Life sciences investors pumped around $15 billion into 175 biotech, medtech and diagnostics firms that went public during the 2014–16 IPO window. To understand what may be in store for those firms and their backers, In Vivo reexamines the fate of a previous generation of companies, the IPO Class of 1997.

Notwithstanding an occasional blip, the environment for medical device companies has never been stronger, with robust technology development, company creation rewarded with high levels of private and venture investment, and strong M&A activity all supporting a business model that was born out of the doldrums that device companies found themselves in a decade ago. Still, there are pressures that are straining the current model and raising legitimate concerns, including physician conflict-of-interest charges; regulatory pathways that are trickier and a climate of evidence-based medicine that leads to longer, more expensive trials; and a robust M&A environment that is sustainable only if a next-generation of acquiring companies steps up. Part one of a two-part series.

Despite studies that show that patient in earlier stages of mitral regurgitation experience better rates of mortality and long term survival following valve repair surgeries, clinicians reserve the invasive procedures for the more seriously ill congestive heart failure patients.

Presbyopia, the inability to focus close-up that come with aging, represents a blockbuster market opportunity since virtually everyone eventually suffers from the condition. The success of LASIK (laser surgery for vision correction) has created a demand on the part of patients and physicians for an alternative to glasses for the middle aged. C&C Vision hopes to be the first to offer a surgical treatment for presbyopia. Like others going after the market, however, C&C aims to validate its technology by addressing a medical need first: it is initially targeting cataracts. In doing so, however, it faces the risk of sidling up to, rather than directly attacking, the presbyopia market upon which it desires to be valued.