Health marketing M&A in good shape with 28 notable deals completed. Tony Walford writes in The Drum

As part of The Drum’s Health & Pharma Focus, Green Square’s Tony Walford analyses mergers and acquisitions in the sector and looks at what is driving investor interest. Given medicines and therapy purchases are often necessity purchases, less prone to reductions in discretionary spend, and coupled with the significant size of pharma marketing budgets, it becomes obvious why healthcare marketing has always been high up on investors’ wish lists. Historically, medical communications tended to be the preserve of the network advertising groups, all of which have their own healthcare subsets containing various specialist agencies (think Omnicom Health Group, Publicis Health, Havas Health and You – the list goes on), but given the attractiveness of the sector, it’s no surprise we’ve seen a rise in the number of PE firms entering the fray. Some of these are huge $500m revenue life science commercialization firms, such as Eversana (backed by JLL/Water Street) and Blackstone-backed Precision Medical Group, but there are also more marketing-focused groups of varying size, many of which are just as significant. For example, take Avalere Health, previously known as Fishawack. Following an LDC-backed MBO in 2017, it made several strategic acquisitions before reaching a pivot point in 2020 when more substantial investment was needed. This came in the form of Bridgepoint and it has since undergone significant transformation, having acquired 19 agencies and consultancies globally and employing over 1,500 staff. OpenHealth started in 2011 as a joint venture between Chime and its founders. The management team scaled it through acquisition before selling it to Amulet Capital in 2018. Having scaled it further, Amulet subsequently sold it to Astorg in 2022. It’s now around $250m in turnover with over 1,400 staff. Real Chemistry is a major player in the healthcare-integrated communications space and, with New Mountain’s backing since 2019, has invested further into its AI and data analytics capabilities, enhancing its service offerings. At its current 2,000 people and $600m turnover, it’s yet another example of how the right investment-backed strategy can achieve real scale. You can see the trend here. Then there are the more mid-market players, such as Knox Lane-backed groups Spectrum Science and Fingerpaint, Waterland’s Sciris and Levine’s Prime Global. These firms have historically focused on investing in agencies delivering at least £2m profit, but there’s some new and entrepreneurial players entering the mix who are happy to look at smaller opportunities where the skills are a fit for what they are looking to build. When it comes to selling a healthcare agency, there’s no one size fits all. That said, the majority of acquirers are looking for at least £1m EBITDA (and preferably at least twice that) for it to move the needle in terms of their own scale, unless it’s a niche offering or in a market they don’t already cover. So, what’s the market currently doing? In 2023, partly impacted by the hike in debt funding costs and combined with many pharma companies reining in spend, which impacted some agencies’ revenues and profits, the headline number of deals declined. That said, it was still a busy year across the piece with 28 healthcare marketing transactions of note being completed. 2024 has started well and, again, it is predominantly the PE-backed acquirers leading the charge. Eight of the nine marketing-specific deals since January have involved PE and it has been a blend of healthcare comms, digital healthcare, market access and payer advisory agencies being bought. In some ways, we should probably stop referring to these groups as being ‘PE.’ The reality is they are now big trade buyers in their own right and sit at the acquisition table next to the publicly listed outfits – it’s become a bit irrelevant where the funding is from. At Green Square, we’re finding digital health is a particularly active and sought-after area, with a growing focus on AI applications. This includes increasing interest in teletherapy platforms and mental health apps, which are attracting significant investment. AI-driven health tech is one of the hottest topics right now as acquirers seek to gain a competitive edge by incorporating these technologies into their existing marketing offerings, driving better insight and faster results for their clients. Overall, M&A activity in healthcare marketing is likely to remain very dynamic, with those agencies that have specialist disciplines, particularly in data and tech, or of scale, being the most sought-after. We’re seeing no reduction in appetite from buyers and, coupled with potential Capital Gains Tax changes on the horizon for those based in the UK, it’s a good time for independent agencies to consider going to market. Read more

Why Stagwell’s acquisition of Latin America agency Pros makes sense. Tony Walford writes in The Drum

Stagwell’s latest agency acquisition is Pros in Brazil, its first in the potentially lucrative Latin America market. With the deals coming thick and fast, Green Square founder, Tony Walford, puts Mark Penn’s latest deal into context. This morning’s news of Allison’s acquisition of São Paulo’s PROS Agency is the fourth acquisition by Stagwell this year and comes hot on the heels of last November’s Movers+Shakers, Anomaly Alliance’s acquisition of French digital shop What’s Next Partners (WNP), Allison buying the UK Sidekick and Constellation’s purchase of US-based Team Epiphany.

According to Stagwell, PROS will become part of Allison, which has its heritage deep in PR and now offers integrated marketing and communications across 50 markets. While Stagwell commenced operations in LatAm two years ago, this is its first acquisition in the region. So, let’s have a look at what’s been going on. Six months ago, Stagwell sold its integrated healthcare offering, Concentric Life, to Accenture in a $245m cash deal, having previously merged its rare disease agency, Scout, into Concentric to create a 270-person Healthcare specialist. The rationale for the sale, according to chairman and CEO Mark Penn, was to “focus on core digital services, including AI-based digital transformation; strengthening our balance sheet; and investing in our future”. We have to admire a decision to divest. When companies offload assets, there’s always a suspicion it’s because things aren’t going well and they need the cash. True, Stagwell wanted to improve its balance sheet and, like most of its peers, it had taken a bit of a knock due to the tech downturn, but the key driver in this case was healthcare being non-core and Stagwell has not invested in other healthcare agencies since. Given the rationale for the Concentric disposal, looking at the acquisition of Movers+Shakers and the four acquisitions so far this year, what do they tell us in terms of strategy? Founded in 2016, Movers+Shakers is one of the fastest-growing social media agencies, adding 21 new clients in 2023 and was one of the first agencies to embrace TikTok, guiding hundreds of brands onto the platform. Its 20m user-generated campaigns have had over 250bn views and it counts Netflix, Hasbro, E.L.F and Amazon among its clients. Definitely tick(toks) the core digital services box. The next acquisition, in January 2024, Team Epiphany (“TE”) is a content, experiential and influencer agency that is rightfully obsessive about culture. BIPOC founded and run, its outputs are very cool, featuring cultural icons such as A$AP Rocky. Albeit TE uses digital channels, it’s not pure play in this regard. But it’s certainly an investment in the future – culture and neutrality of talent (across all metrics) are core tenets of every company today and TE, which has joined Stagwell’s Constellation network, exemplifies this. In February, UK-based Sidekick (represented by us at Green Square), brought experiential, live events, digital storytelling and branded content to Allison, with clients including Amazon, Deliveroo, Sipsmith and EE. What’s interesting about this deal is Allison had been collaborating with Sidekick for over 12 months before discussing a more permanent alliance. Allison has always been keen to acquire capabilities that it doesn’t already have, regardless of market. Very digitally and culturally focused, Sidekick ticked all the Concentric sale rationale boxes. Next up, WNP (acquired in February) again definitely ticks the “focusing on digital services” box, with expertise in AI-enabled CRM and data, digital creative and content. Adding a French footprint to Anomaly and complementing its other European offices in London and Berlin, it brings a mix of French and other European clients to the fold, including some big names such as Danone and BASF. And now PROS. Another Allison play, this is Stagwell’s first LatAm acquisition, and adds a local entity. Female-founded and run, PROS 130 staff brings further cultural balance to the group, with a 10-year heritage and significant clients including Mondelez, Boticário and Amazon (already a Stagwell client across multiple divisions). PROS 2023 growth was stellar at 50% and 20% is tabled for the current year. São Paulo has the largest economy by GDP in Latin America and is the 12th largest city by population in the world. Strategically this deal looks to make a lot of sense – an agency of significant size and stature, increasing Stagwell’s footprint in the region with a proper investment, and the opportunity to cross-sell other group services. In sum, all the acquisitions post-Concentric make sense and look to be smart strategic buys. So, what’s next? Having made a rumored $700m bid for Martin Sorrell’s S4, which, if successful would have taken Stagwell to 22,000 people and mirrored the size of Havas, Mark Penn is certainly not resting on his laurels. His acquisition of MDC in 2021, and the highly regarded brands within it, really put Stagwell on the map and, given its activity over the last year, and with 4 acquisitions in as many months this year, it will be one of the most interesting groups to watch as 2024 pans out.

Green Square, alongside Passion Partnership, is proud to sponsor the 2024 Communiqué Awards.

As the flagship annual health and medical communications industry award event, we’re excited to be sponsoring the new “Excellence in Pro Bono Working” category. This award recognises sector-leading work in this field by celebrating those agencies and in-house departments who are investing their time and expertise to make a positive impact on issues that need it most. The awards ceremony will take place on 4th July 2024 and further details as to how agencies can work with Passion Partnership to give some of their time to Pro Bono causes for the greater good can be found here: Passion Partnership Communiqué Awards 2024 We’re looking forward to a great events ceremony and to meeting some of you on the night.