医疗保健行业投资和退出:2023年年中更新.pdf
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1、Mid-Year 2023 UpdateBiopharma|Healthtech|Dx/Tools|DeviceHEALTHCARE INVESTMENTS AND EXITS|MID-YEAR 2023 UPDATE2We are pleased to bring you the Healthcare Investments and Exits Mid-Year 2023 Update,a comprehensive analysis of the trends,opportunities and challenges in todays healthcare innovation mark
2、et.We began 2023 with a cautious outlook,and theres no disputing that the first half of the year has been difficult for stakeholders across the innovation economy.However,a lot has changed since the start of the year.Public markets show early signs of improvement,inflation is decelerating,interest r
3、ates may be near their apex and the general pullback in investment has stabilized.Still,the current investment environment presents ongoing challenges,marked by fewer deals,slower investment pace and pressured valuations.The time has likely come for companies previously avoiding down rounds through
4、insider extensions to seriously consider valuation resets.Companies also face more investor scrutiny and are working against heightened demand for clinical milestones(page 9)and paths to profitability.Despite these challenges,there are reasons for optimism.We see signs of growth at the early stage w
5、here investment has been buoyed by strong interest from investors(page 11).There are promising bright spots in investment,such as womens health expanding into platform,menopause and mental healthcare(page 18),genomic diagnostics solutions(page 12),and devices with robust digital platforms that incre
6、ase the efficiency of provider care teams(page 13).The new investment environment has reset valuations to match sustainable growth and profitability targets in 2023.This adjustment,while painful for many,will lead to a more sustainable future.Venture fundraising has rebounded since its dip in H222,a
7、nd ample capital remains for right-sized investment into the healthcare innovation economy.While the near-term outlook appears uncharted,our belief in the resilience of the innovation economy remains unwavering.Kale FrankManaging Director,Biopharma,Dx/Tools,Silicon Valley BankJackie SpencerHead of R
8、elationship Management for Life Science and Healthcare Banking,Silicon Valley BankRaysa BousleimanSenior Associate,Healthcare Insights,Silicon Valley BankDiamonds formed under pressureHEALTHCARE INVESTMENTS AND EXITS|MID-YEAR 2023 UPDATE3Healthcare market highlightsHealthcare fundraising and investm
9、entsSector to watch:womens healthHealthcare M&A and IPO activityAuthorsGlossary4New private investment landscape marked by valuation corrections,slower investment pace and smaller check sizes;IPO window largely closed but acquirers active on selective basis in H123FundraisingFundraising rebounded af
10、ter a relatively slow H222,hitting$6.8B in Q123 and$6.9B in Q223.This uptick is driven by expectations for lowering Federal Reserve interest rates,a resetting of valuations and very early signs of a rebounding stock market(mostly in the tech and healthtech sectors).The IPO window remains largely clo
11、sed,tying up limited partner(LP)capital in late-stage companies and limiting return distributions.Consequently,more investors slowed late-stage fundraising.Seventy funds closed in H123,signaling that overall interest in healthcare investment remains strong.There is still an unprecedented amount of h
12、ealthcare-dedicated venture capital(VC)to be deployed to top companies at rational,investor-driven valuations.BiopharmaEarly-stage investment jumped this year but at massively reset valuations.Focus is increasingly on companies led by veteran management teams with in-human proof-of-concept/proven mo
13、dalities with compelling stories at“2023 market prices”and realistic exit prospects that do not rely upon the IPO window opening in the next 12-18 months.At the later stage,pre-IPO rounds hit single-digit pace per quarter as investors are more selective and public markets performance by biotechs rem
14、ains mixed but largely negative.Promisingly,2023-vintage biopharma IPOs are performing well with six of eight trading in positive territory.The IPO window shows early signs of opening,with three biopharma IPOs priced in July 2023 raising$465M combined.HealthtechInvestment kicked off relatively stron
15、g in Q1,especially for seed/Series A companies.However,dollars slowed significantly from Q1 to Q223.Seed/Series A investment slowed 63%,and overall investment slowed 39%.We are on track to hit 2019 investment paces if this investment pace continues into H223.At the later stages,we are seeing fewer m
16、ega-deals,with median check sizes dropping substantially.The market downturn has put pressure on companies to add value in critical places where reimbursement is attainable in the near-term.It has also put pressure on D2C models to turn to enterprise to scale.Demand for proven value-based care model
17、s and chronic condition management remains high.The public markets remain closed,with zero IPOs in H123.Private M&A activity remains strong,but acquisition prices are down as acquirers struggle with valuation disconnect at the later stage.We anticipate that healthtech companies will continue to dela
18、y IPO plans until at least late 2023.InvestmentsAfter a major drop in 2022,investment dollars and pace have remained relatively flat for the last three quarters,signaling the dawn of a new market cycle marked by corrected valuations(focused on fundamentals like clinical assets and paths to cash flow
19、 operations),smaller check sizes and more concentrated cohorts of investors.There is a major increase in insider-led bridge rounds as companies continue to face difficulty attracting new investors and avoid“valuation haircuts”that come with bringing in new capital.Anecdotal evidence indicates that a
20、 wave of down rounds and“structured”term sheets have come to market alongside continued cost-saving measures.While this shift has been a painful reset,the market right-sizing can lead to a more sustainable future.Ample capital remains for right-sized investment into the healthcare innovation economy
21、,albeit on a more diligent basis.Dx/ToolsInvestment in H123 matched that of H222 for Series A and late-stage investments,driven mostly by Q123 activity.There were zero IPOs in H123,marking the first year since 2018 with no IPOs in the first half.Public markets remain closed for new entrants,and all
22、indictors point toward a higher bar for IPO hopefuls,both in terms of revenue run rate and ability to generate cash flow.Investors are driving a rotation in strategy:trading high-cost revenue growth for line of sight to cash-flow positive operations.We expect IPOs to continue to be muted in 2023 as
23、the market watches for a rebound in performance for 2020 and 2021 IPO cohorts(33 of 38 are trading negatively).Private companies with unicorn valuations will likely need to wait until 2024 for big M&A exits.DeviceInvestment in H123 is down 8%from H222,but early-stage investment is up 44%and remains
24、a bright spot for investment activity.There are fewer$100M+deals in 2023 as many top companies raised rounds in 2022,and it is uncertain how many later-stage opportunistic device investors will continue to be active.Device companies are hit hard by supply-chain issues and the decline in elective pro
25、cedures.Companies are working to enable profitable long-term growth while achieving necessary near-term cost savings.Weve seen more investment dollars poured into remote monitoring,at-home care and early detection as demand to reduce medical costs and keep patients out of high-cost,acute-care settin
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