexa), proactive and reactive health coaching, population health reporting, and customizable interventions. While acquisition cost was not disclosed, BioTelemetry retains through a strategic partnership agreement Envolve and its base with Centene health plan members for diabetes RPM for the remainder of 2020. BioTelemetry is also free to pursue business with other health plans. Release.
- BioTelemetry will also be a sales agent in the United States for the Boston Scientific LUX-Dx Insertable Cardiac Monitor (ICM) System. Release.
If you go back to 1994, up to 2013, BioTelemetry was CardioNet and one of the Ur-Companies in the RPM space. They went public in 2015 on Nasdaq, and have quietly made many acquisitions both before and after the IPO. Their 2nd Quarter results were $99 million in revenue; operations were profitable, despite a downturn in revenues from the pandemic and beat their estimates (Zacks). Unlike Teladoc and Livongo, their shares have been solidly up since end of July and they’re rated a ‘hold’. Nothing flashy, but solid work.
Is it the technology, or the human touch? It’s only one study, but the sample size is substantial–450 patients–as was the length of time, one year. This randomized group in the Monitor Trial study published earlier this month in JAMA Internal Medicine came from 15 primary care practices in central North Carolina. All were over 30, were Type 2 diabetics who did not use insulin for control, and had glycemic control (hemoglobin A1c) levels higher than 6.5% but lower than 9.5%, which placed them higher than normal but within excellent to fair control (Endocrineweb.com). The 450 patients were divided into three groups: one with no self-monitoring of blood glucose (SMBG) but were monitored at their doctor’s office, another monitored themselves once daily, and once-daily SMBG with enhanced patient feedback including automatic tailored messages delivered via the Telcare meter (acquired by BioTelemetry in December ’16).
There were no statistically significant differences among the group either in the A1C or another measurement, health-related quality of life and “no notable differences in key adverse events including hypoglycemia frequency, health care utilization, or insulin initiation.”
It seems that in this relatively benign group, self-monitoring alone or mildly enhanced–in other words, patient engagement in SMBG–made no significant difference. The UNC-Chapel Hill researchers concluded that “This pattern suggests that, for SMBG to be an effective self-management tool in non-insulin-treated T2DM, the patient and physician must actively engage in performing, interpreting and acting on the SMBG values.” (Editor’s emphasis) In other words, more–not less–human contact would be needed for SMBG to work better, at least with this group! This Editor would then like to see a comparison with insulin control. Also Healthcare Dive
It depends on the study you read and how jaundiced your view is. If you believe the StartUp Health Insights 2016 ‘Health Moonshots’ report, 2016 digital health funding has hit a zenith of $8.18 bn (up 38 percent from 2015), with 500 companies enjoying funding from over 900 individual investors. Yet over at fellow funder Rock Health, the forecast is far more circumspect. They tracked only half the funding–$4.2 bn in funding–with 296 deals and 451 investors, down from the $4.6 bn over 276 deals in 2015.
There are significant differences in methodology. Rock Health tracks deals only over $2 million in value, while StartUp Health seems to have no minimum or maximum; the latter includes early stage deals at a lower value (their cross-section of ~$1 million deals has 15). StartUp Health gathers in international deals at all levels (pages 11-12), whereas Rock Health only includes US-funded ventures. Another observation is that StartUp Health defines ‘digital health’ differently than Rock Health, most notably in ‘patient/consumer experience’, ‘wellness’ and ‘personalized health’. This can be seen by comparing their top 10 categories and total funding: (more…)
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