The Catalyst Group, Inc

作为医疗市场最受关注的领域之一，数字医疗拥有强劲的全球增长前景。到2024年，数字医疗全球市场规模超过2000亿美元。作为享誉全球的创新之国，以色列的数字医疗投资率是全球平均水平的4倍，其投资额从2020年的6.5亿美元上升至2022年的11亿美元，并在2022年第二季度创下风险投资的历史新高。目前，以色列拥有550多家活跃于数字医疗领域的初创企业，其中一半处于后期产品阶段。以色列本国的风险投资公司是它们最主要的支持来源，同时外国风险投资公司和CVC对于以色列数字医疗的兴趣逐步上升。在全球数字医疗领域最活跃的十位投资者中，有六位都投资过以色列公司，包括Tiger Global Management和General Catalyst等巨头。除此之外，中国投资者也在重金押注以色列的企业。2014-2019年以色列数字医疗投资增长 图源：Invest In Israel2020年12月，海峡创新董事长曹阳、英飞尼迪集团董事长Amir Ga-lor（高哲铭）等出席了以色列数字医疗公司Infinity Medical (I.I.M Infinity INNONATION Medical)的线上签约仪式。该公司由海峡创新与英飞尼迪集团共同创立，致力于投资数字医学领域的公司。英飞尼迪是中国国企华发集团旗下的股权投资平台，在人民币基金领域拥有领先地位，致力于建立并深化以色列知识技术与中国市场之间的互利关系，目前管理资金超过百亿，管理企业超百家企业。海峡创新于2012年在深交所创业板上市，主要业务是智慧医疗和智慧城市。2019年，海峡创新实际控制人变更为平潭综合实验区国有资产局，由此转型为国资控股企业。2021年1月5日，Infinity Medical以色列证券交易所公开上市。时至今日，Infinity Medical已完成250多项投资，拥有15亿美元投资组合，平均内部收益率超过25%。本文主体关系图 动脉网制图那么，这家由国企下场组建的以色列公司究竟有何优势？又能够为中国带来什么呢？以色列：“低风险高回报”的投资环境以色列完善的数字生态系统为各类市场参与者提供了发展数字医疗的沃土。首先，以色列98%的人口享有全面的健康保险。其次，以色列的四家HMO（健康维护组织）及其附属医院在过去二十年中一直使用相同的电子病历平台。因此，这个人口800万的国家在过去二十多年得以积累下大量关于适应症和患者治疗的数据。与此同时，在过去二十年中，许多医疗器械和制药行业的全球领导者都通过收购以色列老牌企业或与之建立合作关系、开设新的创新中心，在以色列开展业务并扩大其规模。这样不断发展的环境还造就了生命科学领域的高技能人才。根据2019年全球技能指数（Global Skills Index）报告，以色列人的数据科学技能在全球排名第一。该地区人工智能和数据分析领域人才储备同样充分。另外，以色列政府对数字医疗和健康数据的发展提供鼎力支持。2018年，以色列政府设立了一项国家数字健康计划，预计在5年内投入2.75亿美元。该数字化项目专注于二次使用脱敏临床数据，使研究人员借助人工智能系统解析数据，以寻找出最有效的疗法或开发新的疗法。能够获得高质量的创新交易流程和高效、具有成本效益的研发和临床试验，对于来自世界各地的市场参与者而言，以色列提供了一个风险相对较低但回报较高的环境。因此，该地区吸引了许多服务供应商、数字医疗基金，拥有成熟的孵化器，帮助初创企业开展研发和商业化活动。以“中国通”为核心的多元化团队与许多同行一样，Infinity Medical由医学、技术、投资和资本领域的知名专家组成。而从董事到投资委员会，Infinity Medical团队成员的个人经历似乎更具多元化色彩。投资委员会主席Amir Gal-Or（高铭哲）是英飞尼迪集团的创始管理合伙人，从事风险投资行业近30年。同时，他还是中国以色列商会的名誉会长，以及以色列空军的战斗飞行员。Gal-Or于2002年开始与中国合作开展业务，于2010年与家人在北京定居，同年创办了中国第一家知识产权银行，与具有全球战略的中国企业家和公司合作。“中国的独特之处在于其不断流动的资本和人力资源。唯一的问题是如何形成正确的商业模式和结构，以从巨大的能量流中汲取灵感，”Gal-Or 说。当被问及多年来孵化科技创业公司的经历，Gal-Or表示，近年来全球范围内的投融资热度一直呈下降趋势，同时人们期望孵化器将资金、建议、服务和其他资源投入初创企业，这就加剧了股权所有者的损失。“一切都是为了获取资源，”Gal-Or说。“建立一个好的孵化器的唯一方法是拥有非常高效的流量——让所有资源流通起来。”Amir Gal-Or 图源：Infinity Medical官网Infinity Medical的创始人Yuval Bloch博士是一名职业儿科医生，于本古里安大学获得医学博士，参与过以色列、中国和非洲的卫生服务和医院规划工作。目前Yuval Bloch在公共和私人医疗保健系统中担任各种管理职位，并创立了医疗咨询公司Ichilov International和AOI Medical Consulting。虽然已经从一名医生转变为风险投资基金管理者，但现在Yuval Bloc每周仍会用五个小时在一个社区诊所照顾孩子，确保不与临床工作完全脱节。Infinity Medical的董事之一Rivka Carmi教授则是国际知名的儿科医生和遗传学家，发表过150多篇遗传学论文。除了学者，她还是以色列大学的第一位女校长，任职期间带领该学校获得了以色列学术界历史上最大的财政捐助。在整个职业生涯中，Carmi致力于为职场和学术界的女性争取权利。她曾与政府合作，推动帮助女性成为生物技术领导者的计划，并在以色列大学推行了让女性在学术界领导职位获得平等机会的政策。2015年，Carmi教授被选为BBC最具影响力的100位女性之一。投资组合覆盖数字医疗最火热细分领域Infinity Medical利用其在创新、全球创业和投资战略方面的专业知识，为那些已推出先进产品的初创数字医疗公司增值。这些独角兽企业的旗舰产品或技术则反映了Infinity Medical长远的投资眼光。2021年，世界上首个社区驱动的基因组数据平台Genoox通过Infinity Medical等投资者筹得了800万美元资金。Genoox拥有世界上最大的综合遗传和症状数据库。工作人员可利用基于云的网络，访问和分析由数百家公司、医疗组织和患者组成的全球用户社区提供的信息，将其与全球数据进行比较。有赖于该平台，医院、健康科技公司、制药公司以及开发中心可以根据每位患者的特定基因结构提高检测的准确性。近年来，诊断一直是以色列数字医疗市场最热门的细分领域。据Start-up Nation Central统计，2021年，诊断领域的投融资额占整个数字医疗市场的32%，连续两年超过3亿美元。除了诊断，Infinity Medical当前的投资组合还涉及治疗和护理（biobeat、Theranica、Nanomedic）、决策支持（Polaris Quantum Biotech）、临床工作流程（Cynerio）领域的产品，覆盖以色列数字医疗市场在过去几年投融资最活跃的几个细分领域。Infinity Medical投资组合 动脉网制图延续英飞尼迪8倍回报跨境投资模式，对外投资总额同比增长11.4%Infinity Medical采用的是英飞尼迪集团坚持了近30年的投资模式。英飞尼迪集团成立于1993年，是专注于中国市场的跨境投资集团，目前已完成上百次交易并成功退出30多笔。其核心投资者包括以色列IDB集团、美国Access Industries、中国国家开发银行和苏州元禾控股有限公司等。英飞尼迪专门投资那些寻求中国战略合作伙伴的以色列企业，并凭借其商业和政府关系帮助它们以较低的成本在中国建立生产基地。中国企业也可通过英飞尼迪的商业网络接触到最先进的产品和技术，以获得长期资本增值。此外，英飞尼迪集团已在中国多个城市设立了基金，结合当地产业优势，对境内外优质成长性企业的未上市股权进行投资，推进当地企业升级。其跨境业务则致力于帮助中国企业走出去，通过更符合国际标准的交易架构和激励方案，帮助中国企业减少政治障碍，获得更高的投资回报。我们以英飞尼迪投资孵化的一个典型案例来进行说明。2004年，位于耶路撒冷的半导体公司Shellcase的股东（包括大型全球企业集团）出现亏损，公司危在旦夕。就在这时，Gal-Or和英飞尼迪集团的其他合伙人决定以1900万美元的融资介入拯救Shellcase。此举还获得了之后的苏州工业园区的支持。作为英飞尼迪在中国的商业模式的标准组成部分，此次融资项目还包括一项重组计划——将Shellcase的制造和营销转移到中国，并将公司名更改为EIPAT，通过出售其技术许可和继续开展联合研发项目来盈利。重组八个月后，Shellcase（现为EIPAT）的IP以3300万美元的价格出售给了Tessera Technologies，但它保留了中国市场的许可。凭借这张牌照，WLCSP于2005年6月在中国成立，该公司到之后实现盈利仅用了12个月。如今，WLCSP已成为晶圆级封装领域的全球领导者，并于2014年2月在上海证券交易所上市。Shellcase/WLCSP是以色列与中国IP合作的成功范例。两家公司的重组实现了双重退出带来的利益：当Shellcase出售给Tessera时，英飞尼迪从以色列实体退出，后又在WLCSP上市时，从中国实体退出，最终共获得8倍的投资回报。英飞尼迪集团双重退出策略 图源：Infinity Medical这种“中国本土商业企业+国际投资（美元或人民币）+先进技术”的投资方式给各方带来更多退出、上市或并购机会。Infinity Medical也沿用集团这一模式，关注活跃于数字医疗领域的新兴公司，并引领其走向全球，最终实现每一个参与者的利润增长——正如Gal-Or所说，要“让所有资源流通起来”。据Infinity Medical财报显示，该公司在2021年全年获得了12.7万美元的融资收入。2022年上半年，Infinity Medical开展业务的活跃度显著上升。截至2022年6月30日，Infinity Medical支出总额同比增长约为62.4%，其中以融资费用占比最高（约48.2%），增长最为显著（约250%）；其经营活动现金流量流出较上一年同期增加46万美元，同比增长108%；投资活动现金流量流出较上一年同期增加45万美元，同比增长150%。Infinity Medical 2022年中期投资报告 动脉网制图Infinity Medical 2022年上半年对外投资总额同比增长11.4%，增加75万美元，全部来自于对Nanomedic的贷款性投资。以色列顶级数字医疗资源为国企赋能根据Infinity INNONATION Medical IIM线上签约仪式的会议实录，海峡创新与英飞尼迪集团将利用特拉维夫医疗中心(Ichilov)的研发能力，以及IBM Israel的支持，将以色列数字医疗技术引入中国，共同领导Infinity INNONATION Medical IIM投资组合在中国的落地和发展。Infinity Medical投资委员会委员Uri Hayik是IBM Israel的首席技术官，负责IBM Alpha-Zone加速计划的活动。作为IBM在数字医疗领域开展的活动之一，IBM Alpha-Zone将为参与公司提供咨询和技术指导，为其进入市场做好充分准备。特拉维夫医疗中心是以色列第二大公立医院，拥有世界上最大的急诊室，也是以色列数字化技术最为先进的医疗中心。在该医院，早期前列腺癌成功率90%、转移性乳腺癌成功率90%。其创新公司Ichilov Tech致力于为医院与初创企业创建合作机会，在创意验证、孵化、临床试验、知识产权许阶段提供创新方案，并与Infinity Medical保持合作关系。此前，海峡创新还与特拉维夫医疗中心的商业化运营公司（ICHILOV INNONATION LTD）、北京以创中合科技有限公司、英飞尼迪集团有限公司（Infinity）共同成立以色列特拉维夫医疗中心国际有限公司，在海峡创新互联网医院的基础之上，构建以以色列医疗体系为核心的国际医疗合作平台。特拉维夫医疗中心国际有限公司股权架构 图源：海峡创新其以色列团队包括Yuval Bloch在内的成员，分别在以色列卫生部、医疗集团、风险投资集团担任核心职位。成立后，该公司将拥有Ichilov国际医疗咨询服务在大中华区的独家业务开拓权，为中国提供以色列医疗技术、医院规划设计、JCI国际认证辅导、医疗管理经验、远程医疗服务等资源。通过这种国际合作模式，海峡创新将获得以色列项目资源、合作平台资源，加强其智慧医疗业务的国内市场壁垒。2021年1月，中国国药集团中国医药投资有限公司也与Infinity Medical签署合作协议。根据协议，该公司将通过Infinity Medical在特拉维夫开展合资企业医疗业务，并寻找以色列投资机会。同时Infinity Medical还与国药集团国健资本签署了合资协议，以在中国推广和分销Infinity Medical投资组合公司的数字医疗产品。Yuval Bloch博士表示：“该协议是以色列与中国在数字医疗领域架起的一座桥梁，它是以色列和中国公司进一步成功开展业务合作的基础，也是两国共有的经济增长的引擎。”*封面图片来源：123rf左右滑动查看更多近期推荐声明：动脉网所刊载内容之知识产权为动脉网及相关权利人专属所有或持有。未经许可，禁止进行转载、摘编、复制及建立镜像等任何使用。动脉网，未来医疗服务平台

Biotech and digital health funding soared in the wake of the COVID-19 pandemic, but both sectors slowed down in 2022. Elena Viboch, partner at General Catalyst, said startups need to focus on the end goal — building technology or therapies that can help patients. She sat down with MobiHealthNews to discuss her takeaways from this year and her predictions for 2023. MobiHealthNews: What do you think the investment environment will look like next year for health tech and biotech? Elena Viboch: On the biotech side, there's a slight turn toward assets over platform. We call 2022 a bridge year, but at least through 2021, we were in the era of the platform company. And biotech, in particular, goes through cycles of platform versus products that are asset centric. And they're really one and the same, right? When we think about what we'd like to invest in, we look for a company with a research platform that can make drugs that couldn't be made other ways, that address areas with high unmet medical need. The point of it, though, is to make medicines for patients. And I think markets maybe got a little bit distracted with platform for platform's sake. I have a cool technology, but the whole point of that technology is to direct it toward making medicines for people. In the current market environment, there is a big shift to focus on – "Okay, well, what are you trying to build? For whom? By when?" Whether it's a therapeutic or a tech product, in a little bit more of a pressured or constrained financing market, it forces a little bit more discipline. MHN: What do you think are some of the value propositions or clinical areas likely to be promising next year? Viboch: Even though there's some pressure, it also pulled the best out of these platforms. There are new ways of making medicines. There's the "precisionization" of clinical development. And then there's high-throughput discovery science. For precision medicine, the first wave was all about monogenic disorders and targeting cancer drivers in oncology. And what we see now is a next generation that's about understanding the underlying biological pathways of polygenic diseases. What that lets you do is take these big, meaty challenges like cardiovascular disease or kidney disease or psychiatric needs, and then segment patients. What you can do is find therapeutics that are more effective because you're treating the underlying biological drivers of their disease. So, you increase drug efficacy, and you reduce patient heterogeneity. The reason that's possible now is because of some of the advances in AI drug discovery in terms of applying new tools to existing human datasets. Then there are also companies that are going out and finding or generating novel datasets, like looking at populations that have been through population bottlenecks or rare homogeneous populations. Then on the cellular side, there's all this neat high-throughput science. You can connect really high-throughput science, understanding genetic drivers at the cellular level, and then, population genetic data and kind of triangulate or reverse translate between those two, figuring out how to treat and make new therapies for really complicated diseases. So, if you can get to those underlying biological pathways of disease, you can make more effective medicines because you have less patient heterogeneity. More year in review stories: How cooling digital health funding changed the market in 2022 Where digital health funding could go in 2023 How retail healthcare, telehealth trends could evolve in 2023 MHN: Digital health and biotech funding have slowed a little bit this year compared to 2021. What do you think are some of the factors behind that decline? Viboch: I think on the digital health side, COVID was such an incredible tailwind that people are recalibrating. What are the changes that are here to stay, and what were temporary changes in behavior? Probably the easiest example is we looked at a lot of companies that had COVID diagnostics and didn't invest because it was a super important problem but it's kind of a peak and trough unless you have a generalized roadmap. Where are you going? What are you going to do from there? So, those are the kinds of companies that really have suffered, versus sustaining companies or enduring companies. For example, Cityblock Health is a company in our portfolio that delivers care into the Medicaid population. That population isn't going away; they still need care. So, whether it's COVID care or healthcare, they're still there. On the biotech side, I think it really is driven by public markets, and probably the same thing for digital health, as well. We're still very bullish and active. And the reason we are is because in challenging environments, the best companies are created. They're not trying to solve all of the problems. There's a constrained resource that focuses the team. And we think that's a really good thing. So, we like to lean in during these environments. MHN: How has that affected the companies you're looking at and investing in? How has it changed your investment strategy? And how are you advising your portfolio companies in this more challenging economic environment? Viboch: I think that we're really lucky because we've always told our companies to focus on making medicines. If your true north is, what do patients need? How am I trying to either keep patients healthy or address their illnesses? Whether it's a go-go market, or more of a challenging market, your behavior is the same. And on the digital health side, or the tech side, I think what we tell companies is focus on building something that matters. The healthcare market is enormous. You just have to focus on building your business and, if you're able to, bend the cost curve, expand health access and equity, or advance the transformation of the healthcare system from a sick care system to a healthcare system. If you can do any one of those things, or ideally all three, the market is so large that even if revenue multiples are down, if you grow into a meaningful company, you will create value for your investors and for society. If you're trying to build an enduring company, then you only have to focus on a couple of things – and be really good at those things. Science is hard and risky. But you have to focus on those few things and just keep chipping away at it. And that's why we exist to help fund people to do those hard things.

After digital health startups scooped up huge amounts of investor dollars last year, the market slowed down significantly in 2022. But it's still a relatively new field, and there's plenty of room for startups that can prove their ability to improve care, says John Beadle, managing partner at Aegis Ventures. He sat down with MobiHealthNews to discuss the growth in partnerships with health systems and venture capital firms, the changing funding environment, and what digital health investment in 2023 could look like. MobiHealthNews: What are some of your big takeaways when you look back at digital health in 2022? John Beadle: Despite the macro environment obviously turning down, the transformation and care delivery and innovation that was spurred by COVID is definitely continuing to accelerate in a lot of different areas. I think the industry has really hit a tipping point, and we should continue to see innovation advancing at a rapid pace. With that said, I think the market has definitely cooled after a red hot 2021. We saw lower deal volume, smaller check sizes becoming the new normal. Terms have also changed a fair bit, liquidity preferences have gone up. So the cost of capital has clearly increased. I joke a lot that digital health companies are great at raising money, but not at making money. But it's evident that the days of selling quarters and collecting dimes are somewhat past us, particularly for companies in growth stages. And so, to maintain those 2021 valuations I think it's become imperative not only to be generating clear value to customers and compelling ROI metrics, but also demonstrating a path to profitability and scalable unit economics. A couple of other major takeaways that I think will continue into 2023: You've seen a big increased focus on partnerships, and companies have shifted from DTC [direct-to-consumer] to B2B [business-to-business], which I think is emblematic of the larger macro environment. Consumers have less disposable income, medical bills are going up, and so you're seeing a lot of companies shift away from selling to individual consumers and trying to sell to businesses instead, both employers and payers. You've also seen VCs and venture studios shift to partnership models. Redesign announced a partnership with CVS and another partnership with UPMC. General Catalyst has pulled together their Health Assurance network to try to offer better distribution for their companies. a16z announced a partnership with Bassett Healthcare. We're obviously pursuing a lot of different initiatives with Northwell. I think that's going to continue in the upcoming period. The last one I might mention is just the increased focus on healthcare from a lot of the incumbent tech players. Google Cloud has announced a number of partnerships with health systems. You're seeing Amazon look at M&A opportunities much more actively. Entities like Morgan Health are really trying to continue to play a big role in accelerating the transitions to more value-based models for employers, where there's very significant pressure to lower healthcare costs and try to deliver benefits that encourage retention and reduce burnout. Providers are under really substantial financial pressure. They've started to look at more innovative models to try to increase the value that they're able to capture through the care they're providing. We still largely live in a fee-for-service world, but I do think there's been an increased focus on risk-based models as a way to try to recapture margin. I think we'll continue to see that in 2023 as well. More year in review stories: How retail healthcare, telehealth trends could evolve in 2023 Where digital health funding could go in 2023 Digital health leaders discuss their key takeaways from 2022 MHN: Why do you think partnerships were a big focus this year? Beadle: Digital health is still quite a nascent market overall. It's much easier in a lot of ways to build things direct-to-consumer. You can launch them a lot more quickly. You only need to convince yourself. You can onboard customers really quickly and gain a lot of market traction. A lot of companies have tried to transition to B2B models, and a great way to do that is the partnerships. I think that one element of it is trying to secure more scalable, predictable distribution for your portfolio companies. I think that was a big driver behind what General Catalyst has been doing with Health Assurance, which is quite impressive. With Redesign, I think it's much more on the side of trying to find a partner for co-creation and innovation, which is very similar to our partnership with Northwell. When we work with them, it's truly us sitting in the trenches with clinical leaders and administrative leaders, trying to better understand how we can deliver models that bring innovation and existing healthcare incumbents closer together. I think something you've seen for quite a long time is that health systems, in particular, play a huge role in determining the overall value proposition for companies and increasing their valuations. But they haven't really been able to achieve a model that enables them to capture any of the upside relative to the amount of value they're delivering. And so I think health systems, as they've been under increased margin pressure, have been trying to find ways to produce diversified revenue streams. MHN: So you noted that funding has definitely declined compared with 2021, which was just a real boom year. Why do you think that happened? And how did it affect investors as well as startups? Beadle: From a macro standpoint, I do think the growth in funding is largely justified, given the complete reordering of healthcare that's been underway. But I think going to a more micro level. There's certainly been a lot of companies funded over the last two years that likely shouldn't have been. But I do think the increased focus on health tech among the VC community is a good thing for the industry and the world. But it's certainly cooled down. Check sizes have cooled down, it's become a lot more challenging to get funded relative to where things were in the last two years in particular, just given that the cost of capital has gone up so much. At the same time, I think the best companies are still all getting funded. But you do need to be serving not only important needs and playing in big markets, but also demonstrate a much clearer path to profitability and more scalable unit economics. One of the other things that I think has been a bit surreal to see over the last two years is companies going from raising $10 million to taking $100 million from players like Tiger and Coatue, which is a really difficult transition to make as it relates to management structures and systems. There's certainly been a lot of growing pains and layoffs for the companies that did that. In the same vein, going from running a company with 25 people to one with 200 people is very challenging, particularly when your pre-product market fit. So I think it's largely a good thing that we've seen this slowdown, given that I think companies are going to need to build with a lot more discipline going forward. MHN: What do you think the funding environment will look like in 2023? Beadle: Given the macro backdrop, I think the slowdown in funding we saw in 2022 is likely to continue through most of 2023. I don't see us going back to '21 levels of investment in the near term. But I do think we'll settle above 2020 numbers with continued year-on-year growth, probably minor growth against that 2020 benchmark, on a go-forward basis. To raise money in this environment, you definitely need more proof points now than you've seen over the last few years, which is driven both by the macro slowdown and the fact that we've seen a lot of vaporware in this space during a time of very easy money. I also think the reset and valuations we've seen should enable a lot more robust M&A activity as we head into 2023. There's a lot of fragmentation and point solutions that need to be consolidated, with employers and commercial payers increasingly looking for solutions that can solve multiple problems. But I think, all things considered, the best companies – the ones that are able to drive high engagement, demonstrate measurable improvements in health outcomes and generate a clear ROI while also driving down costs – should continue to see strong funding.