硅谷银行-医疗保健行业趋势-2023年度报告（英）

PublishedJan.

17,2024HEALTHCARE

INVESTMENTS

AND

EXITS

ANNUAL

REPORT

2023It’s

beensix

monthssincewe

brought

youour

Mid-YearHealthcareInvestmentsand

Exits2023report,

and

I

wishI

could

say

that

much

haschanged

sincethen—

thatinvestmentshaveroaredback,

valuations

aresoaring

and

theIPO

windowhas

liftedwideopen.Unfortunately,we’renotthere

yet.companieshavelimitedfunding

optionsoutside

of

apublic

exit.Forthesecompanies,

apublic

market

turnaround

couldn’t

comesoon

enough.Life

sciencecompaniesare

less

affectedbytheslower

market

iftheyhavestrong

clinicalresults.

Biopharmacompanieswithfavorableclinicaltrials

arefindingplentyofinterestamonginvestorsand

achievingstrong

step-upvaluations.

Thestickiness

we’veseen

inbiopharma

reflectsthe

longertermperspectivemanylifescienceinvestorstake.

Fewertourist

investorsenterthisarena,

and

theLPs

thatinvestinhealthcare

tend

tobemoreimmune

tomarket

whims.

Thatreality

ishelpingtobolsterfundraising.What

has

emerged

isa

clearerpicture

ofwhere

we’re

headed.Strategiesthat

tookshape

monthsago

are

nowshowing

up

inthedata,

as

investorswhooncefavoredlater

stage

deals

havedecisively

pivoted

toward

earlierdeals.

Theresult

has

meant

smaller

checksspread

toagrowing

numberofcompaniesat

right-sized

valuations.Whiletech-focused

VCinvestorsare

struggling

toraise

newfunds,healthcareinvestorshavefared

well.USinvestorsraised

$19Binnewhealth-specificfunds

in

2023,thethird

highest

yearonrecord.Growth

inpromisingareas

such

as

women’s

health,

AI-enableddiagnostics,

drugdiscovery

and

personalized

medicine

are

reasons

for

immenseoptimisminhealthcareinnovation.WhileVCinvestmentinhealthcare

has

settlednear

halfits2021peak,dealcounts

havereboundedinrecentmonthsand

are

approaching

theirpriorpace.

Ifinvestorswere

eversittingon

theirhands

waiting

forclarity,that

timeisover.VCsare

back

towork.Theirinvestmentsare

creatinggreenshoots

ofoptimismacross

thespectrumof

healthcareinnovation.Promisingcompaniesare

beingfunded

atrates

thatapproach

orevenexceed

historic

norms,

and

theadvent

ofgenerativeAItechnologyoffersimmensepossibilityfor

innovativehealthcare

founders.Aswe

looktotheyearahead,

we

understand

that

many

companieswillcontinuetoface

challenges.

Thereset

nowwashing

through

theindustrywill

take

itstoll.But

ifthisprocesscreates

areality

moregrounded

infundamentals,

wherepositiveand

sustainable

outcomes

are

possiblefor

morecompaniesinthe

long-run,

thenmaybeitwas

worth

it.After

all,there’s

nothingmoreirrepressiblethanthepowerof

agood

idea.But

thechallenges

ofthecurrent

market

remain

significant.

Agenerationof

late-stage

companiesthattookhigh

valuations

at

the

peak

ofthe

VCboomnowface

anuncertain

future.

Dozens

or

even

hundreds

ofIPO-readyJackieSpencerHead

ofRelationship

Management

forLife

Science

and

Healthcare

Bankingjspencer@2HEALTHCARE

INVESTMENTS

AND

EXITS

ANNUAL

REPORT

202304Healthcare

Market

Highlights07Fundraisingand

Investment13InvestmentbySector18Spotlight:AIinHealthcare21Healthcare

Exits:

M&AandIPOTrends3HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

20234You

have

tonavigate

a3Dspaceifyou

wanttobesuccessfulinpredictivesimulation

and

modeling.Thatrequires

data,itrequiresAIgivesthe

opportunitytomoveawayfromtheartisanalcraft

ofdrugdiscoverytoanengineeredprocess.”•

Biopharma

companiesfocusedonlarge

population

categories

suchasobesity,cardiovascular,

andautoimmune

diseases,

arelikelytoattractacquisitioninterest

in2024.RayPressburgerGlobalLife

ScienceLead,

Accenturealgorithms,anditrequires

compute.”Frank

O.

Nestle,M.D.GlobalHead

ofResearch

&

ChiefScientific

Officer,

Sanofi•

Forlate-stage

rare

disease

assets,interest

isgrowingfrombuyers

inEurope

and

Asia.Overthelast

yearwe

have

moved

toaviewwherewe

say‘AIisactuallyanecessity’

[for

understandingdisease].”Goodclinicaldataarealwaysimportantfor

creatingmomentum.”•

Exitopportunitiesmoreplentiful

forDr.Matthias

EversChiefBusiness

Officer,

Evoteccompanieswithstrongclinical

data.Alessandro

MaselliPresident&CEO,

CatalentWest

StreetLifeSciencesFundI$650M

fundraising$2B

acquisition$680M

acquisition$250M

acquisitionNote:Quotes

gathered

fromremarks

attheJPM

Healthcare

Conference

Jan

8-11,

2024.

Theywerelightlyedited

forclarity.Source:JPMHealthcare

Conference

andSVB

research.5InvestmentsFundraisingExitsInvestment

volumeshave

leveled

off

overthe

past

fourquarters,

settling

55%

belowtotalsseen

in2021.

However,

the

paceofdeploymentispickingup.Deal

counts

aredown

just

11%fromthe2021peak

andgaining

speed

as

dwindlingrunways

forcefoundersto

acceptless

favorableterms.USinvestors

raised

$19B

fornewhealth-focusedVCandgrowth

fundsin2023,the

thirdhighestamountfor

anyyear.Thismaysignaloptimism

thatdeploymentwillpickupasinflationeases

andtheFedpauses

rate

hikes.WeexpectTheexitmarket

remainstightaslate-stagecompaniesgrapple

withvaluationoverhang.

IPOswereflat

vs

2022

withM&Aactivityfavoring

acquirers

asevidencedbyasurgethe

shareof

undiscloseddeals.Wemaysee

more

IPOs

in2024

aspublicmarkets

adjust

tohigher

interest

rates.fundraising

tobestrong

againin2024.HealthtechBiopharmaDeviceDx/ToolsCompaniesare

stillrecovering

fromtheoverabundance

of

interest

receivedduringthe

pandemic,

with

investmentdown

33%from2022.

Laterstagecompaniesfacechallenges

growing

intolofty

valuations,manyof

which

weredecoupled

fromfundamentals.

Acquisitionsremain

steady,though

therearefewerdisclosed

deals,reflectingthe

strained

environment

thatmanyof

theseonce

highly

valuedCompanieswithstrong

clinical

assetsarestill

finding

fundingtraction,

despiteheadwinds.Promisingdevelopmentsonthe

horizon

include:RNA-basedtherapies,the

GLP-1

class

andADCs.

Whileexitsaredepressed

from

historicnorms,

wesaw19IPOs

thisyear,asignthatthe

IPOmarket

couldbebitingagain,though

IPOsarelargelyreserved

forcompanieswithmorerobustclinical

validation

(phaseIIandbeyond).Giventhe

relianceon

outpatientAfteragangbuster2021

andmodest2022,diagnostics

IPOscameto

agrinding

haltin2023.

Thismarks

the

sector’sfirst

yearsince

2016

withno

IPOs.

Abrightspotinprivatediagnosticsinvestmentsisthetotalcapitalinvested

inseed/Series

Acompanieswhich,

while

shortof

the

peakin2022,

farexceedspre-pandemic

levels.Thecontinued

development

ofprocedures,

the

medical

device

sectorisstill

working

through

knock-on

effects

ofthe

pandemic,

including

haltedproceduresanddisrupted

supply

chains.

Thismanifested

asatough

yearfordeviceexitswhen

totalexitvalues

areattheirlowestpointsince

2017.

Investmentshave

faredrelatively

well.They’redown

25%from2022,

while

dx/tools

andhealthtech

aredown

42%

and33%,

respectively.personalized

medicinewilllikelybenefitthissector.companiesnow

findthemselves

in.HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

20236HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

2023730252015105ClosedfundsFundsstillraising$28B$5B$22BDefyingatrendintheoverall

innovationeconomy,USVCfirmsraised

$19B

for

health-focusedfunds

in2023,making

it

thethird

bestyearfor

healthcarefundraising.$19Bfundraising

was

a

bright

spot

for

healthcarein

2023.USinvestorsraised

$19Bforhealth-focused

venture

andgrowth

funds,

thethird-highesttotal

forany

yearand

justa

14%decreasefromlast

year.Whiletech-focusedVCsare

struggling

toraise

newfunding

amid

theVCdownturn,healthcareinvestorsare

refillingtheirreserves,

hopingtomaximizetheir

upside

potential

as

valuations

drop.Promisingly,the

Fed’s

recentmention

of

potential

interestrate

drops

in2024may

speedup

additional

fundraising.$17B$11B2019$10B2018$9B$8B$6B$7B$4B$4B2012201320142015201620172020202120222023Fourteenfirmsraised

$1B+funds

last

year,

but

that

freshcapital

could

sit

onthe

sidelinesfor

a

while.Thefrenziedsenseof

urgency

we

saw

in2021islargely

gone,

givinginvestorsmoretimetofocus

ondiligence.With

valuationsstill

settling,

investorsare

cutting

smaller

checksandstretchingtheir

funds

further.

Firmsthatfocused

onlaterstage

dealswhenthemarket

was

hotare

nowturningtheirattentiontoearly-stage

deals,whichare

moreshelteredfrompublic

market

volatilityand

may

havecleanercaptables

unencumberedby

downrounds

orout-of-reach

valuations.

Inonenotableexample,LuxCapital

announced

theypivotedtoward

earlierstagedeals.

In2021,Lux

invested44%oftheir

deploymentsintolater

stage

companies.

Now,thetrendhas

flippedwith81%of

dealsgoing

toearly

stage

in2023.Thisshiftmay

bea

bellwetherfor

otherfirms.Notes:1)US

Healthcare

Venture

CapitalFundraising

defined

asanapproximation

ofhealthcare

investmentdollars

tobe

investedby

firmsthathistoricallyinvestin+50%

US

companies.Estimates

basedonanecdotalconversations

with

investors

andexpertanalysis

oflastfunddealpace.2)Notablefunds

basedonlargestestimatedallocationtoventure

healthcare.HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

20238Source:

PitchBook

andSVB

proprietarydata.$60B$50B$40B$30B$20B$10B$0B16431489147012831246Thistimelast

year,

investorswere

mostlytreading

water.Dealcounts

droppednearly

30%fromH12022to10831066936H2

2022,as

valuations

reset.

Today,valuations

remainmuted,

but

deployments

are

pickingup

as

more

investorshavecommitted

toanewstrategy

ofbacking

earlierstagecompanies.

AcrosstheUSand

Europe,

average

dealsizehas

fallenfrom$35MinH12021to$24MinH22023.815801658668Theseshifts

may

signal

stabilization.

Aftera

rapid

declinethat

beganin

January

2022,VCinvestmenthas

leveledoff,

averaging

around

$11Bperquarter

overthelast

year,a

roughly

55%decline

from2021.Fromthe

great

heightsof

two

yearsago,

that

dropmay

feelextreme,but

in

thecontextofVChistory,we’re

back

to2019levels.Thequestion

on

everyone’smindseems

tobe:isthisareturntonormal

orthe

start

of

anew,

morecyclicalnormal?Whichever

thecase,

thedays

of

uncheckedup-and-to-the-right

growth

expectationsare

likelybehind

us

(fornow).2018

H12018

H22019

H12019

H22020

H12020

H22021

H12021

H22022

H12022

H22023

H12023

H2202120222023YoYChange1Sectors

($M)USEU

&UKTotalUSEU

&UKTotalUSEU

&UKTotalBiopharmaHealthtechDx/ToolsDevice31,2156,9242,8812,7132,38314,90138,13836,01014,6689,07424,99714,0638,6504,8303,9571,6591,57212,01929,82718,02010,3098,66317,00310,4714,2814,1611,3721,4151,2398,18721,16411,8435,696-25%-33%-42%-25%-30%33,12911,9556,691Investmenttrendsvary

bysector.

Healthtech,apandemicdarling

withaninflux

oftourist

VCinvestment,saw

aspike

ofcapital

during

2021but

has

failed

tokeeppace

as

virtual

care

and

otherpandemictrendsrecede.Biopharma,

however,

has

beenless

impactedbymarketvolatility.Companieswithstrong

clinicalassets

aregenerally

findingenough

investmenttopursue

thenextmilestone.7,0914,7235,962Total82,99097,89054,80166,81936,47744,665Note:1)YoYchangecalculatedfromJanuary

through

Novemberof2023

andthesameperiod

in2022.Source:PitchBook

andSVB

proprietarydata.HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

20239OverallBiopharmaHealthtechDx/ToolsDevice5554474442403734363322211717161436342625181814121091210777776666565Note:1)Mostactivenew

investors

calculatedasnew(first-time)

investmentsinUS,EU

andUKcompanies

from

1/1/2022-12/1/2023.

Dates

offinancingrounds

subject

to

changebasedonadd-oninvestments.Additional

investors

notlisteddueto

spacelimitations.Source:

PitchBook,conversationswith

investors

andSVB

proprietarydata.HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

20231020212023DeviceDx/ToolsHealthtechBiopharma49%65%All

SectorsNearly

two-thirds

ofdealswereunder

$10Min

2023,

upfromhalfofall

healthcaredeals

in2021.50%46%44%42%Thedaysof

thevanity

valuation

are

longgone.

Nowit’s

allabout

thespoon-feddeals.

Just

likeanIVinthe

hospital,these

investments—

oftenin

theformofinsiderounds

—keep

companiesaliveuntil

theycanthriveagain.Investorsare

increasingly

using

insideand

extensionrounds

tokickthecandowntheroadfor

companiesthatwould

otherwisefail

orbeforcedtotake

adownround.Toget

a

senseof

thistrend,we

definedspoon-feddealsas

later

stage

companiesvalued

at

or

above$20Mraisinga

round

of$15Mor

below.Deals

in

thisrange

are

upacross

all

healthcare.Nearly

half

ofall

later

stagediagnostics

deals

are

spoon-fed

deals,

up

from27%in2021.Thespike

in

theproportionofspoon-feddeals

issimilar

forhealthtech

and

biopharma,but

are

lowerfordevices,whichalready

had

ahigher

rate

ofspoon-feddeals.41%23%31%15%29%27%13%12%8%6%5%3%20%$0-$10M$10M-$20M$20M-$30M$30M-$40M$40M+20212023MedianMiddle

50%

of

dealsSeriesASeriesBSeriesC4.5x4.0x3.5x3.0x2.5x2.0x1.5x1.0x4.5x4.0x3.5x3.0x2.5x2.0x1.5x1.0x4.5xIngeneral,

dealsizes

are

trendingloweras

companiesare

forcedtodomorewith

less,

and

investorsare

moreinterestedinearlierdealswithcleanercaptables.

In2023,VCdeals

lessthan$10Maccounted

for65%of

alldeals,

up

from50%in2021.Greater

scrutiny

on

pricingisalso

affectingstep-ups,

whichhavefallenbelowthepre-pandemicnormforall

stages.

SeriesCcompanies,whichwere

getting

amedian2xincreaseinvaluation

in2021are

nowseeingonlya

30%bump.

But

even

thesenumbers

are

likelyinflated

as

theyonlyincludediscloseddeals,

whichare

a

shrinking

minority

of

all

deals.4.0x3.5x3.0x2.5x2.0x1.5x1.0x2.5x2.3x2.0x2.0x1.9x2.0x1.8x1.8x1.8x1.6x1.6x1.6x1.5x1.5x1.3x201920202021202220232019202020212022202320192020202120222023Notes:1)Aspoon-feddealisdefined

asa

dealthatis

$15M

orlessforlaterstagecompany

with

apre-moneyvaluation

atorabove$20M.

2)

Step-upsare

thelatest

pre-moneyvaluation

divided

by

thepreviouspost-moneyvaluationfordisclosed

dealsonly.HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

202311Sources:

PitchBook

andSVBanalysis.Undisclosed

dealsDown/flat

roundsUproundsStep-Up2StageDealSizeSector1.32xSeriesC$430MBiopharma26%7%1.52x1.49x1.19x1.88x1.05x3.03x1.81x1.13xSeriesDSeriesASeriesCSeriesASeriesFSeriesBSeriesCSeriesC$323M$300M$273M$270M$260M$260M$255M$225MDeviceBiopharmaBiopharmaBiopharmaHealthtechBiopharmaDx/Tools37%6%45%47%48%6%8%9%67%57%48%45%43%Biopharma20192020202120222023Notes:1)Up

rounds

defined

asdealswherethepre-money

valuation

is

higherthantheprior

deal’s

post-moneyvaluation.

2)

Step-upmultiplecalculatedby

dividing

thepre-moneyvaluation

onthecurrent

venture

round

by

thepost-moneyvaluation

ontheprecedingventure

round.Source:

PitchBook

andSVB

proprietarydata.HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

202312HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

202313Q1Q2Q3Q4Pre-money

valuation$15MDealsize2020$6.1B

(281)2021$8.9B

(353)2022$6.6B

(297)2023$4.7B

(218)2023202220212020$9MAgrowing

backlog

ofIPO-hopefuls

pressed

against

abarely-ajar

IPOwindowadds

pressure

toprivatevaluations.

Competition

for

financingisfierceasinvestorsnavigate

unclear

paths

toexits.

Pressure

isespeciallyacute

at

thelater

stages

(SeriesBandbeyond),

whichare

down30%vs.

2022.Early-stageinvestment,moreshieldedfrommacro

headwinds,jumped

inQ2and

Q3’23.

Early-stage

investmentwasstrong

for

companieswith

AI-enableddrug

development—

AI’s

purportedability

tocut

costsand

speeddevelopment

isloweringthecapital

barriers

for

early-stage

biopharmacompanies.$17M$15M$10M$3.0B$1.9B$2.2B$2.2B$10M$848M$1.6B$1.4B$1.7B$854M$2.3B$1.9B$1.9B$1.2B$1.3B$1.2B$946M$13M$10M2020

H12020

H22021

H12021

H22022

H12022

H22023

H12023

H2Thedramatic

slowingofdeal

pace

isgivinginvestorstimefor

diligence.

Investorsare

increasingly

focused

onsufficient

runway

todrivecompaniesthrough

meaningfulclinicalmilestones.

But

thebar

has

beenraised.

FDAdenialshaverisentopeak

levelsin2023,and

R&Dexpenditurehas

notslowed.

While

early-stage

platformcompanieshad

aneasier

timeraising

funds

duringthemarket’s

peak,

thependulumhas

swung

toward

lessrisky

investmentsamid

theensuing

pullback.

Attimes,thismeans

thatveryearly,pre-clinicalassets

are

lessattractivebecause

ofhowlongtheycan

take

toland

intheclinic.Bright

spots

ininvestmentweredrivenbystrong

clinicaldevelopments:

theGLP-1class,

ADCs

andthelandmark

approvalof

CRISPR

developed

drug

forsickle

celldisease,

Casgevy.Q1Q2Q3Q4Seed/Series

ALater

stage2020$27.0B

(699)2021$38.1B

(908)2022$29.8B

(812)2023$21.2B

(626)$300M$245M$215M$145M$137M$100M$430M$401M$300M$273M$270M$260M$9.1B$6.5B$7.9B$6.7B$5.8B$6.4B$3.6B$6.0B$12.6B$11.3B$8.1B$8.6B$6.7B$6.9B$5.6B$4.7B2020

H12020

H22021

H12021

H22022

H12022

H22023

H12023

H2Note:1)Seed/SeriesAincludes

first-timeinvestmentsfrominstitutionalorcorporate

venture

investmentintheUS,EUandUK

andanyfirst-round

investmentsequalto

orgreater

than$2M,

regardless

ofinvestor.Datesoffinancing

rounds

are

subject

to

changebasedonadd-oninvestments.HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

202314Source:

PitchBook

andSVB

proprietarydata.Q1Q2Q3Q4Pre-money

valuation$25MDealsize$5M2020$1.7B

(220)2021$2.6B

(399)2022$2.6B

(432)2023$1.9B

(386)2023202220212020Ifitlooks

likeabubble,it

maypop

likeone,too.Thepandemicushered

ina

massive

wave

ofinvestment,asall

eyesturned

todigital

healthcare,

includingtheeyesoftraditional

techinvestors.

Atthepeak

oftheVCboominH2

2021,healthtechcompaniesraised

$20B.Twoyearslater,that

has

droppedroughly

75%to$5B.One

gauge

ofthedeclineisthedrop

inseed

and

SeriesAvaluations.Whilemany

sectorshaveseen

stability

inearly-stagevaluations,

bolsteredbyan

influxin

investorinterest,healthtech’s

earliest-stage

deals

haveseentheoppositetrendwith

valuations

dropping33%inthe

last

year.

Itmaytake

timefor

thissector

toresetas

many

healthtechcompaniesthatraised

at

large

valuations

in

2021aregrappling

withlimitedoptionstoavoid

adownround.Companiesface

more

scrutinous

investorsand

areworking

against

heighteneddemand

for

strong-uniteconomicsand

paths

toprofitability.$35M$8M$9M$696M$683M$524M$570M$35M$472M$423M$501M$267M$405M$993M$708M$637M$649M$415M$455M$355M$28M$9M2020

H12020

H22021

H12021

H22022

H12022

H22023

H12023

H2Q1Q2Q3Q4Seed/Series

ALater

stage2020$13.4B

(614)2021$36.0B

(999)2022$18.0B

(1062)2023$11.8B

(844)$203M$139M$60M$57M$50M$31M$1.3B$375M$315M$260M$166M$125MOnebright

spot

within

healthtechisvalue-based

care(VBC).

Companiesin

thisspace

provideVBCdirectly,

orenableproviderstoadoptVBCmodels.

Healthtechcompaniesare

facing

such

challengesthat

themeasureofsuccess

ischanging.

Forlate-stage

companies,

evenstrong

metricsmayresult

inaflat

round.

OneexampleisAledade,whichsecured

a

SeriesFdeal

of

$260M

at

a1.05xstep-up.$12.5B$8.5B$5.0B$3.7B$3.0B$3.2B$2.8B$2.6B$3.2B$7.8B$7.3B$7.3B$3.0B$2.3B$3.7B$3.5B2020

H12020

H22021

H12021

H22022

H12022

H22023

H12023

H2Note:1)Seed/SeriesAincludes

first-timeinvestmentsfrominstitutionalorcorporate

venture

investmentintheUS,EUandUK

andanyfirst-round

investmentsequalto

orgreater

than$2M,

regardless

ofinvestor.Datesoffinancing

rounds

are

subject

to

changebasedonadd-oninvestments.HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

202315Source:

PitchBook

andSVB

proprietarydata.Q1Q2Q3Q4Pre-Money

valuation$8MDealsize2020$819M

(111)2021$1.2B

(187)2022$1.5B

(200)2023$1.1B

(185)2023202220212020$3MTheVCheadwindsthat

emergedin2022onlyintensifiedin2023.However,

fundamental

market

driversfordx/toolscompaniesremainedstrong,

withencouragingclinicaldata

reignitingthepromise

ofpersonalizedmedicine

and

advancedtherapeutic

modalities.Seed/SeriesAactivityremainedresilient,droppingfromthemarket’s

peak

but

remainingwell-abovepre-pandemiclevels.Thisdata

reinforcesmarket

anecdotesthat

SeriesAdealactivityrevolvesaround

top-tierprofileswithamixture

of

veteranmanagement

teams

andcompellingstoriesat

a

“2023

market

price.”$312M$10M$4M$4M$413M$359M$217M$311M$256M$365M$10M$535M$97M$343M$274M$286M$273M$261M$181M$150M$9M$5M2020

H12020

H22021

H12021

H22022

H12022

H22023

H12023

H2Whiledxtests

and

R&D

toolssaw

nearly

50%losses

inYoYinvestmentdollars,

dxanalytics

saw

thesmallestdropof34%.

DxanalyticscompanieswithAI-drivendrugdiscovery

platforms

were

a

bright

spot,

as

theymeaningfully

accelerate

time

toclinicand

cut

costsacross

thedrug

development

pipeline–a

concernthat’stop

ofmindnowas

capital

efficiency

isimperative.Theyalso

partnerwithoftentimesdeep-pocketedpharmaplayers.We

expect

for

AI-driven

drug

discoverycompaniestomaintain

high

valuations

and

robustgrowth.

Anotherbrightspot

ispersonalized

medicine(includingpersonalized

clinicaldecisionsupport),

namelyArtera

forcancertreatment,

Viomefor

metabolichealth,Heartflow

for

coronaryartery

disease

and

RapidAI

forstrokes.Q1Q2Q3Q4Seed/Series

ALater

stage2020$10.9B

(341)2021$14.7B

(510)2022$10.3B

(494)2023$5.7B

(431)$90M$57M$51M$50M$40M$38M$36M$255M$215M$175M$150M$140M$131M$103M$4.5B$3.5B$2.8B$3.6BEvolutionaryScale2$3.3B$1.6B$1.5B$858M$1.0B$1.8B$3.5B$3.7B$3.4B$3.1B$2.0B$1.4B2020

H12020

H22021

H12021

H22022

H12022

H22023

H12023

H2Notes:1)Seed/SeriesAincludes

first-timeinvestmentsfrominstitutionalor

corporateventure

investmentintheUS,EUandUK

andanyfirst-round

investmentsequalto

orgreater

than$2M,

regardless

ofinvestor.Datesoffinancing

rounds

are

subject

to

changebasedonadd-oninvestments.2)Companydoes

nothave

logoorwebsite.HEALTHCARE

INVESTMENTS

&

EXITS|

ANNUAL

REPORT

202316Source:

PitchBook

andSVB

proprietarydata.Q1Q2Q3Q4Pre-Money

saluation$22MDealsize$5M2020$950M

(103)2021$1.3B

(189)2022$971M

(137)2023$684M

(142)Whileothersectors

benefited

fromthespotlight

onhealthinnovationduring

thepandemic,device

companiesexperienced

a

setback.

WhenCOVID-19

hit,electiveprocedureswere

largely

paused,

and

supply

chaincongestion/backlogs

impactedmultiplemanufacturersand

devices.Thathas

created

aknock-on

effectimpactingrevenuefor

device

companies,

whichrelyheavilyonoutpatient

procedures.

Thespace

isstill

recovering.2023202220212020$30M$8M$319M$321M$229M$348M$283M$133M$255M$25M$7M$174M$413M$334M$304M$82M$95MInvestorsappear

tobeshiftingattentionfromnewearly-stage

dealstoward

portfoliopreservationtohelpexistingcompaniesensure

theyhaveenough

cash

tohitmeaningful

clinicalmilestones.

Investorappetitefor

early-stage

technology

withlongroads

tocommercialization/payerreimbursement

may

belowered,as

we

are

inarguably

themost

difficultfundraising

time

and

R&Dcosts

aren’t

lowering.Inour

mid-yearupdate,

we

noteddevice

companiesare

facing

increased

challengessellingdevicestohospitals.

Thisremains

true

as

providersfacemountingcostpressures,

drivingdevice

companiestopivotfrom“value”

to“willingnesstopay,”as

theirtechnologymust

haveclearerpaths

tomonetization.$219M$224M$173M$27M$1