Technology Start-up Investment Analysis

early-stage technology investment sectors Version A3 Angels-1.0 © Venture Concept 2011

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Summary This document is contributed for discussion for training on early-stage technology investment. It compares investment sectors , in Switzerland and neighboring Europe. We have indicated some relevant trends and investment structures. The document was prepared Venture Concept internal research from publicly available sources. None of the information represents an endorsement or a recommendation to invest. Readers are encouraged to verify the facts and complement with their own updated research. Summary ................................................................................................................................................................. 1

Investigation of investment sectors ..................................................................................................................... 4

Summary of sectors ............................................................................................................................................ 4

Telecommunications .......................................................................................................................................... 5

Technologies .................................................................................................................................................. 5

Opportunities ................................................................................................................................................. 5

List of start-ups ............................................................................................................................................... 6

Software for security and finance ...................................................................................................................... 7

Technologies .................................................................................................................................................. 7

Opportunities : ............................................................................................................................................... 7

Experts ............................................................................................................................................................ 8

List of start-ups ............................................................................................................................................... 8

ICT for travel & transport, hospitality ................................................................................................................ 9

Technologies .................................................................................................................................................. 9

Opportunities ................................................................................................................................................. 9

List of start-ups ............................................................................................................................................. 10

Experts .......................................................................................................................................................... 11

Industrial technology ....................................................................................................................................... 12

Experts .......................................................................................................................................................... 12

List of start-ups ............................................................................................................................................. 12

Cleantech ......................................................................................................................................................... 14

Opportunities ............................................................................................................................................... 14

VC Investments overview ............................................................................................................................. 15

Technologies ................................................................................................................................................ 17

Experts .......................................................................................................................................................... 17

List of start-ups ............................................................................................................................................. 17

Medical devices ............................................................................................................................................... 19

Technologies .................................................................................................................................................... 19

Experts .......................................................................................................................................................... 20


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Medtech sub-sectors ........................................................................................................................................... 21

Medtech is 30% of life sciences industry ........................................................................................................ 22

Medtech devices is a 300 B$ market .............................................................................................................. 22

Growth : up to 8% in early stage ................................................................................................................ 23

Valuations : 13 to 20 P/E .............................................................................................................................. 23

VC investment : stable, 25% of total ............................................................................................................... 23

VC investment in Switzerland : 50M CHF in medtech .............................................................................. 24

VC investment in neighbouring France : 35M$ in medtech ...................................................................... 24

Overview of sectors ......................................................................................................................................... 25

Cardiology ............................................................................................................................................................ 26

Opportunities : 84B$, 66B$ interventional ..................................................................................................... 26

Epidemiology ............................................................................................................................................... 26

VC deals : over 500M$ in cardiology .............................................................................................................. 27

M&A : over 5B$ at 6 X revenues ...................................................................................................................... 28

Regional start-ups seeking finance in 2010 .................................................................................................... 29

Industry structure : top 20 make 32% of industry ........................................................................................... 30

Orthopaedic ......................................................................................................................................................... 31

Opportunities : 43 B$ growing at 7-17% ........................................................................................................ 31

Epidemiology ............................................................................................................................................... 32

VC investments : 280M$ .................................................................................................................................. 32

M&A : 70% of volume, over 6B$...................................................................................................................... 33


Industry structure : top ten = 62%................................................................................................................... 35

Imaging ................................................................................................................................................................ 36

Opportunities : 16B$ and 7% growth ............................................................................................................. 36

VC investment .................................................................................................................................................. 37

M&A .................................................................................................................................................................. 37


Industry structure : top 3 = 75% ...................................................................................................................... 39

Diagnostics ........................................................................................................................................................... 40

Opportunities : 50B$, 6% growth .................................................................................................................... 40

VC investment around 250M$ ........................................................................................................................ 41

M&A .................................................................................................................................................................. 42


Industry structure : top 3 = 44%, top 10=80% ................................................................................................ 43

Surgical, Ophtalmo, Neuro, Urology .................................................................................................................. 44


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Opportunities : 16B$ ........................................................................................................................................ 44

VC investment : >200M$ ................................................................................................................................. 44

M&A .................................................................................................................................................................. 45


Healthcare information systems ...................................................................................................................... 49

Technologies ................................................................................................................................................ 49

Opportunities: .............................................................................................................................................. 50

Transaction history ....................................................................................................................................... 51

Experts .......................................................................................................................................................... 51

List of start-ups ............................................................................................................................................. 52

Sources ................................................................................................................................................................. 53

Events ............................................................................................................................................................... 53


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Investigation of investment sectors

Summary of sectors In the following pages, we have performed a 1st pass analysis of several sectors. We analyze opportunities around Switzerland. For each one the approach includes :

• Elements of macro analysis such as relevant trends and technologies. • Bottom-up information such as sample of start-ups met during recent events.

Sector Attractiveness Regional expertise Competition

IT security

ITC segment has been selected to narrow down the overall IT segment.

Good technology and access to domestic market.

High EU, US, Asia

IT tourism, transport

Logistics, travel & transport, hospitality and recreation : this is a somewhat unusual grouping of specialized niches benefiting from similar cloud, mobile, embedded electronics, image processing technology innovations.

Switzerland has the mix of business and tech advisors. There are also industrial players.

Fragmented except US.

Telecom

Attractive but not best-in-class as other countries (Nordic, UK, France, Germany). Good Swiss and French M&A players on adjacent telecom markets (consumer entertainment, industrial).

Existing industry contacts and expertise. Low Swiss expertise except niches.

High, Nordic, Asia, US. Corporate VC and dedicated VCs.

Cleantech

Growing segment WW. Regional catch/up public incentives and a few niches. The domain has increasing VC investment investments.

Electricity and power expertise

Very high China, USA

Life sciences

Medical devices segment excluding biotech. Option exist to narrow down to areas like interventional cardiology or orthopedics. Also enabling technologies. The domain has increasing VC investment. Subsector are described in more details in this section.

Leverage regional science know-how and manufacturing expertise

High, consolidation of corporate, established VCs.

Industrial

Generalist approach can be narrowed down to technology expertise in micro-tech, electronics and embedded software.

Modest. Can be executed in synergy with another sector.


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Telecommunications Mobile and fixed broadband telecommunication services are being re-shaped :

• Universal mobility, growing towards 4 billion users is expanding worldwide, especially Asia and BRIC.

• All eyes are on Apple and Android. User experience is driving consumer demand, offering new multimedia content, smartphones, tablets and even reshaping telephony

• More than applications but access to services. Cloud and mobile applications business is approaching the size of the content business.

• A global move of telco infrastructure to lean cloud-based operations drives the consolidation and cost of services down

• Industry players attempt to re-invent themselves with new service business models

Technologies We look for innovation that helps face these challenges.

• New mobile applications and media offerings, personalization using customer and social intelligence,

• Wireless applications enabled by NFC, RFID, machine to machine • Underlying technologies : micro-projectors, sensors, new displays, systems on chips (SoCs) • Telco software for massively scalable business processes improvements to generate

efficiencies, simplification of service delivery to end-users. • Telco software for payment, billing, and operations support.

Opportunities • EU VC investments in communications and networking were 184 M€ / 47 deals in 2010 and 64

M€ / 22 deals in Q1-3 2010 (Thomson) • Growth of smart-phones: 55% smart phone shipments as a percentage of total mobile handset

shipment (IDC 2010). • Mobile applications and content business (10B$ ?). 350K apps (Apple 250K, Android 70K)

reaching 1.8B$ (Gartner) • Augmented reality emerging as a basis for new user experiences combining multimedia,

image processing, 3D movement and feedback (haptics). • 3G wireless, 4G LTE technologies • Broadband and fiber-to-the-home/premises networking. • Telecommunications public stimulus plans boost service providers and equipment

manufacturers.


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List of start-ups The list is a indicative sample.

Name Description Opportunity Information

Apprupt Enables mobile app developers to market their apps on a on a pay-per-download basis to specific target groups of users within its network of publisher partners. Competes with admob, mobclix, getjar. Investor DT, Neuhaus. Hamburg.

5B app download. 250K Apple + 100K Android apps. 25 B$ mobile app market

www.apprupt.com

Axelprod Data transmission using the GSM network for industrial applications. CH

Decentlab GmbH

Monitoring solutions based on wireless communication technology. CH

DigiComCore SA

Software simulation for telecom systems

Fonapp Application and development framework for mobile devices. CH

Founded in 2004 by Esmertec co-founder

Gbanga Mobile, location-aware story-telling engine that blurs the boundary between your reality and the virtual world. Zurich

250K€ e www.gbanga.com

Getjar Mobile appstore with 75K apps for 26M unique visitors serving 350K developers. Second to Apple appstore. Investor Accel.

12.5 M€ raised Profitable since 2004 300% CAGR 17B$ app market in 2012 25% marketshare for Getjar

www.getjar.com

Insightsip Bluetooth low energy system-in-package module. Wireless video transmission in 5GHz RF band.Product ready with industry customers.

2M€ on 860K€ 2010 sales 350K$, cashflow + 2011 SiP market growth 15%

www.insightsip.com

Layar Augmented reality browser with 1M users, 5K developers producing 1.5K apps. Investors Prime Technology Ventures, Sunstones

1.2 B AR capable phones in 2013

www.layar.com

Les Alchimistes

Interconnecting call centers. CH www.les-alchimistes.com

Multibo Radio hood is an audio-enabled podcast targeting social networks. Start-up Munich and London

800K€ @ n/a 38M€ 2013e

www.multibo.com

plista Mobile web advertising for local advertisers. Recommendation and video ads + white label self-service ad booking. Expansion. HQ Berlin

3M€ on 1.25 M€ 5M€ revenue 2011 Serial entrepreneur

www.plista.com

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Software for security and finance This segment of the industry is facing the following changes: Security

• Increased internet security challenges (7% of consumers victim of fraud, 32% of NA SMBs hit by cybercrime several times)

• Protection required on PC but also within internet • Legislation on cyber security and privacy

Financial software • Fragmented IT back-end due to financial sector mergers and acquisitions • Front-end applications to due to acquisition of new customers particularly SMB and affluents, • Demand for on-line products (25% consumer usage of electronic banking, 21% Gen X-Y interest

in mobile payment, 3.6% of users of financial social networks) • New players entering the banking market : nimble entrepreneurial cultures, offer specialized

services and exploit profitable niches, such as monoline lending based solely on quantitative credit scoring.

• Financial governance and compliance requirements ( Sarbanes-Oxley, Basel II, BSA, ARC, Check 21.)

Technologies We will help identify opportunities for relevant technologies : Security

• Endpoint security, authentication, digital signatures • Security services for the cloud and virtualization infrastructure • Information-centric security such as in-device encryption • Business process security and policy management (entitlement management)

Financial software • Electronic trading tools, single-dealer portals • Data integration middleware. • Low-latency transaction processing. • Electronic invoice presentment and payment (EIPP) • NFC contactless payment

Opportunities : • Security software market 16.5 B$, 10% growth (Gartner 2010). • Consumer security software market 4.2 B$, • End-point (enterprise) software market 3 B$, • network services spending 9.1B$ • UK SMB spending on managed security 42 B$ (2007)


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• Appliance-based security for e-mail CAGR 25% • Appliance-based security for SIEM and secure Web gateway CAGR 20% • Chinese video surveillance market483 M$.

Experts • Olivier Trancart, A3, former VP Finance Oracle, System Access

List of start-ups The list is preliminary and reflects opportunities currently available in our network. Name Description Opportunity Information

Adeya mobile security solution, user-friendly and compatible with most existing mobile phones

www.adeya.ch

Amalto Business document exchange in the cloud, mainly active in oil and gas industries in GCC but expanding in other verticals. Competition Ariba, GXs, ADP. HQ Paris. Investors Bas and Success Europe

2M€ on 2M€ 5B$ procurement processes in oil&gas

www.amalto.com www.b2een.com www.onget.net

Axionics Digital identity in your pocket www.axionics.com

Clear2pay Open Payment Framework (OPF) enables financial institutions to improve internal payments processing efficiencies whilst at the same time providing their clients with better payment services that are faster, with richer payments related information. Competes against ACI, Fundtech, IBM. HQ Belgium. Investors Intel, Iris capital, PMV, Quest for growth, …

50 M€ on 110M€ in last round. 43M€ revenue 2010 Tier 1-3 financial institutions.

www.clear2pay.com

Commonit Entreprise web security and mobility. Browser sessions running on a server access internal or external resources. The user accesses sessions using remote display technology. F Rhone Alpes

500K€ on 500 K€ 2010 sales 200K€

www.commonit.com

e24 AG Mobile payment and transaction management

IRIS Internet Risk Insurance Services SA

security monitoring and management platform, with correlation

www.swissiris.com

KeyLemon SA Innovative and convenient services based on biometric identity authentication, based on face and speech recognition, for all Internet users with a webcam.

www.keylemon.ch

Khamsa SA email and mobile phone security

NetGuardians IT monitoring platform, for companies seeking to improve their IT operational governance. and protect from data leaks, forbidden access and unauthorized use of privilege.

www.netguardians.ch

Secu4 Protection of people and valuables based on wireless technologies

BAS /Jade investment

www.secu4.com

Sensometrix SA contactless biometric terminal based on palm vein recognition

Nicolas Rebetez www.sensometrix.ch

Sopima Online contract management moves negotiations on-line and supports collaboration between parties. Sopima is built very secure and the environment is constantly audited – as safe as a bank.

www.sopima.com

Sysmosoft Mobile security solution, with cloud and device software www.sysmosoft.com

Visiosafe Social network enabled video surveillance network. Abnormal behaviors detection and sharing them with network of interest. 150 CHF Wifi IP Pan/tilt Infra-Red camera ; 15 CHF / month Saas management service . competition: alarm systems (500-15K CHF) or Saas without all features.

Market USA 20M homes with surveillance, 2M burglaries (CH 100K, 70K)

www.visiosafe.com

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ICT for travel & transport, hospitality Challenges in these industries include:

• Worldwide competition in the airline industry resulting in revenue drop and refocusing to specialized markets

• Increased requirements for security and safety in public transportation • On-line recommendation, location, reservation systems driving customer purchasing creating

numerous marketing channels. • Need to target new customer segments and customer engagement products in hospitality • Complex and costly human resource management of part-time flexible workforce • Changing patterns of entertainment and recreation

Technologies • Integrated reservation systems covering lodging, multimodal transport (airlines, car, train, bus)

recreation and overall customer self-service. • On-line marketing services including mobile, location, social networking recommendations. • Hospitality management solutions including POS, headsets, inventory, payment, employee

training/scheduling • Transport and logistical process management :bulk inventory (sorting / repackaging goods),

order fulfillment (labeling, pricing), supply chain integration • Just-in time shipping : RFID tracking, warehousing automation, fleet location management. • Technology for media distribution : lighting, display, sound

Opportunities • International tourist arrivals fell by 4% in 2009 to 880M. • Tourism in EU is expected to grow 3% in 2010 and accelerate in 2011, when 2008 levels will be

regained. EU tourism industry generates 5% of EU GDP, with 1,8 million enterprises employing 5,2% of the labor force (9,7 million jobs). Including related sectors it indirectly generates 10% of EU GDP.

• In June 2010, 100 million Americans visited the travel site sub-categories. Travel transactions sites, 32 percent to 5.2 million ( Viator.com #1 in with 1.1 million). Hotels/Resorts sites with 36.6 million (Marriott #1 with 6.5 million).

• "Sheraton Hotels & Resorts announced the launch a website with Facebook Connect to their friends and family for 2-way dialogue about travel experiences.

• (POS) technologies : tableside payment options can manage forecasting, financials, marketing, customer loyalty and inventory control are cited by operators as most important.

• In-room innovations: rich user interface, flat panel display, touch screen at the bedside, greeting at the door, automatic lighting and curtains, RFID-enabled door locks, message indicators sent to the TV television, room settings for every guest ( "good night" button let's guests turn off the lights, TV and music, close the curtains, and enable the privacy notification)


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• Mobile development is occurring within the pizza segment, as Pizza Hut and Domino's both continue to tap next-gen customers through iPhone apps and on-line ordering respectively.

• 300 hotels are now involved in a potential legal action against TripAdvisor, concerned about alleged defamatory reviews appearing on hotel pages on the site.

List of start-ups The list is preliminary. Name Description Opportunity Information

Abonobo

Restaurant guide with single-click access to restaurants' images, menus and notably special offers. Exposing these offers attracts users and makes the application an ultimate tool to capture the undecided audience.

Self-funded http://abonobo.com/

Arxit

FoxyTour Intelligent city, museum and trip guide. It is remarkable of its geolocalization technologies, decision support system (the world's top) and virtual tagging.

http://www.arxit.ch/

Aviq Digital media distribution, over the topo TV for consumers and hospitality solutions. TipTV IPTV device. Zurich

33B$ 2013 market for IPTV equipment, 290 M householdes

www.aviq.com

BMOB On-street sensor-enabled automatic parking management and payment system. Seed. Lugano

Seed www.bmob-park.com

CityOnline.net e-guide access on the web with any mobile device. CH

www.cityonline.net

EverdreamSoft / Moonga

Simple, ergonomic and innovative products to a public that values mobility

Food Arena Geolocalization –enabled ordering , deployed for more than 250 Swiss restaurants, pizzerias and kebab shops.

http://www.foodarena.ch/uk/

Frogbus Virtual low-cost bus service.On-line sales and ticketing across intercity and airport bus operators. Competition Eurlines, National Express internal services. Fleet tracking under development. Development phase . Ireland and France.

1.5M€ on 750K€ Market 500M€ in FR, users <25 >55 airport users

www.frogbus.com

GAB Gestion de véhicules pour le transport routier. Seed www.gabtechnologies.com

Geoguides GeoGuides is a provider of mobile, location-based software products and services. Development using GeoVector’s patented directional search and augmented reality technologies. World Surfer location browser on mobile markets worldwide.

http://www.geoguides.ie

GetYourGuide Online platform for tours, attractions & activities for local suppliers of sightseeing tours, excursions or outdoor products.

www.getyourguide.com

Horizon Info Solutions

Promoting remote resorts for online booking through a portal.

www.resortroute.com

HouseTrip SA Online marketplace for holiday rentals. Property owners will be able to auction short-term rentals of their properties and correlatively users will be able to bid for a stay.

http://www.housetrip.com/

Ingecom Sàrl ACTIVE TAG to track & trace & streamline logistics.

iTaste iTaste makes choosing a restaurant fun and easy. This is second generation Web2.0 applied to mobiles, it's always available, it's interactive, it's relevant and fun. CH

www.itaste.com

MadeInLocal Social network for local life. Keep in touch with your friends, merchants and events near you.

Seed http://www.madeinlocal.com/

Moonga (EverdreamSoft)

Simple, ergonomic and innovative products to a public that values mobility

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NeuroPie Solutions AG

Airport operation intelligence software. Provides in-depth information on key processes such as passenger flows, baggage sorting, security controls, check-in and car park capacity utilization. Airport Performance Management (APM) and Collaborative Decision Making (CDM) software. Zutich.

Jürgen Weder www.neuropie.com

Palisis GmbH Portable business solutions for passenger transportation companies, tourist businesses and others.

www.instantticketing.com

Red carpet Web-based hotel property management system 10€/room. HQ .

www.redcarpetsoftware.com

routeRANK routeRANK finds and ranks the travel routes, based upon preferences such as price, travel time and CO2 emissions, combining rail, road and air.

www.routerank.com

Spoil Me Websites for wealthy consumers Seed www.spoil-me.com

YoureUp Car pooling software solution. 500K @ 1.6M CHF 50K users over 5 years 2012e 3.6 MCHF revenue

Wazzup SaaS for realtor sector. 2500 current real estate customers. Adverting revenue model. Profitable in 2010.

500K€ on 600K€ 2010 sales 1.2M€

www.wazup.com

Provatis SA Fleet management for enterprise and consumer security solution for cars.

Seed www.provatis.com

Experts Example of regional business advisors :

• Prof. Lukas Ritzel, IMI, Luzern • Prof. Ray Iunus, EHL • Prof. Antoine Wasserfallen, EHL

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Industrial technology Manufacturers are generally facing the following issues:

• increased global competition • changing patterns of customer demand • escalating business costs • problems in implementing new technologies • competitive business pressures

Opportunities include innovation and systems that addresses these issues:

• SCM Supply Chain Management – Suppliers oriented • ERP Enterprise Resources Planning – Production oriented (flexible production planning,

inventory tracking, work orders tracking, logistics and operations) • Micro technology • Robotics • Sensors and actuators • Embedded software as part of manufacturing automation

Experts We have industrial contacts.

• Alen Ugnat, Macdal International (microtechnologies) • Luc Olivier Bauer, Nano dimension (nanotechnologies) • Marie-Laure Berthié, EPFL (software, electronics and sensors)

List of start-ups The list is preliminary.


AgoraBee SA AgoraBee provides a complete platform for active RFID (Radiofrequency Identification) and location-aware WSN (Wireless Sensor Network).

Wayenberg Alexandre

Attolight Measurement tool for nanostructures with very high spatial and time resolutions.

Samuel Sonderegger

Canatu Printable electronics and photovoltaic, patented carbon based material for energy and electronics industries. Espoo, Finland

5 M€ @ X 12.4 M€ 4B€ touch sensor market 38% CAGR

www.canatu.com

Celeroton AG Ultra-highspeed electrical drive systems for renewable energy generation

Dr. Martin Bartholet

Dacuda Document scanning with handheld devices. Dacuda's technology bases on real-time feedback, video-stream stitching, and workflow integration. Dacuda's strength and competence is software which can stitch together hand-scanned content. This technology is used to build the world's first scanning computer mouse.

Alexander Ilic

http://www.canatu.com/�


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Dacuda AG Technology based on optical sensors for use in computer mices.

Dr. Alexander Ilic

Dectris Next generation x-ray detectors Christian Broennimann

Femto Tools Design and fabrication of high quality measurement and handling instruments for the micro and nanodomain.

Nagy Zoltan

Future Instruments

System for transforming any surface into a touch sensitive interface.

Greg Kellum

Greenteg Thermoelectric generators (TEGs) and cooling elements (TECs) in a totally new manner, resulting in flexible and low cost thermoelectric devices. Zurich

www.greenteg.com

Imina Technologies

Micromanipulation solutions. The extreme simplicity of the miBot, an ultra compact mobile micro-robot with nanometer resolution motion, enables to significantly reduce the preparation time for setting-up an experiment and makes complex manipulations at nanoscale very easy to perform.

Benoît Dagon

iNoCs Semiconductor modeling software Federico Angiolini

www.inocs.com

Lemoptix AG Development of next generation optical MEMS (micro-electro-mechanical systems)

500K$ over 1.5M$ @ 7M$ 2010 sales 600K$ cash flow positive 2012

www.lemoptix.com

LFCM Fluorescence microscopy is a widely used technique in life sciences. However, high performances in detection come with a limitation on the area to be observed, slowing down large scale studies. Parallelization is a key to increase the throughput and the Large Field Confocal Microscope (LFCM) provides such a solution in the fluorescence imaging domain. The time needed to perform biochemical analysis or tissue studies is therefore substantially reduced. Furthermore, former impractical studies become possible.

Seed

Nanograde Custom production of nanoparticles and the development of products by the use of such nanoparticles.

Halim Samuel

NanoInc Nanoparticle based printed electronics for flexible and disposable RF identification (RFid) tags

Cédric Dockendorf

Nanolytix Detection of nano-particles performing in-house and mobile service analysis of samples as well as the development of innovative technologies to produce and distribute validated turn-key

Christopher Latkoczy

Piezosens Piezoelectric resonators for high-performance sensors in bio and medical applications.

Milyutin Evgeny

Senseor Surface acoustic wave sensors for temperature, pressure and stress measurement. Investors Vizille capital, Sudinova, Success Europe. 20 industrial customers in energy, transportation, automation, healthcare. <<competes with thermocouples and strain gages. HQ Mougins, France.

1.5M€ on 2.3M€ Revenue 2010 1.8M€ cash flow positive 2011

www.senseor.com

Senseplus Microelectronics

3D image sensors ICs for the consumer market Paolo Orsatti

Simplysim Saas software tools for building 3D and virtual reality and augmented reality. Applies to simulation, marketing. Initially corporate R&D customers, 700 beta users. Competition 135 suppliers including Unity3D, Dassault/Virtools. HQ Sophia Antipolis

1M€ over 70K€ raised from SBA, 170K€ sales 2010

www.simplysim.net

Spectralus Periodically poled nonlinear crystals and laser products. PPMgOLN is used for conversion of infra-red laser into wavelengths such as blue, green and yellow (400~600nm) . Applications include instrumentation, laser displays, biomedical, scientific. Competes with Corning, Osram, Novolux. Production Armenia, HQ Russia and USA

15M€ over 6M€ investors S-Group V. 9Me sales 2011e

www.spectralus.com

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Spinomics Automated and miniaturized systems enabling extraction, manipulation and detection of biochemical substances.

CEO Tomas Svoboda CTO Amar Rida

Funded

YanaCo Magnetic nanobeads for protein separation and purification Robert Grass

Cleantech Cleantech covers many different segments such as : energy, air, water, waste and sustainability. Value creation requires multi-disciplinary approaches with solid engineering, scientific and business background.

Opportunities The investment opportunities are driven by the following trends

• Favorable public policies such as 150B$ stimulus investments in energy-efficient infrastructure, climate change programs ( USA 56B$, China 47B$, SK 28B$, EU27 ~23B$). However public intervention can bring unpredictable distortions in this market segment.

• US VC investment in cleantech declined 59% in Q3 2010 to 625M$ into 58 deals. The decrease in Clean Technology investments was driven by a lack of large rounds, which has been seen in previous quarters. (Thomson)

• Cleantech EU investment 155 B$, 5% growth (2008) of which 51B$ in wind, 35B$ in wind. EU VC investments in renewable energy were 383 M€ / 122 deals in 2010 and 64 M€ / 33 deals in Q1-3 2010 (Thomson)

• • Innovation from 2000 cleantech start-ups worldwide, the #100 global cleantech 2010 includes :

USA 55, GB 11, D 7, ISR 5, SE 4, FR 3, CH 1(Landys & Gyr smart metering solutions have raised 250M$ VC funding).

• 6B$ VC-funding of 600 deals (2009) supported by IPO market. In 2002-05 clean tech attracted 6% of total VC in NA - in 2006-09 up top 18% of VC investments. Specialist clean tech investors include Braemar Capital, Chrysalix Energy, Climate Change Capital, DFJ Element, Emerald Technology Ventures, EnerTech Capital Partners, Environmental Technologies Fund, Expansion Capital Partners, Global Environment Fund, NGEN Partners, Nth Power and Rockport Capital.

• Compared to North America, Europe (except Germany) is still lagging behind, as part of the innovation comes from private SMEs which are not open to private equity. In VC investment was 360M$ in 56 deals in 2007 and 1.8B$ in 2009.

• Swiss investment activity funds ( Pictet 650M$ + water 2.4B$, Rotschild cleantech 400M€, Sustainable asset management) and VCs (17+5 MCHF Swiss VC investments in 2008+09, 5.2.5% of VC investments, Emerald cleantech 300M€+150M€ 46 deals, Index est. 30M€ cleantech- below EU and US investments)

• A boom-and-bust scenario looms in energy especially in by solar and biofuels. Swiss energy funds 1-year/3-year returns are ~-15% / -50% returns in 2010. Solar prices drop -40% in 2009 and 0% market growth. Global investment in renewable energy 600B$ by 2020.


p.15

• Innovation gap in air, water, and waste technologies. (126 M$ cumulative VC investment in waste since 1995)

• M&A market from corporations making clean tech venture investments (70 B$ in 1995-2004) include: BASF, Boeing, Chevron- Texaco, Eastman, GE, HB Fuller, Honda, Intel, Norsk Hydro, Mitsubishi, Motorola, Royal Dutch Shell, Schneider Electric, Siemens, Suncor and Unilever

• Cleantech public catch-up initiatives in Switzerland (Geneva, SECO, Private) • Swiss market leaders examples : Meyer-Burger/3S and HCT silicium manufacturing equipment

for solar hold 80% market share. Oerlikon solar thin film solar technologies. • Until 2008, London’s AIM was favored as IPO market 124 amongst clean tech companies, over

NASDAQ and Frankfurt exchanges (solar IPOs include the Norwegian Renewable Energy Corporation (REC) raising 1B$ on listing, valuing the company at 8B$)

VC Investments overview


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p.17

Technologies Based on regional industry and academic expertise we can monitor and support opportunities such as

• Smart grid, storage, energy measurement, regulation systems and related device / software • Cleantech technology enablers : materials and manufacturing equipment • Industrial cleantech : waste and CO2 management • Transport optimization, fleet management, hybrid cars/public transport • Renewable energies technologies : PV, solar/geo thermal, pumps • Water treatment

Experts Network of specialists include :

• 160K Swiss employees, 3% GDP (Swiss cleantech association) • E4tech, François Vuille • Cleantech Alps, Eric Plan • Swiss Biotech, Thierry Schwitzguebel

List of start-ups The list is preliminary. Some start-ups listed in transport software section.


Alertme Home energy monitoring. Web and mobile home energy management . Investors Good Energies, Index, Vantage Point, SET. HQ London.

15 M£ on 13 M£ 50 M€ revenue 2012 e 1B€ equipment in home energy market 28M users by 2015.

www.alertme.com

Avantium Ccatalytic process to convert biomass feedstock into YXY molecule to make materials and fuels. Investors DFJ, Aescap, Capricorn, ING.

15 M€ F on 78 M€ 11 M€ revenue 2010

www.avantium.com

Belair biotech Waste Water treatment research and Development. Geneva

3MCHF on 400KCHF

Domteknika Softcars Clean and high performance urban vehicles with sustainable life cycle (production - use - recycling)

http://www.domteknika.ch

Ecospeed internet-based software tools for calculating energy consumption and greenhouse gas emissions

Enairsy Sustainable energy storage solutions, based on the innovative hydro-pneumatic and power electronic technologies (HyPES) .

Seed http://www.enairys.com

Enecsys Micro-inverters and grid management for PV panels with 25 yearsw lifetime (vs. 10yrs with string inverters) . Competition Enphase, SMA, Fronius. HQ Cambridge

20M€ @ X 13M€ 2 B€ 7 GW market 30% CAGR

www.enecsys.com

Eotheme

Generation plume

Disposable / washable diaper for babies. New textile and industrial design to reduce costs and waste. Competition : Pampers, Huggies and 4 other eco-brands Paris

500K€ on 270K€ @ 2.5M€ 185K€ sales 2010 Target 1.5% of 725M€ market in France

www.hamac-paris.com

Gerocco Solution helping people managing their home energy consumption. Based on electronic devices and web interface, this solution provides simple advices. Geneva

Seed www.geroco.ch

http://www.alertme.com/�

http://www.avantium.com/�

http://www.domteknika.ch/�

http://www.enecsys.com/�

http://www.hamac-paris.com/�

http://www.geroco.ch/�


p.18


Hop-Cube Retail and manufacturing environmental label and on-line information system. Seed. Competition Greentext, Quantis, MyCO2. HQ Paris

500K€ on 100K€ Brand value on FR market

www.hop-cube.com

Iland Consumer solutions integrated in the field of systems and solar technologies. Applications for leisure, expeditions, isolated environments, island situations

BAS investment Estimated 200K CHF

http://www.iland-solar.com

INDEOtec Systèmes automatisé de dépôt R&D par procédé PE-CVD/PVD pour applications photovoltaïque, pour les producteurs de cellules/modules silicium couches minces

autofinancement www.indeotec.com

Innotech Solar

Repowered non-prime solar cells (defects). HQ Oslo, office Zurich, Shanghai. Investors Northzone Ventures, Investinor, Sustainable technologies fund.

35 M€ on 18 M€ 37 M€ revenue 2010, cash flow positive PV market CAGR 30%

www.innotechsolar.com

Kebony Alternative to tropical wood using proprietary wood modification. Investors HQ Oslo

12M€ @ 45 M€ 5 B€ tropical wood market, 2B€ preservative wood market, 5B€ decking market

www.kebony.com

Metalysis Electrochemical reduction technology changing titanium and tantalum production, replacing 70-years old Kroll process, reducing pollution and increasing production ratios. Investors : DFJ Esprit, Cambridge Capital, … HQ Rotterdam.

25 M £ investment to date. 4 B$ Ti production, 800M$ Ta

www.metalysis.com

Mygreenlife Information program on lifestyle that in tune with the environment.

low

NeoCarbon Patent pending industrial high throughput CO2 remediation and biomass production project seeks investors

5MCHF www.neocarbons.com

Nheolis Small wind turbines, 20K€. Early stage. Investors . SBA, Success Europe, Garlaban Holding, ITI group.Aix en Provence, JV in China with Kehua #1 UPS manufacturer

5M€ on 2.8M€ 2010 sales 1.6M€ cash flow + 14B€ market by 2020

www.nheolis.com

Nolaris Solar thermal modules for artificial circular island of large dimensions, up to several kilometers in diameter. It consists of an outer torus and a membrane.suring the load of the solar panels.

Investor Jade Invest www.nolaris.ch

Pragma Industries

Fuel cells manufacturing at less than 1K€/kW (50% of competition) for <200W segment (remote sensors, UPS for telecom, traffic regulation). Investors Finaqui, XMP angels, Herriloa, Sebadour. HQ Biarritz, France 64

3M€ on 900K€ 300K€ sales 2010 1.5 M€ sales pipeline

www.pragma-industries.com

SensorScope Sàrl

Environmental monitoring sensor and cloud software

www.climaps.com

Smixin Hand washing system offers a new sensitivity to water and hygiene: it reduces water consumption by 90% .

Creaholic spin-off ~500KCHF

www.smixin.com

Sustainable reference

B2B and consumer supply chain management and directory focused on sustainability. Spain

No clear model. 200K€ 3F funding

www.sustainablereference.com

Syneola Small to medium size vertical axis wind turbines for building integration and hybrid applications large charging stations for electric vehicles.

Seed www.syneola.com

Vela Solaris AG

Simulation Software for the Renewable Energy Sector

VirVe Precise range estimator to deliver valuable information to electric vehicles.

http://www.hop-cube.com/�

http://www.iland-solar.com/�

http://www.indeotec.com/�

http://www.innotechsolar.com/�

http://www.kebony.com/�

http://www.metalysis.com/�

http://www.neocarbons.com/�

http://www.nheolis.com/�

http://www.nolaris.ch/�

http://www.pragma-industries.com/�

http://www.smixin.com/�

http://www.sustainablereference.com/�

http://www.syneola.com/�


p.19

Medical devices The healthcare industry is adapting to the following changes :

• Demographics trends and emerging markets as a source of future growth for the medtech industry

• Increase the longevity and quality of life of the elderly population • expectation for personalized, patient focused, care delivery • Growing chronic diseases prevalence. • Minimally invasive procedures, biotech solutions provides solutions for cost containment. • Further industry consolidation and M&A will accelerate growth.

Technologies Switzerland has a mix of expertise : bio, pharma, nano/micro and ICT to exploit the bio convergence technology trend. Bio convergence is seen as a general driver for changes. Essentially converged medical technologies fall at the intersection between sectors.

• Device drug delivery : drug eluting stents, implantable insulin pumps • Nano-biotechnology : controlled release, nanotech coatings such as antibiotics, silver, • Nano-sensors for diagnostics • Smart devices : implantable insulin pumps with glucose levels monitoring, controlled

prosthetic limbs.


p.20

• Stem cell research, and in particular the use of human embryonic stem cell-based (hESC) therapies is a controversial topic

Experts • Example of regional business advisors : • Jacques Essinger, PhD • Benoit Dubuis, PhD, Eclosion • Prof. Thierry Berney, A3 HCUG • Prof. Nikos Stergiopulos, EPFL


p.21

Medtech sub-sectors The opportunity :

• Medtech sector amounts to 30% of the life science business with a growth of 8%. • VC investment in EU is 700 M$ (55M$ in Switzerland + neighboring France, 25% of all VC ).

Sector Attractiveness Regional strength Competition

Cardiovascular

500M$ VC investments and 80B$ market, 3% average growth up to 50% in specialties (stents). M&A at 5X revenues. Most attractive sector due to size and growth, particularly in interventional cardiology,

Switzerland has the mix of business and tech advisors. Top industrial players present.

Fragmented except US and 6 companies above 1B$. Local VC competition (MDS)

Orthopaedic

280 M$ investments and 43B$ market growing 7%, 28% in some specialties (spine, orthobiology, extremities). 6B$ M&A market at 5X revenues. Most attractive sector due to size and growth.

Some market leaders in Switzerland. Access to expertise.

Consolidated industry. Top 7=60%

Imaging

Estimated less than 100M$ investments in a 16 to 19B$ market, 6% growth. There are niche applications emerging. PACS segment still growing. More mid-market opportunities.

Modest. Highly consolidated industry. Local VC competition (Ares)

Diagnostics

250 M$ investments 50B$ market, 6% growth, up to 68% in cancer diagnostic. The new developments are at the frontier of biotech. B$ M&A activities at 5Xsales valuations. 10XM$ follow-on round investments required make the sector capital intensive.

Significant expertise in Switzerland with market leader (Roche).

Hyper consolidated industry top 3 =44%.

Surgical

Around 50 M$ investment, 7 B$ market growing at 9 % Manufacturing expertise in Switzerland,

Ophtalmo

Around 50 M$ investment, 6 B$ market growing at 5 % Example : Sensimed.

Neuro

Around 50 M$ investment, 2 B$ market growing at 19 % Significant expertise in Switzerland

Urology

Around 50 M$ investment, 1 B$ market growing at 12 % Low

e-health

Recent trends open opportunities in e-health and m-health but innovation has been slow in hospital and clinical ITC. Possibly a catch-up due to public policies.

Modest. Leverage Swiss life science expertise.

High EU, US because the market leaders are in large countries


p.22

Medtech is 30% of life sciences industry This study excludes on purpose the Pharma and biotech sectors as the size and timeframe of investments make them unsuitable for our strategy. The following definitions and statistics allow a comparison.

• Medtech : development and marketing of equipment (medical devices) and procedures with which diseases may be prevented, diagnosed and treated.

• Pharmaceuticals : research, development and marketing of new and innovative therapies. These large pharmaceutical companies often co-operate with smaller biotech companies or eventually acquire them.

• Biotech : focus on research and development based on biological processes, genomics, recombinant protein engineering, and molecular targets. Typically use biochemistry, microbiology and process engineering to find new therapies and diagnostics to treat diseases.

Sector # listed

companies

Market size B$

Growth %

Medtech 200 300 9% Pharma 20 600 7% Biotech 400 70 15%

Medtech devices is a 300 B$ market The medical device sector has historically been one of the most attractive with 8% CAGR since 1990 and close to 300B$ revenues1. The industry’s results were good in 2009, especially net income for non-conglomerates in EU but also in US. Europe has a track-record of innovation in this field : the first implantable pacemaker was developed in 1958 in Sweden, the first coronary balloon angioplasty in 1977 in Switzerland, the first total disk replacement occurred in 1989 in Germany, and the first percutaneous valves in early 2000's in France and in the UK.

World (2009)

USA (2008)

Europe Switzerland

Companies 11’000 Revenues 294B$ 136 B$

(incl. supplies 35B$)

94 B$ 2500 M CHF

Employment 422’000 530’000 40’000 R&D 5.8 B € Products 100’000 FDA

approved

1 Sources : McKinsey Group, Espicom , others


p.23

Growth : up to 8% in early stage For publicly traded medtech 2010 companies revenues were below the 11% growth in 2008.

CAGR 2009 non-conglomerates

Public

EU

US

WW

Revenues

8%

1%

0.3%

Net income 29%

11%

R&D investment

4%

1

Valuations : 13 to 20 P/E

Healthpoint Capital Index (2010)

P/E PSR

Medical Technology 13.6

2.6

Orthopedic Companies 19.6

2.8

Cardiovascular 18.1

2.4

Dental 3.9 18.5

VC investment : stable, 25% of total VC funding has remained relatively stable, although not to the level of the 2006-7 period, and is expected to grow in 2010. Medtech is the second largest investment sector, behind information and telecommunications, approximately 24% of EU VC investments. In 2009, 87 medical device deals totalled $ 719 million and average deal size was 8.5 M$.

• Worldwide VC funding 3.4 B$ (2009), 2.4 B$ (1H 2010), $517 million 61 deals (1Q 2010) • Europe 701 M$ (2009), 2.8B$ including biotech (2007-2008)

o Switzerland : estimate of 50M$ o France : rough estimate of 100M$ and 35M$ in Rhône-Alpes/Sud

• US 2.7 B$ (2009) • Worldwide capital raised in 2009 13.1 B$

• The National Venture Capital Association (NVCA) has formed the Medical Innovation and Competitiveness (MedIC) Coalition to lobby in favour of medtech innovation in the course of US healthcare reforms .


p.24

VC investment in Switzerland : 50M CHF in medtech On average of 260MCHF/year is invested in life sciences2 and we estimate that 20% of this goes to medical devices ( approx 50 MCHF). The list of sector-focused VCs is indicated later in this document.

VC investment in neighbouring France : 35M$ in medtech On average of 733 M€/year is invested in life sciences in France. We estimate that 35M$ is invested in neighbouring France for medical technology. A sample of French and European medtech focused VCs is indicated later in this document.

• Centre-est & du Sud-est et Rhône-Alpes (Rhône-Alpes, Provence-Alpes-Côte d’Azur, Auvergne, Bourgogne)

• Life sciences : 21 deals, 52 M€ in 1H 20103 • Medtech estimate 2010 35M$ ( 25 % of medical and biotech, 2X)

2 SECA biotech as asset class Booklet No.5 p.160, 2003-2005 average 3 Source : www.afic-data.com

Financement biotech mondial B$

0

5

10

15

20

25

30

2003 2004 2005 2006 2007 2008 2009 2010

IPO Augmentation de capital VC


p.25

Overview of sectors For reasons of growth and profitability, the most attractive segments are orthopaedics and cardiovascular.

Sector VC investments (M$)

Revenue (B$ )

US revenue ( B$ )

Growth (%)

Orthopedics 280M$ 2008

16.5** 43* 7% , 15%**

Cardiovascular > 525 M$ tracked

16.2** 77* 2.8% *, 24%**

Ophthalmology 5.7** 5%** Surgical 865+ 7.7** 33* 9%** Neurology 2.2** 19%** Urology 0.8** 12%** Diagnostics 440+ 22.1** 4%** Imaging 16+,

18.9** 6.8+ 5%**

(B$ 2010e, 2009+, 2008*, 2003** )


p.26

Cardiology

Opportunities : 84B$, 66B$ interventional Growth in cardiology has varied across segments. The market for interventional cardiology has been growing with increasing drug-eluting stent (DES), bio-absorbable and bifurcated stents, intravascular ultrasound (IVUS) equipment and vascular closure devices. European market is growing with rising number of percutaneous transluminal coronary angioplasty (PCTA) procedures. Price erosion is important in the more mature product areas, such as angioplasty balloons and bare metal stents. Unit growth rates in IVUS and vascular closure devices are also expected to fall over the long term.

Sector Revenue (B$ )

Growth (CAGR %)

Interventional 66, 60* 2.4% * Stents (DES) 3.4*

4.5 (EU) 50%

Catheters 7.1, 6* 10.2%* Accessories 1.2** 12%

Rhythm management Pacemakers 3.1** 6% Defibrillators 2.5** 12% Congestive heart failure 1.6** 60% Surgical, valves, aneurysm, closure

2.5** 17%

Diagnostic 13* 2.6%* Other 1.1** 8%

Total 84 40 (NA 2011)

2.8%, 1.6%*

(B$ 2010e, 2008*, 2003** ) European markets :

• interventional cardiology market 648M$ (2009) • Germany 24% of market (2009) • France increase at a faster rate. • UK cardiovascular devices market $1.3bn, growth 4.7% (2009)

Epidemiology • Heart disease and strokes account for 21.7% of deaths worldwide, • cardiovascular disease accounts for 30%. • in 2015 20 million people will die from a cardiovascular-related condition. • (WHO statistics 2007)


p.27

VC deals : over 500M$ in cardiology Recent financing rounds in 2008-2009 (523M$)

Company VCs Amount (M$ )

Comment

Advanced Cardiac Therapeutics

NBGI Ventures 5 B Cardiac ablation technology

BMEYE 8 B Dutch noninvasive cardiovascular monitoring company

CardiAQ Valve technologies

6 A Trans-catheter mitral valve implantation

CardioInsight Technologies

Draper triangle ventures, Case technologies ventures

6 B Electrocardiography mapping technology

CardioMEMS 38 Wireless sensing

Cardiovascular Systems

27 A 11 B

Distribution Agreement With Asahi Intecc, Agreement With Invatec - Revenues Of $56.5 Million

Carmat, F Public grant 46 total artificial heart system

CircuLite 32 C Micro pump to help circulation in severe heart failure patients

CoAxia Sofinnova Partners

21 D NeuroFlo technology for acute ischemic stroke,

Coherex Medical

16 B 22 A

Hole in heart

Embrella Cardiovascular

BioStar Ventures, MedFocus Fund, Edwards Lifesciences

7 B Embolic protection tech firm

Endoscopic Technologies, Estech

NBGI Ventures 8 Cardiac surgery device manufacturer

Endosense 36 Swiss cardiac arrhythmia treatment developer is to step up European commercialisation of its TactiCath force-sensing ablation catheter.

Micell Technologies

5 bridge loan

rapid absorption polymer drug-eluting stent (DES)

Nobita Therapeutics

BA 1 Heart implant

Replidyne 40 B 62 D

Stentys Crédit Agricole Private Equity Sofinnova Partners

22 B

4 A

Stentys, F 23M€ IPO

Euronext listing, stent specialist

Svelte Medical Systems

6 Balloon expandable stent

Symetis, CH Endeavour vision, NGBI Ventures, Wellington Partners

25 B

36 C

Transcatheter aortic valve replacement (TAVR) system Former J6J

TriVascular 30 B Stent graft developer for treating abdominal and thoracic

Veryan Seroba Kernal, Oxford Capital, NESTA

5.4 Biomimics 3D stent


p.28

M&A : over 5B$ at 6 X revenues Examples of M&A activity growing since 2009

Acquired Acquirer Amount (M$ )

Comment

eV3 Covidien 2600 5.2× sales of $500 million, a 20% premium over market price. eV3 product line includes stents, catheters, and other endovascular and minimally invasive vascular devices to treat clogged veins and arteries. eV3’s devices complement—without overlapping—the products of VNUS Medical Technologies, which Covidien acquired in 2009. The purchase of eV3 also broadens Covidien’s product offerings and new product pipeline in the high-growth vascular market.

AGA Medical Holdings

St. Jude Medical

1100 6.5× 2009 revenues of $199 million, 41% premium over market value prior to announcement of the transaction. Products provide diversification into the structural heart defect treatment segment beyond SJM its maturing core product lines of cardiovascular implantables. The structural heart defect market is estimated to be a $2 billion market in the early stages of development. AGA Medical produces a comprehensive line of devices to treat structural heart defects and vascular abnormalities through minimally invasive transcatheter treatments. The company’s Amplatzer products have strong brand name recognition for being safe and effective as well as easy to use. AGA was the only significant medical device company to complete an IPO in 2009, and it has grown at a compound rate of 19% since 2005.

Flowcardia C.R. Bard 1100 $80 million cash from PE Glide Healthcare Partners. Flowcardia has innovative technologies to facilitate the crossing of totally occulated coronary and peripheral arteries. Chronic total occulusions (CTOs) are one of the last clinical challenges in interventional therapy. The absence of safe and effective devices to treat CTOs and the high incidence of restenosis when metal stents are used has been one of the major reasons CTO patients undergo bypass surgery. Flowcardia’s Crosser recanalization catheter, steerable support catheters, and guidewires compose a family of tools that enables physicians to quickly cross CTOs, allowing for subsequent balloon angioplasty, atherectomy, and stent placement.

ATS Medical Medtronic 370 4.9× 2009 sales of $76 million. ATS loss of $6.3 million in 2009. ATS’ product lines overlap two segments where Medtronic wants to expand—structural heart valve disease and cardiac arrhythmias. Medtronic has catheter ablation technologies using radio frequency and cryoablation energy. ATS brings surgical cryoablation procedures for the treatment of cardiac arrhythmias. With ATS under its wing, Medtronic now has grown its cardiovascular operations, which generated sales of about $2.5 billion in 2009

Invatec SpA Medtronic na Invatec manufactures stents, angioplasty balloons, and accessory products. Medtronic expects the acquisition to accelerate the growth of its cardiovascular business by adding new coronary and peripheral vascular products to its product offerings. It is estimated that more than 20 million people in the United States and Western Europe have peripheral vascular disease; the market is $2 billion and growing 10% annually.


p.29

Regional start-ups seeking finance in 2010


ACT advanced cardiac therapeutics

Heat mapping microwave radiometry for atrial ablation AF. Clinical Pre CE. HQ Dresden.

10M€ C @ 15M€

AF market 1B$ +25%

www.actmed.com

Acutus medical Cardiac electrical activation visualization

n/a www.acutusmedical.com

Bmeye Non invasive beat to beat

CV monitoring of BP and cardiac output. Competes with FMS, Uscom (echo), Chettah (impedance) Early-stageHQ Amsterdam

1.5 B€ cardio, anaesthesia, ER markets

www.bmeye.com

Miracor Pressure controlled coronary sinus occlusion increases the venous circulation of the hearth, redistributing flow and washing metabolites post stenting. Vienna, Austria

B @ 10 M€ www.miracormedical.com

Persona medical systems

12-lead ECG with interpretation for MI patients in rehabilitation centers. Berlin.

2M€ @ 1.5M€

23 M CHD patients

www.personamedsystems.com

Qvanteq Stent technologies to address and overcome the adverse effects of today's available coronary artery stents.

Arik Zucker

Sabir medical BP monitor based on pulseoxymetry and machine learning.OR, OB/CYN, ambulatory, home segments. Competes against Pulsoximeters Masimo, Nellcore, Nonin. HQ Barcelona. Investors Ysuis Capital.

1M€ @ x5M€

BP market 445M$

www.sabirmedical.com

VueKlar Cardiovascular

Cardiovascular implants and interventional devices that are compatible with high quality MRI. The technology benefits the following devices: sStents , valves, septal occluders, vena cava filters

n/a www.vueklar.com

Xeltis Tissue engineered cardiovascular implants such as heart valves, arteries and patches.

Tom Sulzer

Funded

H2AD Twittoo Medical gateway for home care monitoring of patients, particularly for

500K€ http://www.twitoo.org seeking

http://www.actmed.com/�

http://www.acutusmedical.com/�

http://www.bmeye.com/�

http://www.miracormedical.com/�

http://www.personamedsystems.com/�

http://www.sabirmedical.com/�

http://www.vueklar.com/�

http://www.twitoo.org/�


p.30


cardiac diseases or after hospital discharge. Based on Bluetooth and GSM communications and hosted medical record. Engineering only in Porrentruy.

VC round in 2011

Industry structure : top 20 make 32% of industry

FY 2009 Ranking

Company 2009 Cardiology sales (US$ million)

Notes

1 Medtronic 7451.00 2 Boston Scientific 6430.00 3 St Jude Medical 4350.51 Cardiac rhythm management, Cardiovascular

and Atrial fibrillation segment sales 4 Johnson & Johnson 2679.00 Cordis division sales 5 Terumo 1453.39 6 Edwards Lifesciences 1321.40 7 Sorin Group 940.40 8 CR Bard 681.50 Vascular segment sales 9 Greatbatch 305.35 10 Thoratec 279.97 11 Merit Medical Systems 257.46 12 AGA Medical Holdings 198.71 13 Abiomed 84.77 14 AngioDynamics 83.46 15 ATS Medical 75.71 16 CONMED 70.98 17 Teleflex Medical 70.80 18 Vascular Solutions 66.73 19 Cardiovascular Systems 56.46 20 AtriCure 54.53


p.31

Orthopaedic

Opportunities : 43 B$ growing at 7-17% Growth from 1999–2004 reflected solid gains in procedures, combined with price increases that averaged 5 to 6%. New technologies such as materials, biologic products for orthopedic surgery, and new products for spine surgery contributed to industry growth during this period. Orthopedics stocks performed well in the late 1990s and early 2000s but have struggled somewhat in recent years.

Sector Revenue (B$ )

Revenue (% WW)

Growth (2009)

Opportunities

Spine 2.8

(740 M$ minimally invasive)

19% Attract investment despite crowding (200 companies offering some form of spine treatment)

Hips and knees 6 (2009)

28%

Extremities, small bones and joints

15%

Trauma 13%

Sport 8%

Biologics, bone graft 4.2 (2007) (2.2 M procedures)

7% 17% Orthobiology is one of the new advances bringing the inclusion of biology and biochemistry in the development of bone and soft tissue replacement materials for skeletal and tissue healing.Stem-cell therapies are forecast to be the fastest-growing category, with a CAGR of 53.9% over the next five years.

Powered instruments 3%

Casting 3%

Total 43, 26 (2007), 3(EU 2007)

7%


p.32

Epidemiology • 50% of all chronic conditions in people over the age of 50 in developed countries, • The aging population is vulnerable to deteriorating bones and joints. • 20% of all visits to outpatient clinics are for musculo-skeletal conditions, • Orthopedic physician practice statistics45 • Elective surgeries (76%) • Joint replacements (55%) (364,000 hip and knee arthroplasty procedures in Germany in 2008) • Sports medicine (27%) • Spine (19%)

VC investments : 280M$ • VC deals in orthopedics were $280 million (2008, -42% compared to 2007). In 2009, the third

largest VC funding was for Small Bone Innovations Inc. It raised more than the $100 million each raised by Twitter and Facebook during the same period. Spine fundings included Apatech, Vertiflex, Paradigm and Spineology

• IPOs $51 million (2008, -70% 2007). Examples : NuVasive, less-invasive system for spine surgery, and Kyphon, treatment vertebral compression fractures.

Recent financing rounds in 2008-2009 (257M$)


Comment

Axiomed Spine 14

Amedica Corp. 30 ceramic implant technology

Apatech 3i Group; HealthCor Partners

35 spine

Baxano Kaiser Permanente , Affinity

30 C Surgical technology for restoring spinal function

BioCeramic Therapeutics

2 tissue regeneration products developer

Implanet, F Auriga Capital,

Edmond de Rothschild Investment Partners , Wellington

Partners

17 Orthopaedic implants for various surgical markets.

OrthAlign 5 A2 KneeAlign system for total joint replacement

Ortho Kinematics

3 spine motion analysis technology

Orthox, UK Public grant 0.6 Silk based orthobiologic biomaterial

Relievant Medsystems

20 Intracept minimally-invasive treatment for chronic low back pain

Resoimplant, D Bavarian 3 New fixation system for shoulder and ankle surgery

5 Source : Viscogliosi Bros December 2008.


p.33

Investment, High Tech Grunderfonds, S-refit

Small Bone Innovations (SBi)

Olympus 108

12

STAR total ankle replacement system. This is the largest single financing in orthpaedics.

Spinal Modulation

27 C spinal cord stimulation system

Vertos Medical 15 D minimally-invasive lumbar decompression (mild) technology

M&A : 70% of volume, over 6B$ 42 mergers and acquisitions with joint reconstruction, spine, and orthobiologics companies accounted for 70% of the deal volume (2009).

Acquired Acquirer Amount (M$ )

Comment

Nexa Orthopedics, BioProfile, DVO Extremity Solutions, and Axya Medical

Tornier products in the extremities (small bone and joint) market.

Osteotech Medtronic 123 Processor of aseptic bone allograft tissue, and Medtronic is hoping that the company’s successful product line positions its biologics business for significant growth over the next few years. 1.3× sales of $96 million, and a 63.5% premium over the market value prior to the announcement. Osteotech produces bone graft, bone matrix, and biocomposite products used in muscloskeletal surgery. Medtronic has been positioning itself at the intersection of medical devices and biologics, where a biologic product is delivered by a medical device. Medtronic‘s focus has been on spine and orthopedic trauma, and Osteotech’s products represent an expansion into joint reconstruction, foot and ankle surgeries, and sports medicine.

Life Cell Kinetic Concepts

1700 leading provider of biological products for soft tissue repair (2008)

Kyphon IPO, Medtronic 3900 Treatment of vertebral compression fractures

Apatech Baxter International

330 Bone graft materials . Price based on achievement of milestones (5.5× sales of $60 million) Apatech’s biologically active trophic glass product ACTIFUSE has the ability to grow bone. Baxter has a proven surgical biologics technology platform and sales exceeding $500 million for surgical biologic products for orthopaedic, cardiovascular, and many other segments. Baxter can increase it biologics product sales with Apatech’s proprietary bioactive silica products, and do so in orthopaedics and many other medical specialties.


p.34


Name Description Opportunity Information Crisalix 3D simulation based on physical properties of

the patient for plastic, aesthetic and reconstructive surgery

Jaime Garcia Giraldez

Delta Robotics

3 dimensional plotter for manufacturing biocompatible bone implants

Marc Thurner

Facet Anatomic facet reconstruction device designed to provide patients with lumbar spinal stenosis and facet degeneration a motion preservation alternative to fusion. Implatente in 30 min, allows L3-S1 treatment. Developing Investors De Novo, Spray ventures. HQ Wiesbaden.

20M€ @ 38 M€ 850 M$ lumbar stenosis market EU

www.facetsolutions.com

iStar medical

Ophthalmic implants n/a www.istarmed.com

NaviSwiss Intraoperative measurement for orthopaedics surgery. HQ CH

4M CHF 2014 e sales 22 MCHF 1.3 M hip replacements, 16% CAGR

http://www.facetsolutions.com/�

http://www.istarmed.com/�


p.35

Industry structure : top ten = 62% Seven large companies account for more than 60% of the orthopedics industry which counts 70 publicly-traded companies. In total more than 1700 companies are involved in orthopedics. Small to medium-sized companies ($100 million to $1 billion in sales) include Alphatec Spine, ArthroCare, Exactech, Integra Orthopedics, NuVasive, Orthofix International, and Wright Medical. Most of these companies concentrate on market niches.

FY 2009 Ranking

Company 2009 Orthopaedic sales (US$ million)

Notes

1 Johnson & Johnson 5372.00 DuPuy division sales has market strength in hips, knees, and extremities, but also participates in virtually all areas of orthopedics

2 Stryker 4119.70 3 Zimmer 4095.40 4 Medtronic 3400.00 Medtronic Sofamor Danek focuses entirely on

the spine and remains the market leader in this area.

5 Synthes 3394.65 6 Biomet 2504.10 7 Smith & Nephew 2135.00 8 DJO 946.13 9 Orthofix International 545.64 10 Wright Medical 487.51 11 NuVasive 370.34 12 Symmetry Medical 365.94 13 Integra LifeSciences 262.17 14 Exactech 177.31 15 Alphatec Holdings 132.16 16 Greatbatch 113.90 17 Osteotech 96.68 18 Orthovita 92.85 19 Corin Group 63.51 20 Kensey Nash 29.79


p.36

Imaging

Opportunities : 16B$ and 7% growth Medical imaging is one of the developments that changed clinical medicine during the last century. In the last two years, 40 companies in this field have received investment. Coupled with the advances in hardware, there have also been substantial developments in software applications, primarily related with Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Another area where software is playing a role is planning of therapies and surgeries. The European cardiology PACS Market earned revenues of US$73 million in 2005 and estimates this will reach US$200 million in 20126.

Sector Revenue7 (B$)

Growth (% CAGR)

X-ray 2.1 3%

Computed tomography

3.3 10.5 %

Ultrasound 1.8 5 %

Nuclear imaging 3.2 6 %

Radiation therapy

Magnetic resonance imaging

2.9 9 %

Imaging information systems

PACS 74 (EU cardiology 2005)

48 %

Total 16 6.8 %

6 Frost & Sullivan 7 Fredonia group estimates


p.37

VC investment Recent financing rounds in 2008-2009


Comment

U-system ID softcapital, Sycamore

10 Automated breast ultrasound system (ABUS) combined with mamography

Crospon 3 EndoFlio gastro-diagnostic imaging device. Received 510k clearance.

Visiopharm NorthCap Partners

Provider of advanced software for quantitative microscopy for life sciences, analysis software, hardware integration, automation, and quality inspection.

Surgix Maayan ventures

Israeli-based company is developing a visual based

system for image guided surgery primarily focused

on orthopaedic trauma, was awarded the Ernest and Young

Entrepreneur of the Year in Israel in 2006 EOS (former Biospace Med)

Wellington, Auriga

15 C Founded by Nobel Prize winner Georges Charpak to provide researchers in biology with innovative imaging tools based on his discoveries in high-energy physics and particle detection. Still seeking funding see below.

M&A Acquired Acquirer Amount

(M$ ) Comment

Orbatech Medical Solutions

GE Healthcare 14 produces the cadmium zinc telluride (CZT) detectors used in GE’s Alcyone nuclear cardiology technology. GE’s system produces views of cardiac anatomy and functionality quickly and with high clarity, with exposure time as short as three minutes.

Sentinelle Medical

Hologic 85 leading provider of innovative magnetic resonance imaging (MRI) breast cancer detection and intervention products. (5.7× sales of $15 million, plus contingency payments)

SenoRx C.R. Bard 200 Producer of x-ray– and MRI-guided breast biopsy systems. (3.6× 2009 sales of $55.6 million). Expands Bard’s diagnostic imaging business beyond ultrasound-guided procedures to include breast biopsy devices that are also designed to operate also in x-ray and MRI imaging modalities.



Aïmago Development of medical diagnostic imaging instruments to visualize microcirculation, the capillary blood flow. Real-time, non-invasive and contact less. Very large application potential incl. reconstructive surgery, intensive care, dermatology, neurosurgery, ophthalmology and metabolic imaging.

Friedrich Michael

Raised capital

CAScination Navigation system for surgery on soft tissues. Similarly to the navigation system in a car, the surgical navigation system displays a map (of the

Matthias Peterhans


p.38


patient) and guides the user to a desired target location (treatment area). This guidance information is displayed in a 3D augmented reality scene and allows for highly precise treatment of tumors. Navigated surgery has the potential to enable surgery on patients which cannot be treated with conventional surgical techniques.

EOS Imaging

With EOS, radiologists and orthopedists can now for the first time, have a full view of their patient’s skeleton: life-size, naturally weight-bearing, in 3D, from all angles. Company in Paris. Investors Wellington, Auriga,…

12M€ round C 2B$ orthopaedics market

http://www.eos-imaging.com

Mindmaze Neuro-imaging solution enables objective measurement of performance through brain activity patterns recorded while patients interact in different virtual environments.

Tej Tadi

PearlTec Positioning device for Computed Tomography and Magnetic Resonance Imaging that allows a higher patient throughput, significantly increased image quality and improved patient comfort.

Fischer Patrizia

1.1MCGF ZKB, Berner Partners

Supersonic Ultrafast US imaging for breast lesion screening. Shear wave ultrasound allows tissue stiffness assessment. Competes with GE, Phillips, Siemens. Developing. Investors Auriga, NBGI, Bioam, Edmond Rotschild, Wellington. HQ Aix-en-ProVence

30M€ @ 53M€ Market size 5.3B$, CAGR 5%. 2012e sales 27 M€ 2010 10 M€

www.supersonicimagine.fr

VirtaMed Surgical simulators for minimally invasive endoscopic surgery with unprecedented realism, using proprietary technology in combination with current computing hardware.

Start Angels Network Zürich Kantonalbank Generated 1.3 MCHF

Tuchschmid

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p.39

Industry structure : top 3 = 75% General Electric (GE), Siemens, and Philips dominate the medical imaging market, with approximately 75% share of the worldwide market. GE remains the undisputed leader of medical imaging.

FY 2009 Ranking

Company 2009 Imaging sales (US$ million)

Notes

1 GE Healthcare 10682.00 Imaging equipment, imaging agents and service 2 Siemens Healthcare 9974.39 3 Philips 4158.79 4 Olympus Medical 3752.66 Medical Systems & Life Sciences segments 5 Fujifilm 2823.73 Medical Systems & Life Sciences segments 6 Carestream Health 2318.68 7 AGFA Healthcare 1642.87 8 Hitachi Medical 1169.92 No breakdown available. Estimated as 12.59% of

total electronic systems and equipment segment (as for FY2008)

9 Covidien 1147.00 10 Konica Minolta 1116.55 Medical & Graphic segments 11 Carl Zeiss 984.61 Medical Systems segment 12 Hologic Inc 619.66 13 Shimadzu 540.23 14 Guerbet 467.87 15 Aloka 346.36 16 Varian Medical Systems 331.00 X-ray products segment 17 Analogic Corp 325.19 18 SonoSite 227.39 19 Sirona Dental Systems 226.73 Previously Schick Technologies 20 Mindray Medical 162.47


p.40

Diagnostics

Opportunities : 50B$, 6% growth Diagnostics include biotechnological-based testing as well as medical devices. Star performers of the IVD industry segment are clinical chemistry and immuno-assay systems.

• Clinical chemistry products benefit from the sales of personal blood glucose monitoring systems and testing-strips,

• Immunoassay will be driven by drug and infectious disease testing. With the rising volumes of blood glucose monitoring among diabetic patients, endocrine condition testing is one of the most popular IVD application. The total diabetes burden is forecast to be 11.5% (25.4 million) in 2011, 13.5% (32.6 million) in 2021, and 14.5% (37.7 million) in 2031.

• Hemostasis tests for D-dimer and other cardiac parameters offer bright opportunities among IVD blood testing systems. The reason for this is their ability to quantify heart attack and embolism risk prior to a cardiac emergency.

• Overall demand for IVD testing is increasing because of an increasing interest in personalized medicine. Biomarkers helps in predicting the outcome of therapies for an individual patient.

Sector Revenue (B$)

EU 27 Revenue (B€)

Growth (%)

in vitro diagnostics (IVD)

50 (2009) 38 (2007)

10.2 (+3%) 6.7%

molecular diagnostics

2.6 (2005) 14%

Cancer diagnostics 15 (2009) 68%

point of care diagnostic (POC)

12 (2005) 7.8%


p.41

VC investment around 250M$ Recent financing rounds in 2008-2009 (208M$). In 1H 2010, 18 companies in the MDx space attracted at least $235.4 million in investments8.


Comment

AdvanDx 8 C molecular diagnostic tests for bacterial infections

CancerGuide Diagnostics

Hatteras Ventures, Cardioinsights

10 A Genomic based cancer tests for personalized medicine.

Curetis, D 27 A Dosepro molecular diagnostic

Exosome Diagnostics

NGN capital, Forbion capital

20 TB test

Foundation medicine

Third Rock Ventures

25 A Clinical laboratory test that analyze genomic in individual patients cancer top personalize treatment

Freedom Meditech

A Noninvasive ophthalmic devices for monitoring glucose levels in diabetics

Lab901 4 ScreenTape laboratory analysis automated diagnostic instruments

Microvisk technologies, UK

3 SmartStrip POC blood coagulation monitor to launch in 2011

Molecular Detection Inc (MDI)

3 C Rapid tests for infectious diseases

mtm laboratories, D

45 C Cervical cancer diagnostics specialist

Myconostica D diagnostic

PharmaDiagnostics 3 B label-free screening technology

PrimaDiag Angels 0.5 robotic platform designed to automate biological processes for lab

Rheonix Cayuga Venture,

12 A Molecular diagnostic, CARD chemistry and reagent system

Saladax biomedical

Excel Venture, Golden Seeds, Ben Franklin technology partners,

8 C Mycare blood test measuring drug levels to treat cancer and nervous disorders

T2 Biosytems Physic Ventures 15 C Next generation diagnostic using nanotechnology, miniaturized MRI

Tethys Bioscience 25 Diabetes risk test, PreDx

Biocartis 41 B

Veracyte 28 B molecular cytology tests

Epigenomics 44

Cyntellect 3

8 GenomeWeb Daily News


p.42


(M$ ) Comment

Clarient GE Healthcare 580 7.7× estimated sales of $75 million, and a 33.7% premium over the market value. Clarient is a leading company in the rapidly growing area of molecular cancer diagnostics, with systems that provide doctors with precise information about a patient’s cancer and help them prescribe appropriate treatment. GE Healthcare moves towards its goal of integrating imaging and clinical molecular diagnostics to both diagnose and monitor cancer and other diseases. The combination of imaging and molecular testing is the Holy Grail in the diagnostics spaces.

Standard Diagnostics

Alere 224 South Korea–based manufacturer of rapid diagnostic products. The acquisition increases offerings for hepatitis, infectious diseases, tumor markers, and urine and protein strips. Acquisition for a 75% interest 5.6× sales of $40 million.

Epocal Alere 257 Canadian producer of blood testing equipment with wireless transmission capability, complements Alere’s Triage technology for wirelessly relaying point-of-care (POC) bedside test results to patient files.

Genzyme Corp. Laboratory Corp. of America

925 2.5× 2009 sales of $371 million. provider of a broad range of diagnostic products


p.43



Abionic Fast and low-cost screening tests for portable medical diagnostic use. As there are currently over 100 million people in Europe suffering from allergies, Abionic will firstly develop a novel personalized allergy diagnostic test that will allow patients to take the optimal medication.

Nicolas Durand

www.abionic.com

Ayanda biosystems

Blood-based test for gynaecological (ovarian and breast). BARD1 protein biomarker has demonstrated specificity, can be used with standard assays, such as ELISA. Pre-clinical. Lausanne

500K – 3M CHF www.ayanda-biosys.com

Mendor Web based management software for self monitoring blood glucose (SMBG) and self care for patients with diabetes. Software implements IDF pair measurement. Glucose monitor and test strips for T1 and T2 diabetics. Competition Roche, Lifescan J&J, Abbott, Bayer. HQ Helsinki

6 M€

8 B€ SMBG market

10% CAGR

www.mendor.com

Motilis Medica

Portable mobility recorder for whole GI tract, accurate and detailed transit monitoring. Competes with Pillcam, bravo given imaging, smartpill. Lausanne

3MCHF

Functional troubles - such as constipation, gastroparesis, dyspepsia and IBS - affect up to 20% of the population , results in 4% of consulting, 350 M CHF market

www.motilis.com

Sense

Sport technologies company specialising in biomedical monitoring tools for professional athletes, teams, as well as clinics and rehabilitation centres.

Alexandros Giannakis CSEM, negotiating

Sensimed Personalized 24 hour intraocular pressure monitor for glaucoma management. Investors Blue Ocean Ventures, Wellington, Vinci, Agate. Pre-sales. HQ Lausanne.

1M€ @ 13M€, M&A (17M€ raised)

www.sensimed.com

Industry structure : top 3 = 44%, top 10=80% The global IVD market is quite consolidated with the top ten market players owning about 80 percent market share.

FY 2009 Ranking

Company 2009 sales (US$ million)

Notes

1 Roche 20% market share

2 Siemens 12% market share

3 Abbott 12% market share

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Surgical, Ophtalmo, Neuro, Urology

Opportunities : 16B$ We are discussing here various other subsectors :

• Surgical • Ophtalmology, sector receiving a noted amount of venture capital interest (Sensimed) • Neurology • Urology

Growth rates are indicated below.

Sector Revenue (M$ 2003 )

Growth (2003)

Surgical 7.7 9%

Ophthalmology 5.7 5%

Neurology 2.2 19%

Urology 0.8 12%

VC investment : >200M$ Recent financing rounds in 2008-2009 (220M$)


Comment

Activaero, D BioMedPartners 16 A inhaled drug delivery technologies

Athena Feminine Technologies

vSpring 2 incontinence tech firm, female incontinence treatment

BeneChill HealthCap 13.5 C non-invasive cooling devices for treating hypothermia

Blue Belt Pittsburgh Life Sciences Greenhouse

2 A Smart surgical instruments

DFine Orbimed, Split 36 E RF kyphoplasty system

Electrical Brain Syncronization, D

4 B Treatment of neurological deficits and stroke and brain trauma.

Eyetechcare, F SHAM 9.4 Ultrasound technology for treating glaucoma

Inspire Medical Systems

Synergy Life Science Partners, Medtronic

17 Sleep apnoea treatment

Lumenis 15 laser, light-based and radiofrequency devices for surgical, aesthetic and ophthalmic applications


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MicroTransponder Angel + grant

7 B

2

Wireless neurostimulation technology. SAINT device for treating chronic pain.

Neuronetics New Leaf Venture Partners

30 D anti-depression treatment using magnetic pulses

NiTi Surgical Solutions

18 F CE-marked and FDA-cleared ColonRing wound closure device

Ocutec Discovery investment fund

0.7 Polyethylene glycol PEG for use in contact lenses

Quanta Fluid Solutions

NBGI Ventures, Seroba Kernal and Wellington Partners

12 home haemodialysis system

TransMedics Foundation Capital, Kleiner Perkins Caufield & Byers, Flagship ventures

36 Organ care systems product for solid organ transplantation. Financing to support commercialization.

Novagali Pharma 58 all rounds

innovative products for all segments of the eye (up to 2008)

Sensimed 4 A

20 ? B

Glaucoma diagnostic


(M$ ) Comment

Micrus Endovascular

Johnson and Johnson

480 Pproducer of catheters and other minimally invasive devices for treating stroke-related brain problems such as aneurysms and arterial thickening. (5.2× sales of $91 million and 36× EBITDA of $13.3 million)

Somanetics Covidien 250 Leader in cerebral and somatic oximetry, (5× 2009 sales of $50 million, and a 32% premium over market value ). Somanetics’ patient monitoring technology continuously measures blood oxygen levels in the brain and body of patients who are at risk for restricted blood flow so that clinicians can detect and correct various complications. The company’s Invos system is the only commercially available cerebral-somatic oximeter shown to improve patient outcomes.

Covidien PH Invest continuous positive airway pressure (CPAP) sleep therapy business

BioControl Medical

Medtronic 350 to 550 Proprietary implantable nerve stimulation devices. If BioControl fails to complete the clinical trials of its devices or obtain FDA approval for them, Medtronic can acquire the company for $350 million.


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X X Stereotools Stereotactic surgery guides compatible with MRI. Ultrasound imaging adapter.

Seed. Lausanne

500K CHF @

300K procedures, 900 M CHF market

2M CHF sales 2013e

www.stereotools.com

X Crisalix 3D simulation based on physical properties of the patient for plastic, aesthetic and reconstructive surgery

Jaime Garcia Giraldez

X Aleva Neurotherapeutics

Micro DBS technologies including probes. Lausanne

450 M€ market www.aleva-neuro.com

X EBS Non invasive brain stimulation. Early stage. Berlin

1.5 M€ @ na

15 M patients aphasia, visual deffects

www.ebstech.de

X NeMoDevices Diagnosis and treatment of patients with stroke and brain injuries . Technologies are based on near infrared extinction and provide two single-use products: a minimal invasive probe (NeMo Probe) and a non-invasive patch (NeMo Patch), which allows monitoring brain blood flow and oxygenation in the Intensive Care Unit.

Emanuela Keller

X Nextstim Navigated brain Stimulation devices for clinical use (presurgical mapping) and scientific research. FDA approved. HQ Helsinki, Finland

n/a www.nexstim.com

X Sapiens DBS providing directional stimulation through cranial implanted MR safe (image guided therapies) 64 electrode probe. Philips spin-off. Competition Medtronics, St Jude, Boston Sc., J&j, Neuropace. Seed. HQ Eindhoven. 3 VCs

12M€ @ na

Neurostimulation market 1500 M€ 16% CAGR; DBS 400M€

www.sapeinssbs.com

X StrokeLab Treatment of brain aneurysms.

Luca Augsburger and Rafik Ouared

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X Vigisense Mobility tracking of Alzheimer elderly patients for prevention of accident, better monitoring of conditions, assistance to care. Based on radio and hosted medical records for care centers.

500K€

Serge Grisard

X 3Brain In-vitro high-resolution electrophysiology. Enables dense electrical activity monitoring of electrogenic cell cultures and provides researchers access to unique spatio-temporal details of network information. Current applications include both neuroscience and high-throughput drug discovery.

Kilian Imfeld www.3brain.com

X Cequr Diabetes drug delivery. Disposable patch for 3days physiological insulin delivery. Development. Investors BMC ventures, Endeavour, Schroeder, Orion, HQ Montreux

9M diabetes T2 patients. 2 B$ insulin IDD device market

www.cequr.net

X InSphero Biological microtissues to test drugs more efficiently. These microtissues resemble human native tissue in terms of structure and function much better than conventional tests. Therefore, they give pharmaceutical developers more insight into the efficacy of new drugs or into potential negative side effects.

Jan Lichtenberg

Business Angel funded

X MedDrop Technology

Local pain therapy by transporting active substances directly through the skin using a special application system that empowered by oxygen.

Hahn Friedrich

X Nanopowers Artificial muscle technology for urinary incontinence. for male (post rpatatectomy) and female.

100 M CHF UI artificial sphincters. 600 M CHF total market.

www.nanopowers.com

X Nebion AG Online analysis system for researchers facilitateS biological discovery and diagnostics by high quality data curation and the development of innovative analysis systems and algorithms.

n/a

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X Powersens Electronic shoe-insoles for diabetic people. These insoles are worn daily and measure foot plantar pressure continuously. They enable to prevent apparition of diabetic foot ulcers, which are responsible for more than half of lower limb amputation in the world ! These innovative and practical insoles will improve the quality of life of many, and reduce significant health care costs.

Marc Rocklinger

X Primequal Injector that fills the market gap between standard disposable syringes and multi use injection pens.

Weill David


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Healthcare information systems While healthcare has been slow in changes and in particular IT adoption, there are driving mega-trends :

• increase the longevity and quality of life of the elderly population, requiring continuum of care • expectation for personalized, patient focused, care delivery • budget reductions and pressures from insurers and regulators, requiring productivity enhancing

solutions. • advances in information technology providing improvement on patient care, emerging

electronic health records,

Technologies We anticipate growth of technology-based solutions in many areas.

• Electronic health records: enabling the communication of patient data between different healthcare professionals (GPs, specialists etc.); healthcare information systems software supporting continuum of care operations or managed care programs.

• Consumer health informatics: use of electronic resources on medical topics by healthy individuals or patients; Patient self-management : remote consultations, testing, medication

• mHealth or m-Health: includes the use of mobile devices in collecting aggregate and patient level health data, providing healthcare information to practitioners, researchers, and patients, real-time monitoring of patient vitals, and direct provision of care (via mobile telemedicine) ;Information devices such as mobile tablets or home monitoring gateway for capturing patient information

• RFID sensors for management of mobile assets. • Management of chronic diseases, mental health • On the rise

o Advanced disease management support o Patient Decision Aids — Healthcare Provider o Patient Throughput and Logistics Management (PTL) o Personal Health Management Tools — Healthcare Providers o Perioperative Charting and Anesthesia Documentation Within the CPR o Integrated Clinical/Financial BI Systems o Personal Health Record

• Sliding Into the Trough o Video Visits o Patient Self-Service Portals (Scheduling/Billing) o Home Health Monitoring o Emergency Department Information Systems as Part of a CPR System o Next-Generation Enterprise Patient Financial Systems (U.S.) o CPR-Integrated Critical Care IS o Patient Self-Service Kiosks o Remote ICU o Rounding Robots o Patient Portals (Clinical)


p.50

• Climbing the Slope o Generation 3 Computer-Based Patient Records o E-Visits (Healthcare Provider) o Ambulatory Electronic Medical Records o E-Prescribing (Healthcare Provider) o Wireless Healthcare Asset Management o ERP (SOA) o Remote Hosting o Computer-Based Physician Order Entry o Disaster Recovery and Business Continuity

Opportunities: • EU VC investments in medical software and IT were 18 M€ / 11 deals in 2009 and 9 M€ / 6 deals

in Q1-3 2010 (Thomson) • Governments programs for health information exchange (USA 20B$ healthcare IT + 140M$

investment in NHIN, France : telemedicine, UK Telecare + connecting for health 10B€ until 2010, F: EHR in 2008, D: E-health card since 2007)

• Healthcare vendor consolidation. o HIS vendors Cerner, iSoft, Cerner, Eclipsys, McKesson, Siemens o PHR vendors : BlueCross, Microsoft HealthVault, Google Health, Dossia, Tolven. o Mobile health vendors : BodyMedia, CardioNet, eCardio, Epocrates, GreatCall

(Jitterbug), and Masimo


p.51

Transaction history Here are recent transactions in wireless, m-health 2009-2010 Name Description Amount Information

InTouch Technologies

Remote presence telemedicine solutions

$ 10.0 Bringea, Galen Partners, InvestCare Partners, Twenty One East Victoria

Imperative Health (MiLife)

Online fitness coaching system $ 4.0 New Venture Partners, Unilever Ventures

MicroChips Monitor and control implanted drug dispensing chips

$ 16.5 InterWest Partners, Polaris Venture Partners, Flybridge Capital Partners, Novartis, Medtronic

Proteus Biomedical

Wireless, adhesive sensor technology

$ 25.0 Novartis, Medtronic, ON Semiconductor

Wireless Medcare

Bed sensors $ 0.5 Carilion Biomedical Institute, Optimum Sensor Holdings

WellAware Wireless remote monitoring systems

$ 7.5 Valhalla Partners, .406 Ventures

TelaDoc Primary care physicians network $ 9.0 HLM Venture Partners, Cardinal Partners, Trident Capital

GymFu Motion-detecting iPhone fitness apps

$ 0.2 Channel 4’s 4iP

Echo Therapeutics

Wireless blood glucose monitor $ 3.6 Cotswold Foundation

Myca Health EMR, admin system, communication tools

$ 5.0 BlueCross BlueShield Venture Partners, Sandbox Industries

CardioMEMS Implantable wireless sensors $ 22.1 Arcapita Ventures, Boston Millennium, Foundation Medical

BL Healthcare Bluetooth-based wireless medical device monitoring

$ 3.0 Undisclosed

BiancaMed Wireless monitoring devices $ 9.8 Seventure Partners, ePlanet, Enterprise Ireland, ResMed

eCardio Remote cardiac monitoring n/a Sequoia Capital

Zephyr Technology

Physiological and biomechanical monitoring

n/a Motorola Ventures

Autonomic Technologies

Implantable device to soothe severe headaches

$ 20.0 Kleiner Perkins, InterWest Partners, Polaris Venture Partners, Caueld & Byers, The Cleveland Clinic

Monica Healthcare

Expectant mothers and babies monitoring

$ 1.6 PUK Ventures, Catapult Venture Managers, University of Nottingham

Phreesia Automatic patient check-in device

$ 11.6 BlueCross BlueShield Venture Partners, Polaris Venture Partners, HLM Venture Partners, Long River Ventures

MiLife Online fitness coaching system n/a New Venture Partners, Unilever Ventures

Experts Example :

• Jean-Claude Mouly, A3, former director Unisys healthcare


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List of start-ups The list includes a sampling of Swiss, EU and US start-ups.


Implanet Beep n Track RFID tracking of equipment and orthopedic implants. Implant division to be split from implants . Bordeaux, France

Round D 25 M€ @ 33M€ 5 M€ SW sales , 15M€ implants 2012e

www.implanet-com

Monitor it sa Home monitoring solutions for CHF patients www.monitor-it.lu

H2AD Paramedical products, 24 hours medical tele-assistance for old aged people and for the hospital discharged patients at home. Saint-Etienne et Health solutions participations in Porrentruy. Developing.

500K€-2M€ 3M€ sales 2013e Marché 400K gateways, > 500M$ EU +US,

www.h2ad.ne t www.twitoo.org

Dybuster AG Dyslexia management and education software, that trains correct writing and spelling skills

n/a www.dybuster.com

Nhumi Technologies GmbH

Nhumi Technologies builds software components and solutions for business partners, pharmas and care delivery organizations to organize, search, summarize and visualize biomedical or healthcare data using a virtual 3D model of the human anatomy.

www.nhumi.com

Avalis Healthcare Systems

Large scale remote management of chronic diseases by providing mobile (telemedicine and selfcare) disease technology to improve and transform the delivery of healthcare. CH

BAS investment, still looking for investors

Cinterion

Telehealth, Telemedicine, Remote patient monitoring, Mobile Fitness Monitoring.. Spun off from Siemens in 2008 after a LBO. Market share of 33% for GSM based M2M wireless modules, well established company USA

Benchmark information

http://www.cinterion.com/

E Medicis Web-mobile platform to help patients and healthcare professionals improve the adherence to treatments. Plan a MVNO, complete a portfolio of pathology specific compliance systems integrating sensors. US

240K€ in 2008 http://www.e-medicus.com/

MedApps

Collects and transmits data from patients’ health monitors in order for medical professionals, care management companies and others to monitor, analyze and respond as needed. USA

5M$ over 5M$ raised; 125 million people in the U.S. targeted

http://www.medapps.com/

Mobidarm

Mobile access to patient records from existing EHR systems e.g. lab results, medication, diagnosis. Workflow and billing support for home care Self-care support for e.g. diabetes patients Initial focus on Symbian OS, expansion to other platforms (Android,iPhone) . Open web service standards (SOAP and XML payload). Security features, user certificates on SIM cards or in other secure storage elements, mobile VPN, WS Security, XML Digital Signatures, and SSH. Helsinki Finland

R&D grant should cover trials in first half of 2010

http://www.mobidarm.com/

Patients Know Best

Patient-controlled medical records, integration into mobile phones of patients and clinicians. 2009/11 – BusinessWeek cover story as one of the world’s 25 most intriguing companies. Integrated with the NHS secure network .Mobiel features : health diary integration with patients’ smartphones, integrated messaging with patients’ and clinicians’ mobile phones, online consultation software subscriptions to US physicians. UK

1 M£ over 200K£

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Sources

Events Date Event Information 29 June 2010 EVCA Private Equity Earlybird Ventures, 8 September 2010 CTI Invest venture day GetYourGuide, Motilis, Peraltec, Anergis, Cultwork 29 September 2010 Medtech summit Meeting 20 medtech start-ups 14 october 2010 Innovation Xchange Apprupt, multibo, clar2pay, plista, canatu, metalysis, avantium,

tobii, Getjar, Stylight, Layar, Innotech, Keybonys, Enecsis, Alertme

27 October 2010 CTI CEO day Hirschfactor, Creathor, Naviswiss, stagend, Ni3, Bmob, Visiosafge

1 November 2010 HBS Private Equity and venture capital Meeting US VCs 17 November 2010 A3 Angels medtech Antlia, Stereotools, Ayanda 18 November 2010 EBAN Winter university Meeting SBA, start-ups 29 November 2010 Mobile Monday Switzerland

hospitality HouseTrip, MadeinLocal, iTaste, routerank, Abonobo, Arxit, Food Arena, L'avenue digital media

1 December 2010 Cleantech investing Meeting cleantech start-ups at EPFL

Technology Start-up Investment Analysis

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