Boston Scientific bags option on mitral regurgitation startup in $540M deal

Boston Scientific HQ
Boston Scientific's headquarters. (Boston Scientific)

Boston Scientific has secured an option to buy mitral regurgitation startup Millipede. The agreement sees Boston Scientific buy $90 million of Millipede stock upfront and gain the right to acquire the rest of the business for up to $450 million down the line.

The deal is structured so either company can trigger the option. Boston Scientific can choose to pay $325 million and commit to a $125 million commercial milestone to buy Millipede outright any time up to the completion of a first-in-human clinical trial. Once Millipede completes that trial, it can compel Boston Scientific to complete the takeover. Both options expire at the end of next year.

That makes the next two years a critical period in the future of Millipede and the IRIS Transcatheter Annuloplasty Ring System it is developing to treat severe mitral regurgitation. Millipede’s device is designed for use in patients with the functional form of mitral regurgitation, a condition characterized by blood flowing the wrong way in the heart. The functional form tends to affect older patients and people who have multiple comorbidities. As such, open-heart surgery has a poor survival rate. 

This has created a need for devices that can be delivered in transcatheter procedures and address the mitral valve failings that cause blood to flow backward in the heart. Boston Scientific is betting that the semirigid annuloplasty ring in development at Millipede is such a device. 

“Intervening with the least invasive approach at earlier stages of severe mitral regurgitation has the greatest opportunity to alter the natural history of the disease and the progression to heart failure,” Boston Scientific CMO Ian Meredith, M.D., Ph.D., said in a statement. “We believe that restoring mitral annular dimensions via a transcatheter mitral annuloplasty ring will be a crucial component to effective, minimally invasive improvement of mitral valve function for appropriately indicated patients.”

RELATED: Edwards buys mitral valve repair player in $250M deal

Boston Scientific’s decision to acquire the option to buy Millipede continues the steady flow of deals covering mitral valve devices. Other recent takeovers include Edwards Lifesciences’ $250 million agreement to buy Harpoon Medical, developer of a device to repair the degenerative form of mitral regurgitation. 

Further back, Edwards struck a $350 million deal to buy mitral valve replacement company CardiAQ Valve Technologies. And rivals Abbott and Medtronic put together similarly sized packages to secure the rights to replacement technologies from Tendyne and Twelve, respectively.

The stream of deals reflects a belief that the success of transcatheter aortic valve replacement (TAVR) will open up further opportunities for transcatheter valve therapy and that the unmet need in the mitral valve field could see the size of the market for devices such as Millipede’s surpass that of the TAVR sector.