硅谷银行（SVB）：2022年医疗保健投资和退出年度报告（英文版）（42页）.pdf

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1、Biopharma|Healthtech|Dx/Tools|DeviceEngage#SVBHealthcareFinancialPublished on January 6,202303Market Highlights25Healthcare Fundraising and Investments26Computational Biology Investments29Healthcare M&A and IPO Activity38Healthcare Outlook:2023 and Beyond40GlossaryHEALTHCARE INVESTMENTS AND EXITS|AN

2、NUAL REPORT 20222Note:1)Market statistics represent SVB commercial bank clients as of 12/31/2022 with a VC-backed round of at least$4M.2)The LIPO(Likely to IPO)list tracks Top 15 Crossover-funded private mezzanine deals($40M+)as a proxy for IPO sentiment and pipeline.All investment data as of 12/16/

3、2022.Source:PitchBook and SVB proprietary data.SVB US Market Stats1 2021-2022of all VC-backed US healthcare companies that raised rounds since 2021 have a banking relationship with SVB.of all VC-backed US healthcare companies that raised rounds greater than$40M since 2021 have a banking relationship

4、 with SVB.72%54%3HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022Venture capital(VC)fundraising was unprecedented in H1 2022.Despite a slowdown in H2,funds closed out the year with nearly$22B to invest into healthcare companies,second only to the record$28B raised in 2021.With over$50B fundraised

5、 in the past two years,venture healthcare has the largest war chest of investable capital ever.Healthcare Investment declined in both deals and dollars each quarter after setting a record in 2021.Total healthcare investment for the year still exceeded 2020,making 2022 the second-largest year ever,th

6、ough Q3 and Q4 fell below 2020s quarterly average.This decrease was likely because investors directed new money toward their existing portfolios instead of new investments,raising insider rounds to focus on hitting valuation inflections before the next outside financing.Additionally,the large crosso

7、ver to initial public offering(IPO)rounds,common in 2020 and 2021,were down significantly in the face of a difficult IPO market.Biopharmaearly-stage investment activity declined,but valuations appeared unaffected by public market turmoil.Atthe seed stage,companies raised more syndicated rounds,likel

8、y due to the uncertain private financing environment for the upcoming year.In later stages,the number of LIPO(likely to IPO)2crossover rounds dropped,down to single digits per quarter in H2 2022.Overall,we noted the most significant declines in oncology and neurology investment.Healthtech shifted to

9、ward early-stage investment,where valuations were less impacted by public market comps.Investment exceeded the record seed/Series A activity from 2021.In late stages,investors shifted their focus toward companies that were closer to profitability and demonstrated the ability to improve health outcom

10、es,access or affordability.Provider operations(PO)companies received the most investment,with many new financings focused on advancing and digitizing provider workflow and clinical decision support.While alternative care(AC)investment was down overall,mental health and primary care solutions continu

11、ed to dominate this subsector.Dx/Tools early-stage investment set a new dx/tools record in 2022 as dx tests dollars doubled and dx analytics activity increased.However,the overall sector suffered the largest drop in healthcare investment,specifically in H2,as investors struggled to reconcile frothy

12、valuations with poor IPO performance over the past few years.R&D tools investment suffered the biggest decline while dx analytics excelled,closing financings with three of the top five largest post-money valuations.Device was the only sector in 2022 to nearly match the record investment in 2021,drop

13、ping less than 10%overall,despite a sharp decline in Q4 22.Companies in non-invasive monitoring raised big financings across deal stages.Overall,$100M+deals increased from 2021,as investors gravitated to the device sectors metric-driven revenue stories.Though valuations stayed steady,investors start

14、ed to introduce more structured term sheets,including liquidation preferences,in later-stage deals toward the end of the year.Venture Fundraises into Downturn,but Investment Declines from 2021s RecordNote:1)IPO statistics represent SVB US commercial bank clients.2)IPO defined as all private,venture-

15、backed IPOs raising at least$25M in proceeds.Public market performance metrics calculated as of 12/31/2022.See sector-specific definitions in the glossary on slide 40.Source:PitchBook,S&P S&P Capital IQ and SVB proprietary data.SVB US IPO Market Stats12021-2022of all VC-backed healthcare IPOs since

16、2021 have a banking relationship with SVB.75%4VC-Backed Exits Plummet as Market Tries To Find BottomHEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022After a record number of healthcare mergers and acquisitions(M&A)and IPOs in 2021,IPOs2were down across all sectors as public market-cap erosion and

17、poor performance of the 2020 and 2021 IPO classes largely blocked opportunities for companies to go public.Private M&A also suffered,as acquirers refocused on preserving cash and/or completing internal projects rather than acquiring new companies.The private M&A deals we did see were smaller in valu

18、e for healthtech,device and dx/tools companies.Though we saw larger deals in biopharma,these companies raised large amounts of private funding,resulting in lower multiples for later-stage investors.Biopharma Off a record 92 IPOs in 2021,there were just 19 IPOs in 2022,with pre-money valuations falli

19、ng to 2019 levels and mixed post-IPO performance for the 11 US and EU IPOs.Private M&A was muted,as acquirers focused on recently public companies,trading well off their highs,instead of private companies with static,high valuations.Of the nine M&A in 2022,five were preclinical stage.At the end of t

20、he year,Nimbus sold its phase II asset to Takeda for$4B upfront,tied for the second largest upfront ever for a venture-backed biopharma company.HealthtechIPOs halted as public healthtechstock performance fell throughout 2022.However,M&A volume has remained strong,almost on pace with 2021s record.Dea

21、l sizes for M&A were down and will likely remain smaller as public market comps continue to fall.Public(and private)healthcare companies led healthtech M&A in 2022,but big tech companies also made notable acquisitions of public healthtech companies in 2022.Dx/ToolsM&A and IPO activity rose to record

22、 levels from 2019 through H1 2021 and propelled dx tools exits to record activity.However,since H2 2021,large public companies in the dx/tools sector suffered from declining market caps,and recent IPOs have experienced even worse performance.In 2022,there were no US venture-backed IPOs and only five

23、M&A deals,with a significantly lower median upfront value than the last two years.However,we did see two cross-sector acquisitions of dx/tools companies,with a healthtechcompany acquiring a dx test company to expand its platform and a biopharma company acquiring an R&D tools company to scale manufac

24、turing.Device2021 set a record for the number of IPOs and M&A,with small-and mid-cap public companies joining big players to buy venture-backed device companies.However,poor performance in the public market forced many acquirers to revisit their cash spend and push acquisitions to the back burner.As

25、 a result,the US IPO market was effectively shut in 2022.Device M&A was also down,but orthopedics and vascular indications had three exits each.US,EU&UK5HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022$3.6B$3.9B$6.1B$7.5B$7.2B$9.1B$9.6B$10.7B$16.8B$28.3B$21.8B2012201320142015201620172018201920202

26、0212022US Healthcare Venture Capital Fundraising12012-2022Annual Report2022Notable Funds with Allocations to Healthcare36Note:1)US Healthcare Venture Capital Fundraising defined as an approximation of healthcare investment dollars to be invested by firms that historically invest in+50%US companies.2

27、)Estimates based off of anecdotal conversations with investors and expert analysis of last fund deal pace and focus on healthtech.3)Notable funds based on largest estimated allocation to venture healthcare.Data as of 12/16/2022.Source:PitchBook and SVB proprietary data.HEALTHCARE INVESTMENTS AND EXI

28、TS|ANNUAL REPORT 20222In the first half of 2022,venture capital(VC)investors accelerated their healthcare fundraising,beating the record pace of 2021.Despite a slowdown in the second half of 2022,venture funds raised nearly$22B to invest into healthcare companies,marking the second-biggest fundraisi

29、ng year ever.With over$50B raised over the last two years,investors now have a record amount of capital ready to deploy into new healthcare portfolio companies.There were three main trends in healthcare fundraising that continued into 2022.First,growth/expansion firms raised large,private funds with

30、 a portion slated for healthcare investment.We estimate$1B+healthcare allocations for large players like Tiger Global(primarily investing in healthtech)and Alpha Wave(primarily investing in biopharma).Second,established biopharma-focused firms continued to raise larger funds led by groups like Arch,

31、Third Rock,Frazier,The Column Group,5AM and Atlas.Of the healthcare funds raised over the past two years,we estimate that 50%-60%is earmarked for biopharma investment.Third,traditional tech firms continued to allocate some capital to invest into healthcare,mostly focused on healthtech.There were 70

32、tech-focused funds that closed in 2022,like Bessemer and Union Square,with a 5%-15%allocation to healthcare,up from 54 in 2021.Number of DealsVC Dollars and Deals by Healthcare SectorsUS,EU&UK2020202120221Sectors($B)USEU&UKTotalUSEU&UKTotalUSEU&UKTotalBiopharma22,5944,79527,38931,7306,91938,64924,60

33、44,87029,474Healthtech211,7601,61313,37333,0312,86935,90012,9053,83716,742Dx/Tools9,1161,78410,90011,9642,70314,6678,2561,6099,865Device5,769 8216,5906,7742,4299,2036,8821,6178,499Total49,2399,01358,25283,49914,92098,41952,64711,93364,580Annual Report20227HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPO

34、RT 2022Note:1)Investment data includes deals as of 12/16/2022.2)Healthtech deals that overlap with other sectors are not included in healthtech totals on this slide but are included in healthtech-specific analyses on pages 13-17.With overlap,healthtech investments for 2022 total$22B.Financing data i

35、nclude private financings by venture-backed companies in the US,EU,and UK.Dates of financing rounds are subject to change based on add-on investments.Source:PitchBook and SVB proprietary data.453481556528714776734748870769622493$0$5B$10B$15B$20B$25BQ120Q220Q320Q420Q121Q221Q321Q421Q122Q222Q322Q422It

36、is important to note the unprecedented increase in venture healthcare investment over the past five years.In 2018 and 2019,total dollars jumped from previous highs of$20B+to a new record of$33B in both years.2020 increased that pace by 75%to reach$58B,and 2021 set the highwater mark at$98B.Investmen

37、t was strong in Q1 2022,buoyed by the$3B financing by Altos Labs.As the public downturn worsened,investment dropped in Q2 and again in Q3,falling below average dollars raised per quarter in 2020.Q4 was down only slightly,buttressed by a bounce-back in biopharma and dx/tools.There are two main reason

38、s for 2022s drop-off in investment:First,to unlock the next round of financing,later-stage companies have found that they need to demonstrate more progress to new lead investors.As a result,investors dedicated more time and capital to supporting existing portfolio companies through smaller insider r

39、ounds,rather than funding new deals.Second,many later-stage investors have paused new deal activity as the public market continues to plummet,causing the number of larger crossover pre-IPO deals to decline significantly.$2.1B$2.8B$3.4B$4.2B$2.0B$1.3B$531M$666M$786M$691M$233M$289M$1.5B$850.2M$433.5M$

40、171.4MSeed/Series A1Dollars and(Deals)US,EU&UKNote:1)Seed/Series A includes first-time investments from institutional or corporate venture investment in the US,EU,and UK and any first-round investments equal to or greater than$2M,regardless of investor.Dates of financing rounds are subject to change

41、 based on add-on investments.All data as of 12/16/2022.Source:PitchBook and SVB proprietary data.BiopharmaSeed/Series A Dollars and Deals by Top IndicationsUS InvestmentEU and UK Investment2020$6.5B(289)2022$6.6B(287)2021$9.2B(357)Median Seed/Series A ValuationsUS,EU&UKPre-Money ValuationDeal Size20

42、2020212022Indications Dollars DealsDollarsDealsDollarsDealsPlatform$1.8B74$3.5B96$2.3B79Oncology$1.7B79$1.6B77$1.7B73Autoimmune$372M9$347M10$493M15Respiratory$81M7$88M7$422M6Anti-Infective$157M11$439M28$409M17Neurology$974M38$1.6B55$402M28Ophthalmology$94M9$194M9$202M9Largest 2022 Seed/Series A Deal

43、s8HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022$12M$17M$16M$10M$10M$9M202020212022H1 2020H1 2021H2 2020H1 2022H2 2021H2 2022Q1Q3Q2Q4Early-stage investment remained consistent in H1 2022 but trailed off in H2,highlighted by a drop in larger$50M+deals(30 in H1,17 in H2).However,seed/Series A val

44、uations were similar to 2021 levels.After early-stage oncology companies raised a record$3.3B from 2020 to 2021,deals and dollars decreased sharply during the second half of 2022(42 deals/$1.2B in H1,24 deals/$502M in H2).Many investors stopped funding new seed/Series A oncology deals while waiting

45、for existing investments to play out.In 2022,investors ramped up their activity in autoimmune,respiratory and even cardiovascular and metabolic companies.These indications traditionally struggled to attract venture investment,given the large dollar outlay needed for clinical trials,especially in car

46、diovascular and metabolic.We now see these areas gaining interest from traditional venture firms with the understanding that private equity(PE)firms,growth investors,sovereign wealth funds and asset managers are likely to write big checks to fund later-stage trials.The two largest early-stage deals

47、in 2022 were in autoimmune and respiratory,funded by both venture and late-stage growth investors.Seed activity remained strong.Most traditional biopharma funds have a dedicated seed program to drive ownership and provide a differentiated strategy for their limited partners(LPs).However,given the un

48、predictable financing landscape,we have noted more institutional seed deals syndicated by multiple large venture firms in 2022.Including multiple deep pocketed investors protects against financing risk while also pre raising Series A financings.Series A&Series B1:Biopharma Deal CountsUS,EU&UKSeries

49、ASeries B3934293338466451706455526438354125242121282739254436523040291815Q119Q219Q319Q419Q120Q220Q320Q420Q121Q221Q321Q421Q122Q222Q322Q422HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 20229After robust Series A activity in H2 2020 and 2021,we expected a corresponding increase in Series B activity 18

50、-24 months down the road.However,instead we noted a steady decline in Series B activity in 2022.Our Thesis-Series A investment in 2020 and 2021 was dominated by early-stage platform companies,many of which were multiple years away from having an asset in clinical development.However,with the downtur

51、n in private financing and the slowdown in early-stage IPOs,many new investors want companies to get into the clinic and show initial data before leading the next round.This forced many companies to raise Series A extensions or insider bridges,providing more time and resources to meet these new mile

52、stone requirements and likely prepare to raise an outside-led financing in H2 2023.The Concern-Inside rounds in 2022 deplete investor dry powder and lead to less inside investor support in the next round.Additionally,we forecast a very crowded and more difficult fundraising environment for the secto

53、r in H2 2023.The Silver Lining-Over the past two years,healthcare venture firms raised a record amount of capital,including many opportunity funds,to provide support for top biopharma companies in 2023.Capital should be available for companies that are able to show positive clinical progress.Note:1)

54、Series A and Series B data are based on series label Pitchbook assigns to each financing.Includes venture investment in US,EU,and UK equal to or greater than$2M.Dates of financing rounds are subject to change based on add-on investments.All data as of 12/16/2022.Source:PitchBook and SVB proprietary

55、data.Biopharma$12.7B$14.7B$21.8B$16.9B$11.4B$5.6B$6.9B$5.8BTotal Dollars and(Deals)US,EU&UKNote:1)The LIPO(Likely to IPO)list tracks the top 15 crossover-funded private mezzanine deals($40M+)as a proxy for IPO sentiment and pipeline.2)Only includes private post-money values from publicly disclosed 2

56、022 financings in PitchBook.3)See glossary on page 40 for computational biology definition.Financing data includes private financings by venture-backed companies in the US,EU,and UK.Dates of financing rounds are subject to change based on add-on investments.All data as of 12/16/2022.Source:PitchBook

57、 and SVB proprietary data.BiopharmaLIPO Deal Activity1Dollars and Deals by Top IndicationsUS,EU&UKHighest-Valued 2022 Financings22020$27.4B(698)2021$38.7B(910)2022$29.5B(778)202020212022Indications Dollars DealsDollarsDealsDollarsDealsPlatform$7.6B148$12.2B216$10.8B176Oncology$8.9B208$11.3B256$6.7B1

58、96Neurology$2.7B89$4.5B126$2.5B93Anti-Infective$1.2B42$1.7B56$1.3B49Autoimmune$747M18$1.8B34$1.5B35Ophthalmology$426M20$965M24$1.4B35AgBio$3.9B postPlatform$3.0B postNeurology$1.8B postPlatform$1.7B postAgBio$1.5B postPlatform$1.3B postOncology$1.2B postNeurology$1.1B postPlatform$1.1B postOncology$

59、967M postRespiratory$950M post10QuarterLIPO DealsMedian Pre-Money($M)Median Deal Size($M)IPO%Q1 2017$245$10888%Q2 2021$150$8662%Q3 2028$140$9254%Q4 2015$140$8753%Q1 2138$184$10053%Q2 2131$200$10510%Q3 2124$169$9013%Q4 2116$172$1020Q1 2217$160$1005%Q2 2211$147$1020Q3 226N/A$1320Q4 227$155$1150HEALTHC

60、ARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022H1 2020H2 2020H1 2021H2 2021H1 2022H2 2022Q1Q3Q2Q4In 2022,biopharma investment steadily declined in each quarter but bounced back in Q4.Overall,we saw the most significant slowdown in oncology and neurology dollars,each down more than 40%from 2021,and even

61、 dropping below 2020 pace.The shortfall in biopharma investment was driven by two main factors.First,crossovers funded fewer LIPO1rounds in 2022,causing$100M+financings to drop more than 25%.Second,new investors demanded more progress before funding the next round(mostly at Series B),forcing compani

62、es to close smaller extensions or insider rounds.However,in late 2022 companies and investors became more open to new investors leading a slight down-round rather than closing an insider round.This helped reset previously inflated valuations and,more importantly,added new investors with substantial

63、dry powder.Venture investors led many of these new deals,usually without crossover participation.Computational biology(comp bio)3deals posted some of the largest post-money valuations in 2022.As an exception to the overall trend in biopharma,investors were more willing to fund preclinical companies

64、if they were applying computational approaches to discover and develop drugs over multiple indications.We saw platform comp bio companies,including Eikon,Tessera and Treeline,reach high valuations despite no assets in the clinic.Note:1)Step-ups are calculated by dividing the companys 2022 financing

65、pre-money valuation by its most recent financing post-money valuation if it occurred between 2019 and 2022.Only includes financing and valuation information from publicly disclosed financings in PitchBook.2)Seed/Series A chart does not include an outlier of a 33x step-up for Genascence.Dates of fina

66、ncing rounds are subject to change based on add-on investments.All data as of 12/16/2022.Source:PitchBook and SVB proprietary data.11BiopharmaHEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022Note:Size of bubble indicates size of 2022 financing.Dotted line indicates median step-up.Seed-A Step-Up2A-

67、B Step-UpB-C Step-UpC+Step-Up1210864201/1/223/1/225/1/227/1/229/1/2211/1/222.3xStep-Up1210864201/1/223/1/225/1/227/1/229/1/2211/1/221.8xStep-Up1210864201/1/223/1/225/1/227/1/229/1/2211/1/221.3xStep-Up1210864201/1/223/1/225/1/227/1/229/1/2211/1/221.1xStep-UpOut of the 778 US,EU and UK biopharma finan

68、cings in 2022,we calculated 154 step-ups1 and step-downs that were outside-led rounds with publicly disclosed valuation information in their previous and current rounds.From our anecdotal perspective,most of the outside-led financings in 2022 were reserved for the top 15%-20%of companies that hit si

69、gnificant development milestones.Many companies instead raised insider rounds or extensions with plans to come back to the market in late 2023.At that point,we expect to see a spike in step-downs as companies reset their valuations.The median step-ups for early-stage deals(seed-A and A-B)were strong

70、,showing that promising new biopharma companies can still be rewarded with up rounds,even in a down market.However,throughout the year,median step-ups shrank for both seed-A(2.7x in H1,1.6x in H2)and A-B(2.0 x in H1,1.5x in H2).Despite this trend,we saw six early-stage step-ups over 3x in H2:Strand

71、Therapeutics(12.6x),Rivus Pharmaceuticals(6.0 x),ELEVAI Labs(4.7x),Bonum Therapeutics(3.6x),ArsenalBio(3.5x)and Neuraptive(3.1x).Later-stage biopharma deals(B-C and C+)had fewer step-ups.Of the 32 later-stage companies from our 2022 dataset,six(19%)were down rounds.While many older companies struggl

72、ed to hold onto their valuations,we continued to see growth for the highest-valued biopharma companies.In 2022,the 11 deals that financed with pre-money valuations of$400M+achieved a median step-up of 1.4x,with only one down round.SVB ConfidentialCorporate Venture Activity Overall4722201913Deal Coun

73、t,US,EU&UK(2021-2022)BiopharmaVenture Activity Overall382925221727 2021112022Note:1)Most active new investors calculated as new(first-time)investments in US,EU,and UK companies from 20212022.Dates of financing rounds subject to change based on add-on investments.Corporate parent and corporate ventur

74、e investment are combined under corporate investor.2)Additional investors not listed due to space limitations.Source:PitchBook,conversations with investors and SVB proprietary data.12HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 202222 2021720229 202116202210 202112202214202152022Late-Stage/Crossov

75、er Activity Overall654339383846 202119202238 20215202233 20216202228 202110202231 20217202233202114202214 2021820221020211020228 20211120229202142022Platform1413131211620218202211 2021220227 20216202292021320229 202122022Oncology262017171520 20216202219 20211202212 20215202216 20211202213 2021220222

76、$835M$857M$1.2B$1.2B$821M$450M$127M$267M$455M$315M$403M$114M$554M$519M$252M$94MSeed/Series A1Dollars and(Deals)US,EU&UKNote:1)Seed/Series A includes first-time investments from institutional or corporate venture investment in the US,EU,and UK and any first-round investments equal to or greater than$

77、2M,regardless of investor.Dates of financing rounds are subject to change based on add-on investments.2)These companies overlap with the dx/tools sector and are included in both sets of sector-specific analyses.Biopharma drug discovery companies excluded from healthtech data.All data as of 12/16/202

78、2.Source:PitchBook and SVB proprietary data.HealthtechSeed/Series A Dollars and Deals by Top SubsectorsMedian Seed/Series A ValuationsUS,EU&UK202020212022SubsectorsDollars DealsDollarsDealsDollarsDealsProvider Operations$733M102$1.5B215$1.6B215Alternative Care$608M73$818M141$923M120Wellness&Educatio

79、n$289M45$303M72$433M103Clinical Trial Enablement$232M14$152M33$123M19Medication Management$42M8$53M13$75M18Healthcare Navigation$144M14$257M23$11M413HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022US InvestmentEU and UK Investment2020$2.1B(264)2021$3.1B(503)2022$3.2B(485)H1 2020H2 2020H1 2021H2 2

80、021H1 2022H2 2022Pre-Money ValuationDeal Size$10M$10M$13M$5M$4M$5M202020212022While 2022 marked a necessary rightsizing in the healthtech investment landscape as a whole,early-stage investment flourished.Early-stage investment set a new record,as investment shifted to new deals that were not inflate

81、d by 2020 and 2021 valuations.Provider operations(PO)companies received the most early-stage investment,with new companies forming to help implement efficiencies in provider workflows,reduce administrative burden and utilize technology to improve decision-making.Alternative care(AC)investments exper

82、ienceda dramatic shift to early-stage,but market saturation in this space will require companies to show improved outcomes,increased quality or reduced cost and proven ROI and unit economics to secure later-stage rounds.Womens health(WH)companies hit$245M in early-stage funding in 2022,the highest s

83、eed/Series A amount ever.Momentum was strong in WH in 2022,with the closing of the largest WH-only focused fund(SteelSky Ventures at$72M)and rapidly expanding WH investment in menopause,pelvic floor therapy and sexual health.The venture studio model has also increased in popularity in 2022,with firm

84、s like AlleyCorp and Redesign Health creating,incubating and supporting early-stage healthtech companies.Q1Q3Q2Q4Largest 2022 Seed/Series A Deals222222After robust Series A activity in 2020 and 2021,we noted a steady decline in Series B activity in 2022.Of the 206 healthtech companies that raised a

85、Series A in 2020,44%(92)raised a Series B through 2022,and of the 247 companies that raised a Series A in 2021,only 23%(58)raised a Series B through 2022.Our thesis-For healthtech companies to raise Series B,new investors are putting increased pressure on companies to show conversion from pilots to

86、commercial contracts.Investors are also pushing for proven or well-defined unit economics and backup plans for profitability,while customers push for tangible improvements in clinical outcomes or cost effectiveness.Companies have turned to Series A extensions or convertible insider bridges to secure

87、 more time to hit these milestones.The Concern-Inside rounds deplete investor dry powder and likely mean less insider support for the upcoming round in 2023.The Silver Lining-There was a record amount of healthcare VC funds raised over the past two years.We think there will be abundant capital to su

88、pport strong stories in 2023.Series A&Series B1:Healthtech Deal CountsUS,EU&UKSeries ASeries B48733760485750516691684910175603819342623282636333048515139432924Q119Q219Q319Q419Q120Q220Q320Q420Q121Q221Q321Q421Q122Q222Q322Q422Note:1)Series A and Series B data are based on series label Pitchbook assigns

89、 to each financing.Includes venture investment in US,EU,and UK equal to or greater than$2M.Dates of financing rounds are subject to change based on add-on investments.All data as of 12/16/2022.Source:PitchBook and SVB proprietary data.HealthtechHEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 202214$7

90、.4B$10.0B$19.7B$22.7B$8.6B$4.4B$5.8B$3.3BTotal Dollars and(Deals)US,EU&UKNote:1)These companies overlap with the biopharma,dx/tools or device sectors and are included in both sets of sector-specific analyses.2)Only includes private post-money values from publicly disclosed 2022 financings in PitchBo

91、ok.3)Biopharma drug discovery companies excluded from healthtech data.Financing data include private financings by venture-backed companies in the US,EU,and UK.Dates of financing rounds are subject to change based on add-on investments.Data as of 12/16/2022.Source:PitchBook and SVB proprietary data.

92、Notable 2022 DealsDollars and Deals by Top SubsectorsUS,EU&UKHighest-Valued 2022 Financings22020$17.4B(772)2021$42.43B(1,273)2022$22.1B(1,240)202020212022Subsectors Dollars DealsDollarsDealsDollarsDealsProvider Operations$5.9B326$10.9B519$9.3B565Alternative Care$5.8B214$20.3B369$6.9B307Clinical Tria

93、l Enablement3$1.2B48$3.2B98$1.7B64Wellness&Education$1.4B103$2.9B164$1.6B206Medication Management$646M28$1.2B37$895M48Healthcare Navigation$843M33$2.2B68$1.4B321993$200M+to$299M$300M+2155202020212022Provider Operations$10.3B postAlternative Care$6.6B postAlternative Care$6.5B postAlternative Care$5.

94、9B postClinical Trial Enablement$4.8B post Provider Operations$3.5B postProvider Operations$3.1B postAlternative Care$2.9B postHealthtech15HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022H1 2020H2 2020H1 2021H2 2022H2 2021H1 2022Investors shifted focus from AC to PO to address workflow efficienci

95、es and implement new virtual care models in provider practices.Later-stage deal sizes were also significantly down in 2022,with$200M+financings dropping by 65%from 2021 and unicorn formation down by more than half,from 44 in 2021 to 18 in 2022.Notably,later-stage mental health(MH)companies defied th

96、is downward AC trend,with the acceptance that MH is a huge intractable problem that is only getting worse.We saw later-stage AC financings for companies that provided tangible value creation for patients,especially through employer-sponsored benefits.PO led all healthtech investment in 2022,with an

97、unprecedented number of companies raising new rounds with solutions to improve workflow,reduce burnout and adopt managed care models.There is a healthy dose of caution with so many start-ups in this subsector,as provider adoption of new tech has historically been slow.However,acquirer interest has b

98、een strong,as almost half of all 2022 healthtechM&A were acquisitions of PO companies.Over the past few years,we saw an influx of venture-backed AC companies that were focused initially on point solutions.We noted a trend of these private companies merging in order to offer whole-person platform car

99、e,providing more touchpoints along the continuum of care to improve quality and management of chronic conditions.11111Q1Q3Q2Q416HealthtechNote:1)Step-ups are calculated by dividing the companys 2022 financing pre-money valuation by its most recent financing post-money valuation if it occurred betwee

100、n 2019 and 2022.Only includes financing and valuation information from publicly disclosed financings in PitchBook.Dates of financing rounds are subject to change based on add-on investments.All data as of 12/16/2022.Source:PitchBook and SVB proprietary data.HEALTHCARE INVESTMENTS AND EXITS|ANNUAL RE

101、PORT 2022Out of the 1,240 healthtech US,EU and UK financings in 2022,we calculated 525 step-ups1and step-downs that were outside-led rounds with publicly disclosed valuation information in their previous and current rounds.From our anecdotal perspective,most of the outside-led financings in 2022 wer

102、e reserved for the top third of companies that hit significant development milestones.Many companies instead raised insider rounds or extensions with plans to come back to the market in late 2023.At that point,we expect to see a spike in step-downs as companies reset their valuations.When compared t

103、o all other sectors,healthtech had the largest step-up multiples in early-stage deals.However,the highest step-ups for seed-A and A-B were mostly in H1(median step-up of 2.9x in seed-A and 2.4x in A-B)vs.H2(median step-up of 2.0 x in seed-A and 1.5x in A-B).The biggest valuations in early-stage also

104、 were in H1.There were 13 Series B step-ups in our analysis where the post money was$200M+,all closed in H1 except PurpleLab,which closed in July 2022.Despite a tough financing environment and low overall step-ups for later-stage healthcare deals,there were attractive step-ups for the very largest h

105、ealthtech financings.We noted 12 companies in our analysis that completed a 2022 financing where the pre-money value was$1B+.The median step-up in these deals was 2.3x from the last round,producing six new unicorns.Note:Size of bubble indicates size of 2022 financing.Dotted line indicates median ste

106、p-up.Seed-A Step-UpA-B Step-UpB-C Step-UpC+Step-Up1/1/223/1/225/1/227/1/229/1/2211/1/222.7xStep-Up1/1/223/1/225/1/227/1/229/1/2211/1/222.3xStep-Up1/1/223/1/225/1/227/1/229/1/2211/1/221.8xStep-Up1/1/223/1/225/1/227/1/229/1/2211/1/221.5xStep-Up1210864201416181210864201416181210864201416181210864201416

107、18SVB ConfidentialCorporate Venture Activity Overall221715119Deal Count,US,EU&UK(2021-2022)Venture Activity Overall524033222228 2021242022Note:1)Most active new investors calculated as new(first-time)investments in US,EU,and UK companies from 20212022.Dates of financing rounds subject to change base

108、d on add-on investments.Corporate parent and corporate venture investment are combined under corporate investor.Source:PitchBook,conversations with investors and SVB proprietary data.17HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 202220 202120202217 20215202213 202192022Later-Stage/Crossover Activ

109、ity Overall312216111014 20218202210 2021620225 2021620227 20213202212 202110202213 2021420225 202110202262021520223202162022Alternative Care1615139912 2021420226 2021920221020213202272021220223202162022Provider Operations17119999 2021820227 2021420225 2021420226 2021320224 202152022Healthtech21 2021

110、10202218 20211520222$192M$444M$436M$423M$481M$211M$42M$123M$249M$128M$122M$60M$214M$284M$99M$104M2020$801M(109)2021$1.2B(190)2022$1.6B(185)Seed/Series A1Dollars and(Deals)US,EU&UKNote:1)Seed/Series A includes first-time investments from institutional or corporate venture investment in the US,EU,and

111、UK and any first-round investments equal to or greater than$2M,regardless of investor.2)These companies overlap with the healthtech sector and are included in both sets of sector-specific analyses.Dates of financing rounds are subject to change based on add-on investments.All data as of 12/16/2022.S

112、ource:PitchBook and SVB proprietary data.Dx/ToolsSeed/Series A Dollars and Deals by SubsectorsUS,EU&UKMedian Seed/Series A ValuationsUS,EU&UKLargest 2022 Seed/Series A Deals202020212022Subsectors Dollars DealsDollarsDealsDollarsDealsR&D Tools$372M53$600M85$496M59Dx Analytics$246M26$413M54$503M65Dx T

113、ests$201M33$222M51$558M5518HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022H1 2020H2 2020H1 2021H2 2021H1 2022H2 2022US InvestmentEU and UK investmentPre-Money ValuationDeal Size$9M$9M$11M$4M$6M$4M2020202120222222222Q1Q3Q2Q4Strong early-stage dx/tools investment in Q1 and Q4 bookended a slower mi

114、ddle of the year,pushing the total dollars for 2022 slightly past 2021.At the same time,later-stage investment dropped dramatically.Three of the four largest early-stage dx/tools deals closed in Q4 2022,spurring our hypothesis that many active dx/tools investors will wait out the downturn by putting

115、 new dollars to work in seed/Series A deals.Dx Tests investment increased for the second straight year,despite the subsectors historically difficult reimbursement and revenue ramp.The top dx test indication was platform(13 deals),as these companies explore multiple applications for their technology.

116、This was followed by anti-infective(10 deals,including four focused on COVID-19),neurology(seven deals),and oncology(six deals).The four largest dx test financings focused on liquid biopsy for cancer diagnosis,led by Exai Bio and Haystack Oncology.Despite operating in a crowded space,both companies

117、leveraged deeply experienced teams to raise$60M+rounds with$100M+post-money valuations.Early-stage dx analytics investment also continued to grow.Aside from platform technologies(19 deals),the most popular sub indications were oncology(11 deals)and neurology(10 deals).There were three$50M+deals in 2

118、022,led by Artera,on oncology dx analytics company,that reached a$400M post-money valuation.Recent R&D tools IPOs have been battered in the public market,and this likely factored into R&D tools decline in deals and dollars.$4.7B$6.2B$8.0B$6.7B$3.5B$1.5B$3.4B$1.6BDx Analytics$10.3B postR&D Tools$9.0

119、post1Dx Analytics$2.2B post1R&D Tools$1.2B post1Dx Analytics$1.2B postDx Tests$950M postR&D Tools$792M postDx Tests$625M postTotal Dollars and(Deals)US,EU&UKNote:1)These companies overlap with the healthtech sector and are included in both sets of sector-specific analyses.2)Only includes private pos

120、t-money values from publicly disclosed 2022 financings in PitchBook.Financing data include private financings by venture-backed companies in the US,EU,and UK.Dates of financing rounds are subject to change based on add-on investments.All data as of 12/16/2022.Source:PitchBook and SVB proprietary dat

121、a.Notable 2022 DealsDollars and Deals by SubsectorsUS,EU&UK2022 Highest-Valued Private Companies2202020212022Subsectors Dollars DealsDollarsDealsDollarsDealsR&D Tools$5.0B148$7.5B222$4.8B181Dx Tests$3.3B92$3.8B149$1.9B118Dx Analytics$2.5B101$3.3B137$3.2B172$100M to$199M$200M+202020212022291119137101

122、11111Dx/Tools19HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022H1 2020H2 2020H1 2021H2 2021H1 2022H2 20222022$9.9B(471)2021$14.7B(508)2020$10.9B(341)1Q1Q3Q2Q4We noted strong dx/tools investment in H1 2022.However,this activity plummeted in H2,with only three$100M+deals(vs.16 in H1),pushing deals

123、and dollars for the year down to 2019 levels.This slowdown may either be temporary or signal that later-stage investors are shifting their new investment focus toward other sectors.Given the shrinking public market,there are limited near-term opportunities to match the huge dx/tools exits from 2020

124、and 2021(including three$1B+private M&A and 13 US/UK IPOs with$1B+market caps),which likely caused investors to reduce later-stage activity.Despite reduced activity,some of the more active investors in 2022 include Catalio and Section 32,corporate Bristol Myers Squibb,and crossovers Casdin and SoftB

125、ank.In R&D tools,Ultima Genomics and Resilience each raised$600M in H1 2022.However,R&D tools investment dropped 85%in 2H.Closing new outsider-led rounds has become more difficult,as investors balance a difficult CapEx environment and incumbent competition with revenue growth and exit opportunities

126、new investments can bring.Later-stage investors continue to focus on dx analytics companies.Four of the five largest deals in this subsector(Tempus,Cleerly,Verana Health and Scipher)were led by crossover/growth players.These deals also included biopharma corporates,which are advancing data-driven pr

127、ecision medicine through investments and collaborations.Substantial oncology liquid biopsy investments have created an increasingly crowded space.We expect some private consolidation in 2023.20Dx/ToolsNote:1)Step-ups are calculated by dividing the companys 2022 financing pre-money valuation by its m

128、ost recent financing post-money valuation if it occurred between 2019 and 2022.Only includes financing and valuation information from publicly disclosed financings in PitchBook.Dates of financing rounds are subject to change based on add-on investments.All data as of 12/16/2022.Source:PitchBook and

129、SVB proprietary data.HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022Note:Size of bubble indicates size of 2022 financing.Dotted line indicates median step-up.Seed-A Step-UpA-B Step-UpB-C Step-UpC+Step-Up1210864201/1/223/1/225/1/227/1/229/1/2211/1/222.7xStep-Up1210864201/1/223/1/225/1/227/1/229/1

130、/2211/1/221.8xStep-Up1210864201/1/223/1/225/1/227/1/229/1/2211/1/221.6xStep-Up1210864201/1/223/1/225/1/227/1/229/1/2211/1/221.6xStep-UpOf the 471 US,EU and UK dx/tools financings in 2022,we calculated 92 step-ups1and step-downs that were outside-led rounds with publicly disclosed valuation informati

131、on in their previous and current rounds.From our anecdotal perspective,most of the outside-led financings in 2022 were reserved for the top 15%-20%of companies that hit significant development milestones.Many companies instead raised insider rounds or extensions with plans to come back to the market

132、 in late 2023.At that point,we expect to see a spike in step-downs as companies reset their valuations.Dx/Tools tied with healthtech as the healthcare sector with the top median seed-A step-up of 2.7x.Ten of the 12 largest step-ups were R&D tools companies,led by Watchmaker(10.4x)and Enable Medicine

133、(9.6x).The two other deals were completed by dx analytics company Xilis(8.8x)and dx tests company Oova(4.8x).In dx/tools,the Series A-B step-ups were primarily in H1 2022 with a strong median of 1.8x.There were three A-B deals with 5x+step-ups:one R&D tools deal from Preomics(6.3x)and two dx analyti

134、cs deals from Genome Insight(5.8x)and BostonGene(5.0 x).By contrast,later-stage dx/tools step-ups were smaller,but still impressive given the large deal sizes.In 2022,10$100M+later-stage financings closed with a median step-up of 1.6x and no down rounds,while also creating two new unicorns,BillionTo

135、One and Visby.SVB ConfidentialCorporate Venture Activity Overall176543Deal Count,US,EU&UK(2021-2022)Venture Activity Overall1610cv109812 202142022Note:1)Most active new investors calculated as new(first-time)investments in US,EU,and UK companies from 20212022.Dates of financing rounds subject to cha

136、nge based on add-on investments.Corporate parent and corporate venture investment are combined under corporate investor.Source:PitchBook,conversations with investors and SVB proprietary data.21HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 20227 2021320224 2021520224 202142022Late-Stage/Crossover Ac

137、tivity Overall1497777 2021220226 2021120226 2021120224 202132022122021520222 2021420222 2021320223 2021120222202112022R&D Tools11108679 2021220226 2021420223 2021520224 2021220225 202122022Dx Analytics644445 2021120222 2021220224 2021020222 2021220223 20211202262021820226 202142022Dx/Tools$487M$247M

138、$446M$567M$234M$170M$71M$141M$119M$164M$70M$20M$268M$128M$39M$19MSeed/Series A1Dollars and(Deals)US,EU&UKNote:1)Seed/Series A includes first-time investments from institutional or corporate venture investment in the US,EU,and UK and any first-round investments equal to or greater than$2M,regardless

139、of investor.2)This company overlaps with the healthtech sector and is included in both sets of sector-specific analyses.3)Definitions for PMA and 510(k)can be found in the glossary on page 40 of this report.Dates of financing rounds are subject to change based on add-on investments.All data as of 12

140、/16/2022.Source:PitchBook and SVB proprietary data.DeviceSeed/Series A Dollars and Deals by Top IndicationsUS,EU&UKMedian Seed/Series A ValuationsUS,EU&UKLargest 2022 Seed/Series A Deals 22020$946M(101)2022$948M(134)2021$1.3B(188)202020212022Indications Dollars DealsDollarsDealsDollarsDealsNon-Invas

141、ive Monitoring$139M18$280M50$160M21Drug Delivery$35M8$63M9$166M7Surgical$180M12$50M11$106M21Neurology$137M7$83M13$54M11Platform$13M3$129M12$45M8Orthopedic$46M7$47M13$50M13Ophthalmology$19M5$86M9$88M722HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022$8M$10M$15M$5M$4M$4M202020212022US InvestmentEU

142、and UK InvestmentPre-Money ValuationDeal SizeMaternal Newborn Health InnovationsH1 2020H2 2020H1 2021H2 2021H1 2022H2 2022Q3Q2Q4Q1In 2022,early-stage investment into device companies started off strong but declined significantly in H2.We saw the biggest drop in non-invasive monitoring deals,possibly

143、 a correction after exceptional investment activity in this indication over the past two years.Overall,it appears that many device investors shifted their focus from portfolio expansion to portfolio preservation in H2,scaling back on early-stage deals to help mid-to late-stage portfolio companies ex

144、tend their cash runways.Additionally,investors focused more on early-stage 510(k)3stories rather than their premarket approval(PMA3)counterparts,given concerns over pivotal trial funding support.We still saw strong early-stage investment from firms like Sant,Broadview,Vensana,Lightstone,and ShangBay

145、.Other larger venture funds also sought out earlier investment opportunities in the device sector as the later-stage space became crowded with new PE,growth equity,hedge fund and crossover investors.In the last two years,corporate venture retreated from seed/Series A device investments,participating

146、 in fewer than 10%of deals,compared with over 30%in both 2020 and 2019.This could be related to the general market downturn,as public device companies keep a critical focus on cash outlay and earnings per share(EPS).However,late in Q4 we heard about multiple strategic early-stage collaborations and

147、build-to-buy deals in the works,suggesting that early-stage strategic support may pick up for device companies in 2023.$3.0B$3.6B$4.6B$4.6B$2.6B$2.3B$2.3B$1.3B2020$6.6B(361)2021$9.2B(549)2022$8.5B(500)Total Dollars and(Deals)US,EU&UKNote:1)These companies overlap with the healthtech sector and are i

148、ncluded in both sets of sector-specific analyses.2)Only includes private post-money values from publicly disclosed 2022 financings in PitchBook.Financing data include private financings by venture-backed companies in the US,EU,and UK.Dates of financing rounds are subject to change based on add-on in

149、vestments.All data as of 12/16/2022.Source:PitchBook and SVB proprietary data.Notable 2022 DealsDollars and Deals by SubsectorsUS,EU&UK2022 Highest-Valued Private Companies2US,EU&UK$50M+to$99M$100M+20202021202230222511169Non-Invasive Monitoring$1.6B post1Non-Invasive Monitoring$1.3B postNon-Invasive

150、 Monitoring$980M postSurgical$756M postSurgical$750M postOncology$750M postOrthopedic$700M postDermatology$620M postDevice1111202020212022Indications Dollars DealsDollarsDealsDollarsDealsNon-Invasive Monitoring$1.0B52$1.0B104$1.8B84Imaging$674M40$1.2B59$537M42Drug Delivery$231M23$623M41$690M28Surgic

151、al$389M28$1.1B34$797M51Neurology$620M26$871M39$650M38Cardiovascular$776M34$638M38$814M37Vascular$407M27$547M31$421M3323HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022H1 2020H2 2020H1 2021H2 2022H2 2021H1 202211Q3Q2Q4Q111111A stellar H1 2022 was followed by a lackluster H2 in which device investm

152、ent dropped to$3.6B,equaling H2 2020 when the COVID-19 pandemic was limiting surgical procedures and device company access to hospitals.In the next six months,we will see whether this was merely a blip before a return to strong investment,a reversion to pandemic activity or a midway point toward a g

153、reater decline.Regardless,strong activity in the first three quarters was surprising in the face of a tough public market and fewer M&A deals.Device ran countercyclical to the pullback in the other three healthcare sectors in 2022.PE,large institutional venture and growth cap investors shifted their

154、 focus toward later-stage revenue-driven device companies with good margins,which have the potential to create sustainable business models at reasonable valuations.For the same reason,these investors were joined by hedge fund and crossover investors that traditionally focused on biopharma.With a gro

155、wing set of later-stage device investors,2022 had more$100M+financings than each of the two prior years.The largest financings and valuations were for companies in non-invasive monitoring,which typically has a quicker timeline to profitability than other device indications.In 2022,the investment dat

156、a painted a rose-tinted picture of the device industry.However,beneath the surface,investors started to rely on term sheets with liquidation preferences greater than 1x,pay-to-play provisions,and even full ratchets,which sweetens the deal for new investors while protecting the company from the optic

157、s of a down round.Its only a matter of time before later-stage down rounds become more prevalent,especially as companies that raised insider rounds and extensions in 2022 come back to the market in H2 2023.24DeviceNote:1)Step-ups are calculated by dividing the companys 2022 financing pre-money valua

158、tion by its most recent financing post-money valuation if it occurred between 2019 and 2022.Only includes financing and valuation information from publicly disclosed financings in PitchBook.Dates of financing rounds are subject to change based on add-on investments.All data as of 12/16/2022.Source:P

159、itchBook and SVB proprietary data.HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022Note:Size of bubble indicates size of 2022 financing.Dotted line indicates median step-up.Seed-A Step-UpA-B Step-UpB-C Step-UpC+Step-Up1210864201/1/223/1/225/1/227/1/229/1/2211/1/221.7xStep-Up1210864201/1/223/1/225/

160、1/227/1/229/1/2211/1/221.7xStep-Up1210864201/1/223/1/225/1/227/1/229/1/2211/1/221.3xStep-Up1210864201/1/223/1/225/1/227/1/229/1/2211/1/221.4xStep-UpOf the 501 US,EU,and UK device financings in 2022,we calculated 99 step-ups1and step-downs that were outside-led rounds with publicly disclosed valuatio

161、n information in their previous and current rounds.From our anecdotal perspective,most of the outside led financings in 2022 were reserved for the top 15%-20%of companies that hit significant development milestones.Many companies instead raised insider rounds with plans to come back to the market in

162、 late 2023.At that point,we expect to see some later-stage step-downs as companies reset their valuations.When compared to other sectors,device had the lowest median multiples for seed-A and A-B step-ups.Device valuations tend to be more resilient to broad market fluctuations than other sectors.Next

163、 round step-ups historically have been more measured,so we expect a smaller number of significant down rounds.For early-stage deals in H2 2022,the top step-up was Invicta Medical(8.6x),a neurostimulation company to treat sleep apnea.Other notable step-ups in H2 included:Qnovia(8.5x),a drug delivery

164、company developing a nebulizer for smoking cessation,AVS Pulse(8.3x),an intravascular lithotripsy company,and Medivis(5.0 x),using augmented reality for surgeries.Only one late-stage deal yielded a step-up over 3x in H2 2022:Delphinus Medical Technologies(3.1x),which develops an ultrasound transduce

165、r for dense breast mammography.However,of the Series B and C+device deals in 2022,the seven highest-valued companies(with$200M+pre-money valuations)were able to finance with a median multiple of 1.4x and no down rounds.Non-invasive monitoring companies were three of the seven deals,with Indigo(1.0 x

166、),VitalConnect(1.1x)and AliveCor(1.6x).SVB ConfidentialCorporate Venture Activity Overall64443Deal Count,US,EU&UK(2021-2022)Venture Activity Overall10108655202152022Note:1)Most active new investors calculated as new(first-time)investments in US,EU,and UK companies from 20212022.Dates of financing ro

167、unds subject to change based on add-on investments.Corporate parent and corporate venture investment are combined under corporate investor.Source:PitchBook,conversations with investors and SVB proprietary data.25HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 20225 20215202242021220223 202122022Late-

168、Stage/Crossover Activity Overall6544422021320223 20211202232021120223 2021120224 2021220222 202122022Non-Invasive Monitoring4Osf33332 202122022Neurology222222 20210202252021120226 202122022Device3 2021020223 2021020222 20211202202021220224 2021020221 2021320221 20212202232021020222 2021020222 202102

169、0221 202112022US,EU&UK26HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022020040060080010001200Q1Q2Q3Q4Q1Q2Q3Q4Q1Q2Q3Q4202020212022BiopharmaR&D Tools$1.1B(61)$5.2B(228)$2.8B(82)$6.1B(270)$1.6B(61)$5.1B(209)Comp BioNon-CompBioComp BioNon-CompBioComp BioNon-CompBio202020212022Q1Q2Q3Q4HEALTHCARE INVES

170、TMENTS AND EXITS|ANNUAL REPORT 202227Seed/Series A2Dollars and(Deals)US,EU&UK3Note:1)To qualify as a comp bio company in this analysis,per review of their website,the company must(1)focus on drug discovery or development(biopharma/R&D tools),(2)apply novel computational tools to gain biological or c

171、hemical insights,(3)have the ability or potential for platform creation and(4)have a team with computational experience.2)For this comp bio analysis,seed/Series A includes first-time investments in biopharma/R&D tools equal to or greater than$2.5M,regardless of investor.Dates of financing rounds are

172、 subject to change based on add-on investments.3)All data as of 12/16/2022.Source:PitchBook and SVB proprietary data.Comp Bio Seed/Series A Investors 202020212022(Sub)SectorMedian Pre-Money(n)Median Deal Size(n)Median Pre-Money(n)Median Deal Size(n)Median Pre-Money(n)Median Deal Size(n)Biopharma$15M

173、(36)$11M(43)$30M(39)$22M(57)$21M(20)$16M(41)R&D Tools$10M(12)$6M(18)$15M(20)$6M(25)$18M(7)$7M(19)Comp Bio Seed/Series A by(Sub)SectorComp Bio2022 Comp Bio:Top Seed/Series AUS,EU&UK3IndicationDeal DateDeal SizePlatform4/6/22$180MPlatform9/2/22$103MAutoimmune2/9/22$101MNeurology11/29/22$96MPlatform3/8

174、/22$85MOncology11/17/22$78MPlatform5/26/22$75MPlatform5/25/22$75MPlatform3/1/22$75MPlatform4/26/22$67M202020212022(4)(2)(2)(2)(2)(1/1)(2)(4/1)(1/3)(2/2)(3/1)(3)(3)(2/1)(3)(4/1)(2)(2)(2)(2)(2)(2)(2)(1/1)(1/1)($M)$990M(43)$158M(18)$2.6B(57)$229M(25)$1.4B(41)$176M(19)Most Active Investor(Biopharma Deal

175、s/R&D Tools Deals)In 2022,seed/Series A investment in biopharma and R&D tools companies dropped from 2021,with deals down 23%and dollars down 25%.Despite this overall decline,computational biology(comp bio)companies made up the same proportion of early-stage activity(23%of deals),with a slightly lar

176、ger median deal size($10M)than their non-comp bio counterparts($9M).Though many investors scaled back new investments to refocus on existing portfolio companies,they continued to dedicate a significant portion of their available funds to companies that are leveraging computational approaches.These c

177、ompanies fall into two major categories,applying novel computational tools to either(1)drive drug discovery and development for others(R&D tools)or(2)advance their own drug pipeline(biopharma).In 2022,early-stage comp bio investment remained relatively consistent for R&D tools but dropped significan

178、tly in biopharma after a record high in Q421.Despite this fluctuation,biopharma continues to attract the majority of early-stage comp bio deals(68%)and dollars(89%).Within comp bio,biopharma had a 2.3x greater median deal size than R&D tools,as these companies need more capital to bring their own dr

179、ug assets through clinical development.We continued to see more traditional biopharma investors in the early-stage comp bio space,led by Flagship,OrbiMed,Polaris and Versant.These investors directed investment to biopharma deals with platform technologies.No R&D tools companies made it onto the list

180、 of 10 biggest seed/Series A comp bio deals in 2022.HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022282022 Comp Bio:Top Post-Money Values2022 Comp Bio:Top Step-Ups(Sub)SectorMultipleDeal DateDeal SizePost-MoneyR&D Tools10.4x6/2/22$40M$230MBiopharma10.1x1/6/22$518M$3.0BENABLE MEDICINE R&D Tools9.6

181、x4/6/22$60M$190MBiopharma5.7x6/2/22$52M$222MBiopharma5.3x7/19/22$50M$130MR&D Tools4.8x6/2/22$28M$148MBiopharma4.2x4/5/22$6M$29MR&D Tools4.1x2/3/22$58M$154MNote:1)To qualify as a comp bio company in this analysis,per review of their website,the company must(1)focus on drug discovery or development(bi

182、opharma/R&D tools),(2)apply novel computational tools to gain biological or chemical insights,(3)have the ability or potential for platform creation and(4)have a team with computational experience.2)Step-ups calculated as pre-money of most recent deal divided by post-money of last deal.3)Step-ups in

183、cluded for companies with valuations in PitchBook.Dates of financing rounds are subject to change based on add-on investments.4)All data as of 12/16/2022.Source:PitchBook and SVB proprietary data.(Sub)SectorMultipleDeal DateDeal SizePost-MoneyBiopharma10.1x1/6/22$518M$3.0BBiopharma2.0 x10/11/22$112M

184、$1.8BBiopharma1.8x2/25/22$300M$1.7BBiopharma1.1x10/4/22$124M$1.5MBiopharma1.8x10/11/22$261M$1.3MR&D Tools2.4x2/17/22$200M$1.3BBiopharma1.0 x11/18/22$100M$1.2BBiopharma2.0 x2/15/22$236M$1.1BSize of bubble indicates size of 2022 financing2022 Comp Bio(All Deals3)US,EU&UK4Biopharma Step-UpsSize of bubb

185、le indicates size of 2022 financingComp BioStep-UpComp Bio Median MultipleNon-Comp Bio Median MultipleSeed-A2.9x2.3xA-B2.0 x1.7xB-C1.3x1.4xC-D+1.0 x1.4xIn 2022 we calculated 78 comp bio and 117 non-comp bio companies with step-ups2and step-downs that were outside-led rounds with publicly disclosed v

186、aluation information in their previous and current rounds.In 2022,the largest comp bio step-ups were all early-stage and concentrated in H1.These fast-growing companies were split evenly between biopharma(all still preclinical)and R&D tools.Though comp bio companies demonstrated bigger seed-A and A-

187、B step-up multiples,later-stage step-ups were more similar across both comp bio and non-comp bio companies,partly due to the overall valuation reset we saw in 2022.Toward the end of 2022,comp bio companies raised smaller step-ups but continued to reach impressive valuations.Of the biopharma/R&D tool

188、s rounds with disclosed$1B+post-money valuations in 2022,a striking majority(8/10)were from comp bio companies,with half in Q122 and the other half in Q422.All but one of these deals were raised by biopharma companies,led by Eikon Therapeutics,which raised a huge 10.1x A-B step-up to become the high

189、est-valued comp bio company to raise a round in 2022.Size of bubble indicates size of 2022 financing.Size of bubble indicates size of 2022 financing.R&D Tools Step-Ups1/1/223/1/226/1/2212/1/220246810129/1/221/1/223/1/226/1/2212/1/229/1/22024681012Step-Up:Seed-AA-BB-CC-D+Global29HEALTHCARE INVESTMENT

190、S AND EXITS|ANNUAL REPORT 20222016201720182019202020212022SVB IndicationPlatformNeurologyDermatologyIPO Price(Date)$17(10/20/22)$19(1/7/22)$17(9/14/22)Market Cap at IPO$1.5B$1.1B$658MPrice 12/31/2022$18.58$36.95$4.30Price+/-9%94%-75%Market Cap12/31/2022$1.6B$2.4B$174MBiopharma Private M&A Deals and

191、IPOs by Year,Global1Note:1)All exit data is global.M&A defined as all private,global,venture-backed M&A deals with upfront payments of at least$75M.IPO defined as all private,global,venture-backed IPOs raising at least$25M in proceeds.Market cap at IPO used to estimate value of public companies.Publ

192、ic market performance metrics calculated as of 12/31/2022.Source:PitchBook,S&P Capital IQ and SVB proprietary data.2022 Largest US IPOs by IPO Market CapBiopharma Exit Values by YearBiopharma$27B$19B$47B$45B$85B$31B$91BIPO Performance by IPO YearIPO Cohort Year2019202020212022Number of IPOs50839619M

193、edian Pre-$/Median Dollars Raised$337M/$85M$495M/$200M$428M/$133M$501M/$155MMedian/Average 2019 Performance20%/52%Median/Average 2020 Performance31%/89%74%/89%Median/Average 2021 Performance-6%/76%-12%/12%-27%/-18%Median/Average 2022 Performance-51%/27%-63%/-36%-71%/-47%-2%/21%30HEALTHCARE INVESTMEN

194、TS AND EXITS|ANNUAL REPORT 2022Private M&AIPOMarket Cap at IPOPrivate M&A UpfrontPrivate M&A Milestones2014151520159283155508396192016201720182019202020212022After four successive years with 50+venture-backed biopharma IPOs,there were just 19 IPOs in 2022.A common theme for the 11 US/EU IPOs was sig

195、nificant crossover and top venture investors in the private syndicate,who then participated heavily in the IPO.Another common theme was the focus on neurology(four of 11 deals)and less on oncology(one of 11).Finally,these deals also had an early-stage focus;five of the US/EU IPOs were phase I and on

196、e was preclinical.The median pre-money valuation for US/EU IPOs in 2022 reverted to the same size as 2019,with a flat median step-up from the last private round to IPO pre-money.IPO performance for the classes of 2020 and 2021 dropped further in 2022,now with firmly entrenched negative performance.H

197、owever,several promising early-stage clinical results in the second half of 2022 redirected some 2021 IPOs upward(Dice,Ventyx and Nuvalent).We hope this trend will continue,as positive news like this could help to reinvigorate the public market.We predicted that 2022 M&A would be robust but dominate

198、d by large acquirers targeting recent IPOs.We noted that these public companies would be more open to M&A than private deals that were stuck with inflated valuations.While private M&A declined to nine deals in 2022,our hypothesis largely played out,as public acquirers hunted for companies that recen

199、tly went public.We noted eight major public acquisitions of recent IPOs for more than$20B,including six$1B+deals.59655521175628111Biopharma Private M&A Deals by Stage1,2Note:1)Stage defined as last completed clinical trial prior to M&A announcement.2)All exit data is global.3)Each dot represents an

200、M&A deal.M&A defined as all private,venture-backed M&A deals with at least$75M upfront,globally.Public market performance metrics calculated as of 12/31/2022.Source:PitchBook and SVB proprietary data.Biopharma M&A Activity by Indication2017-2022Biopharma2022202120202019201820172016$12B$14B$20B$13B$1

201、5B$8B$21B31HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 202211PreclinicalPhase IPhase IIPhase IIIUS CommercialIndication#M&AUpfront($M)Total Deal($M)$B+ExitsYears to ExitOncology25$250$57593.4Platform15$390$44664.4Neurology13$135$60033.8Autoimmune8$330$48012.8Anti-Infective4$913$1,14527.1Anti-Infe

202、ctiveAutoimmuneOncologyPlatformNeurologyMetabolicPrivate M&A Deals 2022M&A by Life Stage and Top Indications32017-2022171819202122CommercialPhase IIIPhase IIPhase IPreclinicalOncologyPlatformAuto-ImmuneNeurologyOrphan/Rare DiseaseAnti-InfectiveAs going public became more difficult,biopharma companie

203、s that closed large rounds at high valuations attempted to navigate private M&A in H122.This resulted in M&A transactions but smaller return multiples.After their final financings,Affinivax and ReViral reached high valuations($1.1B and$230M)then closed M&A deals in H1 2022.Although M&A exit values($

204、2.1B upfront and$525M all-in,respectively)were larger than median biopharma deal values,it still resulted in only modest return multiples for last-round investors.Syndesi,the other M&A in H1,had a$33M post-money valuation in its final financing and closed an attractive higher-multiple exit($130M upf

205、ront,$870M in milestones).In H222 there were six M&A,including five preclinical companies.Similarly to H1,three of these five companies(ViaCyte,MiroBio and Neogene)raised big rounds at high valuations,leading to smaller return multiples for last-round investors.However,Good Therapeutics and DJS Anti

206、bodies raised less capital and achieved stronger return multiples.In December,in one of the biggest private M&As ever,Nimbus sold its second asset(a phase II autoimmune therapy)to Takeda for$4B upfront with$2B in milestones.Private M&A Since 2017:Since 2017,there were 88 private venture exits with u

207、pfront payment of$75M+.Oncology and platform companies dominated,mostly exiting at preclinical stage(15 and eight deals,respectively).The top oncology acquirers were Gilead(four deals),BMS,Boehringer and Merck(three deals each).The most active platform acquirers were Sanofi,Roche and Bayer(two deals

208、 each).815293125532517224748469610322771622016201720182019202020212022-100%-50%0%50%100%150%Jan 20May 20Sep 20Jan 21May 21Sep 21Dec 21Apr 22Jul 22Nov 222016201720182019202020212022Healthtech Private M&A Deals and IPOs by Year,Global1Healthtech Exit Values by YearHealthtechHealthtech Average Post-Exi

209、t Performance 32HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022$62B$2.2B$31B$22B$17B$2.9B$3.2BNote:1)All exits are global.2)Disclosed/undisclosed refers to a disclosed/undisclosed acquisition price for the M&A deal.3)Healthtech VC-backed IPOs from 1/1/15 to 12/31/2022.Index performance is weight

210、ed equally.Public market performance metrics calculated as of 12/31/2022.M&A defined as all private,venture-backed M&A deals with no upfront limitations,globally.IPO defined as all private,venture-backed IPOs raising at least$25M in proceeds,globally.Source:PitchBook,S&P Capital IQ,SVB proprietary d

211、ata and SVB Future of Healthtech 2022 Report.Private M&A(Disclosed2)IPOMarket Cap at IPOPrivate M&A TotalHealthtech VC-Backed De-SPACsHealthtech VC-Backed IPOs3S&P 500(SPX)Private M&A(Undisclosed2)There were no new venture-backed US,EU or UK healthtech IPOs in 2022,marking an end to the robust IPO a

212、ctivity over the last three years.The two IPOs in 2022,both in Q3,were international provider operations companies ClouDr(Hong Kong)and Lunit(South Korea).Macroeconomic factors affecting market volatility hit healthtech stocks harder than other sectors,as median performance fell to-67%at the end of

213、2022.There is no enthusiasm for tech-enabled healthcare growth stories,especially for unicorn companies that expected to trade up post-IPO.Private M&A in healthtech continues to see extremely high deal volume,up 76%from 2020 levels and approaching 2021s record year.Although deal volume is high,acqui

214、sition prices are down as acquirers struggled with the valuation disconnect at the later-stage.Special purpose acquisition companies(SPACs),which gained popularity in 2021,have fallen out of favor for healthtech companies.Median de-SPAC performance since merger close(for de-SPACs since 2021)reached

215、a record low in Q422(-90%),down significantly from 2021(-35%).As uncertain market conditions continue,we expect healthtech companies to remain private and delay IPO plans until at least late 2023,considering M&A opportunities instead.18%-47%-96%718629332111651213151121322121Alternative CareProvider

216、OperationsAlthough activity was high,median M&A deal prices were down significantly in 2022 as acquirers struggled with the lofty post-money valuations from large venture-backed deals over the past few years.Big exits dipped from four$1B+M&A in 2021 to none in 2022.While we expect M&A to continue,de

217、al pricing will likely remain unsettled as valuations for later-stage companies continue to correct.In 2021,healthtech M&A saw strong return multiples for many of the disclosed deals,but public market corrections have lowered multiples in 2022,with a few companies last post-money valuation higher th

218、an M&A exit value.1Public healthcare companies led acquisitions in healthtech,while PE acquisition activity declined over the last few years.We also expect private venture-backed healthcare companies to be well-positioned to be acquirers,given the current market climate and their strong cash positio

219、n from mammoth 2021 rounds.Big tech companies were opportunistic acquirers for public healthtech companies in 2022,with Amazons acquisition of One Medical and Microsofts acquisition of Nuance Communications.We think big tech companies will continue to be acquisitive,possibly in the venture healthtec

220、h space.We believe late-stage M&A activity will continue as public access continues to be muted.Acquirers will look to private M&A to increase digital efficiencies and provide better patient navigation.Healthtech Private M&A Deals by SubsectorGlobal,$50M+Deal ValueHealthtech M&A Activity by Subsecto

221、r22017-2022HealthtechPrivate M&A Deals 2022$50M+Deal Value2022202120202019201820172016Provider OperationsAlternative CareWellness&EducationClinical Trial EnablementMedication ManagementHealthcare NavigationInsurance33HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022Note:1)Return multiple defined a

222、s the acquisition price divided by the post-money valuation from the last private round.2)Deals include healthtech M&A greater than$50M.3)These companies overlap with the biopharma,dx/tools or device sectors.M&A defined as all private,venture-backed M&A deals with no upfront limitations,globally.Doe

223、s not include acquisitions of public targets.Data as of 12/31/2022.Source:PitchBook,S&P Capital IQ,SVB proprietary data and SVB Future of Healthtech 2022 Report.Subsector#M&ATotal Deal$B+ExitsYears to ExitProvider Operations45$180M57Alternative Care26$258M64Medication Management13$403M17$2.5B$23.6B$

224、3.6B$14.4B$11.3B$3.1B$805M33ExchangeSHSESHGSHSESHGSVB SubsectorR&D ToolsR&D ToolsR&D ToolsR&D ToolsIPO Price(Date)$5.48(1/18/22)$3.36(4/25/22)$2.08(3/22/22)$11.32(9/2/22)Market Cap at IPO$2.1B$1.5B$1.0B$965MPrice 12/31/2022$2.10$3.49$2.76$14.96Price+/-62%4%33%32%Market Cap12/31/2022$837M$1.4B$1.4B$1

225、.2BNote:1)All exit data is global.M&A defined as all private,venture-backed M&A deals with at least$50M upfront,globally.IPO defined as all private,venture-backed IPOs raising at least$25M in proceeds,globally.Market cap at IPO used to estimate value of public companies.Public market performance met

226、rics calculated as of 12/31/2022.Source:PitchBook,S&P Capital IQ and SVB proprietary data.Dx/Tools Private M&A Deals&IPOs by Year,Global1Dx/Tools Exit Values by Year2022 Largest IPOs by IPO Market CapDx/ToolsIPO Performance by IPO YearIPO Cohort Year2019202020212022Number of IPOs1010327Median Pre-$/

227、Median Dollars Raised$247M/$69M$888M/$177M$641M/$156M$724M/$202MMedian/Average 2019 Performance46%/66%Median/Average 2020 Performance153%/211%80%/119%Median/Average 2021 Performance144%/274%-23%/-13%-28%/-2%Median/Average 2022 Performance-13%/99%-78%/-66%-82%/-58%0%/-6%34HEALTHCARE INVESTMENTS AND E

228、XITS|ANNUAL REPORT 2022Private M&AIPOMarket Cap at IPOPrivate M&A UpfrontPrivate M&A Milestones2016201720182019202020212022$1.5B$318M$4.0B$9.5B$26.7B$42.3B$8.1BThe rapidly growing M&A and IPO activity from 2019 through H1 2021 propelled dx/tools exits to record levels.However,since H2 2021,the dx/to

229、ols sector experienced significant drops in market caps of large public players and an even greater decrease in small and mid-cap recent IPOs.In 2022,there were no US venture-backed IPOs for the first time since 2016.Specifically,the IPO classes of 2020 and 2021 suffered deep performance declines.By

230、 the end of 2022,Schrodinger was the only 2020 IPO in positive territory.The majority(21/32)of the IPOs from 2021 are down 70%+from their IPO price,including all the US-listed companies except Akoya and Cytek,which are down 52%and 40%,respectively.In 2022,acquirers had little appetite for M&A deals,

231、with just five venture-backed acquisitions.Historically,during these difficult down cycles,acquirers usually directed their deal focus to companies with significant revenues($30M+)that could quickly break even with synergies from the deal.However,we hold out hope that acquirers will instead use the

232、tough private financing environment to shop for early-stage companies that offer complementary or next-gen technologies.To secure attractive exits down the road,the highly valued private companies that raised large rounds in 2020 and 2021 may adapt by collaborating with big players to raise non-dilu

233、tive capital and reduce expenses to extend runway.510611255121010327201620172018201920202021202217564331311011Note:1)All exit data is global.2)Each dot represents an M&A deal.3)This company overlaps with the healthtech sector.M&A defined as all private,venture-backed M&A deals with at least$50M upfr

234、ont,globally.Public market performance metrics calculated as of 12/31/2022.Source:PitchBook and SVB proprietary data.Dx/Tools Private M&A Deals by Indications1Dx/ToolsDx/Tools M&A by Indication2017-2022R&D ToolsDx TestsDx Analytics$2B$2B$1B$13B$8B$789M35HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT

235、 20222022202120202019201820172016Indication#M&A Upfront($M)Total Deal($M)$B+ExitsYears to ExitDx Tests20$313$38026.2R&D Tools29$150$25015.7Dx Analytics6$83$8706.1Dx TestsR&D ToolsPrivate M&A Deals 2022Acquired byAcquired byAcquired byAcquired by3M&A by Life Stage and Top Indications22017-20221718192

236、02122US CommercialNon-ApprovedDx TestsR&D ToolsDx AnalyticsAcquired byPrivate venture-backed dx/tools companies experienced strong M&A activity in 2020 and 2021,with 25 M&A deals,including 11 sold for more than$400M upfront.M&A slowed to just five deals in 2022,with only one in H2.The median upfront

237、 deal value in 2022($100M)was down significantly from 2020($350M)and 2021($225M).We noted two cross-sector acquisitions in 2022,which is unusual but fits with current trends in platform expansion and bringing service technologies in-house.First,Ro(a private healthtech company)acquired Dadi(a male fe

238、rtility test company)to continue building out their suite of direct-to-consumer reproductive health products.Second,Galapagos(a public biopharma small molecule/cell therapy company)acquired CellPoint(an R&D tools company with an automated cell therapy manufacturing platform)to help streamline their

239、manufacturing processes.The other 2022 acquisitions included Castle Biosciences,expanding its reach beyond oncology by acquiring AltheaDx;BioMerieux,adding to its infectious disease franchise by acquiring Specific Diagnostics;Bruker,deepening its brain imaging franchise by acquiring Inscopix.Private

240、 M&A Since 2017Over the past few years,dx analytics exits have emerged as healthcare providers continue to prioritize precision medicine throughout the treatment process.Oncology-focused companies accounted for half of the dx analytics exits.2016201720182019202020212022Note:1)All exit data is global

241、.M&A defined as all private,venture-backed M&A deals with at least$50M upfront,globally.IPO defined as all private,venture-backed IPOs raising at least$25M in proceeds,globally.Market cap at IPO used to estimate value of public companies.Public market performance metrics calculated as of 12/31/2022.

242、Source:PitchBook,S&P Capital IQ and SVB proprietary data.DeviceDevice Private M&A Deals&IPOs by Year,Global1Device Exit Values by Year$4.5B$5.1B$7.6B$13.0B$14.0B$35.7B36HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 2022Private M&AIPOMarket Cap at IPOPrivate M&A UpfrontPrivate M&A Milestones$18.7BEx

243、changeSHGSHESHGSVB SubsectorImagingRespiratoryUro/GynIPO Price(Date)$15.51(8/22/22)$16.92(1/1/22)$5.69(8/11/22)Market Cap at IPO$13.4B$1.1B$596MPrice 12/31/2022$25.66$31.83$4.73Price+/-65%88%-17%Market Cap12/31/2022$21.1B$2.0B$473MIPO Performance by IPO YearIPO Cohort Year2019202020212022Number of I

244、POs811303Median Pre-$/Median Dollars Raised$203M/$97M$469M/$156M$368M/$110M$803M/$267MMedian/Average 2019 Performance54%/128%Median/Average 2020 Performance116%/192%111%/148%Median/Average 2021 Performance55%/206%-14%/72%-20%/2%Median/Average 2022 Performance127%/233%-56%/29%-66%/-35%65%/46%2022 IPO

245、s by IPO Market Cap2021 set a record for the number of venture-backed IPOs and M&A.M&A came from both large-cap med device stalwarts and small-to mid-cap companies.However,public market volatility caught up with the device sector,effectively closing the US IPO market in 2022.The eight US-listed IPOs

246、 from 2020 are all trading in negative territory,except for Inari Medical,which is up over 200%from its IPO price.The class of 2021 had 13 US-listed IPOs with negative median and average performance but still have four deals,PROCEPT BioRobotics,Treace Medical,Paragon 28 and CVRX,trading in positive

247、territory.In 2022,acquirers appeared to be internally focused on existing revenue lines and meeting earnings per share(EPS)expectations rather than exploring venture-backed acquisitions.On a positive note,we continue to see spin-outs from the big device players like Medtronic,which creates more acqu

248、irers down the road.As the market recovers,these new acquirers can help spur M&A.In previous down cycles,device later-stage financing dried up.However,in 2022,later-stage device companies continued to fundraise through the tough financing environment,creating a runway to continue growing revenues.Wi

249、th more time and capital to progress,these companies may be very strong candidates for future IPOs(or big acquisitions)when the market bounces back.12142017162310338811303201620172018201920202021202222223341352231717913158712022202120202019201820172016CardiovascularSurgicalOrthopedicVascularOralMeta

250、bolicNote:1)CE Mark defined as achieving a CE Mark but not FDA approval.US Commercial defined as achieving FDA clearance or approval,with or without CE Mark.510(k),De Novo 510(k)and PMA defined in appendix.2)All exit data is global.3)Each dot represents an M&A deal.4)This company overlaps with the h

251、ealthtech sector.M&A defined as all private,venture-backed M&A deals with at least$50M upfront,globally.Source:PitchBook and SVB proprietary data.DeviceDevice Private M&A Deals by Stage1,2Device M&A by Indication2017-2022CE MarkNon-ApprovedUS CommercialPre-Clinical$4B$5B$5B$9B$4B$7B$3.6B37HEALTHCARE

252、 INVESTMENTS AND EXITS|ANNUAL REPORT 2022Indication#M&AUpfront($M)Total Deal($M)$B+ExitsYears to ExitSurgical10$148$19018.5Cardiovascular15$210$30004.8Vascular14$225$29815.2Orthopedic16$105$18008.2NIM7$225$23017.9Neurology5$120$22007.05Notable 2022 Private M&A DealsPMA Pathway510(k)PathwayM&A by Lif

253、e Stage and Top Indications32017-2022171819202122US CommercialCE Mark OnlyNon-ApprovedCardiovascularVascularOrthopedicNeurologySurgicalNIMM&A in 2021 set records for both the number of deals and median upfront payments.Small-and mid-cap public companies actively bought venture-backed device companie

254、s,joining traditional players to create a very robust set of acquirers.However,poor performance in the public market forced many companies to revisit cash spend and push acquisitions to the back burner.As a result,device M&A declined substantially.The median upfront deal value was$135M,down 41%from$

255、230M in 2021.The biggest exit in 2022 was Medtronics acquisition of Affera,a development-stage cardiac ablation company.The$625M upfront was the second biggest deal value since 2020,and the fourth largest since 2017.CONMED acquired two orthopedics companies,making their first venture-backed device a

256、cquisition since 2016.Two of the three vascular acquisitions in 2022 were CE mark approved,PMA pathway deals that exited prior to US approval(Perflow,MedAlliance).Private M&A Since 2017In device,orthopedic companies had the most exits,mostly pursing a 510(k)pathway(10/15 deals).However,orthopedic de

257、als also had the smallest median deal sizes and took the most years to exit,due to the expense in raising a large commercialization round(14/15 deals obtained FDA clearance)and the time required to ramp revenue before acquisition.Cardiovascular companies had a shorter time to exit since most pursued

258、 a PMA pathway,and the promise of new technologies in big markets pushed acquisition prior to FDA approval.438The material contained in this document,including without limitation the statistical information herein,is provided for informational purposes only and is not intended to forecast or predict

259、 future performance or events,including in relation to the performance and outlook of SVB Financial Group and its subsidiaries.All predictions made are based on previous data trends,which have been quoted accordingly.Any predictions are based on subjective assessments and assumptions.Accordingly,any

260、 predictions,projections or analysis should not be viewed as factual and should not be relied upon as an accurate prediction of future results.The views expressed in this report are solely those of the authors and do not necessarily reflect the views of SVB.Source:SVB proprietary data.HEALTHCARE INV

261、ESTMENTS AND EXITS|ANNUAL REPORT 2022Fundraising and Investments:Venture healthcare fundraising will likely decline to about$15B in 2023,as LPs may be dealing with over-allocation into venture healthcare after two record years of funding into this sector.We expect the slower investment pace to conti

262、nue in 2023,allowing investors to extend the time frame between fundraises.We think investment dollars will revert to 2020s pace.There will likely be an increase in larger,outsider-led rounds in H2 2023.We anticipate many of these rounds will be down rounds or flat“engineered”rounds with sweeteners

263、for new investors,correcting inflated company valuations.There is still an unprecedented amount of dedicated venture healthcare capital to be deployed,so the top companies will continue to climb to high valuations and foster intense competition among new investors.Biopharma:Biopharma investment in 2

264、023 should remain at 2020 levels,although with increased dollars in autoimmune and respiratory.We will continue to see large pre-IPO rounds,but likely at a single digit pace per quarter.Many of the highly valued companies that raised their most recent financings in 2020 and 2021 but cannot go public

265、 will either close down rounds or possibly merge with another private company to augment pipeline or technology.We estimate 25-30 IPOs for 2023 and 15-20 M&A,including increased comp bio acquisitions.Healthtech:We expect late-stage investment to continue to slow in 2023,with lower valuations and few

266、er mega-deals,as public markets continue to put pressure on private valuations.While we expect top healthtech companies to continue raising capital through more insider and bridge rounds,we will likely start to see more down rounds.We anticipate that many healthtech companies will delay IPO plans un

267、til at least late 2023.Instead,we expect a wave of consolidations,especially in alternative care.We also anticipate more tech and healthtech acquirers entering the space.Dx/Tools:Investment in dx/tools should rebound from H2 2022 to finish 2023 at$8B-$9B just shy of 2020s pace led by early-stage act

268、ivity.There will likely be selective larger financings($100M+)with participation from growth/PE investors and sovereign wealth funds,likely in liquid biopsy and precision-medicine dx analytics companies.We expect IPOs to continue to be muted in 2023.Private companies with unicorn valuations will lik

269、ely need to wait until 2024 for big M&A exits and may continue to build value by acquiring other venture-backed technologies.M&A deals will likely rise to hit double-digits in 2023,led by dx tests and analytics deals.Device:Device investment should hit$6B-$8B in 2023,closely mirroring 2020s pace.We

270、expect to see fewer$100M+deals in 2023,as many top companies raised rounds in 2022,and it is uncertain how many later-stage opportunistic device investors will continue to be active.The IPO window will likely stay closed in 2023.However,there will be a strong group of IPO candidates for 2024,with gr

271、owing revenues and high gross margins,some of which may spur large-dollar acquisition interest in 2023.Overall,we expect M&A deals to increase to the mid-teens in 2023.Jonathan NorrisManaging DirectorHjonnysvbJonathan Norris spearheads strategic relationships with many healthcare VC firms and serial

272、 entrepreneurs.In addition,he helps SVB Capital through sourcing and advising on limited partnership allocations and direct investments.Jonathan speaks at major investor and industry conferences about healthcare VC trends.He has 20+years of banking experience working with healthcare companies and VC

273、 firms.Jonathan earned a B.S.in business administration from the University of California,Riverside,and a J.D.from Santa Clara University.RaysaBousleimanSenior AssociateHealthcare IRaysa Bousleiman is responsible for conducting data-driven analyses on the global innovation economy that SVB serves.In

274、 this role,she supports global research efforts that explore investment,fundraising and exit dynamics in the venture ecosystem.Prior to SVB,Raysa worked as a healthcare consultant focusing on health systems revenue cycle management and operations.Raysa graduated from the University of Southern Calif

275、ornia with honors,receiving a B.S.in human biology.Beatriz Atsavapranee analyzes data on healthcare venture investments and exits to identify emerging trends and synthesize key takeaways.She also produces deep dives into specific technical areas across a range of subsectors.Outside of SVB,Beatriz is

276、 a Ph.D.candidate at Stanford University.She has more than seven years of experience developing new biomedical technologies,from peptide-based therapeutics to microfluidic and bioinformatics tools.Beatriz earned a B.S.in bioengineering from the California Institute of Technology.Beatriz Atsavapranee

277、Healthcare Consultantbeatrizastanford.eduAnnie Scolamieri supports the life science healthcare team at SVB with data-driven analyses.She contributes to research and content focused on investment,fundraising and exit dynamics in the venture ecosystem.Annie has a particular interest in healthtech and

278、womens health.Prior to SVB,Annie worked as a hospital program manager in operations,finance and strategy.Annie graduated from George Washington University with a B.S.in public health and a Master of Health Administration.Annie ScolamieriAssociate Healthcare I39HEALTHCARE INVESTMENTS AND EXITS|ANNUAL

279、 REPORT 202240DescriptionsAll-In Deal defined as an acquisition where the full deal value is paid at deal close.Series A defined as all first-round institutional or corporate venture investment,and all first-round investments equal to or greater than$2M,regardless of investor.Upfront Payments define

280、d as initial proceeds from an acquisition paid upon the close of a structured deal;they do not include milestones.Milestones to be Earned defined as proceeds from an acquisition that are paid once predetermined milestones are met.Total Deal Value defined as the full value of the acquisition,includin

281、g milestones to be earned.Time to Exit defined as the time from the close of a companys first institutional round of financing to the exit.Step-Up defined as the valuation change from the last round post-money value to the next round pre-money value.Corporate Investor defined as a corporate venture

282、and parent company investment into venture-backed companies.Computational Biology:To qualify as a computational biology company in this analysis,per review of their website,the company must(1)focus on drug discovery and/or development(biopharma/R&D tools),(2)apply novel computational tools to gain b

283、iological and/or chemical insights,(3)have the ability or potential for platform creation and(4)have a team with computational experience.European Data:All European data and statistics include data from the European Union and the United Kingdom.Device Regulatory DefinitionsNon-approved defined as a

284、device product that has not obtained regulatory clearance or approval for its product.CE Mark defined as a device company that has CE Mark approval but has not received FDA approval.CE Mark is a European Union designation that is typically less difficult to obtain than FDA approval,and the approval

285、process often has a faster timeline.US Commercial defined as a device company that has received FDA approval or clearance of its product and is usually in a commercial stage.510(k):FDA process of scientific and regulatory review to evaluate the safety and effectiveness of Class II medical devices.Ty

286、pically there are little to no human clinical trials required for 510(k)clearance.PMA:Premarket approval(PMA)is the FDA process of scientific and regulatory review to evaluate the safety and effectiveness of Class III medical devices.Typically there are extensive human clinical trials involved for P

287、MA approval.Indication DefinitionsNeurology defined as CNS,pain and psychology companies,as well as neurology implant technologies.Non-Invasive Monitoring(NIM)defined as medical data collection through sensors and other technology worn outside the body.Dx Tests defined as proprietary yes/no diagnost

288、ic tests.Dx Analytics defined as actionable data analytics to help determine treatment.R&D Tools defined as research equipment/services for biopharma and academia.Healthtech Subsector DefinitionsProvider Operations defined as companies that provide solutions to increase the efficiency and accuracy o

289、f provider-provider and provider-patient interactions.Alternative Care defined as companies that provide primary or specialty care outside a hospital or private practice.Clinical Trial Enablement defined as companies that develop solutions to accelerate drug discovery and the digitization of clinica

290、l trials.Healthcare Navigation defined as companies that guide users to relevant providers and/or payers based on their needs.Medication Management defined as companies that aid users in access and adherence to their prescribed medication.Wellness&Education defined as companies that inform users of

291、healthy lifestyle and medical best practices,as well as medical education companies.Biopharma Top 15 Crossover InvestorsBiopharma Top 15 Crossover Investor defined as a public-minded investor who strategically invests in private companies.The Top 15 list includes:RA Capital,Perceptive Advisors,Deerf

292、ield Management,Redmile Group,Cormorant Asset Management,The Invus Group,Fidelity(et al.),EcoR1,Casdin Capital,Janus,Logos,Viking,Citadel,Rock Springs Capital and Wellington Management.HEALTHCARE INVESTMENTS AND EXITS|ANNUAL REPORT 202241The material contained in this document,including without limi

293、tation the statistical information herein,is provided for informational purposes only and is not intended to forecast or predict future performance or events,including in relation to the performance and outlook of SVB Financial Group and its subsidiaries.The material is based in part on information

294、from third-party sources that we believe to be reliable but which have not been independently verified by us,and for this reason,we do not represent that the information is accurate or complete.The information should not be viewed as tax,investment,legal or other advice,nor is it to be relied on in

295、making an investment or other decision.You should obtain relevant and specific professional advice before making any investment decision.Nothing relating to the material should be construed as a solicitation,offer or recommendation to acquire or dispose of any investment or to engage in any other tr

296、ansaction.All non-SVB named companies listed throughout this document,as represented with the various statistical,thoughts,analysis and insights shared in this document,are independent third parties and are not affiliated with SVB Financial Group.Any predictions are based on subjective assessments a

297、nd assumptions.Accordingly,any predictions,projections or analysis should not be viewed as factual and should not be relied upon as an accurate prediction of future results.The views expressed in this report are solely those of the authors and do not necessarily reflect the views of SVB.Silicon Vall

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309、NTS AND EXITS|ANNUAL REPORT 2022About SVBSVB is the financial partner of the innovation economy,helping individuals,investors and the worlds most innovative companies achieve their ambitious goals.SVBs businesses Silicon Valley Bank,SVB Capital,SVB Private and SVB Securities together offer the servi

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