The conventional wisdom in the medtech industry is to pursue the “razor-razor blade” business model, as each placement of capital equipment generates a lucrative annuity of recurring revenues from disposables. The corollary to this conventional wisdom is that so-called “big iron” is to be avoided as, in sharp contrast, it suffers from greater early cash requirements and longer sales cycles that create difficulties forecasting quarterly revenues, and provides no annuities. But that view is no longer the only one that counts, Health Advances CEO Mark Speers argues.

Merck KGaA and Artios penned a global three-year strategic research collaboration to discover and develop multiple precision oncology drugs. The deal could be worth close to $7bn for four-year-old Artios. AstraZeneca announced a definitive agreement to acquire public rare disease drug developer Alexion for approximately $39bn. This was 2020’s largest M&A. Financing reached $28bn in biopharma, $879m in device, and $2.4bn in diagnostics.

Coming year could feature first-time approvals in the EU for at least five gene therapies.