The relative absence of blockbuster M&A within medtech in 2018, compared with recent years, does not mean that consolidation of the industry – and of providers and payers – will not continue apace in 2019 and beyond. In fact, it is written – if not in the stars then possibly in digital coding – that there will be fewer and bigger entities at the top end of the ecosystem of medtech stakeholders. And rising demand will be met more and more by digital tools and functionalities.

The relative absence of blockbuster M&A within medtech in 2018, compared with recent years, does not mean that consolidation of the industry – and of providers and payers – will not continue apace in 2019 and beyond. In fact, it is written – if not in the stars then possibly in digital coding – that there will be fewer and bigger entities at the top end of the ecosystem of medtech stakeholders. And rising demand will be met more and more by digital tools and functionalities.

2016 was a year of surprise and change in political circles, but that's nothing new for the medtech industry, which over a number of years has become accustomed to health care systems demanding different and ever-higher levels of service. Smart medtechs have been ahead of the curve, but the whole industry now factors in clients' wider needs in a holistic approach to patient care. Many companies' current M&A policies are already reflecting the changes to come.

Pfizer signed multiple billion-dollar deals, including buying AstraZeneca's anti-infectives portfolio for $1.6 billion and acquiring Medivation – and the blockbuster cancer drug Xtandi – for $14 billion. Follow-on public offerings accounted for 52% of both biopharma and device financing.