Strategic HealthTech Buyers Going Global: A New Era of Cross-Border M&A

Nelson Advisors
Aug 27
16 min read

Updated: Aug 28

Strategic HealthTech Buyers Going Global: A New Era of Cross-Border M&A

Executive Summary

The global HealthTech landscape is undergoing a profound structural transformation. A confluence of economic headwinds in mature markets, particularly in North America and a recalibration of investor sentiment away from speculative growth has positioned cross-border mergers and acquisitions (M&A) as the primary engine of strategic growth and liquidity.

This report presents a detailed analysis of this new paradigm, arguing that strategic buyers, from big Pharma and health systems to private equity firms, are leveraging M&A to acquire disruptive technologies, access new patient populations and consolidate market share. This shift is not merely cyclical; it represents a fundamental maturation of the sector, where M&A has supplanted the initial public offering (IPO) as the dominant exit strategy.

The analysis will reveal that while deal volume and values are on the rise, success is contingent on navigating a complex web of regulatory, cultural and operational challenges inherent in global transactions.

The report concludes with a strategic blueprint for both acquirers and startups to capitalise on this trend, emphasising that the future of HealthTech is global and its success will be defined by the skill and foresight of market participants.

The Catalysts for a Global Shift in HealthTech M&A

The current surge in cross-border HealthTech M&A is not an isolated event but rather the logical outcome of a series of market corrections and strategic recalibrations that have unfolded since the peak of the pandemic. This section establishes the foundational economic and market conditions that have driven a fundamental shift in investment and exit strategies.

The Post-Pandemic Correction: Slower Domestic Growth and Investor Re-evaluation

The COVID-19 pandemic acted as a powerful accelerant for the HealthTech industry, with the sector experiencing what many referred to as a "10-year growth in 10 months". This period saw a massive influx of capital, with HealthTech funding surging from $16 Billion in 2020 to an unprecedented $62.5 Billion in 2021.This funding boom, however, created an overheated market where valuations often became disconnected from operational fundamentals, fueled by a "growth-at-all-costs" mindset.

The market began to rebalance in 2022 and 2023. A combination of persistent inflation, elevated interest rates, global geopolitical events and supply chain disruptions introduced significant uncertainty. This turbulence caused a sharp drop in investment activity and a significant contraction in valuations, with the inflated figures of 2021 continuing to "loom over the market". Simultaneously, the public market became increasingly volatile, effectively closing the IPO window for many HealthTech startups. In response, investors and venture capital firms began to shift their strategies. The new focus was not on speculative growth but on companies with "strong operational and financial fundamentals" and a clear path to profitability. This change in priorities signalled a move from higher-volume, smaller funding rounds in early-stage entities toward fewer, larger investments in more mature, expansion-stage organisations with proven business models. This created a bifurcated market where weaker players, unable to achieve profitability, were left exposed and susceptible to acquisition at distressed valuations, while high-quality businesses with novel solutions continued to attract capital.

The Rise of M&A as the Dominant Liquidity Mechanism

As the IPO market ceased to function as a reliable exit avenue, M&A emerged as the primary mechanism for liquidity and consolidation. This trend is not merely anecdotal; it is quantified by a demonstrable rebound in deal volume and value. In the first half of 2025, there were 277 M&A deals in the HealthTech sector, placing the market on a trajectory to surpass the 467 total deals of 2024. Similarly, disclosed deal values were on a growth path, reaching $10.3 Billion in the first half of 2025 and on pace to exceed the 2024 total of $19.2 Billion. This activity has provided a welcome relief for venture investors, as M&A values in 2025 have surpassed previous peaks, signalling a more confident deal-making environment.

This M&A surge is driven by a combination of factors, including strategic consolidation within the healthcare industry, rapid technological advancements, evolving regulatory landscapes, and a significant amount of "dry powder" from private equity firms looking to deploy capital.

The transition from IPOs to M&A as the dominant exit strategy marks a profound structural shift, signifying a fundamental maturation of the market. IPOs are typically reserved for high-multiple, high-risk growth stories, while M&A, particularly by strategic and financial buyers, is more focused on tangible synergies, proven revenue streams and the consolidation of fragmented markets.

This indicates that the HealthTech ecosystem is moving away from being a collection of disparate "point solutions" and is consolidating into integrated, scalable platforms. As a result, startups are now incentivised to build for an M&A exit from inception, with a focus on profitability, operational efficiency, and seamless integration, rather than simply on user growth.

The Global Context: Disparate Market Maturity and the Search for Growth

While the North American market has experienced a significant slowdown, the global landscape presents a more complex picture. Deal-making activity is not uniform across continents; rather, it is characterised by disparate stages of market maturity. Europe, for example, saw a resurgence in digital health funding in 2024, reaching $3.5 Billion, a 19% year-over-year increase in the third quarter alone. This trend, particularly pronounced in the UK, Germany, and France, reflects a renewed investor confidence in the region.

Similarly, M&A activity in Asia rebounded in 2024, with the region recording the most insurance mergers and acquisitions globally.This was driven in part by regulatory changes in India that facilitated increased foreign investment. Africa also saw a significant rise in both deal volume and value, with a 468% increase in deal value from 2023 to 2024. This global rebalancing suggests that acquirers, particularly those from mature domestic markets, are increasingly looking to tap into more dynamic or less saturated regions. For large corporations facing slower growth at home, cross-border M&A provides a direct and efficient pathway to new customer bases, diverse revenue streams, and fresh opportunities for growth.

The Strategic Rationale: Why Corporates are Going Global

The decision by strategic buyers to pursue cross-border M&A is driven by a clear set of strategic imperatives that extend beyond simple financial consolidation. This section explores the core motivations compelling large corporations to seek acquisitions beyond their home markets.

Accessing Disruptive Technology and Talent: The AI Imperative

A primary driver for cross-border acquisitions is the desire to acquire disruptive technology and proprietary intellectual property. Strategic buyers are not merely seeking to expand their portfolios; they are looking to gain a competitive edge by integrating innovative solutions that can fundamentally transform healthcare delivery and patient outcomes.

Artificial intelligence (AI) is at the forefront of this trend. Acquirers are no longer merely experimenting with AI; they are actively acquiring companies with "proven, working technology" to accelerate their own capabilities. Examples of this include Tempus AI's acquisition of digital pathology leader Paige, a deal focused on leveraging AI for precision medicine. Similarly, the increasing venture capital channeled into AI-native companies like Ambience Healthcare and Carlsmed suggests that these clinical AI platforms are becoming a prime class for future M&A targets.

Beyond technology, these deals are also a direct route to acquiring valuable talent and expertise.HealthTech startups often attract and retain highly skilled professionals with the knowledge and passion to create impactful solutions. By acquiring these companies, larger firms can quickly access a new talent pool, enhance their R&D capabilities, and foster a culture of innovation that may be difficult to cultivate internally.

Geographic Market Expansion and Risk Diversification

Expanding into new geographic markets is a key driver of cross-border M&A. Acquiring an overseas company provides a strategic shortcut to a broader customer base, allowing buyers to bypass the significant time and cost involved in building a local presence from the ground up. This approach helps mitigate over-dependence on a single domestic market and diversifies revenue streams, offsetting the risks of economic downturns, regulatory shifts, or political instability in any one country.

A notable example of this strategy is Teladoc Health's acquisition of Telecare, an Australian company specialising in virtual healthcare delivery. The motivation for this acquisition was explicitly to strengthen Teladoc Health's presence in the Australian market and expand its international footprint.

Securing Category Leadership and Filling "Patent Cliff" Gaps

Large pharmaceutical and medtech companies are actively using M&A to secure category leadership and optimise their portfolios. The "string of pearls" strategy is particularly prevalent, where large players acquire a series of smaller, innovative companies to fill pipeline gaps, enhance their core platforms, and hedge against the financial risks posed by upcoming patent cliffs.

This trend is most evident in the biopharmaceutical sector, where companies are targeting innovative late-stage biotech firms to reposition their portfolios for growth.

High-value transactions like Novo Holdings' acquisition of Catalent and Sanofi's acquisition of Blueprint Medicines are examples of this strategic approach, aimed at securing growth pipelines in high-demand therapeutic areas such as oncology, rare diseases, and immunology. For traditional healthcare incumbents, M&A is becoming a critical tool to counter not just financial volatility, but fundamental shifts in the healthcare value chain. As new delivery models emerge, these companies are leveraging M&A to fast-track their digital transformation, gaining efficiencies and expanding their capabilities beyond traditional business models.

This represents a broader industry-wide re-platforming, where the core business is no longer just drug discovery or hospital management but also includes leveraging data, AI, and patient engagement platforms to improve outcomes and reduce costs.

High Demand HealthTech Segments and Premium Valuations

The flight to quality in the HealthTech market has led to a clear bifurcation, with certain sub sectors and technological capabilities commanding premium valuations. This section details the specific segments that are most attractive to strategic and financial buyers and the financial metrics driving acquisition decisions.

The Primacy of AI and Advanced Analytics

Artificial intelligence is a dominant force in HealthTech M&A, driving the highest valuations in the market.Acquirers are paying a premium for companies with proprietary AI algorithms, especially in areas like diagnostics, drug discovery, and predictive analytics. The strategic rationale is clear: AI-native platforms offer a competitive edge by improving patient care, enhancing diagnostics, and increasing operational efficiency.The acquisition of Paige, an AI company specialising in digital pathology, by Tempus AI, a technology firm focused on precision medicine, exemplifies this trend.

Advanced data analytics providers are also hot M&A targets due to the critical need for secure, interoperable data platforms in a consolidating market.

Datavant's acquisition of Ontellus, a provider of health records retrieval, was driven by the objective of creating an integrated platform to securely connect health records to those who need them. This focus on data-driven capabilities is paramount for strategic buyers who are modernising their operations and seeking to comply with complex regulatory requirements.

Digital Therapeutics, Telehealth and Patient-Centric Platforms

The post-pandemic telehealth boom has matured, leading to a new generation of hybrid health platforms that combine virtual and in-person care. While the direct-to-consumer market has faced challenges, the business-to-business (B2B) segment remains strong as established players seek to protect their market position and develop their digital offerings.

This has resulted in a wave of consolidation. Notable examples include the acquisition of Livongo by Teladoc Health, a deal driven by the complementary nature of their offerings and a shared mission to empower patients. The merger of EVERSANA and Waltz Health is another instance of companies consolidating to create unified platforms that redefine pharmaceutical commercialisation and patient access. These deals reflect the broader industry shift from fragmented point solutions to scaled, integrated platforms that provide a comprehensive continuum of care.

The Consolidation of Health Systems and Healthcare Services

The healthcare services sector is experiencing a significant surge in consolidation, often driven by financial distress. The post-pandemic reality check has left many startups, fueled by cheap capital and telehealth hype, struggling to achieve profitability. This has turbo-charged distressed M&A activity, with deals involving distressed parties rising significantly. Strategic buyers, including private equity (PE) firms and larger healthcare organisations, are capitalising on this buyer's market to acquire weakened firms at "bargain-basement valuations".

This trend is not isolated to the US; it is also reshaping the UK HealthTech ecosystem, concentrating power in fewer, stronger hands. The merger of hospital systems like Northwell Health and Nuvance Health illustrates the push for streamlined workflows, reduced redundancies and the creation of larger, more efficient healthcare platforms.

Key Financial Metrics Driving Acquisition Decisions

The M&A market in 2025 is defined by a "flight to quality," where companies with strong fundamentals are highly sought after. Buyers are paying a premium for specific attributes that promise future growth and efficiency gains. These include high gross margins, a high percentage of recurring revenue from subscriptions or long-term contracts, and established intellectual property (IP) portfolios. The average enterprise value (EV) to revenue multiple for most HealthTech companies is between 4-6x ARR.

However, those companies with proprietary AI algorithms and advanced analytics capabilities are commanding premium valuations, often reaching 6-8x ARR or more. For companies with positive earnings, the EV to EBITDA multiples have seen a slight increase from 2024, ranging from 10-14x, reflecting a cautious optimism in the market. This focus on profitability and proven business models underscores a new reality for startups: the ultimate value of their company will be determined not by their speculative growth story, but by their ability to demonstrate tangible, repeatable value for an acquirer.

Global M&A in Action: Case Studies and Regional Flows

The trends and strategic rationales discussed are exemplified by a series of high-value cross-border transactions that have defined the market in 2024 and 2025. This section provides a detailed overview of these notable deals, highlighting the key players and their motivations, and also examines the pivotal role of private equity.

Cross-Continental Deal Highlights

The globalisation of HealthTech M&A is evident in recent deals that span continents, driven by the strategic motives of both traditional and non-traditional acquirers.

Johnson & Johnson (US) and Numab Therapeutics (Switzerland): In a deal announced in May 2024, Johnson & Johnson acquired Numab Therapeutics for $1.25 billion in cash. The primary driver for this transaction was the acquisition of Numab's lead asset, an IL-4Ra antagonist for atopic dermatitis, which strengthens J&J's drug development pipeline in a key therapeutic area. This exemplifies the "string of pearls" strategy, where large pharmaceutical players acquire innovative, late-stage biotech companies to fill pipeline gaps.
AstraZeneca (UK) and Amolyt Pharma (France): In March 2024, AstraZeneca announced its acquisition of France-based Amolyt Pharma for an upfront payment of $800 Million and a contingent payment of up to $250 million. This cross-border deal was motivated by AstraZeneca's desire to secure a promising parathyroid hormone receptor 1 agonist for hypoparathyroidism, further expanding its portfolio in rare diseases.
Teladoc Health (US) and Telecare (Australia): Teladoc Health acquired Australian-based Telecare, a technology-enabled company specialising in virtual healthcare delivery. This acquisition, while smaller in scale, demonstrates the strategic imperative of geographic market expansion. Teladoc Health's motivation was to strengthen its presence in the Australian market and extend its service area.
New Mountain Capital (US) and Access Healthcare (India): New Mountain Capital acquired a majority stake in Access Healthcare, an Indian revenue cycle management (RCM) group, for $2 Billion. This transaction highlights the increasing cross-border interest from private equity firms in services-based businesses with proven profitability and scalability, particularly those that can service the US market from a lower-cost location.

The Role of Private Equity and Financial Acquirers

Private equity firms are playing a progressively larger role in the HealthTech M&A market. With a significant amount of "dry powder" and the anticipation of falling interest rates, PE firms are actively seeking opportunities to deploy capital. They are capitalising on the buyer's market by snagging innovative tech at cut rates through distressed M&A, as well as pursuing "buy-and-build" strategies in highly fragmented verticals like behavioural health and medical devices. Examples of PE activity include Clearlake Capital's $5.3 Billion acquisition of ModMed and Bain Capital's $2.6 billion acquisition of HealthEdge.

The globalisation of HealthTech M&A is not just a US-outward phenomenon; it is a multi-directional flow with new regional hubs emerging as both buyers and sellers. While US companies dominate M&A activity, with 60% of acquirers and 80% of targets based there, the data shows increasing activity from European and Asian firms. The renewed investor confidence in Europe and the increased deal volume in Asia suggest that the pool of potential acquirers is expanding, creating more opportunities for exits for startups globally. This new dynamic adds complexity for dealmakers who must now navigate a wider range of regulatory, cultural, and valuation standards.

Notable Cross-Border HealthTech M&A Transactions (2024-2025)

Acquirer	Target	Target Country	Deal Value	Deal Date	Primary Motivation
Johnson & Johnson	Numab Therapeutics	Switzerland	$1.25 billion	May 2024	Access to IP, Pipeline Expansion
AstraZeneca	Amolyt Pharma	France	Up to $1.05 billion	March 2024	Pipeline Expansion, IP Acquisition
Teladoc Health	Telecare	Australia	Not disclosed	August 2025	Geographic Market Expansion
New Mountain Capital	Access Healthcare	India	$2 billion	H1 2025	PE Roll-Up, Access to Services & Talent
KKR & Co.	Cotiviti (50% stake)	US	Not disclosed	February 2024	Financial Investment, Data & Tech
Novartis	Calypso	Netherlands	Up to $425 million	January 2024	Portfolio Expansion
AbbVie	OSE Immunotherapeutics	France	Not disclosed	March 2024	Partnership, R&D Collaboration
Boehringer Ingelheim	Ochre Bio	UK	Not disclosed	October 2024	Partnership, R&D Collaboration

HealthTech Sector Valuation Multiples by Sub-Category (2025)

Sub-Sector	Typical Revenue Multiple (EV/ARR)	Typical EBITDA Multiple (EV/EBITDA)	Key Drivers
AI and Analytics	x6-8+	x12-16+	Proprietary algorithms, proven tech, IP, efficiency gains
RCM (Revenue Cycle Management)	x4-6	x10-14	Operational efficiency, cost reduction, recurring revenue
Digital Therapeutics	x4-6	x10-14	Patient-centric platforms, B2B models, scalability
Telehealth	x4-6	x10-14	B2B solutions, hybrid care models, market consolidation
General HealthTech	x4-6	x10-14	Strong fundamentals, high gross margins, recurring revenue

Overcoming the Hurdles of Cross-Border Integration

While the strategic rationale for global HealthTech M&A is compelling, the success of these transactions is ultimately determined by an acquirer's ability to navigate a complex web of non-financial hurdles. The primary value of a cross-border deal lies not just in the asset being acquired, but in the acquirer's capability to effectively integrate and scale a culturally and regulatory-foreign entity.

Navigating a Fragmented Regulatory and Compliance Landscape

The global regulatory environment for HealthTech is a complex and fragmented maze. Regulators, whose procedures are often geared toward more conventional applications, face a significant challenge in keeping pace with the rapid innovation in digital health. Different jurisdictions have wildly varying standards, from the FDA's approach to Software as a Medical Device (SaMD) in the U.S. to the European Union's CE markings and the General Data Protection Regulation (GDPR). A key challenge for acquirers is ensuring that the target company has a "proven track record of navigating complex regulatory environments," as this reduces risk and speeds up integration.

Data privacy and cybersecurity present a paramount concern. Laws such as HIPAA in the U.S., the California Consumer Privacy Act (CCPA), and Europe's GDPR introduce a multitude of varying requirements for handling sensitive patient information. A merger of incompatible IT systems can leave critical security gaps that are ripe for exploitation by hackers.Due diligence in this area is more challenging across borders due to differences in language, accounting standards, and disclosure norms, which can obscure critical issues.Furthermore, geopolitical and trade policy risks, such as potential tariffs or increased scrutiny on foreign investments in strategic industries, are now being factored into due diligence and deal valuation.

The Critical Challenge of Cultural and Operational Integration

Cultural discord is a leading cause of deal failure. When ignored, differences in communication styles, leadership approaches, and organisational values can lead to a variety of unanticipated consequences, including low employee morale, high turnover, and even patient safety risks. These risks are significantly heightened when traditional healthcare organisations, such as hospitals or pharmaceutical firms, merge with "nontraditional players" like tech startups. The cultural gap between a hierarchical, risk-averse health system and a lean, agile tech startup can be immense, leading to a clash of priorities and working styles.

Operational integration, including the merging of IT infrastructure, business processes, and HR systems, requires meticulous planning to avoid delays and inefficiencies. Without a clear roadmap, the very synergies a deal was meant to achieve can be diminished or even destroyed. The value proposition of a deal is often undermined by these non-financial hurdles, which highlights that the M&A process in HealthTech is fundamentally different from other sectors. The highly regulated nature, patient safety concerns, and sensitive data require an integration strategy that goes beyond simple cost-cutting and focuses on achieving deep, mission-aligned, and compliant operational harmony.

Strategic Recommendations and Forward Outlook

The market correction has set the stage for a new, more sustainable era of HealthTech development driven by M&A. The trend of cross-border deals will accelerate as corporations continue to seek innovative solutions, market expansion, and portfolio optimisation. Success in this environment will be defined by strategic execution and a nuanced understanding of the global landscape.

A Blueprint for Strategic Buyers: Due Diligence, Integration and Value Realisation

To maximise the value of a cross-border HealthTech acquisition, strategic buyers should adopt a multi-layered approach to due diligence and post-merger integration.

Pre-Acquisition: Conduct multi-layered due diligence that extends beyond financial statements to thoroughly assess the target's regulatory compliance, intellectual property, and cultural alignment.Prioritise companies with a "proven track record" in navigating the regulatory environments of their home markets.
During Negotiation: Consider deal structures that retain key management and allow the acquired entity to operate as an independent subsidiary for a defined period. This approach can ease the cultural transition and prevent the loss of critical talent and institutional knowledge.
Post-Merger Integration: Implement a clear and consistent communication plan to address employee anxieties and build trust. Conduct proactive cultural assessments and provide cross-cultural training to help bridge differences in communication and work styles. Focus on a phased integration of IT and operational systems to avoid security vulnerabilities and operational disruption, particularly when merging incompatible data platforms.

Positioning for an Exit: A Guide for HealthTech Startups

In this new M&A-driven market, HealthTech startups should reorient their strategies to become attractive acquisition targets.

Focus on building a business with "strong operational and financial fundamentals" and a "proven business model" rather than on achieving rapid, unfettered growth.
Develop solutions with clear value propositions and a tangible return on investment for strategic buyers, such as demonstrable cost savings or efficiency gains.
Proactively manage and document intellectual property, regulatory compliance, and data security from day one to create a "competitive moat" and reduce risk for potential acquirers. A HIPAA-compliant platform with FDA clearances, for example, is inherently more valuable than one without.
Consider M&A as a primary exit strategy and structure the company to be an attractive target, not just an IPO candidate. This involves building a strong, cohesive team that can be integrated successfully into a larger organisation.

Concluding Outlook: A New Era of HealthTech Globalisation

The global HealthTech market has moved from an era of speculative exuberance to a period of pragmatic consolidation. Slower domestic growth in mature markets, combined with a re-evaluation of investment priorities, has made cross-border M&A the most viable path forward for both corporations seeking growth and startups seeking an exit. The future of HealthTech is global and consolidated, but its success will be defined not by the sheer size of the deals, but by the skill and foresight of acquirers in navigating the complex regulatory, cultural, and operational challenges that lie beyond their borders. This is a period of immense opportunity for those prepared to act strategically and with a nuanced understanding of the new global landscape.

Nelson Advisors > HealthTech and MedTech M&A

Nelson Advisors specialise in mergers, acquisitions and partnerships for Digital Health, HealthTech, Health IT, Consumer HealthTech, Healthcare Cybersecurity, Healthcare AI companies based in the UK, Europe and North America. www.nelsonadvisors.co.uk

Nelson Advisors regularly publish Healthcare Technology thought leadership articles covering market insights, trends, analysis & predictions @ https://www.healthcare.digital

We share our views on the latest Healthcare Technology mergers, acquisitions and partnerships with insights, analysis and predictions in our LinkedIn Newsletter every week, subscribe today! https://lnkd.in/e5hTp_xb

Founders for Founders > We pride ourselves on our DNA as ‘HealthTech entrepreneurs advising HealthTech entrepreneurs.’ Nelson Advisors partner with entrepreneurs, boards and investors to maximise shareholder value and investment returns. www.nelsonadvisors.co.uk

#NelsonAdvisors #HealthTech #DigitalHealth #HealthIT #Cybersecurity #HealthcareAI #ConsumerHealthTech #Mergers #Acquisitions #Partnerships #Growth #Strategy #NHS #UK #Europe #USA #VentureCapital #PrivateEquity #Founders #BuySide #SellSide #Divestitures #Corporate #Portfolio #Optimisation #SeriesA #SeriesB #Founders #SellSide #TechAssets #Fundraising #BuildBuyPartner #GoToMarket #PharmaTech #BioTech #Genomics #MedTech