Fairness opinionsMedical Devices and Supplies2024

Axonics acquired by Boston Scientific: fairness opinion by J.P. Morgan

Announced January 8, 2024 · One-step merger · All cash · DEFM14A filed February 22, 2024
Medical Devices and Supplies Medical Devices
Enterprise value
$3.4B
equity $3.7B
EV / LTM EBITDA
68.0x
EBITDA $50.0M · 14% margin
EV / LTM revenue
9.29x
revenue $366M
DCF discount rate
9.5%–11.0%
Perpetuity growth

Deal terms

ConsiderationAll cash
Price per share$71.00
Premium
Premium basisclosing price of $57.57 on January 5, 2024 (last unaffected trading day)
StructureOne-step merger
Termination fee$75.0M (2.0% of equity)
Reverse termination fee$140M
Go-shopNone
Outside date

Implied value per share by method vs. $71.00 offer

Selected companies — FV / 2024E Revenue $44.00 – $77.50
Precedent transactions — FV / LTM Revenue $41.50 – $83.25
Precedent transactions — FV / NTM Revenue $44.00 – $81.75
Discounted cash flow $44.25 – $75.25
52-Week Historical Trading Range $47.99 – $67.34
Analyst Price Targets $49.50 – $71.25
Present Value of Future Share Price Analysis $61.95 – $69.12

Ranges as disclosed in the banker’s summary of analyses; the red line marks the per-share consideration.

Opinion of J.P. Morgan to the target board

Delivered January 6, 2024 · Fee $40.4M ($37.4M contingent on closing), $3.0M on delivery of the opinion

Discounted cash flow assumptions

Discount rate9.5%–11.0%
Basisweighted average cost of capital of Axonics
Terminal valuePerpetuity growth
Perpetuity growth4.3%–5.8%
Exit multiple
Projection period2023E-2028E
Projections usedAxonics management Forecasts (unlevered free cash flow less stock-based compensation, calculated by J.P. Morgan and approved by management)
Implied value per share$44.25–$75.25

Discounted to present value as of December 31, 2023; adjusted for estimated 2023 year-end cash and present value of net operating losses and other tax assets. Perpetual growth rate based on guidance provided by Axonics management.

Selected public companies (9)

Insulet Corporation · Penumbra Inc. · Shockwave Medical, Inc. · Inspire Medical Systems Inc. · Inari Medical Inc. · Irhythm Technologies Inc. · Alphatec Holdings Inc. · Vericel Corp. · Paragon 28, Inc.

MultiplePeer lowPeer medianPeer highRange appliedImplied per share
FV / 2024E Revenue 4.3x–8.3x $44.00–$77.50

Selected precedent transactions (10)

DateTargetAcquirerMultiple
2023-07Kerecis LLCColoplast AS
2021-10Baylis Medical Company Inc.Boston Scientific Corporation
2021-08Intersect ENT, Inc.Medtronic PLC
2021-03Lumenis Ltd.Boston Scientific Corporation
2020-11BioTelemetry, Inc.Koninklijke Philips N.V.
2018-08K2M Group Holdings, Inc.Stryker Corp
2017-06The Spectranetics CorporationKoninklijke Philips N.V.
2017-02ZELTIQ Aesthetics, IncAllergan plc
2016-06LDR Holding CorporationZimmer Biomet Holdings, Inc.
2013-04Conceptus, Inc.Bayer HealthCare LLC
MultipleLowMedianHighRange appliedImplied per share
FV / LTM Revenue 4.9x–10.8x $41.50–$83.25
FV / NTM Revenue 4.3x–8.8x $44.00–$81.75

Other analyses

AnalysisSummaryImplied per share
52-Week Historical Trading Range52-week range of closing prices for period ending January 5, 2024; reference only, not a component of fairness analysis.$47.99–$67.34
Analyst Price TargetsFourteen publicly available equity research analyst price targets as of January 5, 2024 ranged $55.00-$79.00; discounted back to December 31, 2023 at an 11% cost of equity gave $49.50-$71.25. Reference only.$49.50–$71.25
Present Value of Future Share Price AnalysisImplied future share prices as of December 2024, 2025 and 2026 using forward firm value on NTM revenue and 30-day average revenue multiples, discounted to December 31, 2023 at 11% cost of equity: $61.95 (Dec 2024), $65.99 (Dec 2025), $69.12 (Dec 2026). Reference only.$61.95–$69.12

Approximately $40.4 million total; $3.0 million payable upon delivery of opinion, remainder contingent on consummation. Break-up fee equal to 15% of any payment received by Axonics following termination, capped at $40.4 million. Aggregate fees recognized by J.P. Morgan in prior two years: $0 from Axonics, approximately $2.2 million from Boston Scientific.

3,000+ healthcare deal-level valuation multiples
The Valuation database includes financial details for more than 3,000 healthcare M&A transactions, private and public, with deal-level multiples, categorized by segment, type, and year.
See the Valuation database →

Management projections

Projection yearYear 1Year 2Year 3Year 4Year 5CAGR
Revenue$442M$530M$623M$717M$824M16.8%
Revenue growth20.8%19.9%17.5%15.1%14.9%
EBITDA$72.0M$80.0M$124M$173M$238M34.8%
EBITDA growth44.0%11.1%55.0%39.5%37.6%
EBITDA margin16%15%20%24%29%
Implied EV / EBITDA47.2x42.5x27.4x19.7x14.3x

Year-1 growth is against LTM at announcement ($366M revenue, $50.0M EBITDA); later years are year over year.

Axonics management prepared standalone, non-public Forecasts for fiscal years 2023E through 2028E, which the Board directed J.P. Morgan to use. Revenue grows from $366 million in 2023E to $824 million in 2028E, with gross profit of $271 million (74.8% margin) rising to $635 million (77.0% margin) and Adjusted EBITDA from $50 million to $238 million. Unlevered free cash flow (calculated by J.P. Morgan from the Forecasts and approved by management) moves from $(22) million in 2023E to $104 million in 2028E.

Process notes

Single fairness opinion from J.P. Morgan delivered orally on January 6, 2024 and confirmed in writing the same date to the Axonics Board of Directors; no special committee. Merger Agreement dated January 8, 2024. Termination fees were heavily negotiated (Axonics fee settled at $75 million, ~2.03% of ~$3.7 billion implied equity value; Boston Scientific reverse fee at $140 million, ~3.8% of equity value, tied to failure to obtain antitrust clearances). J.P. Morgan had prior commercial/investment banking relationships with Boston Scientific (~$2.2 million of fees over prior two years) and none with Axonics. Public Trading Multiples, Selected Transaction and DCF analyses were the fairness components; 52-week range, analyst price targets and present value of future share price were reference only.

Other Medical Devices and Supplies fairness opinions

All Medical Devices and Supplies opinions → · J.P. Morgan opinions