On January 6, Stryker announced that it would acquire peripheral giant Inari Medical for $80 per share in cash, with a total transaction value of approximately $4.9 billion (approximately RMB 36 billion). The two companies expect to complete the transaction by the end of the first quarter of 2025, but it is subject to the tender of most of Inari's outstanding shares, regulatory approval and other customary conditions.

At the beginning of 2025, the merger and acquisition king Stryker "re-emerged" and threw in a large acquisition case. Behind the first acquisition of the year is the signal that Stryker has officially entered the peripheral vascular market.

Why premium acquisitions are favored

It is reported that Stryker's acquisition was a premium acquisition. Before the transaction was announced, Inari Medical's stock price was about $48, but the actual official acquisition announcement showed that Stryker acquired it at $80 per share in cash. This premium also made the total transaction value soar to $4.9 billion.

Why did Inari Medical win the favor of the giant? First of all, from the perspective of Inari Medical itself, Inari Medical is a company focusing on the treatment of venous thromboembolism (VTE). Its product portfolio includes a variety of nitinol devices and systems for the treatment of different vascular diseases. Its core products include FlowTriever system, ClotTriever system, LimFlow system, Artix thrombectomy system, etc.

FlowTriever large-caliber mechanical thrombectomy system

FlowTriever is the world's first mechanical thrombectomy system for the treatment of pulmonary embolism. It was approved by the FDA in 2015. This product is a large-caliber device that mechanically binds thrombi in the pulmonary artery through a self-expanding nickel-titanium alloy disc. When the large-caliber catheter is aspirated, the nickel-titanium alloy disc retracts into the catheter and entrains the thrombus.

Moreover, it can directly remove thrombi without the need for auxiliary thrombolytic drugs. Currently, only two products, the EkoSonic endovascular system and the FlowTriever system, are approved by the FDA for the treatment of acute pulmonary embolism.

LimFlow System

The LimFlow system is a minimally invasive technology for the treatment of chronic limb ischemia (CLTI). It received premarket approval (PMA) from the US FDA in September 2023, becoming the first and only FDA-approved TADV (transcatheter deep venous arterialization) device. The system is suitable for CLTI patients who do not have a suitable endovascular or surgical revascularization plan and are at risk of amputation. The

LimFlow system consists of a stent graft, an arterial catheter (ARC), a venous catheter (V-Ceiver), and a valve former (Vector) assembly. Through TADV technology, the system bypasses blocked arteries and delivers arterial blood through veins to ischemic and hypoxic tissues in the feet, thereby relieving pain, promoting wound healing, and potentially avoiding amputation.

Artix Thrombectomy System

In November 2024, the new generation of peripheral artery integrated thrombectomy system Artix was approved by the FDA for the treatment of acute limb ischemia (ALI). The Artix system combines the functions of aspiration and mechanical thrombectomy, aiming to improve surgical standards and reduce complications.

The Artix system consists of four main components: FlowSaver blood salvage device, Artix AX aspiration catheter, Artix thin-walled thrombectomy sheath, and Artix MT thrombectomy stent. The design goal of the Artix system is to capture all thrombi through one system. This integrated solution can effectively remove thrombi and relieve the symptoms of acute limb ischemia.

Thanks to Inari Medical's products, after officially joining Stryker, it will be highly complementary to Stryker's neurovascular business, further enhancing Stryker's position in the peripheral vascular field.

Moreover, from the perspective of Inari Medical itself, its development trend in recent years has also been good. As for last year's performance: In the first half of 2024, Inari Medical's revenue was US$289 million, a year-on-year increase of 22.9%. Among them, the revenue of venous thromboembolism (VTE) business was US$275 million, a year-on-year increase of 20.5%; the revenue of emerging therapy business was US$14 million, a year-on-year increase of 101.3%. In the latest financial report for the third quarter of 2024, its performance was also relatively stable, mainly due to the expansion of its sales area, the expansion of new users, the increase in surgical volume, global commercial expansion and the launch of new products.

Kevin Lobo, Chairman and CEO of Stryker, also has high hopes for this acquisition. He said: The acquisition of Inari expands Stryker's product portfolio and provides life-saving solutions for patients with peripheral vascular disease. These innovations have improved the standard of care for patients with venous thromboembolism and will accelerate Stryker's impact in endovascular surgery.

Stable performance,
7 acquisitions in one year

As the king of orthopedic market value, Stryker's latest market value has reached US$135.4 billion as of January 7. And in the past year, Stryker's development momentum has also been in a period of sustained strong growth.

On October 29, 2024, Stryker's third-quarter financial report showed that its revenue was US$5.494 billion, an increase of 11.9% year-on-year; net profit was US$834 million, an increase of 16.7% year-on-year.

In terms of departments, its medical surgery and neurotechnology department, as well as the orthopedics and spine department, also continued to generate blood and grow steadily in the third quarter, with net sales of US$3.22 billion, an increase of 12.8% year-on-year; and US$2.27 billion, an increase of 10.7% year-on-year.

According to Stryker, the growth of the medical surgery and neurotechnology department mainly comes from the strong market demand for medical surgery and neurotechnology, especially in the international market. With the increase in hospital surgery volume and the demand for high-quality medical equipment, the department has achieved double-digit sales growth in multiple markets. Growth in the Orthopedics and Spine segment benefited from continued demand for orthopedic implants, particularly in the knee and hip implants, and Stryker's leadership in orthopedic technology and product innovation helped the segment maintain solid growth in its core markets.

In addition, in the past year, the "king of mergers and acquisitions" Stryker has also continued to exert its strength and continued its strategy of buying, buying and buying. In 2024 alone, Stryker has acquired 7 companies:

On March 21, 2024, Stryker announced the completion of the acquisition of French joint consumables manufacturer SERF SAS. SERF SAS is a company that develops, manufactures and sells joint replacement products. Its products are divided into implants for hips, knees and appendages, and surgical planning software;

On April 30, 2024, Stryker announced the completion of the acquisition of mfPHD, a leader in modular stainless steel wall systems for hospitals and outpatient surgical centers;

On July 15, 2024, Stryker announced the completion of the acquisition of Artelon, a soft tissue fixation developer. The acquisition will strengthen Stryker's products in the field of soft tissue fixation for ligament and tendon reconstruction, supplementing and expanding Stryker's existing product range for foot, ankle and sports medicine professional customers;

On July 31, 2024, Stryker announced the completion of the acquisition of Molli Surgical. Molli Surgical is a private company that specializes in developing wireless soft tissue positioning technology for breast-conserving surgery. This acquisition will further strengthen Stryker's layout of breast cancer care surgical solutions.

On August 12, 2024, Stryker announced a final agreement to acquire Care.ai, an artificial intelligence-assisted virtual care company. This acquisition will enhance Stryker's healthcare IT products and wireless connected medical device portfolio.

On August 22, 2024, Stryker announced a final agreement to acquire Vertos Medical, a developer of chronic low back pain treatment . Vertos Medical has developed a minimally invasive surgical solution called MILD® surgery for low back pain caused by lumbar spinal stenosis (LSS).

On September 20, 2024, Stryker announced that it had completed the acquisition of NICO Corporation, a company focusing on minimally invasive surgery for brain stroke, providing advanced neurosurgical equipment and solutions.

Regarding the acquisition strategy, CEO Kevin Lobo said in the earnings call that mergers and acquisitions are at the core of Stryker's growth strategy and emphasized that mergers and acquisitions will be the company's first major use of cash in the future.

In 2025, Stryker may continue its M&A strategy. In the first month of the year, the first major acquisition has already been launched. What actions will Stryker take in the future?

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