News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel

News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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NEW White Papers Are Now Available for Clinical Laboratory Professionals

Two New White Papers & One New Lab Product Review Just Added

There is a new resource library for clinical laboratory managers and pathologists that contains White Papers on contemporary topics involving clinical laboratory management, pathology administration, and the medical laboratory testing marketplace. This White Paper library is hosted at www.DarkDaily.com/white-papers and is a useful new information resource for the clinical laboratory profession.

The White Paper resource library is another example of how the Internet and Web 2.0 creates new educational opportunities for medical laboratory professionals and pathologists. The White Papers on clinical laboratory and pathology topics can be accessed 24/7 from anywhere in the world. Each White Paper can be downloaded immediately as a PDF.

In a typical month, DarkDaily.com is visited by pathology laboratory managers and professionals in as many as 180 different countries across the globe! That is another indication of the globalization of laboratory testing.

NEW White Papers:

NEW Lab Product Reviews:

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Sonic Healthcare Acquires Labs in USA and Switzerland

Sonic Healthcare was busy in the month of May. Last Thursday, on May 31, it announced the acquisition of a laboratory company in Zurich, Switzerland. Earlier, on May 1, it acquired Mullins Laboratory of Augusta, Georgia. Sonic Healthcare has also won a hospital laboratory contract in the United Kingdom.

Sonic Healthcare will pay US $80 million to purchase Medica Medizinische Laboratorien. Medica has annual revenues of approximately US $44.9 million. It is one of the larger laboratory companies in Switzerland. Sonic intends to keep the existing management team in place, under the leadership of Medica’s current CEO, Dr. Franz Käppeli.

With little fanfare and even less publicity, Sonic Healthcare, Ltd. acquired Mullins Laboratory. Sonic Healthcare did not issue a press release to announce the acquisition. Mullins Laboratory is a private independent laboratory company that was founded in 1954. In recent years, it has been operated by Stephen C. Mullins, M.D., whose father founded the lab company. Mullins is a pathologist boarded in clinical and anatomic pathology, as well as dermatopathology.

With five pathologists and annual revenues estimated in the $17 million range, Mullins Laboratory serves office-based physicians in Augusta, Georgia and nearby communities. With a population of 195,000, Augusta, is Georgia’s second largest city and is located about 150 miles east of Atlanta. Augusta is a self-contained market for laboratory services and Sonic Healthcare’s business strategy is to maintain the acquired laboratory’s name, local identity, and existing staff. The nearest laboratory division owned and operated by Sonic Healthcare is located in Orlando, Florida, about 400 miles south of Augusta. It is Cognescenti Health Institute and was acquired by Sonic Healthcare last fall.

Earlier this year, in the United Kingdom, Sonic Healthcare won a management contract to provide pathology services to the Ealing Hospital NHS Trust and Ealing Primary Care Trust in north London. Sonic will manage the hospital laboratory and provide laboratory testing services to the primary care clinics affiliated with the trust. The contract is for five years and is like a similar agreement recently signed by Quest Diagnostics Incorporated with West Middlesex University Hospital and the Hounslow Primary Care Trust in north London. The management contract commences in the summer of 2007 and has a five-year term.

Since acquiring Clinical Pathology Laboratories (CPL) in Austin, Texas, in 2005, Sonic Healthcare has been steadily expanding its operations in the United States. Last year it acquired Cognescenti Health Institute in Orlando, Florida, and American Esoteric Laboratories, based in Nashville, Tennessee. Lab directors and pathologists should expect to hear about more laboratory acquisitions by Sonic Healthcare. The company is in active negotiations with a number of independent lab companies.

Related articles:

Sonic Healthcare acquires Medica group

Sonic Healthcare Acquires The Medica Laboratory Group in Switzerland

Cytyc to be Acquired by Hologic

In a deal made public only Sunday, Cytyc Corporation has agreed to be acquired by Hologic. Hologic will pay $6.2 billion for Cytyc, which had revenues in 2006 of $608 million. The price paid represents a 33% premium for Cytyc shares, based on prices at the close of the market on Friday.

When the deal closes, probably sometime between July 1 and September 20, another in vitro diagnostics (IVD) manufacturer will have lost its independence. In this acquisition, Hologic’s prime interest is not Cytyc’s cervical cancer screening products. Instead, Hologic is particularly interested in Cytyc’s product lines for breast cancer, including its Mammosite radiation treatment. That’s because Hologic, with annual revenues of $462.7 million in 2006, has a line of breast cancer diagnostic devices, including an imaging system.

Three things are driving this deal. First, both companies serve the same primary market: ob-gyns. Not only will this help with recognition for the combined company, but it opens up opportunities to cross sell one company’s products to other company’s customers. In particular, since 90% of the nation’s ob-gyns currently use Cytyc’s ThinPrep Pap tests, Hologic believes it can benefit from selling to these physicians.

Second, there are certain economies of scale and other savings that will be realized by combining the two companies. However, layoffs are not planned, and both companies’ CEOs have emphasized that Hologic, post-acquisition, will have 1,200 sales people to promote its products.

Third, the two companies are located within 15 miles of each other, which will help make integration easier. Hologic is based in Bedford, Massachusetts and Cytyc’s corporate office is in Marlborough, Massachusetts. It also turns out that Hologic CEO Jack Cumming and Cytyc CEO Patrick Sullivan live in the same town. Maybe that’s why Cumming’s told analysts that the two companies were “kindred spirits” because of the way their core products complement each other and the fact that so many employees of both firms live in the same region.

Once the acquisition is completed, the company will be called Hologic and Cytyc will operate as a wholly-owned division of Hologic. Cytyc CEO Sullivan is slated to become Hologic’s Chairman and Cumming will be Chief Executive Officer.

Most laboratory managers and pathologists view Cytyc as a company that has a major presence in the market for cervical cancer screening products. That is true, but in recent years Cytyc Corporation has acquired a number of technologies and companies that provide services in other areas of women’s health. Several of these new business lines are growing rapidly. For example, during first quarter 2007, Cytyc’s domestic revenues from its diagnostic products, including cervical cancer screening products, totaled $89.2 million. That was a growth rate of 11% over first quarter, 2006. By contrast, revenues from domestic sales of its surgical products totaled $59.3 million, representing a growth rate of 33% over the revenues of $44.7 million in first quarter 2006.

For first quarter 2007, Cytyc failed to post a net profit. On sales of $169.9 million for the quarter, it showed a loss of $51.2 million, compared to a profit of $29.4 million during the same period a year prior.

Related Articles:

Hologic and Cytyc to Merge Creating a $10 Billion Global Leader in Women’s Healthcare

Hologic Agrees to Acquire Cytyc

Hologic’s Expensive Match-Up

A New Test for Hologic

Cytyc Reports Record Revenue of $168.9 Million for First Quarter 2007

Mayo Medical Lab Executive Highlights Market Opportunities for Hospital Laboratories

At the Hotel Monaco in San Francisco, California last Saturday, an intriguing line-up of lab industry experts delivered presentations that contained some highly useful information. This Dark Daily briefing will concentrate on several comments made by Rodney W. Forsman. He is the Administrative Director of Outcomes at Mayo Medical Laboratories (MML) and Associate Professor of Laboratory Medicine at the Mayo Clinic School of Medicine.

The event was the sixth annual Spring Fling conference, produced by the Golden Gate Chapter of the CLMA (Clinical Laboratory Management Association). The keynote speaker was our own Dark Daily Editor, Robert L. Michel. In attendance was an enthusiastic crowd of laboratory professionals from across Northern California, along with a large number of lab industry exhibitors.

Forsman was speaking on the subject of how community laboratories—particularly hospital laboratories with outreach programs—could play an important role in supporting integration of clinical services within a region. Forsman discussed the leverage that laboratory testing offers clinicians. After mentioning the oft-discussed fact that lab testing costs are about 5¢ on the healthcare dollar and play a role in as much as 70% of all clinical decisions, he provided two insights about the use of laboratory test data at Mayo Clinic which should be of interest to Dark Daily readers.

First, he provided a statistic about the role of laboratory testing inside the Mayo Clinic. Forsman explained that the Mayo Clinic’s EMR (electronic medical record) system has operated since 1995. Laboratory test data comprises 94% of the “objective data” within Mayo’s EMR system. This is a proportion which exceeds the widely-noted statement that laboratory test data makes up 70% to 80% of the typical patient’s permanent health record.

Second, Forsman provided another fact about Mayo to reinforce his point about the essential role that laboratory test data plays within the clinical continuum. At the Mayo Clinic each day, 60,000 laboratory test results are added to the Mayo EMR. This lab test data is in high demand, as Mayo tracks, on average, 200,000 daily retrievals of lab test data from the system by caregivers within the Mayo Clinic.

Forsman’s major point in his remarks was to emphasize how clinical laboratories could improve the value they offer their parent hospitals, referring physicians, and the patients they serve in their local community. He stressed the importance of using financial tools and close management of laboratory resources to accomplish these goals.

In our next Dark Daily, we will highlight insights about molecular diagnostics shared by another nationally-recognized speaker at the CLMA Golden Gate Chapter’s Spring Fling.

Implications of Wal-Mart’s Major Move to Expand Walk-in Medical Clinics

Earlier this month, news reports stated that Wal-Mart is forecasting that more than 6,600 in-store medical clinics will open in the next 5 years in Wal-Mart stores. Wal-Mart’s pilot program began with 75 clinics in Wal-Mart stores in 12 states. The company has declared the clinics a success and now plans for a speedy roll-out of additional clinics nationwide.

These clinics will have numerous implications for the medical community. First, according to Alicia Ledlie, senior director for Wal-Mart’s health business development, Wal-Mart is considering providing is in-store clinics with a common electronic medical records (EMR) system so patient care can be tracked from store to store. Dark Daily reported earlier this year in Corporations Take Electronic Health Records into their Own Hands that Wal-Mart is one of five large employers who created the Dossia Founders Group with the goal of providing digital health records (DHRs) for their 2.5 million workers, plus dependents. Assuming that Wal-Mart agrees on a unified electronic health record format for both its employees and the shoppers in its stores, there will soon be millions of people with the same type of electronic health record.

Second, through the pilot program, Wal-Mart has established that the “if you build it, they will come” principle works when it comes to walk-in medical clinics in Wal-Mart stores. By establishing 6,000 in-store clinics across the United States, Wal-Mart could conceivably have a major influence in shifting how people access healthcare services in this country. The convenience of obtaining routine laboratory tests at in-store clinics may prove quite attractive to many Wal-Mart patrons. CLIA-waived tests that produce instant results could make lab testing become like getting your oil changed at the Wal-Mart lube while you shop for your groceries.

Remember: the key to this is providing consumers with a service that they value. In this case, it is getting medical services quickly and at a fair price. It is likely that some smart laboratories will adjust to this age of convenience by accepting this trend and getting whatever piece of the lab testing pie that they can. In fact, for laboratories serving small towns—where Wal-Mart thrives—this may help them to pick up additional specimen volume, since time to result will be a competitive benefit that Wal-Mart wants from any laboratory provider that it uses to supplement on-site testing.

Finally, it should be noted that these changes are a few years down the road. Currently, walk-in medical clinics that operate from retail stores are using a nurse practitioner and only offer medical services for common ailments that can be diagnosed in a few minutes and are treatable with an over-the-counter remedy or a routine prescription. However, once Wal-Mart has 6,000 of these clinics in operation, it will definitely begin expanding the menu of medical services it offers with its in-store, walk-in clinics.

Related Articles:

Wal-Mart sees medical clinic boom in retail stores

Corporations Take Electronic Health Records into their Own Hands

Quest Diagnostics to Buy AmeriPath for $2 Billion

Here’s the latest shake-up to the laboratory testing marketplace. Quest Diagnostics Incorporated announced this morning that it will acquire AmeriPath, Inc. in a transaction valued at $2 billion.

Both parties expect the deal to close before June 30, 2007. AmeriPath’s annual revenues are in excess of $800 million. Quest will pay $1.23 billion in cash and assume about $770 million of debt when the transaction closes.

With its purchase of AmeriPath, Quest Diagnostics picks up three diverse businesses in laboratory testing. First, it acquires Specialty Laboratories, Inc., based in Valencia, California. Specialty Labs provides reference and esoteric testing services to hospital and certain physician specialists.

Second, it will own AmeriPath Dermatopathology. This business division employs 80 pathologists located in offices across the United States. This business line is fast-growing and very attractive to Quest Diagnostics.

Third, it will come into ownership of the remaining anatomic pathology assets owned by AmeriPath. The largest component of this business division is the hospital-based pathology group practices that AmeriPath acquired over the past 10 years. There are also several pathology subspecialty centers in areas such as gastroenterology, oncology, women’s health, and urology.

For Quest Diagnostics, the timing of this acquisition allows it to shift the attention of Wall Street away from the UnitedHealth contract. The AmeriPath acquisition also allows it to gain lab testing revenues that will more than offset expected losses from the UnitedHealth contract. AmeriPath’s revenues will keep Quest Diagnostics on a growth track for 2007.

But with every laboratory acquisition comes with its own set of unique challenges. It has long been known that AmeriPath has struggled to find the right key to unlock financial success from its multiple business models. In buying AmeriPath, Quest Diagnostics will need to move carefully to integrate AmeriPath’s laboratory testing assets into its existing national laboratory network to maximize the benefits from this acquisition. These issues will be explored in the upcoming issue of The Dark Report.

Finally, one particularly happy party to AmeriPath’s sale is Welsh, Carson, Anderson and Stowe, AmeriPath’s majority shareholder. In March 2003, it paid approximately $840 million to buy the public stock of AmeriPath and take the company private. Then, in January 2006, AmeriPath paid an estimated total of $314.7 million to buy all the public shares of Specialty Laboratories. The impending sale to Quest Diagnostics comes only four years after Welsh Carson acquired AmeriPath and allows the private equity company to cash out its investment.

Related Articles

Quest Diagnostics to Acquire AmeriPath in a Transaction Valued at $2 Billion

Quest Diagnostics to buy AmeriPath for $1.23 bln

Quest Buying AmeriPath for $1.23B

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