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OVERVIEW

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OVERVIEW GOMEZ Emmanuel SQUEDIN Thomas LETURGEZ Thibaut DELEPIERRE Alban * * * * Qu est ce que nuclisens EasyQ et NASBA amplification technology * STS catalyzes the ... – PowerPoint PPT presentation

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Title: OVERVIEW


1
OVERVIEW
GOMEZ Emmanuel SQUEDIN Thomas LETURGEZ
Thibaut DELEPIERRE Alban
2
Institut Mérieux
3
  • Silliker, headquartered in Chicago
  • Institut Mérieux has a 89 holding in the
    company
  • Within the Nutrition / Health division of
    Institut Mérieux, Sillikers mission is both to
    improve nutrition and enhance the quality and
    safety of food products.

4
  • Transgene, based in Strasbourg
  • Biopharmaceutical company dedicated to treating
    infectious diseases and cancer.
  • Institut Mérieux has a 55 holding in the
    company
  • It develops therapeutic vaccines and innovative
    immunotherapy products based on exclusive
    technologies for stimulating patient immune
    systems by using vectors for the expression of
    tumoral or infectious antigens in target cells.

5
BioMérieux Presentation
  • A world leader in the field of in vitro
    diagnostics for over 45 years.
  • Designs, develops, manufactures and markets
    Reagents,
  • Automated instruments.
  • For medical analysis and quality control of
    products of agro-food, cosmetics and
    pharmaceuticals.
  • Contribute to the improvement of public health
    worldwide

6
History
7
Global presence
  • BioMérieux a part of the Institut Mérieux group

BioMérieux is present in 150 countries.
8
Global presence
  • It has 17 production sitesDistributed in
    France, the Netherlands, the United Kingdom,
    Italy, the United States, Brazil, Japan and
    Australia
  • A European logistics center located in France.
  • Based in Marcy-l'Etoile, France
  • Employs 6000 people worldwide, 880 people are
    dedicated in bioMérieux, research, divided in 13
    research centers in the United States, Brazil and
    Europe (Lyon - France, Florence - Italy, Boxtel -
    Country Netherlands).

9
BioMérieux Some results in 2008
  • 8th Global Society in diagnostic biological
  • AC 1 111 million Euros
  • Realizes over 81 of its international business
  • Anonymous Society, capital 12.029.370
  • Sales growth 9,8
  • Cash flow 19

10
Status
  • Anonymous society (AS) is a corporation so named
    because his name does not reveal the names of
    shareholders it may not even know the identity
    when the company is on the stock exchange.
  • Conventional Structure
  • A GD
  • A Board of Directors (11)
  • General meetings.

11
Corporate Governance
  • Board of Directors, Chairman Alain Mérieux.
  • Management Committee 11

Alexandre Mérieux
Alain Mérieux
12
CAPITAL
13
Stock-Market
  • Stock exchange data
  • Number of shares 39 453 740
  • Capitalization of stock-market 3 223.77 MEUR
  • Activity sector Medical equipment
  • Share characteristics
  • Market NYSE Euronext Paris
  • Stock symbol BIM
  • Average daily trading volume in 2008
    approximately 34,700 shares gt for a value of 2.3
    million euros.

14
SHARE PRICE PERFORMANCE IN 2009
15
Acquisitions
16
2006 Sales by technology
17
Economic model
  • ?Very different business model from the
    pharmaceutical industry.
  • Highly diversified product portfolio ? less risk
  • In sales no blockbuster
  • In the development pipeline
  • Shorter development cycles
  • No risk from generics
  • Lower product liability risk In vitro vs In
    vivo

18
A promising market
19
(No Transcript)
20
The sentence
21
Strategy
  • From a strategy focused on the laboratory
  • ?Infectious diseases, oncology and cardiology
  • ?Industrial applications
  • To a strategy focused on pathologies and
    clinicians needs
  • ?Infectious agents clinical and industrial
    applications
  • ?Tests delivering high medical value
  • Oncology
  • Cardiology
  • Point-of-care tests
  • Theragnostics therapeutics and diagnostics

22
Strategy Domain
23
Clinical applications
?become a major reference for doctors and
biologists on key pathologies
?Partnerships with pharmaceutical / biotech
companies specialized in these pathologies. ?Cross
-functional approach by pathologies - One lead
manager for each pathology
24
Commercializing network
25
Commercializing on the quality of commercial
network
2007 2012 Growth rate
5-6
  • Internal RD pipeline
  • Sales network optimization

1
26
Optimization of commercial network
  • Geographical priorities United states and Japan
  • Sustained creation of new subsidiaries
  • Algeria 2007, South Africa 2007,
  • Singapore 2008, Dubai - 2008

27
Etablishment of a global department
  • Creating a world business management

28
Commercializing on the quality of commercial
network
  • Pipeline after internal RD
  • Optimization of commercial network

5-6
1
  • Business Development
  • Distribution agreement
  • Acquisitions
  •  Product companies

1-2
Total
7 - 9
Compound annual growth rate
29
Industry Control
30
Industry Control
?leader sector consolidation
Aim 2012 ? a market share of 30
31
Industry - Strategy
?Became the leader in industry consolidation
  • Undisputed Leadership
  • Capitalizing on the clinical commercial network

32
Partnerships
  • Copan 2007
  • Exclusive worldwide distribution agreement
    authorizing bioMérieux to market, for the
    pharmaceutical industry, an innovative sample
    collection system based on technology developed
    by Copan.
  • This patented product marks a major breakthrough
    because it is the first swab on market that can
    be used to perform a quantitative environmental
    control.
  • ?The unique texture of the Nylon flocked swab
    picks up more microorganism than conventional
    swabs. It is specifically designed for aseptic
    manufacturing facilities control.

33
Acquisition for Industry
34
BTF
  • Provides the world's most precise quantitative
    reference standards for microbiological testing .
  • Use to verify the performance of control methods.
  • Target customers in the industrial microbiology
    market, specifically testing water, food and
    pharmaceutical products
  • ?BTFs range of products and expertise are a key
    addition to portfolio of solutions for
    microbiological control

35
  • Infectious diseases expertise

36
Infectious diseases Clinical diagnostic and
industrial microbiology.
  • Independence and expertise field
  • International scope
  • 45 years of experience and know-how
  • Scientific and technological innovation
  • 13 of the sales in RD
  • 3 main technologies
  • Bacteriology
  • Immunoassays
  • Molecular biology

37
Strategic plan 2007/2012
  • Bacteriology be an incontrovertible leader
  • Accelerate the complete automation of analysis
    processes
  • Focus on chromogenic media
  • Molecular biology become the key leader in
    sepsis and HAI
  • Be the leader of molecular diagnostic automation
    of HIV and hepatitis
  • Biochips launch of a multi-target genetic test
    PLC (ADNA project)
  • Immunoassays increase the number of
    high-medical-value tests and reinforce the Point
    of Care activity
  • VIDAS/VIDIA extend the product range
  • Patients Point of Care
  • Based on the expertise in infectious diseases,
    technical mastery and on a large number of
    products already on the market.
  • Positioning Full automation Point of care in
    clinical market

38
Areas of Expertise
  • Healthcare Associated Infections ?
  • HIV ?
  • Sepsis ?
  • Tuberculosis ?
  • CNS infections
  • Gastro-intestinal infections
  • Hepatitis
  • Mother-to-child transmission
  • Urinary tract infections
  • Respiratory infections
  • Sexually transmitted infections

39
Products and strategy
  • Improve the clinical presence (Superbugs,
    Theranostic )
  • Transverse approach regarding pathologies
  • One manager for each pathology
  • One sponsor for each pathology in the executive
    committee
  • ?Partnerships with pharmaceuticals
    industries/biotechs working on those diseases.

40
Healthcare Associated Infections
  • Among the 10 leading causes of mortality in
    industrialized countries.
  • Impact on the length of hospitalization and
    related healthcare expenses.
  • 5 billion annually in U.S. (WHO figures, 2005)
  • Affect around 10 of hospitalized patients, 1.4
    million worldwide each day
  • Often characterized by resistance to antibiotics
  • bioMérieux research
  • New strains of drug-resistant bacteria adding to
    collection of over 30,000 bacterial stains,
    Centers for Disease Control (CDC)
  • Automation Full Microbiology Lab Automation,
    futher reducing time to result for bacterial
    identification.
  • Chromogenic media direct, reliable and rapid
    isolation of bacteria
  • Prevention and surveillance screening of
    patients, hospital environmental controls,
    epidemiological surveillance.
  • Intervention identification, antibiotic
    susceptibility testing, genotype
    characterization, identify the source of
    infection and prevent epidemics.

41
Sepsis
  • Sepsis is the leading cause of death in
    non-coronary intensive care units.
  • Mortality from severe sepsis 32 to 54
  • In developed countries estimation of 3,000
    people die of severe sepsis a day.
  • In US, total cost of 16.7 billion dollars a year
  • Due to the aging of the population, invasive
    diagnostic techniques and increasing bacterial
    resistance to antibiotics, the number of patients
    with sepsis is rising steadily worldwide.
  • bioMérieux research a race against the clock
  • Tests easier to use, at the patient points of
    care
  • Reduced time for the analysis of blood samples
    from several days to just 2hours
  • Diagnostic
  • Procalcitonin (PTC), introduced in VIDAS system.
  • 20min to have early indications so the patient
    can be given adequate treatment
  • Same technology for monitoring antibiotic therapy
    and patients response to treatment
  • Bacterial identification and antibiotic
    susceptibility testing VITEK 2 system, Etest
    (MIC)
  • Automated blood culture BacT/ALERT 3D, rapid
    growth and detection.

42
FMLA Full Microbiology Lab Automation TM
  • To face challenges, automation
  • Standardization
  • Speed
  • Controlling healthcare costs
  • Added value
  • - Inoculation of Petridishes PREVI Isola
  • - Automated staining of sample slides PREVI
    Color Gram
  • - Urinary screening (detection of bacteria and
    particles) UF-1000i 
  • - Blood culture BacT/ALERT
  • Identification of bacteria and automated
    antibiogram VITEK 2
  • - Genotyping of microbialstrains DiversiLab
  • - VIDAS
  • - NucliSENSEasyQ
  • - NucliSENS easyMAG

5
A strategic partnership with Hitachi
High-Technologies Corporation focused on
microbiology and molecular diagnostics
43
Patients Point of Care
  • Test performed and interpreted near the patient,
    by a physician or a nurse.
  • An estimatedmarket of 4b
  • U.S. 65 of the market
  • Averagegrowth rate 10 a year
  • bioMérieux POC strategy
  • Manualrapid tests
  • QuickVue tests distribution agreement
    withQuidel (2008)
  • Meikang Biotechrapid tests following acquisition
    (2010)
  • Handheld diagnostic solution Partnership with
    Philips (2013)

44
Results - Q4 2009
  • Clinical field 7,4 sales increase
  • Extraction reagents (NucliSENS easyMAG) H1N1
    influenza
  • Interest in FMLA (audit asked) especially PREVI
    Isola and PREVI Color Gram
  • Immunoassays VIDAS, microplate screening, rapid
    testing

45
2009 Product Launches
  • bioMérieux expanded its line of automated
    screening tests for Methicillin Resistant
    Staphylococcus aureus (MRSA), one of the leading
    causes of healthcare-associated infections
  • In the US, chromID MRSA, chromogenic media that
    enables visual identification of MRSA colonies in
    patient sample
  • In Europe, NucliSENSEasyQ MRSA, molecular
    diagnostic MRSA test on the EasyQ automated
    platform
  • For both emergency and routine patient situations
  • 17 new productswerebrought to marketduring the
    year
  • NucliSENSEasyQ HIV-1 v2.0, help FU of HIV
    positive patients
  • VIDAS EBV, detection of EBV, 80 of infectious
    mononucleosis cases
  • VILINKTM, a secure network connection for VITEK2
    installations
  • VITEK2 PC 4.02, software application compatible
    with European antimicrobial susceptibility
    standards (EUCAST)

46
Bacteriology - strategy
47
Bacteriology - Strategy
  • ?Become the undisputed leader
  • More than 40 years of experience
  • More than 50 of the market in automated
    bacteriology

48
Partnerships
  • Cepheid - 2007
  • The product menu comprises both bacterial and
    fungal identification assays as well a series of
    genetic markers for antibiotic resistance.
  • Cepheid is in charge of manufacturing
  • bioMérieux distributes the sepsis assays
  • LabTech Systems - 2007
  • signed an exclusive worldwide license agreement
    for LabTech Systems automated pre-poured media
    (PPM) ? MicroStreak.
  • Eiken Chemical Co., Ltd. (Japan) - 2007
  • Production of PPM for Biomérieux by Eiken
    Chemical Co.
  • Sysmex (Japan) - 2008
  • UF-1000i is highly standardized and automated
    solution for urinary screening methods.
  • Quidel (USA) 2008
  • Exclusive distributor of Rapid diagnosis test for
    Quidel. (Except USA, Japan and Scandinavia)

49
Acquisitions for bacteriology
50
Acquisition of PML microbiological
  • In vitro diagnostics company that provides
    culture media and microbiological products for
    both clinical and industrial applications.
  • ?With this acquisition, bioMérieux is now

51
Molecular biology
52
Molecular biology - Strategy
  • ?Become the leader in sepsis and
    hospital-acquired infections
  • Expertise across the chain
  • ? extraction, amplification, detection
  • Ability to capitalize on know-how in infections

53
Partnerships
  • NuGEN Technologies Announce Cross-License and
    Supply Agreement. (USA) - 2007
  • NuGEN's exclusive WT-Ovation RNA Amplification
    System.
  • enhances Biomérieux amplification capabilities
    for clinical use.
  • AdvanDx (USA) - 2007
  • To provide rapid results for Bloodstream results.
  • identification of bacteria and yeast from
    positive blood cultures in less than three hours.
  • Hitachi High-Technologies (Japan) 2008
  • RD partnerships Focus on Microbiology and
    Molecular Diagnostics

54
Immunoassays
55
Immunoassays - Strategy
?Extend the high medical-value test menu and
strengthen the point of care business
  • Installed base of more than 20,000 instruments
  • Expertise in antibodies

56
Partnerships and Acquisitions
57
China Strategy
58
bioMérieux in China today
  • A long-standing presence
  • Since 1978
  • 1992 Hong Kong
  • 2005 HQ moved to Shanghai
  • 5 offices and more than 100 FTE
  • A large distributor network
  • A strategic foot hold in China
  • A large site and a strong team (mid-2010)
  • China becomes bioMérieux 3rd corporate pillar
  • Research team in Fudan University Cancer Hospital
    (Shanghai)
  • Joint-venture with Shanghai Kehua Bio-engineering
    (microplates)
  • POC strategy Manual rapid testsPhilips
    partnership
  • Meikang Biotech acquisition  this adds up 

59
MeikangBiotechActivites synergy
  • A well-establishedc ompany, Dr Chang - 1992
  • 150 employees, 100 contractors
  • Sales about 5M
  • A wideproduct range rapid tests
  • Infectious diseases
  • Carido-vascular and oncology
  • Drugs of abuse
  • Pregnancy and hormone testing
  • A fully-owned manufacturing site in Shanghai
  • 9,000m2 on 2 hectares of land
  • 30 million tests per year
  • Certifications GMP, ISO 9001, ISO 13485,
    Manufacturing license class III (Shanghai FDA)

60
MeikangBiotechHigher ambitions for the Group
  • Support business growth in China
  • Rapid tests ideally complementing bioMérieuxs
    product offering, mainly for infectious diseases
  • In the coming years additional production
    capacities
  • Optimize cost structure of products for
    developing countries
  • Leverage RD expertise and develop innovative
    products
  • Additional immunoassay RD capabilities for new
    rapid tests
  • A beachhead for the rapid diagnostics and POC
    markets

61
Theranostics
62
Theranostic
  • The good drug for the good patient at the good
    time
  • A theranostic is a diagnostic test that helps
    clinicians make the right therapeutic decision
    for the right patients, enabling a more
    personalized approach to medicine.

63
Theranostic
64
  •  Le theragnostic devrait déboucher sur un fort
    développement commercial après 2012 

65
The Scientific need
  • The overall five-year survival rate is still only
    66. Causes for this high mortality rate include
  • late diagnosis
  • challenging tumor identification and
    classification
  • inappropriate treatment, all of which lead to
    poorer patient outcomes

66
Partnerships - Cancer
  • Leading Biotech for discovery and validation of
    molecular biomarkers and proteomics,
  • particularly for early detection and prediction
    of treatment efficacy
  • ExonHit (France) breast, colon and prostate
  • ProteoSys (Germany) prostate cancer
  • Other partners contribute their expertise
  • French Atomic Energy Commission (CEA)
  • the French National Scientific Research Center
    (CNRS)
  • the Lyon University Hospitals (HCL)
  • ST Microelectronics (ST)
  • Claude Bernard University in Lyon (UCBL).

67
Biomarkers Development
68
Plan 2007 -gt 2012
69
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70
Sept. 17, 2007. Patership in theragnostic
development
  • Co-funded The development of a companion test for
    BN83495 intended for both
  • Clinical development of the compound
  • Diagnostic test  potentially for future
    commercialization
  • The test will be developed on NucliSENS EasyQ
    molecular diagnostics platform. NASBA
    amplification technology.(CLIA certified
    laboratory)
  • Tumour marker tests
  • determining the molecular signature of tumours
  • guiding a rational choice of treatment for
    defined patient groups.

71
The Target
  • Novel breast cancer therapy
  • designed to block the steroid sulfatase enzyme
    (STS).
  • sulfated steroid precursors estrogens
  • STS
  • during pregnancy
  • Found in hormone-dependent breast cancer in
    postmenopausal women, but not BMI.

Role of steroid sulfatase in local formation of
estrogen in post-menopausal breast cancer
patients.Nakata T, Takashima S, Shiotsu Y,
Murakata C, Ishida H, Akinaga S, Li PK, Sasano H,
Suzuki T, Saeki T.Pharmaceuticals Research and
Development Division Kyowa Hakko Kogyo, Tokyo,
Japan. taisuke.nakata_at_kyowa.co.jp
72
BN 83495 Phase I
73
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74
Tyverb, lapatinib
  • Lapatinib is an oral small-molecule
  • inhibitor of the ErbB2/ ErbB1 TK receptor.

Trastuzumab Lapatinib
75
Tyverb, lapatinib
  • Develop in breast cancer
  • Over expression of these receptors has been
    reported in a variety of human tumors.(squamous
    cell/gastric cancer)
  • Associated with poor prognosis and reduced
    overall survival.(agresive form of advanced
    breast cancer)
  • Limits
  • Not in Monotherapy
  • Poso 5 tablets/ day, every days
  • 2 x 70 tablets 2537,74
  • Adverse reactions, at least 10 of patients
    (Gastro-intestinal, dermatologic, fatigue)

2174 / month
76
Approval and fundedLapatinib received approval
in june 2008
  • FDA - EMEA
  • 1st indication In combination with Xeloda
    (growth inhibitor) for a particular type of
    aggresive breast cancer ErbB2. After treatment
    with standard chemotherapy regimes including
    intravenous trastuzumab
  • 2nd indication in combination with letrozole
    (aromatase inhibitor) for the first-line
    treatment of HER2-positive metastatic breast
    cancer in postmenopausal women.
  • FDA
  • 3thr indication in combination with letrozole
    (aromatase inhibitor) for the first-line
    treatment of HER2-positive metastatic breast
    cancer .
  • Refusal to pay for lapatinib as a 1st-line and
    2nd-line treatment for HER2-positive breast
    cancer (EGF 30008)
  • gtfinding it was not cost-effective.

77
Cost-effectiveness
  • Analysis lapatinib capecitabine vs capecitabine
    monotherapy
  • the QALY gain was 0.171 at an incremental cost of
    13,873
  • Incremental cost-effectiveness ratio (ICER) of
    81,251 per QALY gained. Max 35,000
  • the cost effectiveness of lapatinib was
    particularly influenced by the extent of
    trastuzumab use post progression and the
    progression free patients receiving trastuzumab.

78
COMMISSION DE LA TRANSPARENCEAvis 16 juillet 2008
  • LEMEA a attribué à TYVERB une AMM
    conditionnelle, en labsence
  • - de données robustes sur lefficacité de TYVERB
    sur lincidence des métastases cérébrales
  • - et de démonstration sur la survie globale.
  • Le rapport bénéfice/risque sera réévalué
    annuellement. La firme sest engagée auprès de
    lEMEA
  • - données de survie étude EGF 100 151
  • - phase III comparative vs HERCEPTIN
  • Evaluer leffet de TYVERB sur lincidence des
    métastases cérébrales site de rechute (Le
    rapport final soumis en mai 2013).

79
November 17, 2009
  • Development of a predictive test gt treatment
    best suited to different populations suffering
    from breast cancer.
  • This test will be developed from new biomarkers.
    After approval by regulatory agencies, it can be
    used for both cancer receiving adjuvant therapy
    and metastatic cancer
  • Test ErbB2 / ErbB1 ???
  • GSK did not reveal the specific breast cancer
    drugs that the predictive test would accompany.

80
Oncology pipeline
81
  • GSK's decision to work with BioMerieux capacity
    to scale up the development and marketing of the
    test. (not only a biotech)
  • GSK Opportunity for label integration and
    co-marketing

82
AviaraDx acquisition
  • En septembre 2008
  • le Groupe a acquis la société AviaraDx, Inc.
    spécialisée en diagnostic moléculaire des tissus
    tumoraux à partir de biopsies.

Accrédité par un CAP
83
THEROS Breast Cancer IndexSMBreast cancer
recurrence
  • Breast cancer patients are typically classified
    by 3 factors
  • 40 to 50 percent of breast cancer patients are
    inaccurately classified as intermediate risk
    according to St. Gallens risk
    assessment guidelines.
  • under-treatedgt overall survival
  • over-treatedgt cost, side effect
  • Better classification means better treatment
    selection
  • Test is a combination of 2 independent tests
  • ER and PR , endocrine therapy.
  • Tumors ,be sensitive or resistant to
    chemotherapy.

84
THEROS technology
  • THEROS Breast Cancer ? and THEROS CancerTYPE ID
  • objective diagnostic tool
  • quantifiable
  • Practical
  • clinically impactful.
  • faster,
  • effective
  • avoid expensive
  • real time RT-PCR based assays compatible with
    many form of samples.
  • extraction of RNA
  • reverse transcription to cDNA
  • quantitative measurement using real time PCR

85
THEROS CancerTYPE ID
  • 1.4 million new cases ofcancer in the US, 3 to 5
    of new cancer are  cancer
  • of unknown primary  Diagnotisis
  • -lengthy
  • -expensive 18,000
  • Diagnostic tools used studying cells and tumors
    with microscopes, laboratory cell stains ,
    imaging
  • often fall short of identifying where a cancer
    started and what type it is.
  • Molecular diagnostics provides important
    information for cancer type identification
  • The price of a Cancer type test is 3600
  • Recognize over 75 of solid tumors. activity
    levels of 92 genes
  • distinguish up to 39 different tumor types and 64
    subtypes

Schapira DV, Jarrett AR. The need to consider
survival, outcome, and expense when evaluating
and treating patients with unknown primary
carcinoma. Arch Inter Med.1552050-2054, 1995.
86
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87
  • SAN DIEGO Breast Cancer Symposium
  • December 12, 2009
  • three studies using the companys breast cancer
    molecular test (leader dopinions)

88
  • http//www.biotheranostics.com/wp-content/uploads/
    Test-Requisition-Form-website.pdf
  • a two-year agreement with Lab21 to commercialize
    the bioTheranostics THEROS CancerTYPE ID

89
  • Conclusion

90
Clear objectives
  • a strategy focused on patients and pathologies
  • Infectious agents clinical and industrial
    applications
  • high medical-value tests oncology, cardiology,
    point of care and theragnostics
  • Strategy that leverages their strenghs
  • Bacteriology leadership
  • Industry lead sector consolidation
  • Molecular biology become the leader on sepsis
    and hospital-acquired infections
  • Immunoassays extend the high medical-value test
    menu and strengthen the point of care business
  • Theranostics become a preferred partner for
    pharmaceutical and biotech compagnies

91
Good financial results for the third quarter
Sysmex Biomerieux become Sysmexs global
partner for distributing UF-1000i
Acquisition of BTF
Institut Mérieux sells Laboratoire Marcel Mérieux
shares its CEO
AviaraDx acquisition Bad financial results in
USA1
Flu threat
Cepheid Relationship in the development and
commercialization of an innovative line of sepsis
test products
92
SWOT
93
Future Acquisitions ?
  • Biomonitor ?
  • Danish biotechnology company leader in thenostics
    and combine development of innovative and
    proprietary clinical bioassays.
  • Products iLite ? Products based upon the
     gene reporter  technology.
  • Exonhit ?
  • A world leader in the exploitation of alternative
    RNA splicing.
  • Is ability to identify genes whose splice
    variants produce abnormal proteins can be used to
    develop tests for diagnosing diseases at an early
    stage.

94
Conclusion
Conclusion
95
Who wants to work at bioMérieux
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