Sometimes the best medicine is a short, sharp shock; that's why Medtronic's products reside in its customers' hearts and minds (among other places). A leading maker of implantable biomedical devices, the company makes defibrillators and pacemakers that issue electrical impulses or shocks to keep hearts beating normally. Its Cardiac and Vascular Group also produces catheters, stents, valves, balloons, and surgical ablation technologies used to treat vascular and heart disease. The company's Restorative Therapies Group makes nerve and brain stimulation devices, implantable drug delivery systems, products used to manage diabetes, and surgical devices for ear, nose, and throat (ENT) and spinal conditions.
Medtronic got its start treating heart disease -- it was a leader in the development of pacemakers in the 1950s -- and a majority of its revenue still comes from sales of products used to treat heart or vascular conditions. However, it has expanded its reach into the rest of the human body, and the rest of the world, by offering products that treat neurological, musculoskeletal, and metabolic conditions as well.
Within the Cardiac and Vascular Group, which accounts for about half of revenue, reside its Cardiac Rhythm Disease Management (CRDM), Coronary, Structural Heart, and Endovascular divisions. CRDM is Medtronic's largest single unit, accounting for about 30% of sales; the unit makes pacemakers, defibrillators, heart monitors, and other products used to keep the heart beating properly. The remaining Cardiac and Vascular units focus on minimally invasive technologies including drug-eluting stents to prevent reclogging of arteries (Coronary division) and aortic heart valves (Structural Heart), as well as stents, grafts, and balloon systems for non-heart vascular procedures (Endovascular).
Under the Restorative Therapies Group is Medtronic's Spine unit (housing its Sofamor Danek and Kryphon businesses), which accounts for around 20% of sales and manufactures spinal devices and implants, as well as surgical instruments and bone grafting tissue. Other units within the Restorative Therapies Group include the Neuromodulation division, which makes electrical stimulation devices and drug delivery systems for conditions including chronic pain, tremors, and urinary incontinence; Diabetes, which makes glucose monitoring systems and insulin pumps; and Surgical Technologies for ENT supplies.
Medtronic markets its products in more than 140 countries around the globe. More than half of revenues come from the US market; the company's largest international markets include Western Europe and Japan.
The company operates some 260 locations worldwide, including more than 40 manufacturing plants in the US and another 118 in 50 other countries.
Sales and Marketing
Medtronic sells through direct representatives in the US, while using a combination of independent distributors and direct marketing methods in overseas markets. Its products are marketed to customers including hospitals, clinics, physicians, and wholesalers, as well as government health plans and group purchasing organizations.
Medtronic has reporting steadily rising revenues over the past few years, including sales growth of 3% in fiscal 2014 to some $17 billion, which was attributed to strong product sales increases in all three divisions. Within the Cardiac and Vascular Group, growth came from nearly every sector, lead by Atrial Fibrillation and Structural Heart and Endovascular, except Coronary and CRDM defibrillation and pacing systems. New products from acquisitions also helped. Likewise, the Restorative Therapies Group reported growth in all divisions except the Spine unit as did the Diabetes Group.
Net income, which has been fluctuating for years, dropped again in fiscal 2014, by 12% to about $3 billion, as the company paid litigation charges, higher expenses, and acquisition-related costs.
Cash from operations, on the other hand, rose by $17 million to about $5 billion due to an increase in accounts receivable, primarily in southern Europe, and a decrease in inventories.
Strategically, the company maintains a steady stream of new product introductions through a mixture of internal research and development and acquisitions to fuel its growth. Medtronic spends about $1.5 billion (or about 9% of sales) on R&D programs each year, with the goal of producing new technologies that enhance existing products or fulfill unmet medical needs. The company also widens its offerings through partnerships, licensing agreements, and acquisitions. In 2014 it released an insertable cardiac monitor dubbed Reveal LINQ.
Medtronic is also focusing on expanding its international business, which has increased over the past three years to account for 45% of company sales. Medtronic has an especially keen eye on the emerging markets of Brazil, China, India, and Russia. It has laid plans to increase sales in those markets to eventually account for some 20% of company sales.
The company also works to increase efficiency for its customers. In 2013 it began managing cath labs for customers in Europe, which effectively lead to lab upgrades for many. It increased efficiency for itself by purchasing Biostar, its Turkish distributor.
Medtronic sold its smallest segment, Physio-Control, to Bain Capital for some $487 million in 2012. The business provides professional emergency medical response solutions worldwide.
Mergers and Acquisitions
Infections from implanted pacemakers and defibrillators are relatively rare but Medtronic cut the odds for its patients even further in early 2014 when it purchased Tyrx for about $160 million. The company makes implant devices that treat infections associated with surgeries and implanted devices.
A few months later Medtronic offered $43 billion for fellow medical device maker Covidien. In addition to expanding Medtronic's global footprint and delivering what the company hopes will be $850 million in synergistic savings by 2018, the move also lets Medtronic easily move its headquarters to Covidien's home in tax-friendly Ireland.
Other 2014 deals included an Italian hospital manager, an American maker of MRI-guided laser systems, and a Dutch company that makes brain stimulation tools.
In 2013 it purchased Cardiocom and its remote-monitoring and telehealth services and software for about $193 million. The following year Medtronic made progress towards its goal of growing in international markets when it acquired device manufacturer China Kanghui for approximately $816 million in cash. The purchase will add direct distribution operations in the Chinese market, as well as a product portfolio and R&D pipeline containing spinal, trauma, and joint reconstruction devices.