HC Banks
What are the good HC-focused banks?
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Been discussed at length on these forums. Use the search function.
Was hoping for an updated perspective
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Leerink
Damn I hate to do this, but I guess I can try my hand at a ranking.
Tier 1) CVP HC (the rest of the list is only HC-focused boutiques, but CVP HC is so strong right now that I feel they have to be included).
Tier 2) Leerink, MTS, Cain Brothers
Tier 3) Torreya, Edgemont, TripleTree (these guys might be T2, tbh)
Tier 4) HC Wainwright, Ziegler (pretty sure they focus on healthcare public finance), Berkery Noyes, Brentwood
I'm only a 2nd year analyst, so take it with a grain of salt.
Good list. Would probably bump TT to Tier 2. These guys absolutely kill it in HCIT. Only downside is their main office is in MN.
CVP Biotech eats up almost all deal flow in the $2-10 billion range. They poached some known CS rainmakers awhile back who have been getting them on huge deals in HC services too.
Leerink is stronger and on a better trajectory than cain and MTS. Would throw Jefferies and Gugg a notch above Leerink but of course below CVP.
I’m aware jef/gugg aren’t HC specific but still are important players in the huge MM/UMM HC landscape
I almost added JEF to T2 but chose against it since OP wanted a list of HC-specific firms - but you're right. The majority of non-blockbuster HC deals pretty much runs through T2 + JEF + Gugg.
Until their transactions at Leerink show a ton of M&A deal besides IPO/financing - I'd say they're in the correct place.
H.C. wainwright has been growing could def be tier 2 soon.
Calm down, they’re agents on half their ECM deals.
their deal size is growing tho and they have been doing a lot more bought deals
They aren't even in the same universe as the others on the list. Being a co-manager for a shitty ECM deal isn't impressive and the work sucks.
It’s Blair and TT that clean up a large majority of the activity in HCIT. Multiples being paid on some of these deals in the past couple of years are almost unbelievable.
How do you see Cain in HCIT?
Mostly see them on the services side. You can scroll the tombstones on both websites.
Can only really speak to the Biopharma vertical but I’ll take a crack. I see it this way:
OP is asking more about HC boutiques.
Deutsche Bank is on the come up
Any insight on Tools/DX vertical players?
I assume you mean medical devices? If so Guggenheim has the best MedTech group on the street.
If you're talking wearable technology/diagnostics? Hard to say since it can fall under TMT umbrella (Qatalyst was on the Google/Fitbit deal and technically Fitbit does fall under HCIT). If you're talking about telemedicine/HCIT, Blair and TT dominate the middle market as mentioned above by another poster. Lazard has to be also mentioned in the conversation, they seem to have a strong relationship with Teladoc. Helped them buy two companies, inTouch Health for I believe ~$600M and helped them merge with Livongo on a $18+ billion deal (honestly surprising how little love Lazard HC gets on here vs other EBs). This market IMO is going to be huge in 5-10 years but as of now in it's infancy, hard to determine a true leader in the vertical since 95%+ of the HCIT companies out there are likely valued in the middle market range ($150-800 million range I'd say).
Are like SomaLogic, Invitae, PacBio and 10x genomics considered medtech? I think tools and diagnostics is like a vertical within medtech but I dont think Guggenheim is doing those but more traditional medical devices.
Less insight on this but I've heard PWP does pretty well in med devices
As mentioned, CVP absolutely kills it (although they are not only HC focused). The other big players are JPM, MS, GS (not purely HC focused though). Those four firms basically dominate the entire large cap healthcare space across all products.
After those four, there’s a fairly sizable drop and then you have Evercore, Lazard and Jefferies. They’re occasionally on large cap stuff, but not as common as prior four.
After that you have another pretty big drop and have MTS Partners, Leerink, and HC Wainwright. These are basically HC only and focused on LMM space. Leerink is pretty heavy on biotech and does surprising amount of capital markets.
Most of $1Bn+ HC seems to be dominated by a few firms. CVP kills it in advisory. JPM/MS/GS are active across all products given advisory expertise and balance sheet.
It’s actually JPM, GS, MS, BofA, Jeff, then CVP.
JPM/MS/GS are pretty interchangeable. Usually one of them will be top on any given year in M&A and equity. GS/MS aren’t as aggressive on debt. Don't think JPM is consistently top anymore. I want to say they lost an important banker. The team at JPM is also substantially larger than the other two.
Only put CVP high up because they are on mega cap pharma deals consistently and punch above their weight.
Where does Cain Brothers fit into this?
Dominate the middle market HC services and very well respected (I work at one of their client's and our CEO who doesn't really like bankers, trusts them). Listen to a few of the MDs interviews and they're extremely knowledgeable. A lot of university hospitals M&A go through them so it's obvious academic clients trust them (which in healthcare, I think is pretty tough to do as an outsider).
Their DCM capabilities also help them get a solid amount of deal flow when M&A is slow. HCIT business is up and coming.
I would say it's hard to compare them to the other banks discussed. It's more comparable IMO to other MM HC banks.
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