The gene therapy specialist's CEO Sheila Mikhail tells Scrip she is excited to be getting access to the German group's late-stage clinical and operational expertise while keeping AskBio's entrepreneurial culture and carrying on as an autonomous company on an arm’s-length basis.

Stryker is acquiring rival Wright Medical in a $4bn deal catapulting the company to a top position in the trauma and extremities market. The agreement, announced on 4 November, is Stryker’s biggest acquisition this year.

Reported sales and earnings from the big publicly traded orthopedics device companies showed mostly slow growth in 2018, but NuVasive and Stryker reported high single-digit growth while, Smith & Nephew grew in the low single-digits, fueling reports that Smith & Nephew may try to buy NuVasive.

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.