GCF - Our added value in Medical & Health sector - 0823 .pdf
1. OUR ADDED VALUE & M&A TRENDS
IN THE MEDICAL & HEALTH SECTOR
BUY SIDE – FUNDRAISING – SELL SIDE
AUGUST 2023
2. 2
P R I V A T E & C O N F I D E N T I A L
TABLE OF CONTENT
I. Market trends in the Medical & Health sector 03
III. Our expertise, added-value & methodology in the Medical & Health sector. 13
IV. About GEREJE Corporate Finance 23
II. M&A trends in the Medical & Health sector 07
4. 4
P R I V A T E & C O N F I D E N T I A L
M&H sector growth rates by country
(2021 vs 2020)
Growth is driven by 4 main factors :
Self-medication
▪ >80% of adult use OTC medicines
Pharmaceutical industry
▪ 6% CAGR (2022-2027) ; 2021 = +40% pharmaceutical R&D expenditures vs 2010 ;
+145% vs 2000
Strong government support
▪ >70% of total health spending comes from public sources
Sources : OECD, Leem, Imis Lyon
THE GLOBAL MEDICAL & HEALTHCARE MARKET
An ageing population
▪ Between 2015 and 2050, people aged >60 will increase by 34%
5,00%
6,10%
11%
12%
16%
0,00%
2,00%
4,00%
6,00%
8,00%
10,00%
12,00%
14,00%
16,00%
18,00%
France USA ASEAN China India
5. 5
P R I V A T E & C O N F I D E N T I A L Source : Organisation mondiale de la santé, Deloitte
POPULAR INVESTMENT TRENDS
The sector is facing 5 main challenges :
Expanding access to health care
▪ 1/3 of the world's population has no access to medical care
Tackling environmental problems
▪ 5% of cancers are related to environmental problems (10% by 2050)
Controlling infectious diseases and preparing for epidemics
▪ +10% by 2030 vs. 2020 (+40% vs. 2000) of diseases
Taking advantage of new technologies
▪ 2021 : $34bn R&D expenditure in medical technology (vs. $23bn in 2011 vs. $40bn in 2024)
Ensure the hygiene of health care
▪ 1/4 of the world's health facilities do not have access to clean water
6. 6
P R I V A T E & C O N F I D E N T I A L Sources : BPI France, Precedence research
Digital health market size (in $bn)
2021-2030
270
332
468
756
1354
0
200
400
600
800
1000
1200
1400
2021 2022 2023 2025 2030
AI and machine learning development
• AI will bring 45% productivity gains for medical and paramedical professions
Increase in teleconsultations
▪ +20% vs. 2020 in the world (+184% in Europe and USA and x100 post-
pandemic)
IoT to improve patient care
▪ Global market of $94.2bn by 2026 (vs. $26.5bn in 2021)
Accelerating interoperability between different
software and health data security
MUTATION OF THE SECTOR : DIGITALIZATION
8. 8
P R I V A T E & C O N F I D E N T I A L Sources : Bain & Company, GCF Research
M&A TRENDS
Deal in pharma = largest value and volume
▪ 60% of M&A deals in the M&H sector concerns the pharmaceutic industry
Consolidation of the private health services sector
▪ France : 151 M&A deals in 2021 (vs. 79 in 2019, vs. 43 in 2017, vs. 23 in 2015)
Growing appetite from investment funds
▪ Eurazeo has invested €1.6bn in this sector in 10 years (more than 70 investments)
▪ French e-health start-ups raised €930m in 2021 (x2,4 more than 2020)
M&A transactions in Europe are expanding fastest
▪ Europe broke all records in 2021, with deal count growing by 50% and disclosed value
rising 85%
▪ 30% of M&A transactions are in Europe
9. 9
P R I V A T E & C O N F I D E N T I A L
Company Size
▪ The largest the company, the higher the multiple with key thresholds (10M revenue;
50M revenue; 100M revenue…)
Profitability
▪ EBITDA margin compared to peer may be the most important comparison criteria
when the companies’ sizes are similar
Market position
▪ A leading position within a local market improves a valuation multiple, on the other
hand, a mid-tier position will drive a lower valuation
Within the same sector, valuation multiples vary according to the size, profitability, and market
positioning of the company
M&A TRENDS – VALUATION METRICS
10. 10
P R I V A T E & C O N F I D E N T I A L Source Mergermarket, Fusacq, GCF Research Click on the logo to access the website
TEV/EBITDA
Target
Investor(s)
Transaction value $8m €3,3bn $235m €230m
Information
IVFtech (UK) : a manufacturer of
advanced equipment for in-vitro
fertilization laboratories
ELSAN (FR): leader in private
hospitalization
Priory Group (UK) : a behavioral
health center
Vivalto Santé (FR): 3rd
largest group of private
clinics and hospitals in
France
Date Jul. 2021 Feb. 2021 Dec. 2020 Feb. 2020
More info here here here here
6,7x 11,0x 7,8x 12,8x
RECENT TRANSACTIONS [1/3]
11. 11
P R I V A T E & C O N F I D E N T I A L
RECENT TRANSACTIONS [2/3]
Source Mergermarket, Fusacq, GCF Research
TEV/EBITDA
Target
Investor(s)
Transaction value €500m €360m $43m €787m
Information
Laborizon (FR): medical
laboratory
INICEA (FR): 3rd largest private
psychiatric operator in France
Moria (FR) : a manufacturer of
instruments for ophthalmic
microsurgery
Fusion de Capio (SE) and
Ramsay Santé (FR) : actors of
the private hospitalization
Date Jan. 2021 Dec. 2020 Jul. 2019 Oct. 2019
More info here here here here
12,0x 13,0x 4,3x 10,4x
Click on the logo to access the website
12. 12
P R I V A T E & C O N F I D E N T I A L
RECENT TRANSACTIONS [3/3]
Date
Buyer /
Investor(s)
Target
Transaction
Value
Information
Learn
More
May.
2022
€183m Alan (FR) : health neo-insurer here
May.
2022
€21m
Implicity (FR) : remote cardiac monitoring
platform
here
Nov.
2021
€50m
Lifen (FR) : medical communication platform
that facilitates exchanges between healthcare
professionals and patients
here
Nov.
2021
€10m 360 Medics (FR) : medical search engine here
Source Mergermarket, Fusacq, GCF Research, MBA Capital Click on the logo to access the website
14. 14
P R I V A T E & C O N F I D E N T I A L
OUR EXPERTISE & ADDED VALUE [1/2]
We focus on 8 main sectors, including the M&H industry. We have a direct access to > 530
companies in this specific sector in Europe, Asia, and internationally
1. Our Expertise & Experience in the M&H sector
Our multicultural teams with our own offices in Europe and in Asia (Paris , Singapore,
Geneva, Lyon, Nantes, Vienna, Lisbon, Munich), and our partners in the Middle East, Africa
and the US
2. Our International presence
Entrepreneurs close to Entrepreneurs = reactivity & adaptability
3. Our “entrepreneurial” culture
Privileged access to > 900 investors (Cap development funds, VC, debt funds, Family
Offices), with a specific interest in the M&H industry
4. Our Privileged access to Strategic & Financial Investors
15. 15
P R I V A T E & C O N F I D E N T I A L
OUR EXPERTISE & ADDED VALUE [2/2]
We prefer to act over the long term as partners alongside business leaders
5. Advisor & Partner
With over 80 closings between 2016 & 2022, GEREJE is No. 1 & No. 2 between 2016 & 2021 in
the Advisory Fusacq ranking – Corporate banking fundraising rankings in France
6. Our Track-Record
Our expertise in structuring complex operations : Earn-Out, Management Buy-Out, Owner
Buy-Out, Joint Venture…
7. Our Expertise in complex structuring
We work with no conflict of interests and ensure confidentiality & discretion
8. Our independence
16. 16
P R I V A T E & C O N F I D E N T I A L
Small Cap companies
~80 companies in Europe, Asia and Worldwide -
listed in our proprietary data base
Mid Cap companies
~170 companies in Europe, Asia and Worldwide -
listed in our proprietary data base
Investors
~900 investors (PE, VC, CVC, Family Offices, etc.)
with a specific interest in the sector - listed in our
proprietary data base
● ● ●
● ● ●
OUR DIRECT ACCESS TO FINANCIAL AND STRATEGIC PLAYERS
17. OUR EXPERTISE IN THE SECTOR
17
P R I V A T E & C O N F I D E N T I A L
Fabrice LOMBARDO
Founder & CEO of GEREJE Corporate Finance
Expertise at the international level, in Europe, Asia (especially ASEAN), Middle East & Africa, in
GEREJE’s 8 key sectors
Education:
BBA at Oxford Brookes Université, Grenoble Business School, Executive MBA at ESSEC, SFAF
Certified
Key Points:
● + 12 years in Business Dev. (multinationals) ● Creation of GEREJE: 2008 ● +100 deals closed
EXPERIENCE & EXPERTISE
➢ + 15 years in M&A consulting for SMID & Large Caps
➢ Buy-Side Mandate & Sell-Side Mandate
➢ Fundraisings (Equity / Debt)
➢ Valuation & Structuring
➢ Speaker & Lecturer at ESSEC Paris, EGE, EDC Paris BS
18. 18
P R I V A T E & C O N F I D E N T I A L
OUR BUY-SIDE METHODOLOGY
Option: Preparation of a "Long-List" of
potential targets in the targeted sector
and geographical area and ranking them
in order of interest and according to M&A
criteria (sales, EBITDA, etc.)
Initiate contact between GEREJE and the
target(s) (without giving the name of the
client) to validate their actionability
Meeting between GEREJE and the client
to select a short list of targets to be
approached in phase 2
Assist our client in the final Due
Diligence
Optimize the discussions between all
involved parties: legal, audit,
accounting…
Advise on the best strategy and tactic
for final negotiations with the target(s)
until closing.
Assist in the drafting & proof-reading of
final contracts.
Drafting & negotiation of a Letter of
Intent (LOI)
Management of client’s questions &
requests (Q&A)
Optimize the negotiations with the
target
Advise on the best structuring (equity /
debt / mix) in the interest of the
shareholders
Option : Preparation of a strategic and
financial note (detailed profile of the
target) for the client
Signing of the Letter of Intent (LOI)
Signing of a Reciprocal Confidentiality
Agreement (RCA).
Meeting between the target and the client
to confirm the strategic fit and the mutual
willingness to enter negotiations
Phase 1 – 1 to 3 months
Market Screening & Preliminary
Approach
Phase 2 – 4 to 9 months
Maximization of Negotiations –
Signing of LOI
Phase 3 – 2 to 4 months
Final DD – Offer – Optimization of the
Closing
19. 19
P R I V A T E & C O N F I D E N T I A L
BUY-SIDE BEST PRACTICES [1/2]
DEFINE clear & ambitious strategies for yourself & the
potential target
1
2
BE PROACTIVE: approach actionable and specific targets
→ value creation
3
TIME is the essence: giving rhythm by respecting a
structured process
4
COMMUNICATION: take the time to explain every step
until the closing
1
2
3
4
20. 20
P R I V A T E & C O N F I D E N T I A L
BUY-SIDE BEST PRACTICES [2/2]
OPTIMIZE the structuring to align the interests regarding
valuation
5
THINK about the forward value by working on a joint business
model
6
ANTICIPATE tax and legal issues (shareholders' agreement)
7
ANTICIPATE the cultural differences (cross border)
8
21. 21
P R I V A T E & C O N F I D E N T I A L
OUR TAILOR-MADE FUNDRAISING & SELL-SIDE PROCESS
Phase 1 – 1 to 2 months
Preparation phase
Financial analysis (past results and
business plan)
Analysis of possible structuring schemes
(equity/debt/mix)
Set-up of an electronic dataroom
Blind Teaser online on our web
platform
In order to optimize the process, it is essential to prepare the project seriously, explain the use of the
funds and demonstrate the positive impact on turnover and margins
Phase 2 – 2 to 6 months
Selection, teasing and approach of
investors - Maximization of
negotiations
Identification of candidates (”long list”)
Checking of candidates’ seriousness, e-
NDA signing, transmission of
documents
Management and optimization of
negotiations with a ”short list” of
qualified candidates
Phase 3 – 1 to 2 months
Closing optimization
Optimize the discussions between all
involved parties, in particular, legal &
audit advisors of both parties
Supervision of financial audits (option)
Advise on strategy and tactics for final
negotiations
Prepare a Strategic & Financial Note for
investors
Negotiation and signature of the Letter
of Intent (LOI), including all the key
terms of the deal
Transition to phase 2 after mutual consent
Valuation report for business owner(s)
Approach of candidates with a 100%
digitalized process
Set-up of a calendar & deadlines
Advise on the different structuring
schemes (earn out) and final review of
the documents in a M&A point of view
Prepare the executive managers for the
negotiations with the investors in Phase 2
22. 22
P R I V A T E & C O N F I D E N T I A L
DIFFERENT TYPE OF INVESTORS
Strategic and financial investors have different investment criteria and objectives involving different sales
strategies and structuring scenarios themselves
• Strategic investors are often competitors, suppliers or customers of the target.
• Their objective is to identify companies whose products or services can be integrated in synergy with their
existing portfolio or gain market share, in order to create long-term value for their shareholders.
• The main driver of the acquisition is strategic (vs. rapid return on investment). These buyers may also be
unconnected to the target and seek to expand in its market to diversify their revenue sources.
Strategic
investors
• Financial investors/buyers include private equity firms, hedge funds, family offices ...
• These players make investments in companies and achieve a return on investment within 5-7 years with a
sale or IPO.
• Some Family Offices have an unlimited time horizon and can invest large sums of money to support the
growth of the business at all stages of its development.
Financial
investors
These buyers have fundamentally different objectives, so the way they will approach
the activities of the targets in an M&A process will differ considerably.
24. 24
P R I V A T E & C O N F I D E N T I A L
THE “GEREJE” PHILOSOPHY
In the 13th century, the Emperor Kublai Khan awarded
Marco Polo a gold tablet in the form of a long piece of
currency named « GEREGE » along with a password,
which ensured numerous privileges to the beholder.
With this golden passport, Marco Polo obtained all
necessary protections, supplies and assistance which
included horses, food and equipment for his safe return to
Venice accompanied by his immense fortune.
The GEREJE, first diplomatic passport,
ensuring safe and secure cross border
transactions, is a powerful symbol
matching perfectly our mission and goals
GEREJE team members share a common
passion in dealing with cross border
transactions and are united around the
GEREJE symbol reflecting our mind set as well
as our working philosophy.
25. 25
P R I V A T E & C O N F I D E N T I A L
OUR WORLDWIDE REACH
We are an independent M&A firm with an “entrepreneurial” culture, providing both strategic and financial
advisory services, composed of a multidisciplinary team based between Europe & Asia
Our Corporate Film
EUROPE
▪ Paris
▪ Lyon
▪ Geneva
▪ Nantes
▪ Vienna
▪ Lisbon
▪ Munich
ASIA
▪ Singapore
▪ Hong-Kong
EUROPE
MOYEN-ORIENT
ASIE
26. 26
P R I V A T E & C O N F I D E N T I A L
EXECUTION TEAM ENSURING THE QUALITY OF THE DOCUMENTS
Fabrice LOMBARDO
Founder & CEO
Antoine ALEMANY
Partner, Lisbon
Clarisse SUN
M&A Associate, Paris
Laurent GOBINET
Partner, Nantes
Hugo MONNET
M&A Vice President, Lyon
Servais MICOLOT
Partner, Geneva
Jeff CZELUSTA
M&A Director, Munich
Hannah DERENBACH
M&A Analyst, Paris
27. 27
P R I V A T E & C O N F I D E N T I A L
SENIORS BRINGING SECTOR & GEOGRAPHIC EXPERTISES
François LAURENT
Senior Advisor, Hong-Kong
Olivier JOB
Senior Advisor, Lyon
Jean de MORAS
Senior Advisor, Paris
Arnaud BEASSE
Senior Advisor, Vienna
Maurice LAM
Executive Director, Singapore
Gregory LAM
M&A Vice President, Singapore
Bertrand LAM
Partner, Singapore
28. 28
P R I V A T E & C O N F I D E N T I A L
Partial or Total Sell mandate
Managing and Optimizing a sell process, leveraging on
our structuring experience, valuation expertise &
international network to maximize the transaction price.
Using every financial tool to align the interests of all
parties.
OUR SERVICES
The quality of our services relies
in our 100% in-house team
enabling us to manage the
entire transaction process,
thereby ensuring efficiency,
confidentiality and tangible
results
Buy mandate / Acquisition / Joint Ventures
Optimizing external cross-borders expansion strategies.
Global Knowhow, Local Approach
Strategic Advisory – Business Consultancy
The experience and operational know-how of the senior
team allows us to optimize the development strategies of
companies and thus facilitate the management of
corporate finance issues (Fundraising or acquisition)
Fund raising mandate & IPO – Capital development
Structure a solid & realistic business plan in order to
maximize the valuation forward and raise the capital
needed (Equity, Debt, Convertible Shares).
Local Markets Approach and Implementation Assistance
for IPO to maximize forward value & optimize
Transaction Structuring
29. 29
P R I V A T E & C O N F I D E N T I A L
OUR PROVEN METHODOLOGY
GEREJE is recognized for the quality of its documents (strategic & financial analysis) based on personalized
execution, enhanced by a multidisciplinary team acting under one hat !
Execution
Excellence
Each assignment is managed by
one Team leader to optimize the process
We rely on our own proprietary
research
Our mandates are on an exclusivity basis
only, including fixed and success fee
Our mandates are tailor-made
We manage 100% of the Transaction
coordinating the process
We deliver regular reports to optimize
the momentum
Our digital platform allows us to have constant
access to all the necessary information
30. 30
P R I V A T E & C O N F I D E N T I A L
OUR REFERENCES– SMID & LARGE CAP
Click on the logo to access the website.
31. 31
P R I V A T E & C O N F I D E N T I A L
OUR STRONG NETWORK OF PARTNERS
Our solid network of partners in Europe and Asia enable us to get qualified, updated information and optimize our
market screening & approach of targets.
EUROPE
Access to +1,100 Family Offices
+150 banks & private bankers
+100 law firms
ASIA
Access to +700 Family Offices
+200 banks & private bankers
+150 law firms
Partnership signed with Business France (website) in 2021
Coverage of 110 countries, offering a direct access to
international investors
32. 32
P R I V A T E & C O N F I D E N T I A L
TESTIMONIES
In this complicated economic
environment, the support and
involvement of the GEREJE teams
were key to the success of the
project.
Mr. François-
Denis POITRINAL
Founder & CEO
Thank you for the excellent work
done by the GEREJE team.
Mr. Kaci KÉBAÏLI
Founder & Chairman
GEREJE supported us successfully &
diligently in structuring our
fundraising process so we can keep
control of our company, They did a
great job at finding the right
investors for our projects!
Mr. Francois
CHABANIAN
Founder & CEO
In this complicated economic context,
the support and involvement of the
GEREJE teams were key elements in
the success of the operation
Mr. Guillaume
RAGUET
CEO
*click on a logo to access the website
33. 33
P R I V A T E & C O N F I D E N T I A L
Articles
Surveys
Apizee - Les 5 tendances de l'e-santé à suivre en 2022
Organisation mondiale de la santé - défis cruciaux pour les 10 prochaines années
Leem - Le marché mondial du médicament
Imis Lyon - L'industrie pharmaceutique : un vivier d'opportunités à l'international
Mindhealth - Levées de fonds pour les start-ups françaises dans l'e-santé
Precedence research - Digital Health Market Size, Growth, Trends, Report 2022-2030
Organisation mondiale de la santé - Rapport 2019
Deloitte - 2022 Global Health Care Outlook - Are we finally seeing the long-promised transformation?
Bain & Company - Healthcare M&A: Record-High Valuations Are Forcing Acquirers to Get Creative
PWC - M&A in Health Industries 2022
PWC - Medical & Health sector Focus France 2022
The role of government in health development
BIBLIOGRAPHY