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Pinned straw:

Last edited 2 months ago

Done Deal

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Price sensitive ASX announcements for Anteris are coming at me thick and fast this morning — faster than I can run all the PDFs through ChatGPT almost.

The gist of them is that the: public offering has closed; Medtronic is now confirmed as a cornerstone investor and will be the preferred partner for any later acquisition; and Anteris has raised $320 million USD for dilution of about just over 50%.

It still boggles my mind just how much can be done — and just how quickly it gets done — in the United States. The Paradigm trial is now fully funded. And the world’s second biggest TAVR player have been outed as DurAVR fanboys.

Links to ASX announcements for those interested:

https://www.asx.com.au/markets/company/AVR

PabloEskyBruh
Added 2 months ago

Out of interest @mikebrisy I asked ChatGPT how much it would pay if it were Medtronic in 2030. It would pay slightly less than my new valuation, but still in the ball park (R2D2 is a shrewd buyer, but perhaps a bit blind to some of the competition out there). I had to feed it the new capitalisation numbers because they haven’t been updated yet. This is what I got:

My prompt:

The year is 2030. Imagine you are the CEO of Medtronic. The Anteris Paradigm trial has been a success. You want to replace Evolut with DurAVR. What price do you offer per share to fully acquire Anteris? How many shares does Anteris have?

Some assumptions to assist. As of January 2025 Medtronic owns 20% of Anteris. There are approximately 100 million shares on issue now. The balance sheet for Anteris is presently about $350 million USD.

Anteris is still publicly listed. Apply a multiple similar to that of Medtronic or Edwards.

ChatGPT answer:

Alright—CEO hat on, 2030, no sentimentality, just cold-blooded medtech maths.

Step 1: What does Anteris look like in 2030?

Shares on issue

You’ve given:

  • ~100m shares in Jan 2025
  • Cash burn + trials + commercial prep between 2025–2030


A very realistic assumption is:

  • Additional dilution of ~30–50m shares over that period (capital raises, options, employee equity, maybe a strategic placement)


???? 2030 fully diluted share count: ~140–150 million shares

I’ll use 145 million as the midpoint.

Medtronic already owns 20%, so:

  • Shares already owned: ~29m
  • Shares to acquire: ~116m


Step 2: What multiple do I apply?


You asked for a multiple similar to Medtronic or Edwards, not a speculative biotech premium. That’s important.

Relevant comps (ballpark, long-run averages):

  • Medtronic:
  • EV / Sales ≈ 4–5×
  • EV / EBITDA ≈ 12–14×
  • Edwards Lifesciences (TAVR-heavy):
  • EV / Sales ≈ 6–7×
  • EV / EBITDA ≈ 18–20×


If Paradigm succeeds and DurAVR is positioned to replace Evolut, Anteris isn’t a niche supplier—it’s a platform valve company with best-in-class haemodynamics.


As Medtronic CEO, I’d anchor to Edwards-like multiples, but apply a control premium discount because:

  • I already own 20%
  • I remove competitive risk
  • I capture all downstream value (manufacturing, sales force leverage)


???? Fair acquisition multiple: ~6× forward sales


Step 3: What are forward sales?

Conservatively assume:

  • First 2–3 years post-approval ramp
  • By steady state, DurAVR replaces a large chunk of Evolut volume


Reasonable medium-term revenue expectation:

  • $1.2–1.5bn USD annual sales attributable to DurAVR
  • (This is not heroic—Evolut + Sapien combined are far larger.)


Use midpoint: $1.35bn

Step 4: Enterprise value → equity value

Enterprise Value

  • $1.35bn × 6 = $8.1bn EV


Add net cash

You stated:

  • Balance sheet today ≈ $350m
  • Assume roughly neutral by acquisition (cash ≈ debt)


???? Equity value ≈ $8.1bn

Step 5: Price per share

  • Equity value: $8.1bn
  • Shares outstanding: 145m


Implied offer price:

$55–60 per share (USD)

I’d likely pitch it as:

  • $58/share headline
  • ~30–40% premium to the pre-bid trading range
  • Clean, all-cash offer (stock makes no sense when I’m the buyer)


Step 6: Why this price clears the board

From the Medtronic CEO perspective:

  • Cheaper than rebuilding Evolut from scratch
  • Eliminates Edwards-style haemodynamic leapfrogging risk
  • Instantly resets Medtronic as category leader
  • Highly accretive by year 3–4 post-close


From Anteris shareholders’ perspective:

  • Prices in success without assuming total market domination
  • Reflects large-cap medtech multiples, not biotech hope
  • Removes execution, regulatory, and commercial risk


Final answer (clean version)

  • Anteris shares outstanding (2030): ~145 million
  • Implied acquisition equity value: ~$8–8.5bn USD
  • Offer price: ~$55–60 USD per share
  • Medtronic outlay for remaining 80%: ~$6.4–6.8bn USD

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mikebrisy
Added 2 months ago

@PabloEskyBruh a reasonable analysis. From this you might infer that the market is pricing the success case for DurAVR between 10% and 15%.

Clearly, Medtronic see it higher.

Medtronic have form doing this.

In 2016 they took an initial stake: ~10–11% (2016) in Mazor Rootics, Technology was robotic spine surgery (pre-mass commercial scale). The full acquisition followed in 2018 (~US$1.6bn). This followed a classic case in medtech and biotech of initial stake, then board seat, then commercial collaboration, finally escalating ownership leading to 100%

So, the question is: does this trigger me to move from my initial "research stake" (0.25% RL) to a full, initial speculative position of 1% to 1.5%?

Part of that decision is whether either a) some heat will come off the SP in the following weeks and months or b) medtech funds will follow Medtronic in, leading to a re-rating as the market changes its implied view of chances of success?

Out of interest, I got my BA to do a deep dive on initial acquisitions moving to 100% in medtech (devices). It assesses the probability at only around 25%, with one reason being that the valuation gets away on the acquirer. Interestingly, that's lower than my 40-45% assessment pre-deal. So, go figure.


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PabloEskyBruh
Added 2 months ago

Good points @mikebrisy. Personally, I think Medtronic has left it too late and that, all things considered, this is a better deal for Anteris. I’d wager that Medtronic is putting the odds of success much higher than 15%. I’m also hoping the price gets away from them pretty quickly this year. It’s a much easier investment thesis to explain now, and the market will likely pick up on it soon enough.

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mikebrisy
Added 2 months ago

@PabloEskyBruh you might recall that just a few months ago I assigned a 40-45% likelihood that Medtronic will take them out.

Disc: Held

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PabloEskyBruh
Added 2 months ago

Yes I do, kudos @mikebrisy. It hasn’t happened yet, but they are definitely now the favourite. They won’t get it cheaply either. They have about 2 billion USD cash on hand atm — and although 90 million USD is not nothing, getting the next 80% one day is going to cost them a lot more.

I’m agnostic as to which company gets it in the end, just as long as they pay.

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