Prior Fiscal: $30.56 Billion
Percentage Change: -5.0%
No. of Employees: 93,792
Global Headquarters: Dublin, Ireland
KEY EMPLOYEES:
Geoffrey S. Martha, CEO
Omar Ishrak, Executive Chairman and Chairman of the Board
Karen L. Parkhill, EVP and CFO
Noel Colón, SVP, Chief Quality and Regulatory Affairs Officer
Richard E. Kuntz, M.D., M.SC., SVP, Chief Medical and Scientific Officer
Michael J. Coyle, EVP and President, Cardiac and Vascular Group
Sean Salmon, EVP and President, Diabetes Group
Brett Wall, EVP and President, Restorative Therapies Group
Bob White, EVP and President, Minimally Invasive Therapies Group
Last year, Medtronic made a significant announcement regarding a change in leadership. At the start of its next fiscal (which began April 27, 2020), the firm would have a new CEO in place. The previous chairman and CEO of the world’s largest medical device manufacturer—Omar Ishrak—would retire as its chief executive, but remain as part of the board as the newly created position of executive chairman as well as serving as chairman of the board. Ishrak held the CEO role for nine years, during which time Medtronic grew significantly.
“As Omar approaches the company’s mandatory executive officer retirement of 65 years of age next year, we have ensured Medtronic has the right leadership at the right time to advance its mission and deliver shareholder return through a seamless transition,” said Scott Donnelly, Medtronic’s lead director, and chairman, president, and CEO of Textron Inc. “The Board is extremely grateful to Omar for his outstanding leadership—as the company’s annual revenues have doubled and its market capitalization has increased by more than $100 billion during his tenure. We are confident Omar’s contributions to Medtronic will continue as executive chairman.”
During his tenure, Medtronic made the largest acquisition in medtech history when it bought Covidien in 2014 for $42.9 billion. The move was part of a redefined growth strategy that saw M&A used strategically to increase the company’s reach. Ishrak is also credited with inspiring the firm to embrace the concept of value-based healthcare, while also strengthening its position in emerging markets.
“Leading Medtronic as CEO is an honor and a privilege, and I know that Geoff is the right leader to take Medtronic to the next level of its growth and evolution. Geoff is a results-oriented, dynamic, and innovative business leader who is passionately committed to our mission, the advancement of our growth strategy, and the development and diversity of our people. I am confident he has the right track record, commitment, vision, and judgment to lead our company,” explained Ishrak.
The former CEO was referring to Geoff Martha, previously executive vice president (EVP) and president of the Restorative Therapies Group (RTG). Medtronic’s Board of Directors unanimously appointed Martha to assume the newly created role of president as of November 1, 2019. He would also be made a member of the board as of the same date. Then, at the start of the new fiscal, he would move into the CEO role.
“I’ve had the pleasure of working closely with Omar throughout his tenure,” said Martha. “I think I speak for all of us when I say we are tremendously grateful for his leadership over the past nine years, and for his steadfast commitment to the Medtronic Mission. He has provided us with a solid foundation on which to continue the journey.”
ANALYST INSIGHTS: MDT continues to operate generally under four main business units, focusing on more than 30 chronic diseases. They continue with acquisitions in all four business units. The acquisition of Digital Surgery, a surgical AI company, earlier this year follows on the heels of their 2019 acquisitions of AV Medical, Titan spine, Klue, and EPIC Therapeutics. Look for this trend to continue as connected health and telehealth have accelerated their rapid rise further with the arrival of the COVID-19 pandemic. MDT sees this change happening and will not be left behind.
—Mark Bonifacio, President, BCS LLC
Martha joined the organization in 2011 and was named EVP and president of Medtronic’s RTG in 2015. He reorganized the group around key therapy areas and helped to restore consistent sales growth. Martha oversaw a record performance in fiscal year 2019, contributing more than $8 billion in revenue to the firm. During the same period, the $2 billion quarterly average represented historic highs for the company.
Also moving into a new position, Brett Wall, who had been senior vice president and president of the Brain Therapies division of RTG, was promoted to EVP and group president of RTG in November. Wall made his way to Medtronic via the Covidien purchase, where he was president of Neurovascular and International. His 25 years of industry experience has seen him in roles including senior sales, marketing, and operational leadership positions with ev3, Boston Scientific, and C.R. Bard.
In another leadership move, the Diabetes Group gained a new head on October 21, 2019. Sean Salmon, previously senior vice president and president of Coronary and Structural Heart within the Cardiac and Vascular Group of Medtronic, was named EVP and group president of Medtronic Diabetes. He replaced Hooman Hakami, who left the firm after working there for five years. According to Ishrak, while under the oversight of Hakami, the business introduced the world’s first hybrid closed-loop insulin pump system—the MiniMed 670G System—and increased Diabetes Group revenue by over $700 million.
Salmon joined the organization in 2004 and spent 15 years in increasingly senior management roles. He led the firm’s entry into the drug eluting stent market. As president of Coronary and Structural Heart, Salmon led the Coronary and Renal Denervation, Cardiac Surgery, and Structural Heart business units and led numerous functions including Clinical, Regulatory, R&D, Quality, Health Economics & Reimbursement, Business Development, and Strategy.
These moves were announced during a time marred by Medtronic’s first down fiscal period in some time. The organization dropped from its previous record revenue high of $30.56 billion in its 2019 fiscal—the first time a medical device manufacturer topped the $30 billion mark. In 2020’s fiscal, all businesses and segments saw decreases with one exception to finish the period at $28.91 billion. The tally was just slightly above the revenue total for the firm’s 2016 fiscal.
ANALYST INSIGHTS: Another interesting note on MDT; in June 2020, Blackstone group’s life sciences division announced a $337M (USD) R&D investment into MDT’s diabetes device technologies. This is noteworthy as Blackstone’s investment looks to advance some specific programs. If successful, MDT will pay royalties to Blackstone (expected to be in the single digits, though not disclosed). For Blackstone’s life sciences division, the investment represents the first of its kind in the medical devices space. Soon after this announcement, MDT announced the positive results of its pivotal U.S. trial with their MiniMed AHCL, closed loop insulin pump. A long sought after “automating” of the delivery of both base-level insulin as well as correction doses to avoid high and lows.
—Mark Bonifacio, President, BCS LLC
The Cardiac and Vascular Group led all four of Medtronic’s businesses with $10.47 billion, a 9 percent drop over the previous fiscal. Leading the unit was Cardiac Rhythm & Heart Failure, which develops, manufactures, and markets products for the diagnosis, treatment, and management of heart rhythm disorders and heart failure. It depreciated 12 percent to end at $5.14 billion. Providing therapies to treat coronary artery disease and heart valve disorders, the Coronary & Structural Heart division was down 5 percent to finish the fiscal period at $3.54 billion. Contributing $1.79 billion to the coffers was Aortic, Peripheral, & Venous, which was a 7 percent decline. The unit is comprised of a comprehensive line of products and therapies to treat aortic disease, such as aneurysms, dissections, and transections, as well as peripheral vascular disease and venous disease.
The Minimally Invasive Therapies Group diminished 1 percent from $8.48 billion to $8.35 billion. The segment is made up of two businesses—Surgical Innovations and Respiratory, Gastrointestinal, & Renal. The former decreased 4 percent compared the previous period to finish at $5.51 billion. Surgical Innovations provides advanced and general surgical products, including surgical stapling devices, vessel sealing instruments, wound closure, electrosurgery products, hernia mechanical devices, mesh implants, and gynecology products and therapies. The latter, which was the one bright spot for Medtronic in its latest fiscal, completed its 12 month period up 4 percent—$2.84 billion. Respiratory, Gastrointestinal, & Renal offers products for minimally invasive gastrointestinal and hepatologic diagnostics and therapies, patient monitoring, respiratory interventions including airway management and ventilation therapies, and for the treatment of renal disease
The segment most directly impacted by the aforementioned leadership moves, RTG, shrank 6 percent overall to tally $7.73 billion. Responsible for devices and therapies indicated for the treatment of neurological disorders and diseases, as well as surgical technologies designed to improve the precision and workflow of neuro procedures, Brain Therapies withdrew by 1 percent to finish at $2.92 billion. The sector developing and selling medical devices and implants used in the treatment of the spine and musculoskeletal system fell 6 percent in the latest fiscal to complete the period at $2.5 billion. The Specialty Therapies business delivers products and therapies to treat diseases of the ear, nose, and throat, as well as help control the systems of overactive bladder, urinary retention, and chronic fecal incontinence. It wrapped up the term with $1.19 billion in revenue, a 9 percent loss. Pain Therapies had the most dramatic decrease in the segment with a 14 percent fall. The $1.11 billion in sales was for technologies including spinal cord stimulation systems, implantable drug infusion systems for chronic pain, and interventional products.
The Diabetes Group is focused solely on Type 1 and Type 2 of the chronic disease. It contributed $2.37 billion to the organization’s total revenue, which was 1 percent less than the prior fiscal.
Maintaining its tried and true technique for spurring growth to help boost the fiscal’s sagging figures, Medtronic took part in a relatively active season of acquisitions. The deal announcements began just a couple weeks after the close of the previous fiscal period. In May, reports indicated the organization was purchasing Titan Spine, a privately-held firm that provided titanium spine interbody implant and surface technologies. While the financial details were not disclosed, the buy does bring a comprehensive line of titanium, surface-enhanced interbody fusion devices to the Medtronic Spine portfolio.
The company then made a string of three acquisition announcements in as many months. The first was a strategic buy in the diabetes space. Two weeks before the start of 2020, Medtronic declared it was bringing Klue into the fold. The firm’s software revolved around behavior tracking that provides real-time insights into when a person is consuming food. It was expected the system could be incorporated into Medtronic’s Personalized Closed Loop (PCL) insulin pump system.
ANALYST INSIGHTS: Wall street continues it’s positive outlook on MDT, despite the well documented COVID-19-related slowing in elective procedures, which has had a short term effect. MDT has made it clear they will continue to invest both organically and inorganically in order to keep pace with the rapidly changing landscape in our post COVID-19 world.
—Mark Bonifacio, President, BCS LLC
“Bringing Klue and their unique meal detection capabilities into our organization will accelerate our progress to help people with diabetes live with greater freedom and better health,” said Alejandro Galindo, president of the Advanced Insulin Management division, a part of the Diabetes Group.
The PCL solution gained U.S. Food and Drug Administration (FDA) Breakthrough Device Designation in February 2019. Klue was the second in recent acquisitions centered around diabetes care and enhancement of the PCL system; the other was for Nutrino Health in 2018.
A week after the new year, Medtronic made known another purchase. Stimgenics LLC, based in Bloomington, Ill., developed a novel spinal cord stimulation waveform known as Differential Target Multiplexed (DTM) spinal cord stimulation. The therapy to treat chronic pain was already being delivered via Medtronic’s Intellis platform so bringing it all under one roof seemed to make sense.
“Medtronic is committed to providing clinically proven therapeutic options for millions of patients suffering from chronic pain around the world,” said Marshall Stanton, M.D., president of the Pain Therapies business, which is part of the RTG at Medtronic. “We believe that DTM therapy will advance the treatment of chronic pain, supported by clinical evidence and preclinical research on a neuronal-glial mechanism of action. It’s an exciting, new proprietary SCS waveform that will be available on the Intellis platform.”
To bolster its robotic surgical portfolio, the organization brought aboard Digital Surgery, a privately held developer of surgical artificial intelligence (AI), data and analytics, and digital education and training. The terms of the deal were not disclosed.
“Capabilities and solutions in the data and analytics space play a critical role in our continued focus on advancing minimally invasive surgery—from education and training to clinical decision support to reducing cost and unwarranted variability,” said Megan Rosengarten, vice president and general manager of the Surgical Robotics business, which is part of the Minimally Invasive Therapies Group at Medtronic. “We are thrilled to bring the Digital Surgery team and their expertise into Medtronic, not only due to the strategic fit from a technology perspective, but due to the shared belief that patients around the world deserve access to quality surgical care. By pairing digital solutions with robotic platforms and instrumentation, we can have a big impact on expanding patient access.”
In addition to bringing new capabilities and technologies into the fold through targeted purchases, Medtronic partnered with several organizations to increase the level of care delivered to a number of patient groups. One such arrangement with Novo Nordisk A/S targeted diabetics; specifically, the two entities sought to develop solutions to integrate insulin dosing data from future Novo Nordisk smart insulin pens into continuous glucose monitoring devices from Medtronic, such as the Guardian Connect system. By integrating glucose monitoring and insulin dosing data, people with diabetes and their healthcare professionals and caregivers would be able to automatically track both items in a single place. Further, being able to view both glucose and insulin data together can facilitate more productive conversations between patients and their doctors.
Another diabetes-centric partnership saw the medtech giant pair up with Tidepool, a 501(c)(3) nonprofit organization dedicated to making diabetes data more accessible, actionable, and meaningful. The pair agreed to work together to develop an interoperable automated insulin pump system. Specifically, Medtronic would produce a Bluetooth-enabled MiniMed pump to be compatible with Tidepool Loop, an open-source automated insulin delivery app for iPhone and Apple Watch that was still in development at the time of the agreement. Further, Medtronic would also contribute financially to Tidepool to support the integration development effort as well as to develop a software development kit to enable iPhone-to-pump communication.
Turning its attention to stroke care, Medtronic teamed with Viz.ai to accelerate adoption of AI software in U.S. centers dedicated to the condition. The Viz.ai solution leverages the AI to identify suspected large vessel occlusion (LVO) strokes and automatically notify specialists. It connects to hospital computed tomography scanners and alerts stroke specialists within minutes a suspected LVO stroke has been identified, sending the radiological images directly to their smartphones where they can be viewed. Through the agreement, Medtronic would distribute Viz.ai’s existing LVO detection and triage software services. Medtronic’s Solitaire Platinum revascularization device is a stent that retrieves clots from occluded blood vessels in the brain for patients experiencing acute ischemic stroke due to an LVO.
ANALYST INSIGHTS: With Geoff Marta taking over at CEO at MDT, don’t expect much to change as Omar Ishrak (former CEO) remains as executive chairman. MDT will continue to focus on growth across their platforms, both inorganically and organically. The COVID impacts will quickly be in their rearview mirror.
—Dave Sheppard, Co-Founder and Managing Director, MedWorld Advisors
As part of its emphasis on value-based healthcare, Medtronic was on one end of a five-year agreement to develop and deploy such initiatives to help ChristianaCare apply the right medical technologies and therapies to patients who may benefit most, with shared financial accountability between the two organizations. The planned focus for the partnership includes opioid-induced ventilatory impairment, heart failure, and diabetes. Learnings from the Delaware-based collaboration would have the potential to impact health beyond the region since its diverse patient population offers an ideal test ground to develop and scale new value-based initiatives.
“We recognize that creating healthier communities requires integrated care models, passion to improve the status quo, and an aligned purpose of helping patients live healthier and fuller lives,” said John Liddicoat, M.D., executive vice president and president of the Americas Region at Medtronic. “This collaboration with ChristianaCare reinforces our joint commitment to healthcare innovation through value-based arrangements.”
Further revealing aspects of its forthcoming robotic surgical system, Medtronic announced a partnership in which it has been working to incorporate Karl Storz’s three-dimensional (3D) vision systems and visualization components into its platform. For four years, the two firms had been coordinating to integrate the vision solution. “Surgeons can be confident our robotic assisted platform will provide market leading 3D visualization technology combined with best-in-class surgical stapling and energy instruments," proclaimed Megan Rosengarten, vice president and general manager of the Surgical Robotics business, part of the Minimally Invasive Therapies Group.
While Medtronic’s strategy for increasing revenue through the purchasing of complementary businesses and innovations is well known, there is still a strong product pipeline to ensure organic growth is enjoyed as well. The firm shared news on a variety of technologies in development, gaining regulatory clearances and approvals, as well as those being brought to market.
- Gained a CE mark for Cobalt and Crome portfolio of BlueSync-enabled implantable defibrillators and cardiac resynchronization therapy defibrillators, offering physicians heart failure diagnostic insights.
- Received FDA approval for trial evaluating new energy source with pulsed electric fields designed to interrupt irregular pathways in the heart to treat atrial fibrillation.
- Launched Efficio software, which provides enhanced, secure access to patient data and delivers actionable insights in a secure cloud environment, to help clinicians efficiently manage targeted drug delivery therapy with SynchroMed II.
- Earned the FDA approval of the Micra AV leadless pacemaker to treat AV block.
- Obtained a CE mark for the InterStim micro neurostimulator and InterStim SureScan MRI leads, offering sacral neuromodulation therapy to Europeans suffering from incontinence. The firm also announced it submitted a PMA supplement for the technologies with the FDA.
- Gained a CE mark for the Percept PC neurostimulator DBS system with BrainSense technology, which allows physicians to review patient-specific brain signals.
- Launched the Solitaire X revascularization device in the U.S.; the system offers new options for improving outcomes in treating stroke.
- Received FDA approval for its Attain Stability Quad MRI SureScan heart lead, which was designed for precise placement and stability
- Obtained FDA approval for CareLink SmartSync Device Manager, a tablet-based device manager that provides portable and secure wireless programming of the company’s BlueSync devices.
- Launched the Telescope Guide Extension Catheter to support complex coronary cases, as it enables smooth delivery of coronary stents and balloons.
- Announced FDA clearance and launched the SelectSite C304-HIS deflectable catheter system for use in procedures involving His-bundle pacing.
- Gained FDA approval for expanded indication of the Evolut TAVR (transcatheter aortic valve replacement) System to treat symptomatic severe aortic stenosis patients at low risk for surgical mortality (i.e., younger, more active patients).
- Introduced the Envision Pro Continuous Glucose Monitoring System in Europe, enabling type 1 and type 2 diabetes patients and their physicians to see accurate glucose levels and trends over time to develop more optimal diabetes therapy plans.
- Obtained FDA approval and launched the Evolut PRO+ TAVR System for the treatment of symptomatic severe aortic stenosis patients.
- Gained FDA Breakthrough Device Designation for developing stent graft system to treat thoracoabdominal aortic aneurysm.
- Launched the GI Genius Intelligent Endoscopy Module, an AI-based system for a colonoscopy.
- Received Breakthrough Device Designation for a fully implantable left ventricular assist device for patients with advanced heart failure.
- Launched the Activa Patient Programmer, which leverages a user-friendly, custom-configured Samsung mobile device to enable patients to manage their deep brain stimulation therapy more simply and discreetly.
- Announced Shonin approval and launch of the Valiant Navion Thoracic Stent Graft System in Japan; system enables the minimally invasive repair of thoracic descending aortic aneurysms and complicated type B aortic dissections.
- Received FDA approval of the IN.PACT AV drug-coated balloon to treat arteriovenous fistula lesions.
- Expanded the scope of Surgical Synergy with the FDA clearance of the Stealth Autoguide System for cranial procedures.
COVID-19 Consequences
Q4 2020 Revenue: $6.0 Billion (ended April 24, 2020)
Q4 2019 Revenue: $8.1 Billion (ended April 26, 2019)
Percentage Change: -26%
That’s not to say, however, that Medtronic hasn’t been quite active in lending its assistance in whatever ways it could in battling the virus. In a surprising yet generous move, the firm made the full design specifications for one of its ventilators, including manuals, design documents, and software code, open source. This enabled anyone to access the files for the Puritan Bennett (PB) 560 portable ventilator in order to manufacture it. The unit had originally been intro-duced in 2010 and offers a compact design, enabling easy portability.
In a related story, the company also announced its team-up with Foxconn Industrial Internet, a business group within Foxconn Technology Group, to produce 10,000 of the PB560 ventilators. Foxxconn passed the regulatory and quality requirements of Medtronic to enable it to manufacture the units. The arrangement has the units being produced in Foxconn’s Wisconsin facility, but they would be marketed and sold by Medtronic. The partnership was established as a direct result of Medtronic’s ventilator open source initiative.
These efforts are in addition to the company stating in March it had increased ventilator production by 40 percent and was attempting to double its capacity to manufacture the device.
Further, the organization also launched two solutions from its Medtronic Care Management Services (MCMS) business, each designed to help assess, monitor, and triage support for patients who may be concerned about COVID-19. One was the Respiratory Infectious Disease Health Check, which was offered to existing MCMS customers. The second was a new COVID-19 Virtual Care Evaluation and Monitoring solution Medtronic made available to U.S. health systems, health plans, and employers. The latter offering uses a virtual assistant to evaluate patients through a CDC guideline-based survey for COVID-19 symptoms.