12/02/2025
M&A in Medical Devices: Is the Market Shifting?
After spending the weekend at the Southern Neurosurgical Society meeting, one of the hottest topics among surgeons and industry professionals was the surge in M&A activity in the medtech space.
The biggest and most recent deal? Stryker Spine divestiture of its spine business to VB Brothers, forming VB Spine. But that’s not the only major move—Nevro was just acquired by Globus Medical Medical, adding to a growing trend of consolidation.
Why is this happening?
The reality is that many of these companies aren’t seeing the profit margins or returns they once did. Take Nevro as an example, or NuVasive, Paragon 28, and ZimVie’s spine division to Medical—several of these companies were carrying significant debt, and with high interest rates and a tighter capital market, financing growth isn’t as easy or inexpensive as it once was.
🔹 The cost of capital is high, making it harder for companies to raise funds at favorable terms.
🔹 Interest rates remain elevated, putting pressure on leveraged businesses that relied on cheap debt to fuel growth.
🔹 Investors are shifting focus—in today’s market, profitability is more important than aggressive market share expansion.
At the same time, private equity investment is slowing as firms reconsider backing mid-sized companies that aren’t generating strong profits. The multiples tell the story:
🔹 NuVasive was acquired in an all-stock transaction at less than a 3x multiple
🔹 VB Spine (Stryker’s divested spine business) is rumored to have sold for $700M-$1B, equating to a 1.x multiple
🔹 High Ridge (formed from ZimVie’s spine spinout) is speculated to be under a 2x multiple
🔹 Paragon 28 was bought for $1.1B by Zimmer Biomet, at an estimated 4.7x multiple—relatively low compared to historical orthopedic deals
The Days of High Multiples Are Gone
Compare this to the golden age of high-multiple acquisitions, like Medtronic Cranial and Spine Therapies acquiring Kyphon at a 9.6x multiple in 2007 or St. Francis Medical Technologies, which sold for a high-multiple deal structure. Back then, private equity and strategic buyers were willing to pay a premium. Today, that environment no longer exists.
What’s Next?
As private equity becomes more cautious, we’ll likely see more M&A activity—particularly as cash-hungry, mid-sized companies look for exits and larger, more financially stable players seize the opportunity to acquire at lower valuations.
What companies do you think are ripe for a takeover or exit? Will we see more consolidation, or will private equity find a way to keep fueling mid-market growth?
