Who are the leading European HealthTech and MedTech M&A Advisors for Venture Capital portfolio companies?

Nelson Advisors
55 minutes ago
14 min read

Executive Summary: The Structural Transformation of the Exit Environment

The European healthcare technology (HealthTech) and medical technology (MedTech) sectors are currently navigating a period of profound structural transformation. The fiscal years 2024 and 2025 have marked a decisive shift from the liquidity-fuelled exuberance of the post-pandemic era to a disciplined, metrics-driven environment characterized as a "flight to quality."

For Venture Capital (VC) firms and the boards of their portfolio companies, this shift has fundamentally altered the exit calculus. The selection of a Mergers and Acquisitions (M&A) advisor is no longer a commoditised decision based on brand prestige; it has become a high-stakes strategic choice that must align with the specific asset class, whether industrial MedTech hardware or AI-driven digital health software and the increasingly complex regulatory architecture of the European Union.

This report provides an analysis of the advisory landscape available to European VC-backed founders. It draws upon extensive market data, deal logs, and industry reports to categorize and evaluate the leading financial advisors. We observe a bifurcation in the market: "Industrial MedTech" assets, valued on EBITDA and supply chain resilience, are gravitating towards mid-market powerhouses like Rothschild & Co and Houlihan Lokey. Conversely, "Digital Health" assets, valued on recurring revenue and algorithmic defensibility, are increasingly served by specialised technology boutiques such as Arma Partners, Clipperton and Nelson Advisors.

Furthermore, the exit environment is being reshaped by macro-regulatory forces. The implementation of the EU AI Act in August 2024 and the forthcoming European Health Data Space (EHDS) have introduced new layers of due diligence. Acquirers are demanding "concentrated value," prioritizing assets that offer immediate, clinically validated operational efficiencies. This has elevated the role of technical due diligence providers like Code & Co to that of quasi-advisors, whose audits of code quality and AI governance can dictate valuation outcomes as significantly as financial metrics.

The following analysis details the capabilities, track records and strategic value propositions of the advisors steering the European health innovation economy.

The Macro-Strategic Environment: Drivers of Valuation and Liquidity (2024–2025)

To understand the positioning of specific M&A advisors, it is essential to first dissect the macroeconomic and sector-specific currents shaping their mandates. The period of 2024–2025 has been defined by a "Selective Recovery," where headline deal values have surged due to mega-cap consolidation, while the lower-middle market, the engine room of VC exits, has faced intense scrutiny regarding profitability and unit economics.

The "Flight to Quality" and the AI Premium

The most significant driver of valuation in the current cycle is the "AI Premium." In a market correcting from the revenue-multiple compression of 2023, capital is aggressively flowing toward "best-in-class" assets that leverage Artificial Intelligence to solve labor shortages and administrative inefficiencies in healthcare.

Analysis of deal activity in late 2024 and early 2025 suggests a bifurcation in valuation multiples. Companies specialising in premium segments, specifically those with proprietary, clinically validated AI algorithms or advanced analytics capabilities are commanding valuations in the range of 6.0x to 8.0x revenue multiples. In contrast, standard HealthTech SaaS platforms, particularly those viewed as "point solutions" rather than comprehensive platforms, are trading in a compressed band of 4.0x to 6.0x revenue.

This valuation gap has profound implications for advisory selection. Selling an AI-native pathology platform requires an advisor capable of articulating complex deep-tech narratives to buyers who may not be traditional healthcare incumbents.

Specialist advisors like Nelson Advisors and Clipperton have built their value proposition around this "translation" capability, helping founders bridge the gap between clinical utility and software scalability metrics.

The Transatlantic Bridge: US Capital as the Primary Liquidity Engine

Despite the resilience of the European innovation ecosystem, the primary source of liquidity for substantial exits remains the United States. US strategic acquirers and private equity firms continue to drive the majority of deal value for European assets. Data from 2024 indicates that approximately 41% of VC exits advised by leading tech-centric firms were sold to US strategic buyers.

This "Transatlantic Bridge" has become a critical selection criterion for M&A advisors. VC boards are increasingly favoring advisors with a physical presence in North America or a proven track record of cross-border execution. This trend was exemplified by the landmark acquisition of the European boutique Bryan, Garnier & Co by Stifel Financial Corp in 2025.This merger was explicitly designed to create a "transatlantic advisory powerhouse," combining Bryan Garnier’s deep roots in the European mid-market healthcare ecosystem with Stifel’s extensive US capital markets reach and equity research platform. For a European VC-backed company, engaging an advisor with this dual footprint offers a streamlined path to NASDAQ listings or sales to US giants like Boston Scientific or Abbott.

Private Equity: The "Buy-and-Build" and "Add-On" Imperative

While strategic M&A grabs headlines, Private Equity (PE) remains the dominant volume driver. PE deal volume in European healthcare reached record highs in 2024, but the nature of this activity has evolved. Rather than purely large-cap platform buyouts, the market is seeing a massive volume of "add-on" acquisitions. Major PE-backed platforms are acquiring smaller, VC-backed innovators to integrate specific technologies or expand into new geographies.

This dynamic favours advisors with deep, legacy relationships in the PE community. Firms like Rothschild & Co and Houlihan Lokey excel at this specific form of "matchmaking." They maintain continuous dialogue with the investment committees of major sponsors like PAI Partners, EQT, and Nordic Capital, allowing them to identify "off-market" exit opportunities for VC portfolio companies that fit the specific strategic needs of a larger platform.

The Regulatory Moat: EU AI Act and EHDS

The regulatory environment in Europe has shifted from a passive backdrop to an active driver of M&A outcomes. The full implementation of the EU AI Act in August 2024 classified many medical AI systems as "High Risk," mandating rigorous governance, data transparency, and human oversight. Simultaneously, the European Health Data Space (EHDS), slated for fuller implementation in 2025, is creating a single market for health data.

For M&A advisors, this creates a new due diligence hurdle. Advisors must now prove not only a target's financial health but its "regulatory sovereignty." Boutique advisors are leveraging compliance as a valuation driver, arguing that a target with a fully compliant AI stack commands a premium because it "de-risks" the acquisition for the buyer. This has led to tighter collaboration between financial advisors and specialized legal/regulatory consultants earlier in the exit process.

2. The Mega-Cap Titans: Architects of Global Consolidation

At the apex of the advisory pyramid sit the "Bulge Bracket" firms. These global institutions are the gatekeepers of the capital markets, essential for multi-billion dollar transformative deals, complex carve-outs, and dual-track IPO processes. For venture capitalists holding stakes in "unicorn" status companies (valuation >$1Bn), these firms provide the necessary balance sheet and global reach.

Goldman Sachs: The Uncontested Value Leader

Goldman Sachs retains its position as the preeminent financial advisor by deal value in Europe. In 2024, the firm advised on approximately $417.8 billion worth of deals across all sectors, maintaining a dominant market share in healthcare transactions valued over $1 billion.

Strategic Focus & Value Proposition: Goldman Sachs is the advisor of choice for "Mega-Deals" involving global pharmaceutical giants or massive cross-border mergers. Their value proposition lies in their unparalleled access to global capital markets, their ability to finance mega-deals through their own merchant banking arms, and their deep connectivity with the C-suites of the Fortune 100. They are less active in the lower-middle market where most early-stage VC exits occur, but they are critical for late-stage exits or IPO planning.
Key Transactional Case Studies (2024–2025):
- Olink Holding ($3.1 Billion): Goldman Sachs acted as a financial advisor to Olink in its acquisition by Thermo Fisher Scientific. This deal exemplifies Goldman's strength in complex cross-border diagnostics deals, navigating the sale of a Swedish-based asset to a US giant. The transaction required navigating complex Swedish takeover rules alongside US securities law, a hallmark of Goldman's cross-border expertise.
- Zeus Health ($3.4 Billion): Advised Zeus, a leading manufacturer of polymer components for medical procedures, on its sale to EQT Private Equity. This transaction highlights their capability in the MedTech supply chain and industrial healthcare segments. Crucially, the Private Credit business within Goldman Sachs Asset Management often serves as a lender in such deals, demonstrating an integrated "one-firm" approach that can grease the wheels of large buyouts.
- Sanofi Consumer Health Separation: Goldman was mandated (alongside Morgan Stanley) to handle the potential separation of Sanofi's consumer health unit, a deal of massive complexity valued potentially at €20 billion. This reinforces their status as the go-to bank for massive corporate restructurings and carve-outs.

J.P. Morgan: The Cross-Border Heavyweight

J.P. Morgan (JPM) consistently ranks alongside Goldman Sachs, often acting as the lead advisor on the largest and most complex transactions. Their healthcare practice is renowned for its depth in life sciences and MedTech, particularly in bridging European innovation with US capital markets.

Strategic Positioning: JPM is particularly strong in complex financing structures and accessing global equity capital markets. For VC-backed companies, JPM is typically engaged when the company reaches a valuation in excess of $500 million or is contemplating a NASDAQ listing alongside a trade sale process. Their deep relationships with US institutional investors make them invaluable for European biotechs and mature healthtech companies seeking transatlantic liquidity.
Notable Involvement: JPM advised on the Shockwave Medical transaction (a $13.1 billion acquisition by Johnson & Johnson), one of the largest MedTech exits of 2024. This deal underscores their ability to execute massive strategic sales in the medical device sector.

2.3 Morgan Stanley: The Private Equity Trusted Partner

Morgan Stanley maintains a top-tier position, particularly in advising on sales to large-cap Private Equity firms. Their "Financial Sponsors" coverage group is widely considered one of the best in the industry.

Key Transaction: Advised EQT Private Equity on the disposal of LimaCorporate to Enovis. This transaction highlights Morgan Stanley's strong relationship with top-tier Private Equity firms looking to exit comprehensive European assets. It also demonstrates their expertise in the orthopedics and implantable device sub-sector.

The Mid-Market Engines: Volume, Ubiquity, and PE Relationships

For the majority of successful European VC-backed HealthTech companies—those exiting between $100 million and $1 billion, the "Mid-Market Global Connectors" are the primary engines of liquidity. These firms combine the sophisticated processes of the bulge bracket with the agility and specific sector focus of boutiques. They are the "workhorses" of the exit market.

Rothschild & Co: The Undisputed Leader by Volume

Rothschild & Co occupies a unique and dominant position in the European advisory landscape. It is consistently ranked #1 by volume, advising on 132 deals in 2024 alone.² Unlike the US-centric bulge bracket banks, Rothschild has a deeply entrenched network of local offices across France, Germany, the UK, Benelux, and the Nordics. This decentralised structure gives them unparalleled access to the "Mittelstand," family-owned businesses, and local private equity ecosystems.

Value Proposition: Rothschild is effectively the "House Bank" for the European mid-market. They excel at "industrial" healthcare deals, clinics, laboratories, CDMOs (Contract Development and Manufacturing Organisations), and medical devices. Their sheer volume of deal flow gives them real-time visibility into buyer behavior that few competitors can match. They are often the first call for Private Equity firms looking to sell a portfolio company.
Key Transaction - ELITechGroup: Rothschild acted as a key advisor to PAI Partners (the seller) in the sale to Bruker (valued at €870 million). This transaction reflects their long-standing relationship with the French private equity ecosystem and their ability to execute sales to US strategic buyers. PAI Partners is a frequent client, illustrating the depth of Rothschild's sponsor relationships.
Relevance to VCs: Rothschild is an ideal partner for VC-backed companies that have reached significant scale (typically EBITDA positive) and are attractive to Private Equity buy-and-build platforms. Their process is rigorous, broad, and designed to maximise competitive tension among financial sponsors.

Houlihan Lokey: The Healthcare Services and MedTech Specialist

Houlihan Lokey has aggressively expanded its European footprint, significantly bolstered by its acquisition of GCA Altium. It has become a dominant force in Healthcare Services, MedTech, and Pharma Services, often competing directly with Rothschild for volume leadership.

Strategic Strength: Houlihan Lokey is noted for its dedicated healthcare teams and expertise in capital-raising and M&A for European medical technology clients. They are particularly strong in the UK and DACH regions. They are consistently ranked #1 for global M&A deal count under $1 billion, making them the definition of a mid-market leader.
The "Meta-Advisory" Role: A testament to their standing in the financial community is that they acted as the sell-side advisor to Bryan, Garnier & Co in its sale to Stifel. When an investment bank specializing in healthcare needs to sell itself, it hires Houlihan Lokey. This speaks volumes about their reputation for execution capability.
Sector Focus: They are a top choice for MedTech outsourcing, contract manufacturing, and pharma services—sectors that are currently seeing high consolidation activity as supply chains reconfigure post-pandemic.
VC Relevance: Their "Capital Markets" group is also highly active in placing growth equity, making them relevant for late-stage VC rounds as well as full exits.

Jefferies: The Pharma Services and Diagnostics Expert

Jefferies has established itself as an aggressive and highly capable advisor, particularly in the Pharma Services and Diagnostics sub-sectors. They operate with a "bulge bracket" attitude but a mid-market agility.

Notable Activity: Jefferies was also involved in the ELITechGroup sale (advising PAI Partners alongside Rothschild), demonstrating their capability in managing exits for major European private equity firms to US strategic buyers. They bridge the gap between the mid-market and the bulge bracket, often taking on deals with slightly higher complexity or cross-border components than pure mid-market firms. They are particularly known for their aggressive sell-side processes and ability to mobilise US buyers.

The Digital Economy Powerhouses: HealthTech as SaaS

A distinct category of advisors views HealthTech not through the lens of traditional healthcare (clinical trials, reimbursement), but through the lens of the "Digital Economy." These firms apply Software-as-a-Service (SaaS) valuation metrics to healthcare assets, often achieving higher multiples by positioning companies as "Tech" rather than "Health."

GP Bullhound: The Unicorn Hunters

GP Bullhound operates as both an advisor and an investor, giving them a unique "Hybrid" model. They focus heavily on Growth and Late Stage companies, particularly those with a B2C or consumer-tech angle.

Strategic Focus: They brand themselves as "Unicorn Hunters." They are particularly strong in B2C Digital Health, capitalising on the intersection of consumer technology and wellness. Their events and research reports are influential in the European tech scene.
Key Transaction: GP Bullhound is noted for its involvement with high-profile "unicorn" rounds, such as Flo Health, which raised $200m from General Atlantic, valuing the company at over $1 Billion. This is a landmark deal for the "FemTech" sector, proving that B2C models can achieve massive exits and establishing GP Bullhound as a leader in consumer-facing healthtech.

The Specialist Boutiques: Domain Expertise and Founder Focus

For early-to-mid-stage VC portfolio companies (Deal size $20M - $250M), the "Mega-Cap" and "Mid-Market" firms may lack the necessary operational empathy or niche technical understanding. This gap is filled by highly specialised boutiques that offer domain-specific expertise and a "high-touch" service model.

Nelson Advisors: The "Founders for Founders" Archetype

Nelson Advisors has carved out a unique and defensible market position as a "Founders for Founders" advisory firm. Unlike traditional investment banks staffed by career financiers, Nelson Advisors is led by individuals who have built, scaled, and exited their own HealthTech ventures.

Key Leadership:
- Lloyd Price (Co-Founder & Partner): A serial entrepreneur who exited Zesty to Induction Healthcare Group. He brings over 25 years of experience and serves as a Health Executive in Residence at UCL Global Business School for Health. His background spans consumer internet (Yahoo) and deep HealthTech, allowing him to translate consumer engagement metrics into healthcare valuations.
- Paul Hemings (Co-Founder & Partner): Combines investment banking background with entrepreneurial exits (e.g., Neutrally).
Strategic Focus: Nelson Advisors specialises in Lower Mid-Market ($25M - $250M) deals. They are particularly adept at navigating Founder-led exits, Digital Health, Health IT, and AI-driven health solutions. Their "Build/Buy/Partner/Sell" strategy is tailored for early VC exits where strategic positioning and narrative building are more critical than pure financial engineering.

The Critical Role of Technical Due Diligence: The "New Advisors"

In the era of AI and complex software stacks, financial due diligence is no longer sufficient. Acquirers are increasingly conducting rigorous Technical Due Diligence (Tech DD) to assess code quality, scalability, and AI compliance. The findings of these audits can kill deals or significantly impact valuation. Consequently, Tech DD providers have become critical "advisors" in the M&A process.

7.1 Code & Co

Code & Co has emerged as a specialized partner for Tech and Product Due Diligence. While not an M&A lead advisor (they don't negotiate the deal price), they are a critical enabler of the transaction

Role: They work alongside financial advisors to audit the target's technology. For a VC-backed HealthTech company, a clean "bill of health" from Code & Co regarding their software architecture, code quality ("technical debt"), and AI governance can be a significant valuation driver.²⁹
Relevance: As the EU AI Act classifies many HealthTech systems as "High Risk," the independent verification of AI models provided by firms like Code & Co helps mitigate regulatory risk for buyers, thereby preventing "price chips" (reductions) during the closing phase. They advise on over 650 deals and work with leading PE funds.

Black Duck (formerly Synopsys Software Integrity Group)

Black Duck specialises in Open Source and Security audits.

Role: In M&A, their primary role is to identify Intellectual Property (IP) risks, such as the presence of "copyleft" open-source code that could force a proprietary software product to be open-sourced. They also scan for security vulnerabilities. For HealthTech companies handling sensitive patient data (GDPR/HIPAA), a Black Duck audit is often a mandatory requirement from US acquirers.

The Venture Capital Perspective: Mapping Funds to Advisors

The choice of advisor is often influenced by the VC investors on the cap table. Different VCs have different exit preferences and relationships.

Life Science Specialists (Sofinnova, Forbion, Medicxi): These funds invest in biotech and deep MedTech. They typically require advisors with deep scientific understanding and ECM (Equity Capital Markets) capabilities to support IPOs or sales to Big Pharma.
- Preferred Advisors: Jefferies, Kempen & Co, Goldman Sachs, Centerview Partners.
Tech & Growth Generalists (Atomico, Balderton, Index Ventures, Northzone): These funds invest in Digital Health and SaaS. They view assets as "Technology" companies.
- Preferred Advisors: Arma Partners, GP Bullhound, Clipperton, Morgan Stanley (for large exits).
Impact & Early Stage (Calm/Storm, Nina Capital): These funds often rely on boutique advisors who can hand-hold founders through their first exit.
- Preferred Advisors: Nelson Advisors

The Exit Backlog: A critical context for 2025 is the "exit backlog." As noted by Galen Growth, private equity firms are sitting on a record number of companies held for more than four years. This creates immense pressure to sell, driving volume for advisors like Rothschild and Houlihan Lokey who specialise in clearing PE portfolios.

Comparative League Table: Selecting the Right Partner

The following table summarises the leading advisors based on their primary "Persona" and strategic fit for a Venture Capital portfolio company.

Advisory Category	Key Firms	Best Use Case for VC Portfolio Company	Typical Deal Size	Key Strength
The Titans	Goldman Sachs, J.P. Morgan, Morgan Stanley	"The Unicorn Exit" – Multi-billion dollar trade sale or dual-track IPO.	>$1 Billion	Access to global capital markets; complex cross-border execution.
Mid-Market Engines	Rothschild & Co, Houlihan Lokey	"The PE Platform Sale" – Selling a profitable, scaled asset to a PE buy-and-build platform.	$100M - $1B	Massive deal volume; deep relationships with all major PE sponsors.
Digital Economy Specialists	Arma Partners, GP Bullhound	"The Tech Play" – Selling a high-growth Digital Health SaaS company to a Tech buyer.	$100M - $1B+	Applying SaaS/Software valuation multiples to healthcare assets.
Specialist Boutiques	Nelson Advisors, Clipperton, Hampleton	"The Founder's Exit" – Selling a niche, domain-specific asset; high operational involvement.	$25M - $250M	Deep domain expertise (AI, Health IT); "Founder-centric" empathy.
Regional Champions	Carlsquare (DACH), Cambon (France), Carnegie (Nordics)	"The Local Hero" – Navigating complex local reimbursement (DiGA) or regulatory landscapes.	$20M - $500M	Unrivaled local network and regulatory understanding.
Tech Due Diligence	Code & Co, Black Duck	"The Tech Validator" – Pre-sale audit to prove code quality and AI compliance.	N/A (Service)	De-risking technology assets for buyers; defending valuation.

Conclusion and Strategic Outlook

The landscape of European HealthTech and MedTech M&A advisory is defined by specialisation. The era of the generalist investment banker successfully managing a complex digital health exit is fading. For Venture Capital investors and founders, the optimal advisor selection depends heavily on the specific "DNA" of the company being sold.

For assets where value is derived from clinical outcomes, hardware, or industrial scale, the Mid-Market Engines (Rothschild & Co, Houlihan Lokey) and Regional Champions (Carlsquare, Carnegie) remain the most potent partners due to their deep roots in the industrial healthcare and private equity ecosystems.

Conversely, for assets where value is derived from data, software metrics, and AI, the Digital Economy Specialists (Arma Partners) and Specialist Boutiques (Nelson Advisors) offer a decisive advantage. Their ability to frame a healthcare company as a "Technology Platform" allows them to unlock superior valuation multiples by targeting tech-centric buyers rather than traditional healthcare incumbents.

As we move into late 2025 and 2026, the influence of the EU AI Act and the European Health Data Space (EHDS) will further bifurcate the market. Advisors who can competently navigate the intersection of clinical validity, technological scalability, and regulatory compliance will become the defining architects of the next generation of European healthcare exits.

The rise of "Founders for Founders" firms like Nelson Advisors, alongside the integration of technical due diligence into the core M&A process, signals a permanent shift towards a more operationally nuanced, empathy-driven advisory model that aligns closely with the unique needs of the European innovation ecosystem.

Nelson Advisors > European MedTech and HealthTech Investment Banking

Nelson Advisors specialise in Mergers and Acquisitions, Partnerships and Investments for Digital Health, HealthTech, Health IT, Consumer HealthTech, Healthcare Cybersecurity, Healthcare AI companies. www.nelsonadvisors.co.uk

Nelson Advisors regularly publish Thought Leadership articles covering market insights, trends, analysis & predictions @ https://www.healthcare.digital

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

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