MedDevNews, Q4 2023

Ending 2023, economic uncertainty, declining reimbursement rates, cybersecurity, and talent scarcity have been identified as the industry’s biggest risk factors, leaving some parties less optimistic about this year’s financial outlook. However, England has been hearing an increase in discussions related to M&A and capital raises and is optimistic that 2024 will not be as slow as 2023. In addition, budget increases will come for line items such as transformative technologies such as AI, leaving industry leaders more optimistic for 2025.

England & Company Healthcare Investment Banking team closed multiple transactions in Q4 2023 in the orthopedic medical device and extremity markets. Notably, England facilitated the strategic relationship between Extremity Medical and Henry Schein, with Henry Schein being a significant new entrant in the orthopedic extremities market. The England team completed four orthopedic transactions in 2023 and tops the global rankings in investment banking for orthopedic companies.

20 Years of Trusted Advice & 2023 Year In Review

In 2003, we launched England & Company to provide high-quality strategic advisory services to entrepreneur-led technology companies – businesses that the established investment banks had largely abandoned in the wake of the “dotcom bust.” Leveraging market experience, creativity, and an unflagging loyalty to our clients, we achieved some terrific results. Celebrating our 20th year of providing trusted advice, we continued to deliver for our clients in 2023.

Over the last 20 years, we expanded areas of industry focus, service offerings, and geographic footprint to become an investment bank with a full suite of advisory services and a global reach dedicated to mid-market companies and their financial sponsors. To maintain momentum for the future, in 2023, we continued to add exceptional professionals to our platform, expand our international reach, and, most importantly, deliver compelling results for our clients.

Moving into our third decade, I’d like to take a moment to thank our clients for the trust they have placed in us over the years and share some highlights from the last year. Our client-focused mission will never change, and our ability to deliver has never been stronger. If your company is contemplating a strategic initiative – acquisition, sale, capital raise, or restructuring – please reach out to me or any of our team.

Craig England, CEO

Growing the Platform

Over the past year, England attracted highly accomplished professionals to enhance our Debt Advisory and Restructuring capabilities, as well as expand our advisory reach in Technology and the Asia-Pacific region.



Expanding International Reach

In 2023, England transacted with companies in a dozen countries across five continents. During the year, we continued to leverage our membership in the World M&A Alliance, a partnership of thirteen middle-market investment banks worldwide.

Additionally, in 2023, we opened an office in Singapore to deepen our reach in the Asia-Pacific (APAC) region. Our presence in Singapore has yielded meaningful results for clients based in both North America as well as the APAC region, providing them with access to an expanded array of investment and M&A opportunities.

Delivering Results

Selected 2023 Transactions

As an advisory firm with a complete suite of services, England & Company continued to provide the solutions that our clients needed in 2023. Working with public companies, sponsor-backed companies, and founder-owned companies, our advisory transactions included raising capital (growth equity, convertible debt, and secured debt), arranging a strategic partnership, completing a leveraged recapitalization, helping an international company divest its U.S. operations, and assisting business owners realize the value they have created through sell-side M&A transactions. Selected transactions from 2023 are highlighted below:


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Founded in 2003, England & Company is an independent investment bank that provides strategic advisory services and capital markets transactions to owners, executives, and boards of directors of domestic and international companies. The firm’s clients include leading companies in the Business Services, Consumer, Energy & Sustainability, Healthcare, Industrial & Infrastructure, and Technology & Media markets. England’s suite of advisory services includes:


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Richard F. NeJame Joins Firm to Expand Capital Structure Advisory Practice

England & Company, a leading independent investment bank, announced today that Richard F. NeJame has joined the firm to enhance its Capital Structure Advisory Practice, focusing on corporate restructuring and special situations. Mr. NeJame brings over 25 years of experience advising leveraged and distressed corporate clients, as well as institutional, private equity, and other investing clients. During his career, Mr. NeJame has executed over $100 billion in aggregated transaction value in over 80 deals.

Based in its New York office, Mr. NeJame will work with the England Debt Advisory practice, expanding the firm’s coverage of issuers and creditors for special situation financings and distressed M&A transactions. As with the broader debt advisory effort, Capital Structure Advisory will be coordinated with England’s experienced industry bankers who are focused on business services, consumer, energy, healthcare, industrial & infrastructure, and technology & media.

“While the U.S. economic picture looks promising, the sustained period of higher interest rates created a complex set of challenges for many companies that could linger for the next few years,” said Craig England, CEO of England & Company. “Rich’s restructuring experience and industry reputation enhance our capability to provide clients the highest quality services in both ideal and challenging circumstances.”

“I am excited to join England & Company, as it provides an outstanding, independent advisory platform for me to expand the scope of their debt advisory practice,” said Mr. NeJame. “With the evolving market for leveraged credit, there is a greater need for investment banks that can complement restructuring expertise with new capital solutions. I look forward to working with my new colleagues to deliver on these capabilities on behalf of established and future clients of the firm.”

Mr. NeJame started his career at Alex. Brown & Sons, where he became an integral part of the team that established the restructuring group at Lazard Frères & Co. He later led restructuring groups at Gleacher & Company and Oppenheimer & Co. Most recently, Mr. NeJame was a Senior Managing Director at B. Riley / FocalPoint prior to joining England & Company. Mr. NeJame earned his undergraduate degree from Duke University and his MBA in Finance from the Wharton School at the University of Pennsylvania.

OneroRX Completes Recapitalization to Drive Growth

December 2023 – England & Company is pleased to announce that it served as the exclusive financial advisor and placement agent in the debt and equity recapitalization of  OneroRx, Inc. (“OneroRx”). The financing, provided by Cyprium Investment Partners LLC (“Cyprium”) and Wells Fargo Bank, allowed OneroRx to realign its shareholder base and strengthen its balance sheet, and will enable it to continue to grow through acquisitions.

OneroRx, based in West Des Moines, IA, is a leading technology-enabled, integrated pharmacy services company operating community pharmacies and telepharmacies in underserved rural and urban areas in six states in the Midwest. In its locations, OneroRx maintains a smaller physical footprint than the national pharmacy chains and more efficient operations that enable the Company to better meet the needs of underserved communities and focus on clinical services rather than retail. The Company’s growth strategy incorporates acquisitions, building de novo sites, growing its patient base, and leveraging additional specialty services across its network.

“We have a robust M&A pipeline, and this transaction gives us the flexibility we need to position ourselves better to invest in growing the business,” said Joseph Dunham, OneroRx’s Chief Executive Officer. Dunham added, “The England team was critical in evaluating our alternatives, finding the right partners, and bringing this transaction together.”

About Cyprium

Cyprium is a private equity and mezzanine firm focused on non-controlling investments in profitable middle-market companies, allowing company owners and their management teams to retain a controlling interest in their businesses.  Cyprium provides common equity, preferred stock, subordinated debt, or any combination thereof, offering flexibility and increasing the certainty of close. With offices in Cleveland, New York, and Chicago, the firm invests $5 million to $60 million per transaction in U.S. and Canadian companies with $4 million or more of EBITDA. For over 25 years, the team has deployed $1.9 billion in 100 platform investments.

Joel Strauch Joins England & Company to Expand Technology Investment Banking

England & Company, a leading independent investment bank, is excited to announce that Joel Strauch has joined the firm to lead the expansion of its technology practice. Strauch brings over 25 years of experience providing merger and acquisition, capital raising, and other strategic advice to growth companies, primarily in the infrastructure software sector.

Based in its Washington, DC office, Strauch will be active with infrastructure software companies as he also works with the balance of the England team to enhance coverage of SaaS, data-oriented, and other technology businesses across the firm’s established practices in the Energy & Sustainability, Healthcare, and Industrials & Infrastructure sectors.

Prior to joining England & Company, Strauch was a Managing Director and led the infrastructure software practice at DC Advisory, Signal Hill Capital, and Updata Advisors. He began his investment banking career at Alex. Brown & Sons.

“The IT landscape is shifting rapidly as digital transformation initiatives move forward, new and advanced technologies are widely adopted, and AI/ML become mainstream. Joel has spent his investment banking career providing strategic advice to companies at the forefront of these changes,” said Craig England, CEO of England & Company. “Joel’s deep experience positions us well to partner with companies in the core technology sector as well as with businesses in our established practice areas that are addressing and responding to these tectonic shifts.”

Powerside Completes Growth Financing

December 2023 – England & Company is pleased to announce it served as the exclusive placement agent to Power Survey and Equipment Ltd. (“Powerside“) in its successful closing of a growth equity investment from Energy Growth Momentum LLP (“EGM”). Powerside, based in Saint-Laurent, Quebec and Alameda, CA, plays a pivotal role in advancing the transformation of the industrial and utility electric power infrastructure with its unique ability to analyze, detect, and correct power quality issues arising from the increase in electric vehicles, a more distributed energy resource mix, and more renewable generation.

“We are pleased with England & Company’s service in closing a significant growth equity investment to fund Powerside’s growth initiatives with new offerings in several key markets: industrial power quality, EV infrastructure, and at the grid edge,” said Dr. Ross Dueber, CEO of Powerside. “England’s power & utility technology team was instrumental to sourcing highly qualified institutional investors, providing strategic advice and execution support throughout the transaction. Their senior bankers and deep bench are a solid complement to Powerside’s leadership team as we continue our rapid growth.”

About Powerside

Powerside has a 75-year legacy in power quality. The company has deployed over 80,000 monitoring solutions and over 15,000 power corrections projects in over 50 countries. Its expert team utilizes a customer-centric approach and a suite of tailored measurement, intelligence, and correction solutions to help customers quickly identify and meet power quality challenges head-on.

 About Energy Growth Momentum

Energy Growth Momentum is a growth equity investor focusing on high-growth digital solutions necessary to drive decentralized and decarbonized energy infrastructure. EGM backs talented management running proven operational and digital technological ventures in their next growth phase by providing them with capital, operational expertise, and an industrial network.

Extremity Medical Enters into Strategic Relationship with Henry Schein, Inc. and Closes Growth Financings

December 2023 –England & Company is pleased to announce the closing of several strategic and financial transactions for Extremity Medical, LLC in 2023. Extremity Medical is an orthopedic medical device company specializing in extremity implants known for improved outcomes, especially in patients with poor bone quality. Based in Parsippany, NJ, Extremity Medical develops and markets proprietary, next-generation products to address fixation, fusion and motion preservation in procedures in the lower and upper extremities, including the foot & ankle, hand, and wrist. It is one of the largest privately held independent companies in the U.S. serving the foot & ankle market.

Extremity Medical has entered into a strategic relationship with Henry Schein, Inc. (NASDAQ: HSIC), a leading FORTUNE 500 global healthcare products and solutions company, and a new entrant into the orthopedic extremities market. The relationship is part of Henry Schein’s expansion in orthopedics and complementary to Schein’s pending acquisition of TriMed, Inc. For more information about Schein’s expansion, please see this link.

Matthew Lyons, Extremity’s Chairman and Chief Executive Officer, said, “We are very excited to be working with Henry Schein in its build up in orthopedic extremities. They will bring significant complementary products and sales channels with TriMed. It’s a perfect fit between Extremity’s full portfolio of innovative lower extremity products and wrist replacement and TriMed’s leading portfolio of upper extremity products.” Lyons added “The England team did a great job identifying this creative opportunity, leading the negotiations and bringing the transaction to the finish line.”

England also closed a total of $21 million in convertible note and working capital financings for Extremity Medical between June and November of this year. Extremity Medical will use the new capital provided by its latest financing to invest in the growth of its business and refinance existing debt. Lyons said “The England team was instrumental in securing us innovative growth and working capital financing solutions in a challenging environment.”

Extremity Medical’s innovative product portfolio includes advanced implant systems for addressing Charcot neuropathy in diabetic patients, as well as less-invasive surgical implants to correct common foot deformities, and address trauma and arthritis. Extremity Medical also offers a revolutionary total wrist replacement to restore more natural wrist motion in arthritic patients.