2024 in Review

by James Cavuoto, editor

As we look back on the year 2024, the neurotechnology industry has much to be happy about, despite a few setbacks along the way. Without a doubt, the most impactful event of the year was Boston Scientific’s purchase of Axonics for $3.7 billion, a deal that can only breed optimism and entrepreneurial activity in the space.

Just looking at this month’s spate of investment activity [see Financial News, p 9], we can’t help wonder if that deal is already exerting an effect. Investors put in $102 million for Precision Neuroscience, $50 million for Cala Health, and $26 million for Wavegate. These funding rounds join healthy investments for Amber Therapeutics, which closed a $100 million A round for their mixed urinary incontinence therapy, ShiraTronics, which received a $66 million B round for its migraine device, INBRAIN Neuroelectronics, which got a $50 million B round for its graphene-based BCI technology, Noctrix Health, which closed a $40 million C round for treating restless legs syndrome, Neuspera, which got a $23 million D round for its OAB therapy, and Avation Medical, which got $22 million also for OAB. A host of other neurotech firms announced funding rounds more than $10 million, including Neurable, Motif, Rune Labs, Nalu, and Elemind. And several European neurotech firms raised substantial funds through public markets or private placement, including Nyxoah, ONWARD, and WISE.

Aside from the Boston Scientific/Axonics merger, a number of smaller deals took place during 2024. Financial firm Tether acquired a majority stake in Blackrock Neurotech for $200 million. Science Corp. acquired the assets of Pixium Vision after that company faced liquidation. Bioventus sold off its Bioness neurorehabilitation product line to Accelmed Partners for $25 million plus up to $20 million in incentives. ReShape LifeSciences sold off its vagus nerve blocking technology and other obesity assets to Indian firm Biorad Medisys for about $5 million. And as we report on page 6 of this issue, electroCore acquired the Quell assets from NeuroMetrix for a song, after that company faced potential liquidation.

NeuroMetrix’ exit from the industry is a somewhat sad outcome given the degree of innovation that its CEO, Shai Gozani, had injected in the industry. He pioneered—for better or worse—the strategy of selling neurotech therapies direct to consumer, and also dabbled in crowdfunding and recruiting new clinical specialties. The firm’s efforts to gain approval for fibromyalgia will stand as a hallmark that electroCore may benefit from down the road.

On the reimbursement front, 2024 presented a mixed bag of benefits and detriments. Cala Health, which was nearly sidelined by negative CMS decisions in 2023, emerged victorious when the agency reversed its decision and reinstated substantial coverage for the company’s wearable device. Vendors of implanted PNS systems are still struggling with low levels of reimbursement, though certain indications, such as sacral nerve stimulation for OAB, yield higher payment levels from CMS. Open surgical implantation of cuffs for vagus nerve stimulation and hypoglossal nerve stimulation has the highest reimbursement, around $34,000.

Several neurotech firms, including Spark Biomedical, were successful in getting new codes specific for their applications, such as noninvasive auricular stimulation.

But all-in-all, the good news in 2024 outweighed the bad news for the neurotechnology industry. It’s still too early to assess what 2025 will bring to the industry, but barring any catastrophic events, it should offer a continuation of the technological and financial progress we have witnessed in recent years.