Who are the leading MedTech M&A Advisors in Europe?

Nelson Advisors
2 days ago
15 min read

Updated: 1 day ago

Who are the leading MedTech M&A Advisors in Europe?

Executive Summary: Landscape of Leading MedTech M&A Advisors in Europe

The advisory landscape for European Medical Technology (MedTech) Mergers and Acquisitions (M&A) is distinguished by a structural bifurcation across transactional size and specialised focus.

The market influence is segmented into three distinct classes: Tier 1 Global Banks, which dominate based on aggregate transaction value due to their capacity to underwrite and execute multi-billion-dollar strategic acquisitions; Tier 2 Integrated Firms, which drive high deal volume and provide comprehensive advisory services essential for mid-market and private equity-backed transactions; and Tier 3 Specialist Boutiques, whose leadership is derived from deep, qualitative expertise in niche high-growth segments like Digital Health and Healthcare AI.

Recent market data confirms this segmentation. While the overall MedTech sector M&A activity surged in 2024, reaching levels second only to the 2021 peak, with 305 acquisitions announced totaling $63.1 billion year-to-date, this surge reflects a dual focus: large strategic deals securing Tier 1 prominence, alongside a rise in smaller deals sustaining the transactional volume driven by Tiers 2 and 3.

A critical finding is the unique position of Rothschild & Co, which serves as a bridge between these tiers, achieving the top European ranking for M&A advisory in 2023 by both deal volume and aggregate value across the broader healthcare sector. This demonstrates their strong institutional capacity to handle large, complex transactions while maintaining broad transactional coverage throughout the continent.

Strategic counsel mandates that advisor selection must precisely align with the deal profile. For massive, cross-border strategic acquisitions ($1 Billion plus), Tier 1 Global Banks are essential for their global capital markets access, financing power, and high-level execution capability.

Conversely, middle market and venture capital backed companies, particularly those focused on disruptive technologies, are better served by Tier 2 and Tier 3 firms. These specialists provide superior commercial diligence, specialised regulatory insight, and unparalleled access to founder-led companies in the critical mid-market and high-growth HealthTech niches, where technological specialisation is paramount to valuation.

The overall market resilience suggests that major corporate acquirers view European assets as strategically vital for portfolio replenishment and digital integration, reinforcing the long-term importance of expert European M&A advisory.

European MedTech M&A Market Context

Deal Flow Dynamics: Surge, Selectivity and Scale

The European MedTech sector has recently demonstrated significant transactional momentum. Mergers and acquisitions activity in 2024 year-to-date (YTD) totalled $63.1 Billion across 305 announced acquisitions. This level of activity is a major indicator of corporate health and strategic necessity within the industry, reaching a point second only to the high peak observed in 2021.

Despite persistent global macroeconomic headwinds, the European market is characterized by a definitive "flight to quality." This phenomenon means that high-quality assets attract intensely competitive auctions and premium pricing, evidenced by increasing deal values (a 15% rise globally in deal values during H1 2025) even as the overall transaction count has seen a decline globally. This flow of capital, highly selective in nature, is directed toward high-quality, strategically necessary targets. The increasing concentration of capital in fewer, larger transactions inherently favours the Tier 1 global financial institutions capable of handling these high-value strategic mandates.

Furthermore, the MedTech venture investment ecosystem reflects increasing selectivity. While the number of funding rounds decreased (691 rounds YTD 2024), the total dollar value raised surged to $19.1 Billion, surpassing the total funding value of 2023. This concentration indicates that fewer, more mature MedTech companies are successfully reaching the scale and financial maturity required to become attractive M&A targets or secure major late-stage funding, a trend that specifically benefits advisors skilled in late-stage capital raising and successful exit strategy planning.

Strategic Imperatives Driving European M&A

Current European MedTech M&A activity is driven by fundamental strategic imperatives centered on innovation and consolidation.

1. Digital Transformation and AI

The pursuit of high-growth segments such as AI-driven HealthTech and Digital Health is a primary engine of deal activity. These technology-centric targets are commanding premium valuations in the market, with average revenue multiples potentially reaching the range of 6–8x, or even higher, compared to the general MedTech market. The market's aggressive search for advanced capabilities, such as those related to deep learning, is generating significant deal flow, as strategic buyers recognise the necessity of securing these assets to position themselves for future healthcare delivery models.

This need for sophisticated valuation and positioning in complex technology environments magnifies the importance of specialised boutique advisors (Tier 3) who possess the necessary technical literacy to accurately assess and market these high-multiple, technology-enabled targets. A generalist advisor may struggle to justify the high valuations based purely on traditional financial metrics, giving the specialised firms a significant competitive advantage.

2. Private Equity Momentum and Consolidation

Private Equity (PE) firms remain profoundly influential drivers of European MedTech M&A. The sector continues to attract substantial PE capital, with Ireland serving as an example, recording an almost 140% increase in PE transactions from 2023 to 2024 in its life sciences sector. Highly active and focused PE firms such as ArchiMed and Nordic Capital are key participants, actively pursuing consolidation strategies across medical devices, consumer health, and HealthTech. This PE activity is not merely transactional; it represents a value-creation lifecycle where firms acquire and consolidate smaller European MedTech companies, often guided by Tier 2 integrated firms, to construct larger, more valuable platforms ready for eventual sale to global strategic corporate buyers or secondary PE funds. Advisors excelling in PE transaction volume are therefore critical actors, effectively serving as gatekeepers to the next generation of large MedTech assets.

3. Regulatory Environment and Risk Mitigation

The rigorous regulatory environment within the European Union significantly shapes M&A diligence. The sector is currently undergoing a massive transition under the stringent Medical Device Regulation (MDR) and the In Vitro Diagnostic Regulation (IVDR). These regulations impose complex requirements governing device safety and performance across their entire lifecycle. The regulatory certainty (or uncertainty) of a target company directly impacts its valuation and the timeline of any transaction. This complexity necessitates the engagement of financial advisors who either possess or partner with deep technical and legal expertise to navigate regulatory compliance, intellectual property (IP), and data privacy issues, which often represent the greatest risks and potential bottlenecks in complex MedTech acquisitions.

Tier 1: Global Bulge Bracket Banks

These institutions command the top of the league tables based on aggregate M&A transaction value, dominating the market for mega-deals and complex, public-market transactions. Their core strength lies in their ability to provide sophisticated financing solutions and unparalleled global access for the largest strategic acquisitions, typically exceeding $1 Billion.

Goldman Sachs & Co.

Goldman Sachs is firmly established as a global M&A powerhouse. The firm held the #1 ranking globally as a financial advisor by M&A value in 2024 and maintained a leading regional ranking in both Europe and the US. With an astounding global value of over $1.08 Trillion advised across 430 deals in 2024 YTD, its capacity for large-scale transaction execution is unmatched. The firm sustains deep engagement with the sector, demonstrating confidence in the European market by hosting specialised events such as the European MedTech-Healthcare Conference. Furthermore, its ability to close new, oversubscribed life science funds suggests robust backing from limited partners and a continued ability to facilitate capital deployment into the sector.The firm focuses on handling the largest and most complex cross-border transactions, particularly those involving public companies and requiring substantial debt financing.

J.P. Morgan (JPM)

J.P. Morgan maintains a consistent position among the top global financial advisors, securing Global Rank #3 by M&A value in 2024. The institution advised on transactions totalling $805.6 Billion across 405 deals in 2024 YTD. JPM is not only a major transactional player but also a key thought leader in the MedTech and Biopharma sectors, regularly publishing comprehensive reports detailing critical trends in venture funding, licensing, and M&A activity. The firm emphasises its commitment to clients through a specialised team of bankers capable of handling the "most advanced and complex M&A and capital markets transactions," confirming their focus on strategic, large-cap mandates. Although specific European MedTech deal lists are often integrated within broader life science highlights, JPM's capacity is evident through advisory roles in major European life sciences transactions, such as AstraZeneca's $1.3 Billion buyout of CinCor Pharma.

Other Global Powerhouses

Other Bulge Bracket banks consistently feature prominently in the European M&A ecosystem. Morgan Stanley (Global Rank #2), Citi (Global Rank #4), and Bank of America (Global Rank #5) all rank within the top five globally in terms of M&A value and maintain significant European platforms. These firms provide the essential capacity, global network, and balance sheet strength necessary for multinational MedTech corporations engaging in major strategic M&A.

It is important to acknowledge that while these Tier 1 banks dominate by aggregate dollar value, the immense scope of their global operations means their explicit MedTech focus can sometimes be less granular than the dedicated sector specialists in Tiers 2 and 3. MedTech companies whose transactions do not exceed the billion-dollar threshold, or those requiring highly specialised regulatory and commercial deep dives, often look beyond Tier 1 firms for more focused expertise.

The competitive edge of Tier 1 Banks lies fundamentally in their capacity for leverage, balance sheet support and unparalleled global capital access, rather than niche, regulatory-heavy, mid-market commercial expertise.

Table 1: Select Top-Ranked Global Financial Advisors by Overall EMEA M&A Value (YTD 2024)

Rank (EMEA)	Global Rank (Value)	Company Name	Global Value (USDm)	Deal Count	Primary European M&A Role
1	1	Goldman Sachs & Co.	1,084,689	430	Mega-deals, Financing, Public Markets Access
2	3	J.P. Morgan	805,592	405	Large Strategic Acquisitions, Capital Markets
3	2	Morgan Stanley	856,780	366	Large-Cap M&A, Private Equity Transactions
5	4	Citi	543,557	216	Cross-Border Mandates, Corporate Strategy

Tier 2: Integrated Advisory and Mid-Market Powerhouses

The Tier 2 category consists of highly integrated advisory firms and specialised investment banks that drive a significant portion of the European M&A market's volume. Their strength is derived from deep regional networks, comprehensive service offerings, and consistent presence in private equity-driven transactions and complex commercial diligence mandates.

Rothschild & Co.

Rothschild & Co. stands out as a preeminent European advisor, having achieved the distinction of being the top-ranked firm in Europe for M&A advisory in 2023 by both deal volume and value. This dual leadership status is a strong indicator of their ability to secure mandates for both large, high-value strategic transactions and a substantial volume of mid-market deals.

The firm possesses a leading and established presence in handling large and complex healthcare transactions across the continent. Their long-standing European heritage and extensive regional network provide a critical advantage in winning mandates from European corporate entities, major private equity houses, and sophisticated family-owned MedTech businesses.

The Big Four and Integrated Specialists

Deloitte

Deloitte is widely recognised as a leading mid-market M&A advisor within the life sciences and healthcare sectors in Europe. The firm’s strength is rooted in its capacity to provide integrated strategic, financial, and commercial advisory services for HealthTech and MedTech deals. This holistic approach, combining transaction execution with deep due diligence expertise across tax and operations, is highly valued by both strategic buyers and private equity investors navigating the complexities of the European regulatory landscape.

Houlihan Lokey

Houlihan Lokey is a consistently prominent advisor known for its dedicated healthcare group serving European clients. The firm is frequently involved in complex healthcare M&A and capital-raising assignments, maintaining high visibility in private equity-backed deals across the region.

Integrated Consulting Firms (EY and KPMG)

Ernst & Young (EY) and KPMG are integral to the European life sciences and healthcare deal ecosystem. While often involved in M&A execution (KPMG is explicitly mentioned as a highly regarded advisor in the broader sector), their roles often emphasise strategic consulting, operational performance optimisation, and rigorous due diligence necessary before an M&A event. They assist MedTech companies in aligning resource allocation with key performance indicators (KPIs) to maximise profit margins and ensure long-term sustainability, making them essential partners in the pre-deal phase.

Regional Volume Leaders in Medical Devices

Analysis of deal volume in the European medical devices sector reveals a highly active and localized mid-market environment. Data for the first nine months of 2024 indicates that Cavendish Financial was a top-ranked advisor by volume for general European medical devices M&A deals.

Critically, the private equity segment of the medical devices market is intensely competitive. For the first nine months of 2024, multiple firms, Aritma, Clearwater, Deloitte NSE, Ernst & Young Global, and Houlihan Lokey, all shared the top rank in European medical devices Private Equity deal volume.

This phenomenon, where multiple firms share the highest volume rank, underscores the highly fragmented and competitive nature of the mid-market advisory space. It suggests high transaction volume across many deals, but with low average deal counts per firm, which is characteristic of regional M&A.

Clients in this segment prioritise deep-rooted regional connections, nuanced market access, and robust integrated diligence capacity, favoring the specific expertise of the Big Four and specialised integrated firms over the global capital capacity of Tier 1 Bulge Brackets. These firms are essential for executing the high volume of PE-backed transactions that drive market consolidation.

Top-Ranked Financial Advisors in European Medical Devices M&A by Deal Volume

Advisor	Type	Primary Role	Q1 2024 Rank (Volume)	Q1 2023 Rank (Volume)	Focus (PE vs. General M&A)
Rothschild & Co	Integrated/Global	Complex Transactions	N/A (Top overall 2023)	N/A (Top overall 2023)	Large/Complex Healthcare
Cavendish Financial	Regional/Specialist	General M&A Deals	1	1	Medical Devices M&A
Clearwater	Mid-Market Advisory	Private Equity Execution	1	1	Medical Devices PE Deals
Deloitte NSE	Integrated Advisory	PE, Commercial Due Diligence	1	1	Medical Devices PE Deals
Houlihan Lokey	Mid-Market Specialist	PE, Capital Raising	1	1	Medical Devices PE Deals
Aritma	Mid-Market Advisory	Private Equity Execution	1	-	Medical Devices PE Deals

Specialised MedTech and HealthTech Boutiques with Niche Expertise

Tier 3 advisors focus intensively on specific segments, such as Digital Health, Health IT, and AI. Their "leading" status is measured qualitatively by their deep domain knowledge, ability to successfully position highly innovative companies, and their strong thought leadership within their dedicated niche, rather than by overall M&A value or volume across all sectors.

HealthTech and Digital Health Specialists

Nelson Advisors

Nelson Advisors is highly recognised for its exclusive dedication to the European healthcare technology (HealthTech) sector, specifically digital health, health IT, consumer healthtech, healthcare cybersecurity, and Healthcare AI companies.

The firm distinguishes itself by leveraging the entrepreneurial expertise of its founders to deliver tailored M&A, investment, and partnership guidance. Strategically, the firm focuses on guiding early-stage, high-growth companies through M&A exits, a crucial service in periods defined by tight venture capital funding and a less active initial public offering (IPO) market.

While physically headquartered in London, UK, their service reach spans the UK, Europe, and North America, supporting complex, cross-border transactions. For targets focused on disruptive technology like AI, the credibility of this specialised counsel, demonstrated by sector-specific market analyses and thought leadership, often provides more value than raw global league table ranking alone.

https://nelsonadvisors.co.uk

ConAlliance

ConAlliance is positioned as a premier M&A advisory firm focused exclusively on the global healthcare and life sciences industry. As one of the most sought-after specialist M&A advisors in Europe, ConAlliance offers bespoke, holistic support tailored to the complex needs of the industry. The firm explicitly focuses its renowned M&A advisory services on advising companies in the mid-market segment of healthcare and life sciences, boasting experience advising on more than 250 M&A transactions.²⁵ Headquartered in Germany and the UK, their international network facilitates access to key decision-makers and healthcare-focused equity investors globally.

Dedicated Healthcare Investment Banks

The European market’s growing maturity and strategic importance have attracted greater specialization from US-based investment banks.

Leerink Partners

Leerink Partners is branded as "The Healthcare Investment Bank," with an exclusive focus on the sector, including dedicated coverage for MedTech, Tools, and Diagnostics. In a significant move highlighting the commercial opportunity in Europe, Leerink recently launched a London office to mark its international expansion. This expansion confirms that the European MedTech market has reached a critical size and maturity to warrant dedicated, sector-exclusive capital markets and M&A attention. Leerink’s deep connectivity to US capital markets and strategic buyers provides superior value, facilitating the complex, cross-border M&A that is increasingly common.

Stifel

Stifel’s Healthcare Investment Banking Group offers integrated solutions covering M&A, capital raising, and restructuring for organisations across the healthcare industry. Like Leerink, Stifel represents the growing trend of focused investment banks providing specialised financial advisory services to the European MedTech ecosystem.

Comparative Profile of Key Specialised European MedTech/HealthTech Advisory Firms

Advisory Firm	Primary Focus	Typical Deal Size Focus	European Presence	Competitive Advantage
Nelson Advisors	HealthTech, Digital Health, AI	Mid-market, Early-Stage Exits	UK, Europe, North America (London HQ)	Deep HealthTech Specialisation, Founder-Led Exits
ConAlliance	Healthcare, Life Sciences	Mid-Market Segment	Germany, UK, Global Network	Exclusivity in Healthcare, Bespoke M&A Advisory
Deloitte	Life Sciences / Healthcare	Mid-Market M&A	Pan-European NSE Network	Integrated Strategy, Financial, and Commercial Due Diligence
Leerink Partners	Healthcare Investment Bank	MedTech, Biopharma, Tools	International Expansion (London Office)	Deep US/Global Capital Markets Connectivity

Strategic Advisor Selection: Mapping Expertise to Transaction Profile

Selecting the optimal M&A advisor in the European MedTech sector requires a nuanced assessment of the firm's core competencies against the specific needs and risks of the transaction. The leading advisor is not always the one at the top of the generalist league tables but the one best equipped for the deal's size, sector, and geographical complexity.

Key Criteria for Advisor Selection

Deal Size and Capital Requirements

For mega-deals, especially those involving multi-billion dollar valuations or public-to-private transactions—Tier 1 Global Banks are necessary due to their capability to organise complex financing and manage cross-border execution risk on a global scale. For the robust European mid-market ($50M–$500M), Tier 2 integrated firms offer the necessary blend of financial execution experience and local market access, often providing stronger value by reducing execution risk through comprehensive due diligence.

Buyer Profile and Geographic Access

The European market is highly attractive to US strategic acquirers, including major players like Stryker, Boston Scientific, and Enovis, who are actively executing deals on the continent to bolster their orthopedic, interventional, and digital portfolios. This high volume of US-inbound M&A confirms the demand for advisors who can effectively bridge the cultural, valuation, and regulatory gaps between US acquirers and European targets.

Firms with established transatlantic capabilities, such as Leerink Partners and Nelson Advisors, offer superior value in facilitating these crucial cross-border mandates. Conversely, transactions involving European Private Equity firms (e.g., ArchiMed, Nordic Capital) often rely heavily on Tier 2 integrated and regional firms for access and deep-seated local relationships.

Sector and Technical Nuance

In high-growth segments like Digital Health and AI, the primary value driver is technology, often protected by intellectual property (IP) and tied to complex regulatory pathways. Here, specialised boutiques (Tier 3) are leading advisors, as they possess the technical literacy to accurately value complex, intangible assets and effectively position the company to a highly technical audience of buyers. When the MedTech asset is focused on disruptive technology, the advisor’s credibility, demonstrated by deep sector insight and specialized knowledge, outweighs raw global capital access.

Case Study Analysis: Strategic European Acquisitions

The acquisition strategies of global MedTech leaders illustrate the reliance on advisors with strong European execution capacity. For instance, Stryker's acquisition of the France-based joint replacement company SERF SAS from Menix in March 2024 was a strategic move to strengthen its orthopaedic portfolio across Europe.Although the financial advisor for this mid-sized bolt-on acquisition was not explicitly named in the public release, the seller (Menix) engaged specialised legal counsel, Paul Hastings.

This choice of specialised legal support strongly suggests that the associated financial advisor in this transaction likely possessed significant regional European depth (Tier 2 or 3 capacity) rather than relying solely on a large generalist bank. The ability of major US MedTech players to successfully complete these strategic acquisitions confirms that European innovation is highly valued and that leading advisors must provide both financial expertise and seamless regional execution capabilities.

Conclusions

The identification of leading MedTech M&A advisors in Europe necessitates a categorical approach based on the specific transactional requirement.

Mega Deals and Global Capital: For high value, strategic transactions ($1 Billion plus) requiring global capital markets connectivity and complex financing, the leading advisors are definitively the Tier 1 Global Bulge Brackets (Goldman Sachs, J.P. Morgan, Morgan Stanley). Their capacity to underwrite and manage cross-border risk on a massive scale remains unrivalled.
Breadth and Integrated Mid-Market Execution: Tier 2 Integrated Advisory Firms (Rothschild & Co, Deloitte, Houlihan Lokey) are the volume leaders and the preferred partners for Private Equity transactions and mid-market deals. Rothschild & Co's recent dual leadership in value and volume marks them as a uniquely powerful, pan-European institution. These firms excel by offering integrated services, combining financial execution with essential commercial and operational due diligence required for complex European assets.
Specialisation in High-Growth Sub-Sectors: For transactions involving disruptive or early-stage MedTech and HealthTech companies (especially those focused on AI, Digital Health, and Cybersecurity), Tier 3 Specialist Boutiques (Nelson Advisors, ConAlliance, Leerink Partners) are the leading advisors. Their leadership is qualitative, rooted in deep sector specialisation and the ability to command premium valuations for technology-driven assets by expertly positioning IP and regulatory compliance readiness.

A critical strategic recommendation for stakeholders is to recognise that in European MedTech M&A, regulatory risk often supersedes purely financial risk. Therefore, the leading financial advisor must demonstrate a robust capacity to integrate seamlessly with top legal counsel specializing in EU MDR/IVDR compliance, data protection, and IP law (e.g., White & Case, Latham & Watkins). The ideal advisory team is a composite structure, combining the financial scale of Tier 1/2 players with the technical and regulatory precision offered by specialised boutiques and legal experts.

Nelson Advisors > MedTech and HealthTech 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

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