Medical network - April 6, this paper extracts from line to follow research report "on the eve of the qualitative change - 2017 white paper on China's medical health industry investment 

 

Overall, the 2017 China medical technology and the development of the medical equipment market will present the following several important trends: 

 

1, two votes full implementation of promotion channel change 

 

Two votes to 2017 from last year's pilot to full implementation, big companies will channel sinks, small and medium-sized dealers will be eliminated one batch, mergers, a group of transformation. Under this trend, the industry will be gave birth to three big trend change: horizontal acquisitions, vertical extension and transformation. 

 

In horizontal acquisitions, well-funded, strength, channel far-flung large commercial companies, will continue to merger and integration of regional channels, and channels into supply chain integration solutions provider, performance will have erupted. 

 

And longitudinal extension can be divided into three types: one is the production-oriented enterprises downstream channel, namely large dealers for the purchase of a business, such as business acquiring handheld device maker e-ten creatures, Ann to buy ChengShiJun CDH; 2 it is flow-through upstream enterprises produced, namely the circulation enterprises acquiring upstream technology, such as circulation of POCT, medical m&a barriers to high technology product line; Three is downstream of value-chain of enterprises and circulation enterprises to the terminal services, such as dean diagnosis continue to actively layout terminal third-party laboratory. Longitudinal extension makes in the upstream and downstream enterprises with more power, thus through synergy ascension profit margins. 

 

Transition refers to the medical device production enterprise with channel type between the transformation of business model, such as part of the equipment dealers in two votes, camp to CSO and large regulation under the background of transformation; Part of the instrument type agent business under the background of the type or the transformation and distribution business. 

 

All in all, distributors, extension and transformation of mergers and acquisitions will make the channel link gradually towards the focus, this is the future of the integration of two votes trend channel. 

 

2 and decentralized treatment brings the opportunity of domestic equipment 

 

In 2017, the hierarchical medical reform will continue, and carried out throughout the country. Although patients shouldn't change rapidly, the concept of "everything duck prophet", classification of diagnosis and treatment will bring medical resource allocation to sink at the grass-roots level. With high-end medical equipment market monopolized by foreign companies in our country's situation is different, the vast grassroots medical market, has been the domestic brands in the battleground of horse racing, and from the policy side, the state also encourages and supports grassroots medical units use excellent domestic medical instrument and equipment. We expect that as the policy tilt and focus on money, domestic excellent equipment brand, both channels of the big brands or products in a unique feature of technical counterpart, broke out in areas at the grass-roots level will be welcomed. 

 

There, on the one hand, is the upgrading existing equipment upgrade opportunities, on the other hand is to meet the growing demand for primary care, but also easy to operate equipment. We will focus on inspection diagnosis equipment (especially the POCT and fast inspection equipment, etc.), chronic diseases related to household appliances, medical equipment, rehabilitation equipment, doctors follow-up follow-up safety of simple ultrasound imaging equipment, and other areas of the equipment at the grass-roots level. 

 

3, third party service is based on equipment 

 

Along with the continuous deepening of the reform of medical and all kinds of new mode of trial and error, we think that more and more institutions and companies will realize: for hospital service, win-win "mode of mutual benefit", and hospital hospital than leather, rob hospital business "subversive model" more in line with current medical business environment, under the various third-party services, "based on equipment, all kinds of" Internet + "mode of thinking and will be incorporated into the service. 

 

In October 2016, the national health development planning commission issued the medical test laboratory basic standards and management norms (trial) notice, clearly belong to the separate set of medical institutions, medical test laboratory for the independent legal person unit, independent bear corresponding legal responsibility, set up by the family planning administrative department of public health at the provincial level for examination and approval. And the health development planning commission issued in January 2017 "about medical imaging diagnostic center, independent set the basic standards and management norms of medical institutions interpretation clear center of medical imaging, pathology examination, blood purification, as independent medical institutions is inevitable. 

 

From health planning commission to third parties such as diagnosis, imaging and pathological post support, as well as a large medical enterprise in this layout can be seen with mergers and acquisitions, based on medical instrument and equipment diagnosis, imaging, pathology, third party logistics, disinfection, maintenance, equipment, packaging and other emerging intensive service mode will strongly promote the development of medical industry. Due to these areas and capital-intensive industries, I believe there will be a lot of investment and m&a events occurred. 

 

We see in the field of the third party inspection, the upcoming golden field inspection of key enterprises, a rising star such as thousands of wheat medicine, Beijing and also continue to get capital support rapid development; In the field of the third party image, A pulse sunshine for A round of Goldman's investment, safe and good doctors, cosmos group of listed companies also positively layout in this field; Disinfection, old Ken medical and its holding is active layout third-party disinfection supply chain; Elder brother and third-party service companies, such as the medical, ke cross medical respectively on the new three board and access to capital investment. 

 

We also observed, such as the third party inspection, third party image diagnosis related third party, not only can provide service to the hospital, more can be geared to the needs of the vast consumption market, such as could combine good early screening, medical products and services, mold will break through the hospital market, creating trillions of levels of the health care market, such as large data again, and the combination of artificial intelligence and so on "Internet +", or dock with the new drug research and development, etc, will be immeasurable potential. 

 

4, new technology penetration instrument field 

 

Early screening technology, artificial intelligence, 3 d printing, medical robots will bring in diagnosis and treatment of subversive revolution. 

 

The earlier screen can be divided into two broad categories: genetic disorders early screening and tumor early screening. Hereditary disease sieve, often referred to as prenatal screening and early through genetic testing method to calculate the probability of genetic disorders; Tumor before the screen is to point to in patients with clinical symptoms by liquid biopsy, gene sequencing to do early detection of cancer. Both for the improvement of population quality, improve cancer survival rates is of great significance. Grail has early cancer screening company $900 million B round of funding, once again aroused the heat of the capital. The importance of early screening is self-evident, the future in combination with artificial intelligent diagnosis technology, will be born again trillion-dollar blue ocean market. 

 

The diagnosis of artificial intelligence, artificial intelligence and the combination of medical image is a hot focus recently. China and the United States last year, the number of medical imaging rate were 30% and 63%, respectively, and the number of radiologists growth rate only 4.1% and 2.2%, respectively, imaging diagnosis of supply and demand gap is huge. New trend or read piece of artificial intelligence will overturn the future imaging diagnosis, make up for the inadequacy of the number of artificial diagnosis and accuracy. At present, scientists from Google brain and Verily companies to develop artificial intelligence diagnosis breast cancer diagnosis accuracy reached 88.5%, those of human famous pathologists 73.3% accuracy. Future diseases more artificial intelligence diagnosis breakthrough and improve accuracy, the perfect fit the rapid development of the third party image industry, makes the imaging diagnosis of cloud platform become the final solution of imaging diagnosis. 

 

3 d printing is a newly emerging field of medical equipment. Orthopedic devices of class 3 d printing industry in recent years has been preliminary input use, such as the history of the 3 d knee arthroplasties, icahn medical 3 d hip, secco key bone too mai di 3 d printing. 3 d printing another big application field is dental, overseas giant BEGO, pollan meca medical giants have production for oral application of 3 d printing equipment, such as 3 d Systems, EOS is also preliminarily introduced Chinese hospitals. Technology change will is deterministic trend in the development of instrument market. 

 

Global medical robot industry revenues of about $8.5 billion in 2016, a conservative estimate future 5 average annual compound growth rate will reach 15%, to 2020, will exceed $15 billion. This among them, the surgical robot will account for 60%, and rehabilitation robots will account for 20%. The surgical robot, leonardo Da Vinci robots since approved has successfully completed the hundred million cases of complex surgery. Rehabilitation robot under the gradually break through of technology also increasingly into the market, according to the university of Michigan's rehabilitation robot association predicts that rehabilitation robot compound growth rate of 37% in the next five years, far higher than other medical robots. In this area, foreign enterprise cinema-goers, Cyberdyne, Hocoma, companies such as Woodway exoskeleton robot has come, butterfly, science and technology of China, Fourier robot, anyang god rehabilitation medical device companies such as production of medical robots also gradually put into use. 

 

Now these new technologies in the field of medical apparatus and instruments of the company is still in its early, is still mainly in the pre - A wheel, A round of investment is given priority to, we expect these areas this year will be A growing number of startups and investment event, leading companies will also emerging. Technology platform type company v.s. vertical; V. innovation department of big companies, small entrepreneurial firms, who will stand out, we will wait and see. We think see migration ability, landing platform type company vertical company see channel promotion ability, large enterprise innovation department see interaction ability, resources and single point of small entrepreneurial firms see technology ability. 

 

5, precision medical from concept to mature gradually 

 

In January 2015, the then President of the United States of Mr Obama's proposed "precision medical plan", the word "precision medical" gradually into the popular vocabulary in the field of medical treatment, as the NGS, capture, edit, DNA biological information technology matures, etc. Precision medical also gradually from concept to mature. From the point of diagnosis and treatment process, precision medical treatment can be divided into early screening, diagnosis, and prognosis of follow-up. 

 

Leading enterprises in the field of genetic screening early basic shape, berry and is coming to the capital market, novartis wo innovative wholesale funding source for international trust &investment, Solomon's optimal production sequencing instrument NextSeq 550 ar, and fetal chromosomal aneuploidy detection kit for the CFDA medical equipment product registration approval. In the field of tumor early screening, recently, the cancer early Grail won a $900 million B round sieve company, once again aroused the heat of the capital. The importance of early screening is self-evident, the future in combination with artificial intelligent diagnosis technology, will be born again trillion-dollar blue ocean market. And one of the founders of 鹍 far gene, professor zhang 鹍 and his team in Nature Genetics, "released latest film, the first in the world high flux methylation noninvasive detection of new technology, the future can be used for noninvasive early cancer screening and source. At home, Mr Cheng introduced gene methylation early colorectal cancer screening products also won the CFDA medical instrument, the results will bring about the heat of the industry, was born in this field is expected of a batch of start-ups. In technology, the development of early screen mainly depends on the liquid biopsy, capture and amplification techniques, such as DNA methylation and the discovery of other targets such as the development of technology, we also need to accumulate enough clinical data, with clear clinical evidence, to become the gold standard for early screening. 

 

In disease diagnosis, accurate medical applications at present most is accurate drug and follow-up of the tumor. By tumor molecular pathology, such as the NGS, generation of sequencing, the PCR, such as FISH, CTC, single-celled sequencing technology, from molecular level to explain the patient's individual situation, to accurately in clinical treatment and prognosis, combined with targeted drugs, cell therapy means, realize accurate and individualized treatment. 

 

At present, the domestic field of NGS and ctDNA competition situation, many enterprises showed the trend of person, after the last two years of their, will soon celebrate the industry reshuffle period and more fierce competition. We expect the industry in the short term to see the business development and commercialization of landing ability, medium term service quality and capacity of the product research and development and the viscous and customers, the accumulation of long-term will see big data applications, commercial ecological building and the development and commercialization of new technology. Leading enterprise, the scale of the world and gene, burning stone medicine enterprise capital interest continuously, and to yuan code, the United States due to genes, genes, and become, science and technology as representative's emerging powers are in their different starting points to catch up. 

 

6. Momentum continued strong overseas investment and m&a 

 

Since the end of 2016, the investment institutions and large enterprises on the market in the medical equipment investment, give priority to with robustness, attaches great importance to have sales profit, there are channels of mature stable investment opportunities, and began to actively seek overseas companies to invest in technology, in order to realize the introduction of products, from domestic channels and complementary advantages. Due to the overall commercial cycle faster than new drugs, medical devices we expect investment institutions this year, especially the dollar fund, will follow this trend, we will continue to increase investment in overseas technical medical equipment companies even mergers and acquisitions; And a-share companies mergers and acquisitions overseas medical equipment companies will also continue, m&a has become A domestic enterprises to introduce foreign technology, foreign enterprises in China business an effective way to the ground. 

 

Since 2016, nine medical 93.88 million euros for Ann eDevice, overweight medical testing equipment; Purple xin pharmaceutical acquisition of Nabsys2.0 into genetic testing; Beijing Oriental Cnoga's $50 million investment in Israel noninvasive medical equipment company; Three biological $200 million deal to buy U.S. PTS diagnosis, into the POCT diagnosis of IVD industry domain. In vitro diagnosis, gene sequencing, innovative medical devices as high technical barriers, fast growth of the hot areas, is leading to buy battleground. In 2017, will be leading the country rushed to layout overseas for a year.