Led by the USA, global healthcare startups raised over USD 29 billion during the first half of 2019. Yet, the scale differences in the secondary markets for healthcare startups are as vast as the differences between millions and billions.
Healthcare is being reshaped by the changing demographics, cutting-edge technologies, and mutant regulatory approaches all around the globe. Beneath this uncertain and fickle ground, there is a rock-solid and surging demand.
Global spending on medicines reached USD 1.2 trillion in 2018 and is set to exceed USD 1.5 trillion by 2023, that is bigger than the Turkish and Dutch economy combined. Yet, it is the tip of an iceberg.
Through medical big-data and almost-entirely penetrated smartphone networks, traditional healthcare services are transforming into “online clinics”, creating a brand-new playground for the PE and VC investors. On top that, third party medical facility providers, such as CROs and R&D houses, started to be able to scale themselves and became visible for the investors.
China has already created its unicorns in the digital health services scene: PingAn Good Doctor (平安好医生) and JD Health (京东健康) are the vanguards.
Eagle Eye: Global Healthcare Startup Fundraising Arena during the First Half of 2019
Healthcare has led all sectors in total returns to shareholders (TRS) by around 15% between 2010 and 2015 globally, MGI estimates. However, there are high imbalances in Healthcare VC/PE investment distribution globally, and the fast-paced changing administrative and social mechanisms in the underdeveloped regions making it harder for investors to assess and invest in the healthcare projects in these regions.
The USA, the world’s most generous healthcare consumer, led the global healthcare startups funding in the first half of 2019, accounting over 60% of the entire fundraising events.
GEM reports that the healthcare entrepreneurship ratio increases as the surrounding economy get developed. The reason for this is the high barriers to entry, which explains why Europe follows the USA with over USD 3 billion worth of financings.
There is a significant clustering effect observed in the Middle East, consolidating more than 90% of the entire healthcare investments to Israel, postulating the significance of the environment.
In healthcare, barriers represent the capital and R&D capacity, which is a formidable filter for relatively underdeveloped and developing regions, including Africa and South America: only four startups could raise a significant amount of funds during the first half of 2019.
In Asia, as the Chinese healthcare system gets saturated, as well as the government continually reforms its public health policies, China’s presence gains more visibility in all industries, including healthcare. China dominated healthcare fundraisings in the APAC region during the first half of 2019, and the trend exhibits that its presence will be stronger in the following years. Yet, the Chinese healthcare system is still immature with deep structural problems.
During the period, the investors preferred to inject their capital mostly during Series A and B. In North America and Europe, mature healthcare companies attracted PE and corporate investors, mostly in their last stages to exit. Payor services, pharma and biotech have generated the greatest median return in Healthcare PE investments, McKinsey calculated.
Indeed, insurance and biotech companies from San Francisco, Clover Health and Verily raised the most significant pre-IPO financings of the first half of 2019, raising USD 500 million and USD 1 billion respectively. The giant investments from the USA have been followed by China's internet behemoths: JD Health, a JD.com subsidiary healthcare services platform, raised USD 1 billion during the same period.
Pharmaceutical and medical devices projects in North America drew the investors' attention during the first half of the year. Radiology Partners' USD 700 million funding demonstrated the massive potential in digital healthcare services, as well. Collective Health, yet another healthcare payer services institution that worth mentioning, has raised over USD 200 million from Soft Bank.
In Europe, an immune-oncology company from Germany is the winner of the EU fundraisings during the period; the company raised over USD 325 million. Notably, the outstanding amount of influx of investments into the immunotherapy field is observed in China, as well. Doctolib, an online booking platform from France, stands as the second-largest, raising over USD 166 million, new healthcare services platform showed presence in Europe, as well. The investments in Biotech and AI-driven diagnostic devices followed.
In the Middle East, one country has been carrying the flag, Israel. The country particularly stands alone with its biotech and high value-added medical devices startups. Since the companies from Israel do not have a scalable B2C market, it is rare to see digital healthcare services projects from Israel. Theranica, a medical device producer, marked its brand raising over USD 35 million.
Triggered by the massive and growing market, Indian healthcare and wellness startups enjoyed the influx of capital during the first half of 2019. Medikabazaar, an online B2B marketplace for medical devices raised over USD 28 million, standing as one the biggest investor magnets of the country. On the other hand, wellness companies Sequoia-backed Healthkart and IDG-backed CureFit raised over USD 145 million in total.
In Southeast Asia, a similar trend to the Middle East is observed: the market is dominated by one country, Singapore. Novena Global Lifecare, an integrated Healthcare platform, raised over USD 20 million; marking one of the significant investments during the period.
There has yet to be formed a robust marketplace for secondary market investors in healthcare in Latin America and Africa yet, however, there was a small batch of scalable investments, including, among others, mPharma and mDaas Global from Africa, as well as EvaTech and Senshi from Latin America.
The global scale differences in the secondary market for healthcare investments are as wide as the differences between millions and billions. Unfortunately, the capital influx in healthcare has yet to be seen where there is an urgent need for better health care.
Yet there is a room for optimism, as well. Through the latest IT solutions, medical devices provide a possibility to convey and transfer the healthcare resources from developed to underdeveloped regions. AI and 5G present a future where a patient with a tumour in Bangladesh could be diagnosed by the doctor located in London.
Definitions
Startups are defined as companies that were founded within less than 10 years dated the time being evaluated, and are not publicly-traded.
Only regular funding series such us angel, seed, and Series A through pre-IPO are taken into consideration. No initial public offering, debt financing, crowdfunding or other types of financing activity be analyzed.
Data only contains disclosed financing series and hence, the actual financing volume may be greater. The deviation from the real investment will not affect the conclusions made above.
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