Rank: #15 (Last year: #13) $9.52 Billion (€9.14B)
Prior Fiscal: €8.76 Billion
Percentage Change: +4.4%
R&D Expenditure: €526M
No. of Employees: 64,262
Global Headquarters: Melsungen, Germany

In late September 2024, a nightmare scenario played out for a medical device manufacturer. As a result of Hurricane Helene, historic flooding took place in Asheville, N.C., home to Baxter’s primary facilities for IV solutions. In fact, the location was reported to be responsible for approximately 60% of the nation’s supply. The incident put the IV solution supply at critical risk.

With the threat of Hurricane Milton hitting Florida just weeks later, B. Braun was cautious to attempt to avoid a similar situation at its facility. As the reports over the expected intensity at the time of landfall grew more dire, those at the company took action. Aided by the federal government via the Administration for Strategic Preparedness and Response (ASPR), the firm sent more than 60 truckloads (approximately 70,000 cases) of IV solutions north and out of Florida. Had the products remained at the location and a similar outcome as Baxter’s experience took place, many vulnerable populations that depend on the IV solutions would have faced a significant issue.

Fortunately, B. Braun reported its manufacturing plant and distribution center in Daytona Beach, Fla., were not seriously impacted by Hurricane Milton and resumed operations on Oct. 11, just days after landfall. The product shipped out of Florida was able to be returned to the location so normal distribution procedures could be renewed.

The company also announced initiatives it was taking to help increase the much-needed supply of IV fluids and complementary medical devices. The Florida location, along with the firm’s Irvine, Calif., facility increased production of IV fluids by 20%. In Allentown, Pa., the company expanded manufacturing of tubing, valves, connectors, and other devices. The increases were reported to result in the offering of 30 million additional IV sets annually.

“I want to thank the officials at ASPR and other federal agencies who have been working with us day and night to address this situation and also all of our employees who are demonstrating their commitment to patient care by their tireless efforts to increase the supply of these vital products,” Rob Albert, CEO of B. Braun of America, said in a company statement. “Events like these are why B. Braun invested well over $1 billion in the last five years to increase our capacity to supply these critical healthcare products from facilities on both coasts. We will continue to do everything we can, working closely with government agencies, industry partners, and other stakeholders, to help ensure that providers and patients get the infusion therapy products they need.”

Albert had taken on the CEO role earlier in the year on April 1, although he had been with the company for almost 40 years. Starting as a manufacturing supervisor in operations in 1984, Albert moved through the ranks of the organization, also spending time in roles in marketing and sales. He had been serving as senior vice president and chief marketing officer of B. Braun Medical Inc. before the promotion to CEO.

FROM THE TOP: “Our work is guided by a clear focus on our customers and their everyday responsibilities. We develop, produce, and supply high-quality, safe medical products for them—such as automated infusion pumps, digital surgical microscopes, and innovative dialysis machines. By combining these products with software and services, we deliver smart solutions that improve treatments and workflows alike: intensive care units are becoming quieter, surgeries are more precise, and dialysis more efficient. This makes us a true partner for those who depend on our solutions.”

—Anna Maria Braun, CEO

Albert succeeded Jean-Claude Dubacher who remained as chairman of the board of B. Braun of America, where his responsibilities shifted to a global management role. “As I assume my new global role in the B. Braun organization, I could not be more confident that we have selected the right person to lead B. Braun of America,” said Dubacher. “Rob’s business knowledge, innovative mindset, industry leadership, and passion for people are unmatched. Under his leadership, B. Braun will continue making a lasting difference for the millions of patients and providers who depend on our products and services.”

Regarding those products, the organization made several announcements concerning them during the 2024 fiscal year.

In February, B. Braun launched its new Heparin Sodium 2,000 units in 0.9% Sodium Chloride Injection, 1,000 mL (2 units/mL). This marked the fifth product in its portfolio of Heparin premixed bags. The offering enables the organization to serve the diverse needs of healthcare facilities and their patients for this high-alert medication.

A new Levetiracetam in Sodium Chloride Injection line of products was launched in May. The offering expanded the company’s portfolio in the anticonvulsant space with Levetiracetam in three concentrations.

July saw the first U.S. hospital to convert to NRFit connectors. While B. Braun had supported more than 3,000 conversions worldwide prior to this event, the occasion was significant as a promotion of patient safety since they prevent accidental connection to devices for other applications. Gillette Children’s Hospital in St. Paul, Minn., transitioned to the new ISO Standard for neuraxial and regional anesthesia devices, which are 20% smaller in diameter than Luer connectors.

The Introcan Safety 2 Deep Access IV Catheter, the latest addition to the brand’s portfolio, gained FDA 510(k) clearance near the end of September. The product merges the technologies of the original Introcan Safety 2 Multi-Access and Introcan Safety Deep Access Catheters, offering clinicians an advanced solution that combines the strengths of both devices. The catheter provides fully automatic passive safety needlestick protection and multi-access blood control in longer lengths and is designed to access deeper veins in patients with difficult vascular access and to achieve longer dwell times.

B. Braun Interventional Systems Inc., a member of the B. Braun Group of Companies, provided its own product announcement during the fiscal year. It launched its ACCEL All-Purpose and Biliary Drainage Catheters with TrueGlide Hydrophilic Coating for percutaneous drainage. The catheters are designed for optimal patient comfort and clinical care; they feature large oval holes designed to maximize fluid drainage volume, while the TrueGlide Hydrophilic Coating helps with a smooth catheter insertion.

A week before the U.S. sat down to Thanksgiving dinner, Aesculap Inc., one of the largest manufacturers of surgical instruments, launched its next generation of bone punches—SQ.line KERRISON Bone Punches. Designed specifically to meet the demands of spinal and cranial neurosurgery, SQ.line KERRISON Bone Punches help ensure the surgeon and staff are equipped with a dependable and comfortable instrument.

These products join the portfolios of a company that’s enjoyed modest growth year over year, growing by almost €2 billion since 2020. The organization’s latest annual take was €9.14 billion, a 4.4% rise.

Leading the firm’s three units in terms of revenue was Hospital Care, which grew by 5%. That figure translated to €4.93 billion in sales. B. Braun reported the increases as coming primarily from three regions—Germany, Western Europe, and Eastern Europe. While an FDA inspection in 2023 resulted in a San Diego location being closed and subsequent loss of sales in personalized nutrition, gains in other product areas offset the decrease.

Aesculap filled the company’s coffers with €2.16 billion, which represented 6.2% growth over the previous year. The elevation was attributed to strong sales in the same regions as Hospital Care, with North America also added to the list. On the other hand, Asia-Pacific saw diminished results.

Jumping by almost 2%, Avitum wrapped up its fiscal year with €1.88 billion in revenue. The gains were reported as being due to rising sales in Western and Eastern Europe, as well as the LATMEA region.

€8.76 Billion ($9.67 Billion)
Prior Fiscal: €8.5 Billion
Percentage Change: +3.0%
R&D Expenditure: €485M
No. of Employees: 63,011

As healthcare rapidly embraces artificial intelligence and finds new clinical uses for the smart tool, companies are also seeking to leverage the capability outside the direct diagnosis or treatment of patients. In 2023, B. Braun Medical began exploring the use of artificial intelligence as a way to maintain and service their products in the field. Billed as Service Assistant, the software aids a technician in the identification and diagnosis of a dialysis machine that has a problem.

“The development of the Service Assistant is setting standards for technical services. Quick and agile implementation of new technology in the service process allows us to keep refining the high efficiency of our services,” said Alexander Kammenhuber, head of Technical Services at the company.

The software also allows for the technician to quickly and efficiently check on the availability of a necessary part to complete a repair. In addition, it can provide the necessary steps required to replace a component and what tests will be needed to ensure the repair was properly done.

“Of course, I can look up the part numbers for replacements or the repair steps myself,” said Claudia Esteban Patón, a 25-year-old service engineer. “But with the Service Assistant, it goes much faster and it works perfectly with my daily routine.”

One day, Patón may use the Service Assistant tool to check on an infusion system connected to the DoseTrac Enterprise Infusion Management Software, a next-generation infusion management software solution launched in June 2023. The product provides users a mix of real-time views and retrospective reporting features to help them better understand their infusion pump fleet and associated data.

Further, the platform can connect up to 40,000 pumps at an unlimited number of facilities with just one application. Since DoseTrac enables users to manage their infusion pumps from a single central application regardless of number of units or locations, pumps can be moved between locations seamlessly without any loss of data.

The organization also gained clearance from the U.S. FDA for its AQUAbase nX Reverse Osmosis System, which provides high-quality water for dialysis patients without the use of chemicals. The system has up to a 75% raw water conversion rate that may conserve water usage and reduce costs of power, pre-treatment, and maintenance of equipment.

In October, B. Braun Medical launched its Introcan Safety 2 IV Catheter with Multi-Access Blood Control. In addition to automatic needlestick protection, clinicians are protected from blood exposure by a blood control feature every time the hub is accessed. This functionality reduces the risk of bloodborne pathogen exposure throughout the IV process. According to the company, studies show passive, fully automatic safety devices prevent needlestick injuries two times better than a semi-automatic “push button” safety shield and three times better than a manually sliding shield.

About two weeks before the end of the 2023 calendar year (and B. Braun’s fiscal year), the firm launched the CARESITE Micro Luer Access Device and Extension Sets. The innovation was designed to reduce exposure to harmful chemicals and decrease infection risk, making IV access safer for patients and healthcare providers. Made with a drug-resistant material, the BPA-free device can help reduce the risk of infections and drug exposure resulting from stress cracks associated with material and drug incompatibility.

These products join a company that tallied €8.76 billion during its 2023 fiscal year. This represented a 3% increase over the previous period and continued a string of gains year-over-year, with the exception of a minor dip in 2020.

The company’s largest unit, Hospital Care, enjoyed a 3.4% rise to finish at €4.69 billion. According to B. Braun, this was primarily attributed to gains in Western Europe and Latin America. While a recall and temporary production stoppage occurred with the CAPS (Central Admixture Pharmacy Services) business due to an FDA inspection in the U.S., other offerings achieved greater sales and offset any decrease.

The Aesculap business experienced a 5.2% rise over 2022 to add €2.16 billion to the company’s coffers. Sales growth was witnessed in Europe, the U.S., and areas of Latin America. Demand was especially strong for knee and hip implants, surgical instruments, imaging systems, and suture material.

Avitum, the smallest revenue-generating division, contributed €1.85 billion to the firm’s 2023 revenue, almost flat against prior year (down 0.7%). As the demand for infection prevention decreased as the world moved further away from the height of the pandemic, so too did sales of the firm’s gloves and masks as a result. While sales of extracorporeal blood treatment products grew a small amount and wound, ostomy, and continence care all saw gains, it was not enough to offset the minor decrease for the year.

While Avitum did see a slight loss in revenue, it did gain a very important employee. Dr. Jean-Claude Dubacher was appointed as a member of B. Braun’s Executive Board on Dec. 12 and would take on the responsibility for overseeing Avitum. The move relieves company CEO Anna Maria Braun of the task as she had been pulling double duty on an interim basis. Dr. Dubacher started with the company in 2019 as CEO and chairman of the board of B. Braun of America. Before that role, he was with Johnson & Johnson’s EMEA surgical ophthalmology division.

Also joining the Executive Board of B. Braun SE (officially Jan. 1, 2024) was Ingrun Alsleben. Formerly with Bayer Group as CEO/CFO for Turkey and Iran, Alsleben would replace the retiring Dr. Annette Beller as the company’s CFO (on April 1, 2024). In the announcement regarding the change from August 2023, Prof. Dr. Thomas Rödder, chairman of the Supervisory Board of B. Braun SE, stated, “I am delighted that with Ingrun Alsleben we have been able to recruit an exceptionally accomplished and internationally experienced financial expert and leader to the B. Braun SE Management Board. Mrs. Alsleben is just as familiar with successful transformation processes as she is with different cultural requirements—both are very valuable for B. Braun.”

In addition to new products and personnel, B. Braun also rolled out a new educational platform for healthcare providers. Billed as B. Braun e-University, the platform is intended to help improve clinical practice and patient care. It aids providers in staying current with education, with 50 on-demand and microlearning video courses (at the time of launch; now about 80) covering Infusion Systems, IV Fluids and Irrigation, IV Sets and Access Devices, Vascular Access, Closed System Drug Transfer Devices, Compounding, Drug Preparation, and Pain Control. Continuing education courses are also available through the platform.

Continuing its emphasis on education, the company proudly announced the global accreditation of Aesculap Academy by the Royal College of Surgeons (RCS) of England. Founded in 1995, the Academy offers a wide range of training courses and seminars worldwide for doctors and nurses. In 2022, more than 268,000 healthcare professionals were trained in about 4,200 courses worldwide, on-site and online.

The accreditation process is a review of the entire surgical education center. This includes the assessment of facilities, resources, faculty, and the education portfolio, as well as the quality management processes that underpin the delivery of the center’s educational product. RCS England center accreditation is only awarded where there is a clear demonstration of the quality of each of these components.

“We are honored and very proud that the Royal College of Surgeons of England has recognized the Aesculap Academy for the quality of our training not only in several countries, but globally,” proclaimed Dr. Gabriela Soskuty, managing director of Aesculap Academy.

€8.50 Billion ($9.07 Billion)
Prior Fiscal: €7.86 Billion ($8.9 Billion)
Percentage Change: +8.1%
R&D Expenditure: €541M
No. of Employees: 65,055

Plastic waste from medical devices and its manufacturing has been an ongoing concern for some time—but with greater attention put toward environmental impact in recent years, the spotlight has perhaps never been brighter. Fortunately, many companies are attempting to tackle the issue, trying to resolve it within their own firms, which, of course, could lead to best practices other organizations could replicate.

In the latter portion of 2022, B. Braun announced it had secured a state grant to fund a recycling project involving medical plastics waste. The goal of the effort was reported to leverage advanced technology to recycle non-hazardous plastic waste from the company’s Hanover Township manufacturing site and the Lehigh Valley Health Network’s Cedar Crest Hospital.

Scrap materials from the B. Braun location as well as packaging materials, non-PVC IV bags, disposable gowns and masks, and irrigation bottles from the hospital would be collected and recycled. Both organizations are working with PureCycle Technologies, a company that uses a patented technology to separate color, odor, and other contaminants from certain non-hazardous plastic waste feedstock to transform it into virgin-like recycled polypropylene.

“This project provides an opportunity to make a big impact on the growing challenge of reducing plastic waste from hospitals in our healthcare system,” said Pennsylvania Senator Pat Browne, Chairman of the PA Senate Appropriations Committee, who helped secure the grant. “I commend B. Braun and Lehigh Valley Health Network for having the vision to work together to address this important sustainability issue.”

Its recycling project wasn’t the only positive environmental news to involve B. Braun during its 2022 fiscal. According to WFMZ-TV, a regional news outlet for the area, the U.S. Environmental Protection Agency (EPA) declared the company’s Allentown facility was not among the 23 highest risk locations involving ethylene oxide (EtO) emissions. During the agency’s Dec. 1 webinar, it also stated the firm didn’t break any rules regarding those emissions.

The EPA based its assessment on data from a two-year study that ended in July 2022. It was also revealed the risk radius for exposure to the emissions dissipated at a quarter to a half mile from the site.

During the EPA’s webinar, a representative of the state’s Department of Environmental Protection (DEP) was complimentary of B. Braun and the actions taken to eliminate as much risk as possible. The company worked with the DEP to update equipment to minimize the EtO emissions. “Once it became clear that there was a risk in that area, B. Braun proactively installed controls,” explained Andy Sweitzer, air quality environmental group manager for the state DEP. “I wish other facilities were as proactive as B. Braun.”

B. Braun’s FY22 financials also had a positive story to tell. The firm finished the year with an 8.1% rise over the prior year. In real figures, that translated into €7.86 billion in 2021 to grow to €8.5 billion in 2022. Gains were enjoyed across every region of the world in which the firm sells medical products with the exception of Germany, which saw a minor decrease year over year.

Digging deeper, each of B. Braun’s three primary businesses each posted growth in their sales figures. Hospital Care jumped 10.1% to close its books at €4.54 billion, attributed to inflation-driven price adjustments and stable demand. The Aesculap division mirrored its sister segment with a 10% progression over the previous year, adding €2.06 billion to the company’s coffers. These gains were primarily a result of increases in demand for knee and hip implants, surgical instruments, and suture materials. With a modest 1.7% bump, the Avitum division came in at €1.86 billion, noting extracorporeal blood treatment therapies as a leading reason.

In 2022, B. Braun also took a number of steps to ensure its financials continue to travel in the right direction. In the middle of the year, it launched its new Introcan Safety 2 IV Catheter with one-time blood control. The product was developed with clinician safety in mind as it reduced needlestick injury risk and blood exposure. The device’s Blood Control Septum is designed to restrict the flow of blood from the catheter hub after needle removal until first connection of a Luer access device.

Continuing with the IV products topic, the company also declared it had gained the FDA’s approval for a new pharmaceutical manufacturing plant in Daytona Beach, Fla. It was stated the site would produce 0.9% sodium chloride for Injection in the organization’s Excel Plus IV Bags (available in both 1,000 mL and 500 mL sizes). B Braun noted the Daytona Beach facility was part of its more than $1 billion investment to address IV fluid shortages in the United States.

Addressing another challenge (this one regarding a cybersecurity concern), the company announced it earned UL 2900-2-1 (Software Cybersecurity for Network-Connectable Products, Part 2-1: Particular Requirements for Network Connectable Components of Healthcare and Wellness Systems) certification for its Space Infusion Pump System. The achievement was accomplished through the UL Cybersecurity Assurance Program.

According to a news release, the evaluation included a review of all of B. Braun’s development processes for software to determine if they reflected “cybersecurity best practices and a security-minded approach.” It also involved an examination of internal processes to determine the organization’s ability to inform customers of cybersecurity issues, mitigate them, and provide updates.

“The value of integrated systems must never be taken at face value without also remembering that cyberattacks are a serious threat in any clinical setting,” said Jonathan Stapley, senior director marketing—Active Devices at B. Braun. “The importance of taking proactive steps to minimize risk cannot be overstated. We sought third-party experts at UL Solutions to evaluate our Wireless Space Infusion Pumps and the processes that support them to confirm that.

The company also sought to expand its product catalog through M&A. This transaction (financial details were not disclosed) involved the onboarding of the Clik-FIX catheter securement device portfolio from Starboard Medical. The Clik-FIX portfolio is comprised of several components.

• • Clik-FIX Peripheral catheter securement device: An all-in-one integrated securement device with bio-occlusive dressing.

• • Clik-FIX PICC/Central catheter securement device: A universal device designed to secure most peripherally inserted central catheters (PICC) and central catheters with an active dual locking mechanism.

• • Clik-FIX Universal catheter securement device: Designed to stabilize and secure any medical tubing junction with a Luer lock connection.

• • Clik-FIX Neonatal PICC catheter securement device: Compatible with most neonatal PICC lines, it features a soft foam securement base with no hard plastic parts to cause pressure, bruising, or trauma to a baby’s skin.

• • Clik-FIX Soft PICC/Central securement device: With a soft foam securement base and no hard plastic parts to cause pressure, bruising, or trauma to the skin, it is also compatible with most PICC and central lines.

The company also shed assets in a deal with Healiva that saw the transfer of critical manufacturing assets for Healiva’s first cell therapy product EpiDex. The transaction included a qualified cell bank from B. Braun, which was necessary to ensure GMP-compliant manufacturing of the product. Financial details of this agreement were also not disclosed.

Maintaining an eye on the future, September saw a ribbon cutting ceremony for an expanded Allentown, Pa., plant. The 310,000-square-foot facility boasts approximately 110,000 square feet of manufacturing space. The company explained that while the location was designed for high-speed, high-volume automation, it should provide 300 to 500 jobs in the coming years.

A final noteworthy development for B. Braun during its 2022 fiscal was its collaboration with Massachusetts General Hospital (MGH), a research hospital, to generate technologies that would improve patient care and enhance the well-being of healthcare workers. Citing the challenges of the pandemic and the stresses it caused for hospital staff, Hiyam Nadel, MBA, CCG RN, director of the Center for Innovations in Care Delivery at MGH, predicted many ideas for solutions could come from those same professionals. Through a combination of B. Braun’s incubator team with the clinical expertise of MGH staff, innovations could be conceived that would help with the difficulties faced, especially in addressing digital documentation fatigue. It was reported B. Braun and MGH intended to publish findings of the venture in hopes of commercializing those with the greatest potential.

€7.86 Billion ($8.90 Billion)
Prior Fiscal: €7.42 Billion
Percentage Change: +5.8%
R&D Expenditure: €316M
No. of Employees: 66,234

B. Braun posted a rise in sales last year, growing 5.8% to €7.43 billion. All three business divisions posted revenue increases, with the Aesculap division showing the most growth. The Hospital Care division generated €4.12 billion in 2021, rising 5.1% from the previous year. Germany, Latin America, and North America were the major sales drivers, followed by Eastern Europe and Switzerland. High infusion pump and accessories sales drove growth in Germany, Great Britain, and the U.S.; however, sales in China were reduced due to price reductions. Growth was in the double digits in other Asia-Pacific markets like Japan, Australia, and Thailand.

Last February, the business earned U.S. Food and Drug Administration (FDA) approval for its Acetaminophen injection available in multiple doses. Available in sturdy, flexible PAB IV Bags in both 1,000 mg in 100 mL and 500 mg in 50 mL doses, the injection is manufactured using dual-sourced active pharmaceutical ingredients to mitigate potential supply risks.

B. Braun unveiled its Peripheral Advantage program to improve patients’ peripheral intravenous (IV) therapy experience last April. The program combines clinical instruction, data-driven insights, and advanced tools so nurses can achieve first-stick success and prevent many complications related to peripheral IV therapy. Real-word data is collected throughout to provide baseline and ongoing insights and analytics to help gauge the program’s impact on patient satisfaction, first stick success, IV catheter dwell time, and cost containment. Professional on-site clinical instruction and a complete set of cutting-edge tools are also included.

September saw the launch of CARESAFE IV administration sets with an optional AirStop component. According to B. Braun, they are the first robust IV administration set portfolio not made with polyvinyl chloride (PVC) and diethylhexyl phthalate (DEHP). The sets protect the enviromnment and reduce patient exposure to toxic substances. They also help protect from risks related to air infusion and help prevent the line from running dry—the AirStop filter only allows fluid to pass through.

In December came the release of the next-gen OnGuard 2 closed system transfer device (CTSD) to prevent escape of hazardous drugs into the environment. Enhancements made include modifications to material composition intended to increase compatibility with known hazardous drugs, as well as extended microbial ingress claim for the vial adaptor for up to a week.

A few days later, the division unveiled a portfolio of Magnesium Sulfate ready-to-use injectable drug products. The release aims to ensure the reliable supply of a leading drug for prevention and control of seizures associated with preeclampsia and eclampsia.

The Aesculap division posted an 8.6% increase last year with proceeds of €1.87 billion. The division has recovered from 2020’s poor performance caused by COVID-19, but hasn’t yet reached its pre-pandemic level. The repeated elective procedure postponement caused knee, hip, and spine implant sales to be below the company’s expectations—felt particularly in the German, Turkish, Vietnamese, and Malaysian markets. The U.S., China, Australia, Spain, and Russia experienced growth in containers, minimally invasive surgery, angioplasty, and access port product sales.

The company’s Interventional Systems business began a collaboration last March with Infraredx, a Nipro Company, to accelerate the FDA IDE trial for the SeQuent Please ReX drug-coated PTCA balloon catheter. The trial is studying treatment of coronary in-stent restenosis—gradual re-narrowing of a coronary artery after stent implantation. Both will pool clinical expertise and financial resources to execute the study.

The division entered a partnership with REVA Medical to distribute REVA’s Fantom Encore bioresorbable scaffold for coronary interventions in November, beginning in Germany and Switzerland. The bioresorbable scaffold offers a reliable, sustainable solution for patients who require temporary physical vessel support.

The Avitum division’s 2021 sales rose 5.7%, reaching €1.83 billion. Extracorporeal blood treatment sales were strong. The main growth markets were China, the U.S., and Italy according to the company’s annual report. Wound management and ostomy and continence care products expanded as well, and demand for infection control products remained high. Rising purchase prices and supplier delivery issues hampered the business’s growth.

B. Braun Medical Inc. made two executive changes last year as well—former Steel Partners CFO James Allen replaced the retiring Bruce Heugel as senior VP and CFO in last May, and Jennifer Prioleau succeeded retiring Cathy Codrea as senior VP, chief legal officer, and chief compliance officer last fall.

$9.12 Billion
Prior Fiscal: $8.39 billion
Percentage Change: +8.7%
No. of Employees: 64,317

Caroll H. Naubauer had led Bethlehem, Pa.-based B. Braun’s North American operations as CEO for almost two and a half decades. Neubauer announced his retirement last June, and left the company on Aug. 31.

Since leading the company, B. Braun of America’s revenue rose from $247 million to over $2 billion. He began his tenure at B. Braun in 1988 as a legal assistant to the company’s management board. Three years later he was named general counsel for B. Braun Group, and took the helm as CEO in 1996. Jean-Claude Dubacher began succeeding Neubauer on June 1 of last year, while Neubauer continued in various management roles through August. Dubacher became chairman and CEO of B. Braun Medical on Jan. 1, 2021.

“We thank Caroll Neubauer for more than three decades of truly remarkable achievements for our company, for his close collaboration with our partners in the healthcare industry, and for his tireless work for the benefit of patients and healthcare providers,” Prof. Ludwig Georg Braun, chairman of the Supervisory Board of B. Braun SE, told the press. “Unforgotten will remain as well his persistent, determined and successful efforts to achieve the repeal of the U.S. Medical Device Tax.”

B. Braun settled patient infringement litigation against Mallinckrodt Hospital Products Inc., its affiliates, and New Pharmatop L.P. in October. The lawsuit was brought on in response to the firm’s new drug application to market its acetaminophen injection product. Under the settlement terms, B. Braun earned a non-exclusive license to launch a competing IV acetaminophen product in the U.S. with dosage amounts of 1,000 mg/100mL and 500 mg/50 mL.

B. Braun had some issues concerning fraud and unauthorized product distribution in late 2020. In October the firm warned against attempted fraud when selling the company’s disposable gloves. The company reported new cases of people abusing supply shortages associated with the pandemic by using fake B. Braun business documents for distribution of Vasco Guard disposable gloves. Customers and business partners from Italy, Australia, and the Netherlands had been increasingly contacting the firm to verify authenticity of offers, products offered. And business documents.

Last April, the firm earned FDA emergency use authorization (EUA) for its Perfusor, Infusomat, and Outlook infusion pumps to deliver continuous nebulized medications into a nebulizer to treat COVID-19 patients. They were also authorized to decrease healthcare workers’ exposure to COVID-19 patients during the pandemic. The EUA also authorized ground medical transport use of Infusomat.

In December, the company was made aware of a recall from the company Janus Trade Group of eight Introscan safety catheter product codes not authorized for U.S. sale. B. Braun claims the recalled products were distributed in the U.S. without their knowledge, and urged that the recall didn’t indicate clinical performance concerns for the products. B. Braun pursued action against Janus to cease and desist distribution.

Because B. Braun is a manufacturer of critical care and other hospital products, the pandemic did not impede the company’s growth due to the steady need for those products. Its $9.12 billion in revenue gained last year represented an 8.7 percent rise from the year prior. Its Aesculap surgical division was the only one that fell from the previous year—dropping 11.4 percent to 1.7 billion euros—due to the reduced volume of elective surgeries.

The Hospital Care division posted gains to 3.5 percent to reach 3.5 billion euros. The Out-Patient Market business swelled 5.8 percent with 971 million euros in proceeds. Finally, the Avitum franchise rose a slight 1 percent, coming to rest at 1.2 billion euros.

Last August, B. Braun won FDA clearance for its SpaceStation MRI to let Space infusion pumps continuously deliver medications to patients in the MRI suite. SpaceStation MRI shields Space infusion pumps against 1.5 and 3 T magnetic fields to protect the scanner and remove imaging interference. Each station holds up to four pumps and proprietary TeslaSpy software monitors magnetic field strength to allow proper MRI placement and positioning.

Also in August, the company gained FDA clearance for Onvision ultrasound guidance for real-time needle trip tracking. It combines the B. Braun and Philips Xperius ultrasound system with the Stimuplex Onvision needle to accurately position the needle tip for peripheral nerve blocks. It was the latest advance in Philips and B. Braun’s multi-year alliance for innovation in ultrasound-guided regional anesthesia. The tip tracking technology indicates needle tip position in relation to the ultrasound viewing plane to an accuracy of 3 mm, according to the company. A micro-sensor on the needle indicates real-time needle tip location.

Last April the company recalled one lot of 2g Ceftazidime for Injection USP and Dextrose for Injection USP (50 ml)—a cephalosporin antibacterial—in Duplex Container to the hospital/user level. During stability testing, the batch was found to exceed specification limits for high molecular weight polymers (HMWP) at the 19-month stability interval. Elevated HMWP levels have been shown to cause kidney damage and liver issues in animal studies.

In December, B. Braun gained a new pediatric indication for Cefalozin for Injection and Dextrose Injection (1g and 2g) in Duplex to treat infections and for perioperative prophylaxis in ages 10 to 17.

$8.39 Billion
Prior Fiscal: $7.91 Billion
Percentage Change: +8.2%
No. of Employees: 64,585

B. Braun is familiar with recent leadership changes. During the prior year, it was announced then-CEO Prof. Dr. Heinz-Walter Große would be retiring from the firm, having served eight years in the role. That opened the door for the company’s first female leader—Anna Maria Braun.

In 2019, the organization faced another change near the top of its management tree. In December, it was announced long-time CEO of B. Braun of America, Caroll H. Neubauer, would be stepping down from the post at the end of the year. Weeks later, the firm declared Neubauer, who led the U.S.-based division for approximately two and a half decades, would retire at the end of August 2020. The transition marks the end to a career that spanned 32 years at B. Braun for a man who started as legal assistant to the chairman of the Management Board and served as general counsel for the B. Braun Group. He took over the CEO role in 1996.

Anna Maria Braun, CEO of B. Braun SE and B. Braun Melsungen AG, praised his exceptional commitment: “We thank Caroll for his pioneering leadership, his valuable advice, his passionate support for our employees and, above all, for his friendship.”

Filling the vacant role as chairman and CEO was Jean-Claude Dubacher, Ph.D., who had joined the company Aug. 1, 2019, as president of B. Braun Medical Inc. Dubacher had moved over from helming the commercial operations for the Surgical Ophthalmology Division of Johnson & Johnson in Europe, Middle East, and Africa. He brought with him more than 15 years in consulting and corporate roles, including strategy, commercial, supply chain, and manufacturing.

“Jean-Claude’s broad leadership experience across multiple therapy areas and business disciplines will serve us well at B. Braun,” said Neubauer. “His focus on customers and supporting people to be successful in developing, manufacturing, marketing, and selling products and services that benefit patients is exactly the right approach to ensure our ongoing growth.”

That ongoing growth has been maintained fairly consistently in recent years. 2019 sales increased over the previous year by 8.2 percent, finishing at 7.47 billion euros. The gain continues a run of such growth since at least 2015, when the firm’s sales tally was 6.13 billion euros.

ANALYST INSIGHTS: With the retirement of CEO Caroll Neubauer, B. Braun begins a new era in 2020/2021. Initially, don’t expect much to change as the German-based organization is conservative by nature. The next year should begin to give hints on the future direction for the organization under new CEO Jean-Claude Dubacher.

—Dave Sheppard, Co-Founder and Managing Director, MedWorld Advisors

Further still, the rise in sales was enjoyed by all four of the organization’s divisions. The Hospital Care unit jumped 6.8 percent to end 2019 at 3.34 billion euros in sales. Favorable exchange rates were partially responsible for the rise, but the segment also enjoyed strong sales performance in China, the U.K., Indonesia, and the Netherlands. Hospital Care is responsible for providing products and services for infusion therapy, nutrition therapy, and pain therapy.

The Aesculap division improved during the fiscal to close at 1.97 billion euros, a 7.9 percent leap over the prior year’s figures. Positive sales increases for the partner for surgical and interventional treatment concepts in inpatient and outpatient care were recognized in China, Russia, and the U.S.

B. Braun’s Out Patient Market segment addresses the needs of patients dealing with chronic diseases outside the hospital setting, focusing on five therapeutic areas—infection prevention, diabetes care, continence care and urology, wound management, and ostomy care. The 917 million euros represented growth of 9.1 percent compared to the prior year’s sales. U.S. sales gains were particularly noteworthy, followed by China, Germany, U.K., and Spain.

The company’s division providing products and services for those with chronic and acute kidney failure eclipsed the gains of its sister units. Enjoying an 11.8 percent rise over 2018’s 1.08 billion euros, B. Braun’s Avitum business reported sales for 2019 of 1.21 billion euros. Product exports were the most notable driver for the gains, and sales grew in Indonesia, the Philippines, Russia, Singapore, and the U.S.

B. Braun also engaged in several moves to help bolster those financial figures for future fiscals. One such transaction saw the organization take over the business operations of Nephtec GmbH. The deal bolstered the product portfolio in the area of the central preparation of dialysis concentrates for the Avitum business.

“In taking over the business of Nephtec GmbH, we are reacting to the increasing worldwide demand in this area. In addition to the expertise in connection with filling large cartridges, we are also extending our existing network of production locations in the course of the acquisition,” explained Dr. Holger Seeberg, member of the Management Board at B. Braun Avitum AG.

Further strengthening the future growth prospects for the Avitum division, B. Braun also purchased the Medisystems Streamline Bloodlines business from NxStage Medical. Specifically, the agreement included the Streamline Bloodline for the Dialog+ hemodialysis system, Streamline Bloodline for the Fresenius Medical Care hemodialysis system, and Streamline Bloodline Long for the Fresenius Medical Care hemodialysis system.

B. Braun did not disclose the financial terms of either deal.

The company did, however, disclose the amount it was investing in its effort to alleviate IV fluid shortages. In May, the company announced Solutions for Life, a $1 billion investment in new and enhanced IV therapy manufacturing facilities to help ensure a reliable and consistent supply of vital IV fluids. The enhancements included as part of the investment were a new, state-of-the-art manufacturing facility in Daytona Beach, Fla., and modernizations to existing facilities in Irvine, Calif., and Allentown, Pa. It would also result in the establishment of a new distribution facility in Daytona Beach, along with enhancements to preexisting distribution centers in Ontario, Calif., and Breinigsville, Pa.

“IV fluid shortages have the potential to cause serious complications for patients across the country, particularly in times of public health emergencies,” said U.S. Sen. Pat Toomey (R-PA). “B. Braun is making an important investment to address this concern by expanding production capacity and improving the ability to deliver IV fluids when and where they are needed.”

The firm also partnered with other members of industry to further enhance care delivery. In an ongoing venture with Philips, the two firms worked to improve upon their Xperius ultrasound system with the introduction of the Onvision needle tip tracking. The integrated, point-of-care solution empowers anesthesiologists to perform regional anesthesia procedures, such as peripheral nerve blocks, more safely and efficiently. The new development was a result of the combination of Philips’ Onvision needle tip tracking technology and B. Braun’s Stimuplex Onvision needles.

In another joint effort, B. Braun and GWA Hygiene took on hospital-acquired infections by leveraging smart technology. The initiative saw one of B. Braun’s newer disinfectant dispensers merged with GWA Hygiene’s sensor technology, called NosoEx, which was incorporated into the dispenser. The resulting innovation enabled hand disinfection processes to be recorded.

Dionne G. Bussell, senior vice president of global marketing and sales at B. Braun explained, “Using a portable transponder, with which we equip the hospital staff, in combination with the sensors contained in the dispenser, it is possible to record how often the dispenser is actuated, how much liquid is dispensed from it, and therefore the fill level. All this data is visualized in a software interface and can be used to deduce specific hygiene measures.”

B. Braun announced a series of integration projects in which the firm’s technology was incorporated with another company’s innovation to enhance smart healthcare devices, streamline communication, or further boost the efficiency and level of care delivered. Such integration projects in 2019 between B. Braun and a partner revolved primarily around the firm’s Space Infusion Pump Systems. Partners involved included STANLEY Healthcare, Guard RFID Solutions Inc., Spok Care Connect, West-Com Nurse Call Systems, TeleTracking Technologies, and Meditech Magic.

The organization also shared several noteworthy product announcements in the course of the fiscal. The firm’s Interventional Systems unit received Breakthrough Device Designation Status from the FDA for its SeQuent Please ReX Drug Coated PTCA Balloon Catheter. The device is indicated for the treatment of coronary in-stent restenosis.

The Interventional Systems business also launched the NuDEL CP Stent Delivery System in the U.S. The device is intended to treat coarctation of the aorta and right ventricular outflow tract conduit disruptions. The product combines three separate devices into a single tool, providing physicians procedural efficiency by eliminating the need to hand crimp or load a mounted stent into an introducer.

B. Braun Medical also debuted a Heparin Sodium Injection solution. According to the company, the product is the first Heparin 5,000 USP Unit/0.5 mL prefilled syringe with attached safety needle for subcutaneous and intravenous use in the United States.

COVID-19 Consequences

[Note: Since B. Braun is privately held, first quarter reporting is not available.]

B. Braun Medical delved into the fight against COVID-19 when it obtained Emergency Use Authorization (EUA) from the U.S. Food and Drug Administration for its Perfusor Space Syringe Infusion Pump, Infusomat Space Volumetric Infusion Pump, and Outlook ES Pump systems. Specifically, the EUA was granted for use in the “tracheal delivery of continuous nebulized medications into a nebulizer to treat patients of all ages with or suspected of having the Coronavirus Disease 2019 (COVID-19) and to decrease the exposure of healthcare providers to such patients during the COVID-19 pandemic.”

In April, the company also announced its “up close and personal” connection to the virus, sharing that seven employees at its Lehigh County manufacturing site had tested positive. Fortunately, several had already returned to work at the facility at the time of the announcement. Further, the site had implemented a number of safety measures including temperature screening, masks, social distancing, contact tracing, and heightened cleaning and disinfecting procedures.

AT A GLANCE
$7.90 Billion
Prior Fiscal: $8.13 billion
Percentage Change: -2.8%
No. of Employees: 63,751

After six generations, a woman is finally taking the reins. B. Braun has remained family-owned for 180 years, ever since 31-year-old Kassel pharmacist Julius Wilhelm Braun bought Rose Pharmacy in Melsungen, Germany, and began its transformation from a small herbal remedy shop into the global, multi-billion-dollar medical and pharmaceutical technology enterprise it is today. As each Braun generation handed the B. Braun legacy to its successors, the company continued to develop dynamically.

Last October, then-CEO Prof. Dr. Heinz-Walter Große announced his retirement after eight years behind the wheel and 40 years with the company. His successor: 39-year-old Asia-Pacific president and mother of three, Anna Maria Braun. Her father, Ludwig Georg Braun, had captained B. Braun for 34 years and is the head of the company’s supervisory board.

She is notably one of very few women in the German economy in such a lofty position. According to the German Institute for Economic Research, only seven of the 200 largest companies outside the financial sector in Germany—B. Braun included—are led by a woman. But rather than basking in the spotlight, Ms. Braun immediately took a practical approach to her leadership.

“I don’t think in terms of ‘special moments,’” she stated in a Q&A featured in the company’s 2018 annual report. “…we’ll be in the thick of the day’s business and focusing on the tasks ahead of us.” She also spoke about growth, new forms of collaboration, and team building.

Ms. Braun holds a Master of Law degree from Georgetown University and worked as a commercial lawyer in Düsseldorf, Germany, before joining the family business in 2009. She began leading B. Braun’s Malaysian subsidiary in 2013 and joined the Management Board as Asia-Pacific president in 2016.

Foreshadowing her promotion, perhaps, a nine-year Malaysian project was completed under Ms. Braun’s leadership last April. The company officially opened five new, enhanced production plants and other administrative buildings in Penang. These will produce medical devices across B. Braun’s portfolio, including devices for infusion therapy, pharmaceutical solutions, and surgical instruments. Penang also hosts B. Braun’s Asia Pacific regional headquarters; the B. Braun Global Centre of Excellence for Intravenous Access with over 100 engineers and full research and development capabilities; and the Aesculap Academy Skills Learning Centre, which provides continuous medical education and training to doctors, nurses, and other healthcare professionals in Malaysia and across the Asia Pacific region.

“B. Braun has truly grown with Malaysia for close to half a century,” Ms. Braun told the press at the time. “Our success is a result from the strong support from the government, industry, and most importantly, our 7,700 employees.”

Ms. Braun officially became CEO April 1—now with over eight times the number of employees under her purview.

“I’m looking forward to continuing B. Braun’s successful history,” Ms. Braun concluded in the Q&A. I won’t be doing it alone, but together with my colleagues on the Management Board and with every employee.”

Ms. Braun was handed somewhat of a mixed bag upon assuming B. Braun’s leadership. Though sales in euros increased 1.8 percent to 6.9 billion, unfavorable currency exchange rates brought about nearly a 3 percent drop in sales in the form of U.S. dollars ($8.13 billion). Africa, the Middle East, and Germany saw the most substantial sales boosts, with Europe overall proving to be strong. B. Braun mentions it had not seen effects of Brexit on performance as of the end of last year.

Hospital Care is B. Braun’s largest business, consisting of infusion equipment and supplies, infusion and injection solutions, intravenous catheters, products for clinical nutrition, and pumps and their associated systems for inpatient and outpatient care. The division regularly accounts for about half of the company’s sales. Its 3.13 billion euro proceeds were relatively flat (0.5 percent rise) compared to the previous year.

Unfavorable currency exchange rates most heavily impacted sales in the U.S., Russia, Brazil, and Argentina—although these areas saw growth in local currencies, sales in euros in some were below the previous year. Strong sales in Germany and the U.K. somewhat offset this. Solutions for clinical nutrition and automatic infusion pumps, as well as anesthesia products, were last year’s main growth drivers.

Last January B. Braun Medical Inc. introduced the Introcan Safety Deep Access IV Catheters. Meant to access deeper veins for difficult access patients with damaged or not visible or palpable superficial veins, the longer peripheral catheters facilitate IV procedures involving ultrasound guidance. They are made of polyurethane, come in four longer-length configurations, and their back-cut universal bevel both produces a precise tricuspid incision and allows a variety of insertion angles.

B. Braun won FDA clearance for the wireless second-generation software for its Perfusor Space Syringe Pump. The first syringe pump cleared with air and road transport in the indications use, the Perfusor Space 2nd Generation Syringe Pump integrates with all of the company’s integrated electronic medical record (EMR) technology. An integrated piston break prevents inadvertent dosage during a syringe change, and post-occlusion dosage reduction software minimizes dosage after occlusion. Each pump also contains a microprocessor to ensure independent modularity, preventing channel confusion and catastrophic pump failures. The pump launched during last October’s National Association of Neonatal Nurses conference.

Last October saw the introduction of Surecan Safety II Port Access Needles. Safety engineered to access IV ports, the non-coring port access needles can be used for power injections up to 325 psi. Surecan Safety II’s manually activated safety mechanism allows visual confirmation with a green dot visible through the clear bottom plate when successfully engaged, in addition to tactile confirmation. Ranging from 19 to 22 gauge in size, Surecan Safety II is inserted into the septum of a subcutaneously implanted port to infuse fluids and drugs, and sample blood.

The Aesculap division, which encompasses products for general surgery, orthopedic joint replacement, regenerative therapy, neurosurgery, laparoscopic surgery, interventional vascular diagnostics and treatment, degenerative spine disorders, and cardiothoracic surgery, garnered 1.82 billion euros last year, rising 2.1 percent from the year prior. China, Germany, Russia, Spain, Poland, and the U.S. were primarily responsible for the increase, offset by weaker performance in the Middle East, Malaysia, and Thailand. Strong angioplasty, endoscopy, suture product, high-speed power systems, and access ports sales were encouraging; however, Aesculap’s orthopedic achievements were subpar. Despite significantly increased sales volume, considerable market price drop for knee and hip replacements prevented growth.

Aesculap initiated a joint venture last January with Christoph Miethke, founder and CEO of Potsdam, Germany-based hydrocephalus treatment product developer Christoph Miethke GmbH & Co. KG. The venture aims to develop implants for targeted drug delivery, and the newly established B. Braun Miethke GmbH & Co. KG intends to bring its first product to market within the next few years.

Last February, Aesculap acquired surgical instrument maker Dextera Surgical for $17.3 million in a move to buy Dextera out of Chapter 11 bankruptcy. The deal saw Dextera receive $13.6 million, with $2 million going into two-year escrow, and $900,000 going toward repaying a loan from Aesculap. Dextera is a designer and manufacturer of surgical staplers and devices for coronary bypass graft surgery. Through the purchase, Aesculap expands its arsenal of beating heart coronary and video-assisted thoracic surgery. Among B. Braun’s new acquired technologies are Dextera’s MicroCutter 5/80 stapler, PAS-Port proximal anastomosis system, and C-Port distal anastomosis system. Aesculap will oversee operations in Dextera’s home of Redwood City, Calif.

B. Braun Interventional Systems and NuMED Inc. launched expanded size and newly indicated Cheathan-Platinum (CP) stents shortly following their FDA approval last May. The newly approved indication for the Covered and Covered Mounted CP stents allows treatment of right ventricle to pulmonary artery (right ventricular outflow tract, RVOT) conduit disruptions. These disruptions are identified during conduit pre-dilatation procedures performed in preparation for transcatheter pulmonary valve replacement. All sizes and configurations of the Covered CP Stent are now approved for the treatment of both coarctations of the aorta and RVOT conduit disruptions.

The Out Patient business—which houses infection prevention, diabetes care, continence care and urology, ostomy care, and wound management technologies, accrued 841 million euros in sales last year, rising 1.6 percent over the previous year. U.S. sales notably increased, and international sales were bolstered by proceeds from China, Great Britain, Turkey, and the Czech Republic. German sales remained flat, mainly due to weak wound care, continence care, and urology performance. Logistics issues in France and a production stoppage in Sligo, Ireland, also adversely impacted the Out Patient division’s growth.

Last April, colostomy management solutions firm Stimatix GI disclosed that B. Braun Medical SAS was the acquirer of its assets. The deal occurred in November 2014, but the purchase agreement at the time included a nondisclosure agreement preventing release. Since the Stimatix GI product launched in mid-2018, B. Braun authorized the disclosure. B. Braun both acquired Stimatix GI’s assets and agreed to sell the firm’s ostomy products. Stimatix GI’s Artificial Ostomy Sphincter helps to holistically restore the various physiological, behavioral, and aesthetic functions of a healthy anus and rectum in colostomy patients.

The Avitum division, which provides products and services for acute and chronic kidney failure patients, grew sales 4.9 percent to reach 1.1 million euros last year. Consumer product and dialysis machine revenues were strong, particularly in Germany, China, and the Philippines—tempered by weaker sales in Mexico and Great Britain. The company’s dialysis centers performed well worldwide, acquiring locations in Portugal, Australia, and New Zealand last year. B. Braun’s clinical network also expanded in Russia, the Czech Republic, and Switzerland last year.

B. Braun Medical Inc. began the deal to acquire NxStage Medical’s Medisystems Streamlines bloodlines business last July. According to an SEC filing, the sale was part of NxStage’s pursuit of Federal Trade Commission approval for its $2 billion acquisition by Fresenius Medical Care. As such, the acquisition was contingent on the closure of the Fresenius-NxStage deal. That closed in late February of this year, at which time B. Braun finalized the purchase. The spoils included Streamline Bloodline for the Dialog+ hemodialysis system, Streamline Bloodline for the Fresenius Medical Care hemodialysis system, and Streamline Bloodline Long for the Fresenius Medical Care hemodialysis system. The additions helped to fortify Avitum’s complete integrated line of dialysis products.

Last September, B. Braun opened Europe’s most modern dialyzer production site with a celebratory inauguration event in Wilsdruff, Germany. The firm invested over 100 million euros in the new production site and created about 140 jobs. B. Braun hopes to double its production capacity in Saxony with the new site.

“In Germany, currently around 100,000 patients are reliant on regular dialysis therapy. Dialysis is very strenuous for those affected, yet it is vital,” German Minister of Health Jens Spahn emphasized in his speech at the inauguration. “B. Braun is making an important contribution to high-quality medical care for people with chronic kidney failure. At the same time, today’s opening of the dialyzer production site is a clear commitment to the future of the industrial location of Saxony. With around 5.5 million employees, the healthcare economy in Germany is an important motor for the overall economy.”

$8.1 Billion
NO. OF EMPLOYEES: 61,583

In this era of such substantial M&A activity, it’s somewhat unusual to see two major players in a particular therapeutic space join forces to collaborate on a joint venture that results in a new product technology. Much more often, we see one medtech giant make a play for another in a full company merger. Or, at a smaller scale, one company may divest a division, product line, or technology to another in an effort to streamline its focus on serving specific healthcare needs.

Regardless of the norm, collaboration does occur and ultimately, is likely in the best interests of patients as it helps leverage the best each firm has to offer. That’s the scenario that played out between B. Braun and Philips—the arrangement announced in April 2017. Coupling the expertise of B. Braun for its anesthesia and pain management acumen with Philips for its knowledge of ultrasound and image-guided therapy solutions, the anticipated output of the multi-year alliance will be innovative solutions to improve ultrasound-guided regional anesthesia. This type of therapy is a growing alternative to general anesthesia. The end results would also be instrumental in enhancing vascular access, such as procedures to insert catheters into deeply seated veins.

“Philips and B. Braun have a reputation for clinical innovations and a shared commitment to work with patients and care providers to optimize healthcare delivery and improve patient outcomes,” said Rob Cascella, chief business leader of the Diagnosis & Treatment businesses at Philips. “By partnering with B. Braun, we have created a solution for ultrasound-guided regional anesthesia comprising the Xperius ultrasound system, decision support software, echogenic needles, and a suite of services. We look forward to jointly developing further innovations. This new alliance is a great example of our commitment to partnering with industry leaders with complementary skills to increase our footprint in the therapy market.”

The Xperius ultrasound system, the first technology solution resulting from the cooperative effort, would be made available in both a cart version and a mobile tablet solution. It was designed specifically to support the needs in regional anesthesia at the point of care. According to the companies in an announcement of the alliance, regional anesthesia can have significant advantages over general anesthesia for both patients and hospitals, such as reduced opioid consumption, fewer side effects (such as nausea), and faster post-surgical recovery. But the implementation of regional anesthesia can be challenging to perform. As a result, the companies recognized the need for new solutions that improve the safety, effectiveness, and efficiency of regional anesthesia procedures.

“Our customers are looking for fully integrated system solutions that address all aspects of their everyday work in caring for patients, including the enhanced efficiency needed to meet ever-increasing demand for their services,” said Dr. Meinrad Lugan, member of the board for the Hospital Care Division at B. Braun. “This new alliance with Philips illustrates our commitment to sharing expertise, not only with our customers, but also with other key technology players, to meet healthcare needs and challenges faced today and into the future.”

ANALYST INSIGHTS: B. Braun continues to quietly execute in its core markets. With its mix of OEM and hospital products, its portfolio management seems a little bit complicated. However, I’m sure somewhere in Germany, they are confidently executing a grand master plan.

—Dave Sheppard, Co-Founder and Principal, MedWorld Advisors

According to the announcement, the Xperius platform would be co-branded and sold via B. Braun’s global sales network, with Philips providing installation and service.

Perhaps inspired by the value of the potential output of these collaboration agreements, B. Braun announced another such arrangement with another company later that same month. While not to the same scale as the Philips deal, B. Braun announced an alliance with Christie Medical Holdings, centered specifically around the latter’s vein finder technology—the VeinViewer System.

The deal involves B. Braun becoming the exclusive U.S. distributor of the VeinViewer System, which then enables the firm to couple the device with its own line of IV products, such as its Introcan Safety IV catheter and STEADYCare extension set with Wedge catheter stabilizer. With as many as 90 percent of hospital patients receiving a peripheral IV catheter as part of their treatment plan and the VeinViewer saving time for IV insertion and improving first stick success, the tandem offers the opportunity for significant savings at healthcare facilities.

“These technologies are intended to work together to improve placement, insertion, duration, and safety associated with peripheral IV catheter therapy,” said Tom Sutton, B. Braun Medical’s vice president of marketing for IV Systems, Vascular Access, and Pharmacy Admixture Products. “The VeinViewer technology is an excellent addition to our infusion therapy product line, because it addresses the first critical step in peripheral IV therapy success by helping the clinician select the best vein for placing an IV catheter. Our hospital customers are seeking solutions to improve the patient experience associated with peripheral IV access. This collaboration helps us achieve that.”

The Xperius platform and VeinViewer join B. Braun’s portfolio of 5,000 healthcare technology offerings (95 percent of which are manufactured directly by the company) that resulted in 6.8 billion euros in sales for the German firm in its 2017 fiscal year, which ended Dec. 31. That figure represented a 4.9 percent increase over 2016’s 6.5 billion euros. Those product lines and brands—addressing 18 therapy fields in total—are divided into four divisions: Hospital Care, Aesculap, Out Patient Market (OPM), and B. Braun Avitum.

Taking a closer look at the performance of these individual segments reveals that all four played a role in the company’s increases over the prior year. The Hospital Care division, which focuses on products and services primarily involved with infusion therapy, nutrition therapy, and pain therapy, posted a 4.1 percent gain (3.1 billion euros) over the prior year. The Aesculap division, providing expertise in surgical, orthopedic, and interventional treatment concepts related to inpatient and outpatient care, rose moderately over 2016 by 3.6 percent (1.8 billion euros).

The most impressive increase of all the units, a 9.2 percent gain (1 billion euros), was enjoyed by B. Braun’s Avitum division—dedicated to offering products and services for people with chronic and acute kidney failure. Finally, the Out Patient Market division, contributing with a 5.9 percent increase (828 million euros) of its own over the previous year, meets the needs of patients with chronic diseases outside the hospital setting.

Further, the Latin America and Asia Pacific markets posted especially strong gains for the company, notching increases of 8.9 percent and 9.2 percent respectively in local currencies. North America sales rose by 5.2 percent while the Africa/Middle East region exceed that with a 9.2 percent gain in local currencies. Europe’s rise mirrored that of North America, posting a 5.1 percent increase over 2016 (not including Germany, which grew by 3.5 percent).

While the company’s financials painted a rosy picture for the medtech firm in 2017, there were some rocky roads the organization traveled during the year. In May, B. Braun received an FDA warning letter regarding an inspection from the prior spring (2016) of an Irvine, Calif., facility. The letter cited issues with the location’s CAPA procedures and repeat violations of inadequate leak detection for IV products. A recommendation was given that the firm should engage a consultant to assist in meeting CGMP requirements.

The company also faced legal challenges during the year. A lawsuit was filed alleging that one of B. Braun’s blood clot filters caused the death of a patient. That patient was implanted with an IVC filter in March 2015. According to reports, the device fractured and pieces lodged within the heart and lungs. The lawsuit charged that the product was defective and dangerous when it was sold.

Another lawsuit targeted B. Braun subsidiary Aesculap Implant Systems. That suit revolved around the firm’s ceramic-coated artificial knee, alleging the ceramic joints did not effectively adhere to the patients’ bones, rendering them defective. Further, it was alleged the ceramic coating permitted moisture to collect between the bone cement and the implants, which caused the implants to become loose and fail.

$6.8 Billion
NO. OF EMPLOYEES: 58,037

Meet Xiaoqian, a 30-year-old human resources manager from Shanghai, China.

Xiaoqian is a typical Millennial: She’s single, lives at home with her father, works flexible hours, and equates good health with a happy life.

“What’s the most important thing in life?” she asks. “Health, I think. I want to be healthy in order to be able to explore the world and learn something new every day. I want to finish things I have started. Everything else, I just take as it comes. When will I have the chance to enjoy my life, if not now?”

Meet Xiaoqian, B. Braun Melsungen AG’s 2016 cover girl.

Swathed in a soft, golden backlight and smiling naturally off to one side, Xiaoqian graced the front of B. Braun’s 2016 annual report, a stodgy, 168-page dissection of the company’s fiscal performance. It was the second consecutive year the German device manufacturer gave an Everyman (or in this case, “Everywoman”) a starring role in its annual report.

“Every single life is precious. That is why a life story is again our focus for the Annual Report this year,” B. Braun Management Board Chairman Prof. Dr. Heinz-Walter Große said in the document’s introduction. “The central character of this year’s report takes us on a journey through her everyday life. We accompany Xiaoqian from Shanghai and gain insight into her life and a changing China. Xiaoqian represents the diversity and opportunities that life offers us and that we strive for every day at B. Braun.”

Life—specifically the unremarkable journeys of China’s 1.37 billion citizens—held a wealth of opportunity for B. Braun last year: In addition to earning “Best Employer” honors, the company opened a 3,000-square-meter Aesculap Academy in Suzhou (roughly 52 miles from Shanghai), its first global Aesculap training center outside of Europe. Like dozens of others worldwide, the Academy was established to provide local physician training in various surgical procedures (neurosurgery, orthopedics, cardiac, etc.) and educate clinicians on operating room processes/procedures and supply room management.

The Middle Kingdom is also credited with helping boost B. Braun’s bottom line in 2016 (year ended Dec. 31). Overall sales rose 5.6 percent to 6.47 billion euros and profit (before taxes) jumped 18.5 percent to 527.8 million euros, according to the company’s annual report. Strong product demand in the Asia Pacific region—led by China, Indonesia, and Vietnam—fueled much of that sales growth, though solid gains in the North American and German markets helped as well. Total Asia Pacific revenue swelled 8.3 percent to 1.16 billion euros, while North American sales posted a 7.6 percent increase (to 1.5 billion euros) and German proceeds ended the year 5.9 percent above 2015 levels.

“2016 was an exciting year that brought new ideas and changes,” Große wrote in the annual report. “For the B. Braun Group, it was the first full year of implementation of our 2020 corporate strategy. We have defined the course of our future with this strategy: As a ‘system partner for health care,’ we want to better understand the problems of our customers and partners to develop compatible approaches to solutions in collaboration with them. The goal is to achieve the best results through the interactions of people, products and processes.”

That formula worked exceptionally well for the company last year, spawning hardy profits in all four reporting divisions. China, Germany, and the United States powered a 3.7 percent sales hike in B. Braun’s Aesculap division (to 1.72 billion euros), mostly due to higher angioplasty-related revenue stemming from knee implants, endoscopy products, instrument containers, and technical services. The growth, however, was somewhat surprising, considering the price declines plaguing the German stent and implant market.

ANALYST INSIGHTS: B. Braun has remained fairly quiet in 2016 and year-to-date in 2017. B. Braun is focused on its goals to have a more cohesive company set to come to fruition in 2020. It remains a solid “brick and mortar” service company that provides consistent support and aims to work with its customers to achieve better and more affordable healthcare. Who could not agree with that?

—Dave Sheppard, Co-Founder and Principal, MedWorld Advisors

The Hospital Care division hatched a surprise of its own, overcoming Latin American currency devaluations and stagnant demand for injection needles, syringes, and intravenous drug products to increase its 2016 revenue 4.7 percent to 2.99 billion euros. Growth champions included automatic infusion pumps/equipment, regional anesthesia products, and the Nutrilipid nutrition solution bag that debuted in the United States in 2015. Future gains are possible through the company’s echogenic peripheral nerve block needle technology and NRFit connectors for neuraxial use, both of which debuted last fall at the American Society of Anesthesiologists meeting in Chicago, Ill.

B. Braun also attempted to secure its fiscal future through a patent infringement lawsuit it filed last spring against Becton, Dickinson and Company, and Becton Dickinson Infusion Therapy Systems Inc. Entered in Delaware, the suit accuses Becton Dickinson of infringing on B. Braun’s patents by manufacturing and distributing the BD Insyte Autoguard BC IV catheter and BD Nexiva closed IV catheter system. B. Braun has filed additional lawsuits involving foreign counterparts of the patents in question in Australia, Belgium, and the Netherlands, and has won judgments in Austria and Germany involving three of the patents involved in the Becton Dickinson suit.

The Avitum division locked in future growth with a handful of product introductions in 2016, including the Aquabase water treatment system, the xevonta dialyzer, the Diacap Pro dialysis machine, the OMNI acute care system, and the Dialog iQ hemodialysis machine. The latter product features two biological inputs for more accurate hemodynamic condition data, one-touch priming, and automated bloodline loading/ejection.The Dialog iQ machines and OMNI system premiered too late in the year to truly impact sales, but the division was none the worse for wear: Avitum led B. Braun divisional growth in 2016, expanding revenue 11.6 percent (15.4 percent at constant currency) to 944.8 million euros. Strong demand for consumables and dialysis machines as well as significant increases in Asian, European, and U.S. proceeds helped the division overcome a potentially damaging Class 1 recall of its Dialog+ Hemodialysis systems last spring.

B. Braun recalled the product over conductivity sensor defects (specifically, cracks) that could allow air to enter into dialysis fluid or dialysate solution used to help filter waste and excess fluids in the blood. Air in dialysis fluids can lead to improper blood filtration, which could cause possibly fatal medical complications, according to the U.S. Food and Drug Administration. The company recalled 1,033 Dialog+ units in the United States that were manufactured between April 1, 2013, and July 3, 2013, and distributed between June 25, 2013, and Oct. 7, 2015.

Conversely, the Out Patient Market division had no such threats to profits last year. It relied on U.S. growth in elastomeric pumps, infusion solutions, and infusion systems, as well as strong sales in Eastern Europe, Asia-Pacific, and Latin America to boost revenue 5.5 percent to 781.7 million euros.

$6.7 Billion
NUMBER OF EMPLOYEES: 55,719

Among the other Top 30 companies in this year’s list, B. Braun maintains one aspect that keeps it somewhat unique—it’s still a family-owned business. The 176-year-old firm has maintained a long history with six generations of family members leading the company to continued success to become one of the largest medical device manufacturers in the world. Further, all indications point to the company staying the course in terms of remaining a family-owned business. Even the introduction to the annual company report highlights B. Braun’s medical device offerings through the presentation of Ole, a family man from Munich, Germany. Throughout his life, Ole has relied on medical technologies like those the company offers, from wound care products for his sports injuries to spinal surgery solutions for an inevitable procedure that he’ll need at some point.

B. Braun is built on four distinct product group divisions:

Hospital Care—Infusion equipment and supplies, infusion and injection solutions, intravenous catheters, products for clinical nutrition, as well as pumps and their associated systems.

Aesculap—General surgery, joint prosthetics in orthopedics, neurosurgery, laparoscopy, interventional vascular diagnostics and treatment, surgery for degenerative spine diseases, and cardiac and thoracic surgery.

OPM (out patient market)—Hygiene, diabetes, incontinence, stoma, and wound management.

Avitum—Hemodialysis, acute dialysis, and apheresis, as well as products and services along the entire dialysis value chain.

As of the close of 2015, B. Braun offered more than 5,000 products and 120,000 SKUs, as well as services for 18 therapy fields and applications. In preparation to hold a leading position in the industry (and a place on this annual list), the company continues to plan for the future and invest in what the needs of healthcare will require tomorrow.

“In its 176-year history, B. Braun has always been preparing for the future by setting the right course early on. This is also how we have approached today’s buzzword, ‘digitization.’ Ten years ago we introduced a fully IT-supported production with our LIFE factory for standard IV solutions. And we plan to continue to capitalize on synergies and develop new potential by harmonizing global processes,” said Prof. Dr. Heinz-Walter Große, chairman of the management board in his forward in the company’s 2015 annual report.

On the whole, the company had a favorable year in 2015, seeing an increase of 12.9 percent over 2014 with 6.13 billion euros in sales. That continued an ongoing trend over the previous four years of consistent growth through rising sales. “We are very satisfied with the economic development of the last fiscal year. We are above the forecasted corridor for sales growth and have also significantly improved operating profit,” Prof. Große said during the financial statement press conference.

That good fortune carried over to all four major company divisions, each posting double-digit percentage gains over 2014. The company’s largest division (46.6 percent of total sales), Hospital Care saw a 13 percent increase with 2.86 billion euros in sales. Seeing strongest sales in surgical instruments and endoscopy products, the Aesculap division (27.1 percent of total sales) celebrated an 11 percent increase over prior year, with sales of 1.66 billion euros. The OPM division (12.1 percent of total sales) enjoyed the highest percentage growth, up 15 percent over 2014 with sales of 741 million euros. Just shy of that percentage increase, Avitum (13.8 percent of total sales) grew 14.7 percent with sales of 846 million euros.

Looking at the worldwide marketplace for the company’s products, sales in Europe were significantly greater, encompassing almost 50 percent of total sales. Germany alone accounted for 16.9 percent of the company’s revenue, with the rest of Europe tallying 32.6 percent. Both percentages, however, were down from 2014 in terms of total company sales, giving way to an increased percentage in North America, which accounted for 23.3 percent of total sales, and Asia-Pacific, which came in at 17.5 percent of the total sales. Latin America (6.4 percent) and Africa/Middle East (3.3 percent) rounded out the company’s worldwide sales picture.

“Our goal is to grow our revenues by 5 to 7 percent annually and to exceed sales of 8 billion euros by the year 2020. We are all engaged and committed to this goal,” said Prof. Große. With this vision in mind, the company invested more than 1 billion euros in new production sites and research and development projects in 2015. Germany saw the lion’s share of this spend, accounting for 48.7 percent of the total. The actual research and development investment in 2015 was 262.4 million euros, up from 2014 (228.8 million euros).

Meanwhile, prior investments saw fruition in 2015 with a number of products gaining regulatory approval or clearance. Of note were the following:

• • U.S. approval of a new Space infusion pump software generation, which makes wireless communication to each individual pump possible.

• • Introduction of a self-expanding VascuFlex stent made of nitinol.

• • Novosyn Quick expanded the company’s portfolio of resorbable suture materials.

• • The intervertebral implant TSPACE XP became available as a third-generation product.

In addition to internal technology developments, B. Braun supported its future growth with the minor acquisition of Lauer Membran Wassertechnik GmbH, a provider of water treatment systems for dialysis. Having partnered for years prior, B. Braun made the purchase to fulfill the growing desire of the industry to have a single source for dialysis products.

$6.5 Billion
NO. OF EMPLOYEES: 54,000

Few voices have been louder than that of B. Braun Medical Inc.’s in the Herculean struggle to repeal the medical device excise tax, a part of the Patient Protection and Affordable Care Act of 2010. This April, during a Senate Committee on Finance Subcommittee on Healthcare hearing, B. Braun’s Chief Financial Officer (CFO) Bruce A. Heugel made an impassioned plea for lawmakers to hear what he and others in the medtech industry—particularly the smaller companies—are asking for: relief.

“Sustainability is key to B. Braun,” Heugel said. “We have responsibility to our employees, shareholders and community not to end up like Bethlehem Steel. So when the new medical device tax takes away $33 million through 2015, we are forced to launch painful counter measures. As the CFO we follow a simple rule: We balance our check book, and do not spend money we do not have.”

Heugel meant it when he said he will not spend money he doesn’t have. He listed no fewer than 10 areas in which B. Braun has had to make cuts or tighten its belt because of its reported 29 percent increase in its federal tax bill. Those cuts included clinical trials, research and development, pension plans and hiring. Most notably was the company’s decision to scrap plans for a new corporate headquarters building in the Lehigh Valley area near Bethlehem, Pa. In 2013, the company purchased 21.5 acres of undeveloped land from Lehigh University. In 2014, the plans for that new headquarters came to a halt due to the reported $13 million a year the device tax had been costing B. Braun.

“The medical device tax stopped that project,” Chairman and CEO Caroll H. Neubauer said. No plans have been announced for restarting construction.

Despite the strong message B. Braun has been sending regarding the detrimental effects of the device tax, the company is in good shape. In fact, the management board reported in the 2014 annual report that “overall, the B. Braun Group is in a good, stable financial condition.”

In fiscal 2014, sales of the B. Braun Group overall amounted to 5.43 billion euros ($6.59 billion) representing year-on-year growth of 5 percent.

The B. Braun Avitum Division, which provides modern treatment systems, consulting services and training courses, reported particularly good sales growth at 20.5 percent. The Outpatient Market Division also achieved solid growth at 5.7 percent. In contrast, sales in the Hospital Care and the Aesculap Divisions were only slightly higher than the previous year at 2.2 percent and 3.7 percent, respectively.

The regions Latin America as well as Asia and Australia recorded a high level of sales growth in their local currencies—18.3 percent and 10.3 percent, respectively. In euros, however, as a result of the sometimes heavily devalued local currencies, growth rates were more moderate: Latin America at 6.2 percent and Asia and Australia at 7.3 percent. Europe (excluding Germany) experienced stable growth of 3.8 percent, despite the market environment continuing to be challenging. Germany achieved a solid sales growth of 5 percent. In U.S. dollars, the North America region generated growth of 4.3 percent over the previous year. A stronger U.S. dollar at the end of the reporting year contributed to a sales increase in euros of 4.2 percent. In the region Africa and the Middle East, growth was very dynamic at 11.3 percent.

Despite the good sales year, B. Braun’s earnings remained stable at 316 million euros ($342.4 million). Budget cuts within the governmental health systems of some countries in which B. Braun is operational had an impact on earnings which resulted in lower margins. Increasingly complex approval processes for medical devices led to higher costs. Also, even though plans for a new global headquarters in Pennsylvania came to a grinding halt, the company did open its new Canadian headquarters in August, which meant significant investment dollars spent in North America.

“We believe our new office is an investment in the community and will allow us to strengthen collaboration and local networking and grow in the future as our product lines expand,” said Bob Comer, president of B. Braun of Canada Ltd.

Product News

Despite the halting of many areas of operations, B. Braun did have a lot of product movement activity in 2014. In January, the company earned U.S. Food and Drug Administration (FDA) approval of 5 percent dextrose and 0.45 percent Sodium chloride injection containers. In April, the company launched a new 1.5 percent glycine irrigation USP (United States Pharmacopeia) Titan XL 3L container. It was the third launch within B. Braun’s growing line of eco-friendly fluid therapy products. Then in October, The FDA approved B. Braun’s of Sterile Water for Injection USP in 2L and 3L containers. These pharmacy bulk package new products will be used with B.Braun’s Pinnacle TPN Management System and other automated compounding devices.

$7.12 Billion
NO. OF EMPLOYEES: 49,889

Rafael Mohrstedt was ecstatic the first time a co-worker called him by name. His own name.

For months after joining his father’s department at B. Braun Melsungen AG, the 27-year-old architect was known simply as “Werner’s son.”

“When I first started, it was strange having my Dad as my supervisor,” recalled Mohrstedt, who has worked for the company’s Brazilian subsidiary in São Gonçalo since 2006. “Most of my co-workers simply referred to me as Werner’s son. Now, however, I have earned their trust and they all call me by my real name.”

While convenient (think carpooling) and clever (employee retention), the Mohrstedts are a rarity in the 21st-century business world, as takeovers, layoffs, pension cuts and Chapter 11 bankruptcy reorganizations has forced workers to hopscotch around the job market to remain employed. But worker longevity is fairly common at B. Braun, where families like the Mohrstedts, the Rachners, the Griffiths, the Sanchezes and the Bakar-Bt Basirs work together (in some cases, side-by-side) at various manufacturing sites throughout the world.

Such domestic-professional bliss actually is welcome at B. Braun, an anomaly itself among the planet’s corporate titans. The company has been family-owned since its humble 1839 start as a small pharmacy (then named Rosen-Apotheke) on the banks of the Fulda river in central Germany’s North Hesse Highlands. The firm is now in its sixth generation of Braun ownership, with 70-year-old Prof. Dr. h.c. Ludwig Georg Braun chairing its Supervisory Board and Otto Philipp Braun managing the company’s Iberian Peninsula and Latin American branch.

With the arrival of its 175th birthday, B. Braun becomes an exception to the kinship business rule, joining only a handful (3 percent) of ancestral companies still operating into the fourth generation or beyond. Roughly 30 percent of family enterprises survive into the second generation and 12 percent remain viable into the third generation, according to statistics.

Clearly, B. Braun can attribute its overall market longevity to strong family values. But equally strong principles have helped as well, enabling the company to grow through honesty, integrity and benevolance.

“In addition to family values, I have always been driven by the ethos of the ‘honorable merchant’—‘Only do honest business so you can sleep with a clear conscience!’ This ethos has always been important to our family and shapes the entire company,” Ludwig Georg Braun said in an interview included within the company’s 2013 annual report. “We do not pursue growth for growth’s sake.
The important thing is to see the world with your eyes open, to understand the markets and the people who live there, and to identify trends early on. For example, we saw an opportunity to significantly improve hygiene by using plastic and single-use products. If you seize such opportunities, financial success is the logical outcome.”

And there’s no sense arguing with logic—at least not Ludwig’s kind of rationale, anyway. Company data show the B. Braun growth formula has begat solid profits for the last five years, hitting historical highs in both 2012 and 2013. Last year was the most lucrative for the company as sales jumped 1.6 percent (5.8 percent in constant currency rates) to 5.1 billion euros ($7.1 billion) and operating profit climbed 2 percent to 478.5 million euros ($658.7 million). The company’s cost-cutting measures and internal efficiency improvements counteracted public spending cuts, stringent medical/pharmaceutical product placement regulations, and competitive pricing to improve its EBITDA margin to 15.2 percent. Actual  EBITDA (earnings before interest, taxes, depreciation and amortization) rose 3.6 percent to 784.9 million euros ($1.08 billion) and consolidated annual net profit ballooned 9.3 percent to 315.5 million euros ($434.3 million). (Editor’s note: Percentages reflect changes based on the local currency in which the financial data were reported—in this case, the euro—and do not take into account annual foreign currency exchange fluctuations. Dollar amounts were converted using the exchange rate on the last day of the reporting period, Dec. 31).

Executives attributed the company’s stellar fiscal record last year to robust gains in the company’s core business areas (Hospital Care, Aesculap, Out Patient Market, B. Braun Avitum). As a whole, core business sales increased 3 percent to 2.9 billion euros ($4 billion); the rise was nearly double the 1.7 percent increment posted by B. Braun’s specific focus areas (home care, enteral nutrition, diabetic supplies, orthopedics, neurosurgery, vascular systems, IV catheters, wound drainage, etc.).

The Hospital Care and B. Braun Avitum divisions were the year’s top performers, besting their brethren segments by significant margins. Hospital Care sales rose 2.6 percent to 2.4 billion euros ($3.4 billion) due to strong demand for infusion therapy primary care products (i.e., parenteral nutrition solutions and injectables such as the Introcan Safety 3 Closed IV Catheter, a Top 20 Innovation Award winner). Specific business area revenue inched up 1.7 percent to 1 billion euros ($1.3 billion).

Acquisitions drove B. Braun Avitum growth, catapulting sales 9.5 percent to 613 million euros ($843.8 million).

Revenues remained essentially flat in the Aesculap and Out Patient Market (OPM) divisions, rising a negligable 0.1 and 0.5 percent respectively. Wound and incontinence care products helped bolster OPM revenues by 3 million euros last year, pushing the division’s sales gross to 609 million euros, or $838.3 million. The strength of both focus areas offset the pecuniary gaps left by the discontinuation of insulin production and the transfer of veterinary business to the Aesculap division, which failed to benefit from the switch or a sales partnership with Maquet Surgical Workplaces. The two entities agreed to jointly offer comprehensive operating room integration solutions for endoscopy.

The strong euro, particularly in comparison to other currencies like the sharply devalued Japanese yen, impacted growth within the Aesculap division’s specific business areas, capping the overall hike at 0.3 percent. The Closure Technologies business area, comprising B. Braun’s suture portfolio, was the only such subdivision not affected by volatile foreign exchange rates.
Though they wreaked havoc on Aesculap’s overall profits, fluctuating world currencies had a minimal impact on the company’s bottom line in 2013. Only North American profits faltered, tumbling 1.6 percent to 1 billion euros ($1.4 billion); revenues rose in the remaining locales, with Africa and the Middle East posting a chart-topping 12.4 percent surge to 157.8 million euros ($217.3 million). Latin America and Europe were profit-makers as well, growing sales 4.7 percent and 3.8 percent respectively while revenues in B. Braun’s home base of Germany climbed 1.7 percent to 952.2 million euros, or $1.3 billion.

Much of the company’s regional strides resulted from past facilities investments. In 2012, for example, B. Braun expanded and reorganized production at its Tuttlingen, Germany, facility; added nutritional product manufacturing areas in Melsungen and Crissier (Switzerland) and began a cross-divisional modernization and expansion of its Penang, Malaysia, site, where Noorhassu Diyana Bt Basir takes coffee breaks with her mother, Suria Bakar.

B. Braun continued working on the Penang expansion last year and enhanced its footprint in both Brazil and Hungary with twin redevelopment efforts. The company is building a new industrial park in Guaxindiba, Brazil, near two major freeways and Guanabara Bay. The project’s first phase will add a logistics center to the site, with storage areas for finished products and tanks for storing combustible materials. The second phase will consist of an administration center and a medical device manufacturing plant. The entire project—situated on a 200,000-square-meter plot (an area equivalent to 28 football fields) is scheduled for completion in 2017.

The company’s expansion of its Gyöngyös, Hungary, facility was considerably less complex but nevertheless doubled the site’s production area and capacity, thus enabling the manufacture of an additional 100 million products annually. A new 5,300-square-meter cleanroom  also was added to handle the production of disposable blood lines, wound drainage systems, catheters, and customized infusion sets.

“The clean room has brought processes to the latest standards of technical development and ensure a more efficient production,” plant manager Jozef Bognar said.

$6 Billion
NO. OF EMPLOYEES: 43,676

All companies keep secrets. KFC Corporation keeps its famous fried chicken recipe (that surreptitious mix of 11 herbs and spices) locked in a corporate vault more than 30 years after Colonel Harland Sanders’ death. At Apple’s sprawling headquarters, employees reputedly are banned from design labs, and windowless “lockdown” rooms sequester precious information from the outside world (including the company’s own rank-and-file workers).

Such a clandestine atmosphere is non-existent at B. Braun Melsungen AG. The company’s management board, in fact, promotes a corporate culture of knowledge sharing and partnerships, a philosophy reflected in the manufacturing firm’s 2011 annual report.

“The theme of this annual report, ‘Sharing expertise, Promoting partnership,’ is important to us,” Management Board Chairman Heinz-Walter Große said in a brief letter to shareholders. “It is one of B. Braun’s recipes for success as we not only see ourselves as a partner to hospitals, physicians and healthcare personnel but also take responsibility for patients. Achieving peak performance is not something you can do on your own. The ongoing exchange between physicians, healthcare personnel and patients helps us to continually improve lives, whether through research or through daily interaction with our colleagues and business partners. Our corporate culture is based on the firm belief that fair and reliable partnerships lead to the best results…”

Or, perhaps, the next best outcome. B. Braun recorded its second-most profitable year in company history in 2011. Net profit totaled 256 million euros ($331 million) and gross profit remained steady at 2.1 billion euros ($2.7 billion). (Editor’s note: Percentages reflect changes based on the local currency in which the financials were reported—in this case, the Euro—and do not take into account annual foreign currency exchange fluctuations. Dollar amounts were converted using the exchange rate on the last day of the reporting period, Dec. 31).

Net sales rose 4.2 percent to 4.6 billion euros ($6 billion), though foreign currency exchange rates boosted that growth to 5.3 percent. EBITDA (earnings before interest, taxes, depreciation and amortization) slipped 1.7 percent to 688.5 million euros ($891.5 million) due to cost-cutting measures by public healthcare purchasers, higher commodity prices and startup costs for new factories.

B. Braun opened new or expanded facilities in Romania, Serbia, Vietnam and Germany last year, and announced the expansion of a manufacturing plant in Glandorf. Located 220 kilometers (136 miles) north of the company’s headquarters in Melsungen, Germany, the Glandorf plant produces drugs and medical devices for dialysis therapy. B. Braun is spending 50 million euros on the expansion project, adding a new dialysis production facility and fully automated high-bay warehouse to meet increased product demand. The factory is expected to open early next year.

B. Braun opened its expanded facility in Timisoara, Romania, in mid-February 2011. The 4 million-euro expansion plan raised total annual production capacity at the site to 19 million units of infusion solutions and is expected to help the company increase its presence in southeastern Europe.
Executives envision the Romanian facility as a distribution hub for B. Braun in the region, delivering products to such neighboring markets as Albania, Bulgaria, Macedonia, Montenegro and Serbia.

“Though the investment in Timisoara, we plan to make the location a hub for other neighboring countries’ needs, which will strengthen Romania’s position within the B. Braun group,” Meinrad Lugan, head of the company’s Hospital Care & OPM divisions, said during an opening ceremony at the plant.

B. Braun also reinforced Vietnam’s position in the company with the opening of a 32.6 million-euro IV production plant in Hanoi. Encompassing 9,800 square meters (32,152 square feet)—slightly larger than a soccer field—the new facility will enable the company to increase its annual production of IV sets to 100 million units from 35 million units. Over time, production possibly could reach 200 million units annually, bigwigs noted.

Besides the production facility in Hanoi, B. Braun has offices in Can Tho, Danang, Hanoi, Hue and Ho Chi Minh City, Vietnam.

The company doesn’t have quite the same market penetration in southeastern Europe as it does in Vietnam, but officials attempted to correct that disparity (in part) with the addition of a facility in Belgrade last summer. Dragan Soljakovski, managing director of B. Braun in Coatia and Serbia, said the new facility sends a “strong signal in a country with great challenges but also enormous potential for the entire Balkan region.”

Other new facilities born to the B. Braun family last year include an IV pump and dialysis machine manufacturing plant in Melsungen, Germany, and the Bucharest chapter of the Aesculap Academy, a medical training program established by the company in 1995.

B. Braun’s Aesculap division (which oversees the Aesculap Academy) was the second-largest contributor to growth in 2011, amassing 1.35 billion euros ($1.75 billion), a 5.8 percent increase compared with the 1.28 billion euros ($1.69 billion) the division garnered in 2010. Surgical products were the main growth driver in the division, followed by vascular therapeutic devices. Sales of drug-eluting balloon catheters and wound closure products were strong as well. Orthopedic and spine sales were off, reflecting continued stagnation in both sectors.

The Aesculap division was outperformed by the Hospital Care unit, which generated 2.15 billion euros ($2.79 billion) in sales last year, a 3.5 percent increase compared with the 2.08 billion euros ($2.76 billion) the division collected for B. Braun in 2010. IV catheters (Introcan Safety and Vasofix Safety catheters) and injectable drugs (Propofol-Lipuro, Duplex and Heparin) were top-grossing products, as were large-volume IV solutions and standard IV sets. Increased demand helped lift sales of regional anesthesia products, according to the company’s annual report.

In February, the Hospital Care division marked a very special milestone: Its LIFE facility in Melsungen manufactured the billionth Ecoflac plus container for standard IV solutions. Since production of the Ecoflac container began in 2004, the company has grown its market share from 25 percent to more than 45 percent, executives noted.

Sales in the Outpatient Market division rose 2.5 percent to 568.4 million euros ($736 million). Hygiene management devices, diabetes care items and incontinence care products achieved above-average growth.

B. Braun’s Avitum division trailed its siblings, netting 500.6 million euros ($648.2 million) in sales last year, a 5.4 percent increase compared with the 474.8 million euros ($629.1 million) the unit posted in 2010. Growth came mostly from dialyzers and machines, though the division’s dialysis provider business performed surprisingly well due to increased patient demand in India, Russia and South Africa.

Research and development spending jumped 15.7 percent to 179.9 million euros ($233 million), but operating profit fell 5.2 percent to 432.2 million euros ($559.6 million).

$5.9 Billion
NO. OF EMPLOYEES: 41,666

Guy Egon, M.D., works at the Centre de l’Arche in Le Mans, France, a rehabilitation facility for children and adults suffering from severe burns, neurological disorders and musculoskeletal diseases. In addition to his duties as a physician, Egon helps B. Braun Melsungen AG set up focus groups that provide feedback on the company’s products. One of those focus groups led to the development of the Actreen Lite Cath, a sterile, single-use prelubricated catheter for patients suffering from urinary incontinence, and its cousin, the Actreen Lite Mini, a urinary catheter designed specifically for women.

“Together with experts from a wide range of fields, we are constantly expanding and consolidating our knowledge and sharing it with customers, business partners and clinicians,” former Management Board Chairman Ludwig Georg Braun, who retired March 31, 2011, tells readers in the company’s 2010 annual report (he was replaced by former Board Vice Chairman Heinz-Walter Große). “As such, we are living up to our guiding principle of ‘Sharing Expertise’ every day.”

Such generosity with its knowledge helped the company increase its overall sales last year by 9.8 percent and its gross profit by 10.9 percent in euros, though a stronger U.S. dollar and more robust currencies in Asia and Latin America also contributed to the growth. (Editor’s note: Percentages reflect changes based on the local currency in which the financials were reported—in this case, the Euro—and do not take into account annual foreign currency exchange fluctuations. Dollar amounts were converted using the exchange rate on the last day of the reporting period, which for B. Braun, was Dec. 31). In keeping with its commitment to “share expertise,” the company established a public-private partnership with the government of India’s Andhra Pradesh to establish 11 dialysis centers within state-run hospitals. Once up and running, the centers are expected to provide free treatment to roughly 1,000 patients suffering from chronic kidney diseases.

That partnership was one of the crowning achievements in B. Braun’s efforts to share its know-how with a greater number of people last year. Those efforts culminated in the opening or completion of several expansion/construction projects in Europe and Southeast Asia, including the expansion of a Swiss facility that manufactures empty parenteral nutrition bags and the completion of construction of a clinical nutrition factory in Germany. In addition, the company expanded the dialyzer production capacity in its Radeberg and Berggießhübel facilities (both in Germany), put the finishing touches on its Ecoflac production facility expansion project in Rubi, Spain, and worked to ensure the multi-year expansion and restructuring of its Penang site in Malaysia would be completed on time (its target completion date is 2014). B. Braun also constructed a new, five-building manufacturing campus at its headquarters in Melsungen, Germany, to expand its infusion pump production capacity. Dubbed Avitum Village, the new campus will be able to produce more than 207,000 pumps annually, executives said. One of the five plants is dedicated to infusion pump production, while the others house research and development space as well as services and training areas.

“This is a campus that is completely devoted to the development, manufacture and support of infusion devices,” Gale White, vice president of Infusion Systems Marketing for B. Braun Medical Inc., said when construction of the new campus was announced. “It will enable us to meet the increasing demand for syringe and large volume infusion pumps today and well into the future.”

Demand for B. Braun’s Infusomat Space and Perfusor Space infusion pump products was “highly encouraging” last year but both devices have quite a ways to go before they can be considered bestsellers. Still, the two products helped boost 2010 sales by 9.6 percent to 2.08 billion euros in the company’s Hospital Care division. Other sales drivers included the firm’s multi-chamber intravenous bag (Nutriflex) and single-chamber bag (Lipofundin, in particular); the Introcan Safety and Vasofix Safety catheters; needles and sets for regional anesthesia; and injectable medicines, namely Propofol- Lipuro and Duplex.

The Asia/Pacific region generated the most sales for the Hospital Care division, though transactions improved in Eastern Europe, Russia and Poland. The division itself netted the most amount of money for the company, followed by the Aesculap division, Outpatient Market division, and Avitum unit.

The Aesculap division posteda record 11.1 percent sales increase in 2010, year ended Dec. 31. Sales totaled 1.3 billion euros ($1.7 billion), according to the company’s 2010 annual report. Executives attributed the increase in this division to robust sales of Vena Cava filters, single-use elastomeric pumps and SterilContainer systems as well as the SeQuent Please drug eluting balloon stent, which received CE Mark approval in 2009. Other strong performers were knee systems, Novocart 3D, a product for treating articular cartilage damage, and spinal devices such as the Spyder Minimally Invasive Spinal Retractor System, a mechanism that features top-loading blades that can be removed intra-operatively without the need to remove the retractor frame during use. The blades and retractor arms are made from X-ray translucent titanium alloy and retract and tilt, giving surgeons an optimal view of the procedure site and eliminating the need for large incisions.

B. Braun’s Avitum division rebounded from its poor 2009 showing to post the largest sales increase last year. Data from the annual report indicate that sales expanded 12.9 percent to 475 million euros, or $629 million. Growth in this division came from recovering currencies in the Czech Republic and Poland as well as strong sales of disposables, concentrates for dialysis and dialyzers (artificial kidneys). Sales of dialysis machines, which were impacted in 2009 by weak demand, recovered last year to become one of the division’s best sellers.

The weakest sales growth came from B. Braun’s Outpatient Market division, which was unable to top its 2009 act. Sales climbed 5.5 percent to 555 million euros, or $735 million. Strong sales of skin and wound management products, particularly the Prontosan product line, was offset by high flu vaccine inventory and lower demand for the serum. Urological incontinence and irrigation therapy products experienced solid growth, though urine drainage bags and closed urine systems (Ureofix) posted weaker than expected sales due mostly to a supplier default.

“12. B. Braun

$5.8 Billion

KEY EXECUTIVES:
Lugwig Georg Braun, Chairman of the Management Board
Heinz-Walter Große, Vice Chairman of the Management Board
Wolfgang Feller, Head of the Avitum Division
Hanns-Peter Knaebel, Head of the Aesculap Division
Meinrad Lugan, Head of the Hospital Care and OPM Division
Caroll H. Neubauer, Head of the North America Region

NO. OF EMPLOYEES: 39,504

GLOBAL HEADQUARTERS: Melsungen, Germany

It is innovation that shapes the future. Like the chorus of a popular song, this mantra recurs several times throughout a four-minute video that appears on the corporate Website of B. Braun Melsungen AG. The video explains the importance of innovation at the 171-year-old firm, and ways the company is driving innovation to improve the quality of life for patients.

“B. Braun’s corporate success is based on its innovative strength,” the video tells viewers. “Every innovation increases B. Braun’s knowledge pool.”

The company’s basic philosophy toward innovation is repeated in its 2009 annual report, aptly titled “Innovations for a Better Quality of Life.” In the report, Management Board Chairman Ludwig Georg Braun tells “business friends” that innovation at B. Braun is not an end unto itself, but rather an ongoing process to continuously improve both the quality of medical products and the quality of life.

“Our company owes its success to a large degree to its ability to continue accumulating knowledge, to share that knowledge with customers, business partners and users, and to formulate new solutions,” Braun noted in the report. “In the past, entirely new products were the norm, but now our focus is on the further development of existing products.”

The further development of some existing B. Braun products helped the company further its overall sales last year by 6.4 percent and boost its gross profit by 6.8 percent. (Editor’s note: Percentages reflect changes based on the local currency in which the financials were reported—in this case, the Euro—and do not take into account annual foreign currency exchange fluctuations. Dollar amounts were converted using the exchange rate on the last day of the reporting period, which in this case, was Dec. 31).

In keeping with its commitment to innovation, company executives in December signed an investment package worth 1.6 billion euros for the four-year period beginning in 2011 (the package is worth an estimated $2.3 billion). The firm also plans to invest in its various facilities worldwide, including those in Malaysia, Indonesia, Brazil and Argentina. The investment program, executives said, will be funded by the cash flow generated from operating activities over the next several years.

If the company’s cash flow in the near future is anything like it was in 2009, B. Braun will have no trouble financing investments at its international locations. Operating cash flow more than doubled last year, climbing to 613.4 million euros ($879 million) from 249.1 million euros ($513.4 million) in 2008. Executives attributed the increase to higher operating profit (410.5 million euros compared with 345.6 million euros in 2008) and a positive change in working capital.

B. Braun managed to escape a direct hit on its sales and profits from the brutal economic slowdown that engulfed the world in 2009. According to the company’s annual report, the recession slowed demand for automated infusion systems, dialysis machines and capital goods, which impacted sales of power systems in the company’s Aesculap Division. Capital equipment, which accounts for 14 percent of the company’s overall sales, also was adversely affected by the global financial crisis. Conversely, sales of disposable products rose.

The ebb and flow of demand throughout the year apparently was enough to offset the overall impact of the world’s poor economic health on B. Braun’s bottom line. The company reported $5.8 billion in sales, $2.7 billion in gross profit, and $343.3 million in net profit. B. Braun also posted higher sales in most regions of the world, though in one area growth was flat.

Latin America experienced the largest sales increase last year, jumping 19.3 percent to $364 million. Asia and Australia reported the next highest gain, earning $702 million for the company, a 15.9 percent increase compared with the $605.6 million that region generated in 2008. North America and Germany each made $1.2 billion for B. Braun, an 11 percent rise compared with their 2008 earnings of $2.2 billion. Revenue was flat in Europe and Africa due to fluctuating sales throughout the region.

B. Braun recorded sales gains in all four of its divisions for the second consecutive year, enabling the company to break the 4 billion euros sales barrier for the first time in its history. The firm’s Hospital Care division netted the most sales, followed by the Aesculap division, Outpatient Market division, and Avitum unit.

The Hospital Care division reported $2.7 billion in sales, an 8.8 percent increase compared with the $2.5 billion the unit posted in 2008. Sales drivers included the Ecoflac Plus containers and safety peripheral IV catheters (Introcan Safety and Vasofix Safety), as well as intravenous drugs and syringes. The recession dampened demand for automatic infusion systems (space pump systems) at the start of 2009, but demand picked up throughout the year, enabling the company to record significant growth in space pump systems sales.

The Aesculap division posted the largest sales increase last year, growing 10 percent to $1.65 billion despite disappointing sales of power systems and orthopedic devices. Executives attributed the increase in this division to robust sales of sutures and access ports (such as the Celsite Access Ports) as well as the SeQuent Please drug eluting balloon stent, which received CE Mark approval last year. The SeQuent Please stent uses a drug matrix that is applied to the balloon of an angioplasty catheter. The matrix consists of paclitaxel, a medication used for years in drug-eluting stents to treat cardiovascular disease, and a radiologic contrast agent called Ultravist 370. When the balloon is inflated to dilate the narrowed blood vessel, paclitaxel is delivered directly to the diseased area.

Besides sutures and stents, the Aesculap division also sells surgical technologies, sterile container systems, orthopedic products, spinal devices and neurosurgery systems.

The Outpatient Market division outperformed its 2008 act by increasing sales 7.8 percent to $753 million. Growth in this division primarily was driven by hygiene management and anesthesia products, though the company’s Prontosan series of wound irrigation and wound decontamination products is gaining traction in the market.

The weakest sales growth came from B. Braun’s Avitum division, which reported $35.7 million sales, a mere 1.4 percent increase compared with the $35.2 million the unit earned in 2008. With dialysis products and services as its main offerings, this division was most vulnerable to the downturn and therefore was impacted by weak demand for dialysis machines. Particularly sharp declines were recorded in Western Europe and North America, though the dropoff in those areas was offset by sales gains in Peru and China as well as above-average growth in Germany.”

$5.3 Billion
NO. OF EMPLOYEES: 38,132

The executive team at B. Braun has always taken a conservative, long-term approach to business management. That approach has served the company well throughout its 169 years, particularly during times of economic upheaval.

It should come as no surprise then, that B. Braun emerged virtually unscathed from last year’s economic meltdown. In fact, the company experienced stronger growth than the market average,

The Aesculapium in Tuttlingen, Germany. Photo courtesy of B.Braun.

posting organic overall growth of 6 percent and a 4.9 percent jump in gross profit. (Editor’s note: Percentages reflect changes based on the local currency in which the financials were reported—in this case, the Euro—and do not take into account annual foreign currency exchange fluctuations. Dollar amounts were converted using the exchange rate on the last day of the reporting period, Dec. 31).

B. Braun reported $5.33 billion in sales last year and $2.47 billion in gross profit. The company experienced higher sales in most areas of the world but saw a decrease in the United States due to a decline in value of the U.S. dollar.

“The Management Board considers performance in fiscal year 2008 as satisfactory overall,” B. Braun’s 2008 annual report states. “We were able to increase both sales and interim profit. The global financial crisis that dominated the year has only had a minor impact on B. Braun. Our sales volumes to date have not suffered any adverse consequences. However, we were negatively affected by high energy and raw material prices during the first eight months of the year, and by the extremely volatile currency markets. The healthcare market as a whole was not affected by the crisis in 2008.”
Some of B. Braun’s profit though, was affected. Operating profit fell 0.9 percent to $487.3 million, while net profit slid 15 percent to $260.8 million. The company’s profit before taxes also took a hit, falling 5 percent to $378 million.

B. Braun posted sales gains in every corner of the world last year except North America. Europe and Africa reported the most significant gain, as sales grew 11.6 percent compared with 2007 levels to reach $2.17 billion. Germany posted the next highest gain, growing 5.6 percent last year to reach $1.14 billion. The Asia/Australia market generated $605.7 million in sales for B. Braun, an 8.8 percent increase compared with 2007 levels, while Latin America made $305.7 million for the company, a 5.6 percent gain compared with the prior year. With $1.1 billion in sales, North America was the third-highest revenue generator in 2008, but the U.S. dollar’s decline triggered a 4.4 percent decrease in sales compared with 2007.

All four of B. Braun’s divisions posted sales gains last year, with the Avitum unit achieving double-digit growth. The company’s Hospital Care division, which manufactures infusion therapy products, needles and syringes, catheters, IV sets and other products for basic clinical care and intensive medicine, reported $2.48 billion in sales, a 3.7 percent increase compared with its 2007 result. According to the annual report, the Hospital Care division was   “hit relatively hard”  by unfavorable exchange rates. “The division was not able to achieve growth rates it had in previous years,” the report stated. “If exchange rates had been similar, the increase in sales would have been significantly higher.”
In Europe, the Hospital Care division further consolidated its business in 2008. Demand for large volume parenterals and IV catheters (particularly the Vasofix Safety and Introcan Safety IV catheters) contributed to the sales increase in this division.

Sales for the Aesculap unit climbed 7.3 percent to $1.54 billion. Sales in Europe and Asia were robust, but the company reported weak growth in Latin America and a decline in North America (due to exchange rates). This unit develops surgical technologies, sterile container systems, closure technologies, as well as orthopedic, spine, neurosurgery and vascular systems. Last year’s main sales drivers didn’t change much from 2007—they continued to be surgical instruments, sutures and the ortho-traumatology segment. New products attracted customers, too—executives said the OrthoPilot Next Generation for the implantation of knee and hip endoprostheses and the EndoSponge for treating complications from rectal resection proved popular in 2008.

The Outpatient Market division generated $698.9 million in sales for the company, a 4.9 percent increase compared with its 2007 year-end result. European customers generated the bulk of the sales, with Asia posting “stable” sales growth and Latin America performing poorly. As with the company’s other divisions, sales in North America were obliterated by the dollar’s decline.
Popular products within this unit last year include those for parenteral nutrition, wound care management and hygiene management.

B. Braun’s Avitum unit, which provides dialysis products and services, once again reported the most significant sales growth of the company’s four divisions. Sales jumped 14.6 percent to $567.7 million as the unit focused on recruiting more European customers. Latin America contributed considerably to the sales gain, but business in North America and Asia merely kept pace with general market growth. Sales figures and profit margins were not the only measures of B. Braun’s success last year. Construction began on several new buildings, including a medical manufacturing facility in Hanoi, Vietnam, and a 164,000 square-foot LIFE Nutrition and Central Laboratory facility in Melsungen, Germany. The $267 million nutrition lab will provide hospitals with IV nutrition to patients who can no longer take nourishment by mouth.

B. Braun subsidiary TETEC opened a 4,265 square-foot facility in Reutlingen, Germany, for the production of cartilage transplants. The building includes 1,738 square feet of office space.
In October, B. Braun celebrated the manufacture of the 500 millionth Ecoflac container. Two months later, the company celebrated the 100th anniversary of its foray into the manufacturing of sutures. To commemorate the milestone, B. Braun sponsored a competition to generate ideas and facilitate dialogue with scientists worldwide. Doctors from 27 countries submitted more than 200 proposals based on the theme, “The Future of Sutures.”

$5.3 Billion
NO. OF EMPLOYEES: 35,000

How do you say “steady growth” in German? We’re not sure, but the answer may be synonymous with B. Braun. In its 168th year (fiscal year 2007), the company posted a 7.6% increase. (Editor’s note: Percentages reflect changes based on the local currency in which the financials were reported—in this case, the euro—and don’t take into account foreign currency exchange fluctuations year over year. Dollar amounts were converted using the exchange rate on the last day of the reporting period, Dec. 31.) Sales for the year were $5.3 billion. Net profit increased 19.7% to $320 million. The company also increased its workforce by almost 10%.

According to the company, Russia, the United Kingdom, Spain and China experienced “outstanding growth” during the past fiscal year. Eastern Europe also posted sales gains, as did the Asia-Pacific region (excluding China and Japan), B. Braun officials said.

B. Braun’s Hospital Care division, which manufactures infusion therapy products, needles and syringes, catheters, IV sets and other products for basic clinical care and intensive medicine, posted a 7.4% sales gain, totaling approximately $2.5 billion. The performance largely was driven by the US market, Europe and Russia—where B. Braun recently has increased its activities. The company reported double-digit growth in sales of IV pumps and related disposables and IV catheters.

For 2007, sales in the Aesculap unit grew 7.1% to reach $1.5 billion. Research and development were the name of the game for Aesculap, with expenditures 30% more than the company average. The division develops surgical technologies, sterile container systems, closure technologies, as well as orthopedic, spine, neurosurgery and vascular systems. All product areas experienced strong rates of growth, often in the double digits, the company reported. Surgical instruments and suture materials remained the sales leaders of the division, while cardiology and neurosurgery also made an above-average contribution to growth in sales for the year.

The strong dependence of the company’s Outpatient division on US business (50%) led to division growth of only 1.3% as a result of currency exchange rates—a total of $696 million. Double-digit growth, however, was generated in European markets (Germany, the United Kingdom, Spain, France, Russia). By combining the hospital and homecare markets, B. Braun management is positioning the Outpatient division to capitalize on the transition from inpatient to outpatient care, creating a sales continuum. In terms of new product launches, antibacterial wound care products with silver coating, a new generation of catheters with optimized packaging and the ongoing expansion of the MRSA (methicillin-resistant Staphylococcus aureus) product portfolio have proven highly successful, the company said.

B. Braun’s Avitum division, which provides dialysis products and services, was the growth leader across the company’s four main divisions. Sales growth was 19.6%, exceeding management’s expectations. Revenues totaled approximately $517 million—the result of a 16% increase in product sales and a 27% bump in services. International growth also played a role in a larger bottom lime. In the past fiscal year, the division expanded its activities in Poland, the Czech Republic, Slovakia, Spain, Hungary and South Africa. The company also broadened its service with the acquisition of Baxter Healthcare Ltd.’s Renal Therapy Services business in the United Kingdom.

For 2008, B. Braun officials said the company is reaching manufacturing capacity in hospital care and medical devices. As a result, a majority of investments made in 2007 were earmarked for expanding production capacities for core products. Work will continue this year on new facilities in Germany, as well as expanding capacity in the United States, Brazil, Peru and Spain.

The company also predicted sales growth of more than 8% (after exchange rates) for FY08. Products driving growth are expected to be automatic IV systems and IV catheters for the Hospital Care division, core categories for Aesculap and IV nutrition for the Outpatient division. The largest percentage increase in growth once again, however, will be for dialysis equipment, B. Braun predicts. In the United States, the company expects 10% revenue gains (in dollars).

$4.2 Billion

Key Executives:
Ludwig Georg Braun, Chairman of Management Board
Michael Ungenthum, Vice Chairman of Management Board, Chairman Executive Board of Aesculap AG & Co. KG, Aesculap Division
Caroll Neubauer, Head of North American Region
Wolfgang Feller, Head of Avitum Division
Meinrad Lugan, Head OPM and Hospital Care Divisions

No. of Employees: 34,000

World Headquarters: Melsungen, Germany

On this year’s list, B. Braun enjoys the distinction of being the only privately held company to take its place here, based on fiscal 2006 figures. All that will change next year after the wave of private equity investment changes the landscape somewhat for companies such as Biomet, Kodak and Bausch & Lomb. But no matter what kind of financial winds may change the fortunes of some of the companies on this list, B. Braun certainly is the only company in the lineup that’s been a privately held organization for more than 160 years.

For fiscal 2006, the company reported sales of $4.2 billion, a 9.8% increase compared to last year. Net profit grew 17% to $228 million. The company attributed strong sales performance of large-volume infusion solutions and intravenous (IV) catheters as the main factor driving growth. The service sector also recorded high sales growth of 25%.

The United States, Latin America and Eastern Europe remain the strongest sectors for B. Braun. Europe (excluding Germany) and Africa combined are the largest percentage of the company’s sales (36.9%). North America is the second largest market at 24.7%. Germany is third with 21.9% of the company’s sales. B. Braun said it was able to generate 7% growth in Germany despite the impact of new tax laws.

B. Braun’s Hospital Care division, which offers products and services for infusion therapy and for basic clinical care in intensive medicine, operating areas and anesthesia, reported 2006 sales of roughly $2 billion (a 9.3% increase). High growth was the result of infusion pumps and disposable medical products as well as with IV solutions and indwelling IV cannulas, the company said. While markets in North America and Europe remained strong, B. Braun Russia recorded the best increase in sales, in excess of 70%.

The Aesculap surgical division increased sales 8.2% to $1.2 billion. Growth was driven by expanding markets in Central and Eastern Europe and in North and Latin America. For 2006, the company focused on the rollout of its activL lumbar artificial disc.

A double-digit increase—13%—also was reported for B. Braun’s Outpatient division, which is focused on diabetes care, skin and wound management, clinical nutrition, as well as stoma and incontinence care. The division recorded sales of $585 million for 2006. The main areas of growth were Spain, the United Kingdom, the United States and Brazil. In Chile, B. Braun opened a new production facility for enteral nutrition products in April 2006.

As a systems supplier for hemodialysis and extracorporeal blood treatment, the B. Braun Avitum division manufactures and sells products and services for the treatment of chronic and acute kidney failure and for therapeutic apheresis. Sales grew by 12.9% to $369 million, although sales in some countries were affected by developments in government healthcare policy regarding reimbursements for dialysis treatment. In spite of tough competition, most markets performed very well. Growth was driven by business in the United States.

In the next three years, B. Braun said it plans to invest approximately $1.5 billion in its operations—half of which is slated for Germany. Outside Germany, the company plans to expand production facilities for infusion solutions and accessories in Pennsylvania, which the company said would result in 300 new jobs. At its facility in Bethlehem, PA, B. Braun operates one of the largest medical device contract manufacturing businesses in the world.

A new infusion solutions production facility also is planned for Spain.

For fiscal 2007, B. Braun expects healthcare market conditions to remain steady, and the company is aiming for sales growth of 10%. The company also predicts higher profit growth of at least 15%.

$3.9 Billion
No. of Employees: 30,973

The lone privately held medical device manufacturer in the Top 30 managed a slight rise in fiscal 2005 sales at 3%, despite the strong dollar.

In terms of the strong dollar, for instance, the Melsungen, Germany-based company was hurt in the earnings department as earnings increased by 14% in Euros; in dollars, the company actually dropped 7%.

While many medical device companies are making a big push in the high-growth region of Asia, B. Braun also continues to build in its growth area in Europe. More than half of the company’s 2005 sales came from Europe—including B. Braun’s home turf of Germany, which produced 23% of the company’s total sales.

And B. Braun is building on its stronghold in Europe after opening a state-of-the-art IV solution factory in Melsungen, Germany along with the expansion of a medical product manufacturing facility in Escholz-matt, Switzerland.

“Thanks to cutting edge technology and the contribution of our dedicated employees, with these two major investments, we have been able to create long-term competitive cost structures in Central Europe, particularly for basic hospital care products,” said Ludwig Georg Braun, chairman of the management board, B. Braun.

While the company did well in Germany, it faces several hurdles there, including extensive talk on social and fiscal reform along with the trend toward hospital privatization.

While Central and South America are B. Braun’s smallest regions, combined they offered the highest percentage of growth in 2005 with a 30% jump in revenues. The region benefited from the continued leadership from its core segments of surgical instruments and suture materials.

The North American region incorporates almost a quarter of the company’s total sales, having reached $852 million in 2005. The biggest drivers in the region were its orthopedic products, safety products and the Duplex, a dual chamber system for intravenous medical care. In the United States, where B. Braun operates one of the largest contract manufacturing businesses in the world in Bethlehem, PA, the company has developed revenue from its partnership with Premier, the largest hospital group purchasing organization.

After Central and South America, B. Braun grew the fastest in its Asia and Australian regions, with a 14% jump. These areas are benefiting from new plants in the last few years in the company’s surgical instruments sector. China is particularly noteworthy, as B. Braun opened the China Instruments Production plan in Suzhou, China in September 2005 and another plant, China Healthcare Infusions Elements Factory, is currently in development in Suzhou.

The company operates four major divisions: Hospital Care, Aesculap, Out Patient Market (OPM) and Avitum. The Avitum division was previously called the Medtech division, which manufactures dialysis machines.

The company’s main core of business is its Hospital Care division, which was bolstered by a few areas including peripheral IV catheters. The company also improved on its IV pump product line with the expansion and further adaptation of the Fluid Management Generation Space to meet the needs of hospitals with new and improved software.

In the Aesculap division, which manufactures surgical products, Eastern Europe and the North and Latin American markets fueled much of its success. In 2005, the division launched several new products, including the Metha hip short shaft prosthesis. The company also launched, in 2006, the aktivL IVD (intervertebral disk) prosthesis, a second generation of intervertebral disk implants, and the Univation knee endoprosthesis system.

In spite of all these positive developments, Aesculap has been hurt in China as a result of regulatory restrictions.

B. Braun made two acquisitions in fiscal 2005 in Tetec AG of Reutlingen, Germany and Ascalon. Tetec is a manufacturer of biological tissue replacement, while Ascalon is a manufacturer of the hollow fiber membranes.