CytoSorbents Corporation (CTSO)

[techxen]

Fresenius has had a poor track record with acquisitions in the past. The whole Akorn fiasco - a $4.75B deal that Fresnius pulled back from after discovering fraud (Akorn chairman resigned as Chairman and was charged with engaging in conspiracies to commit racketeering, mail fraud and wire fraud in an indictment filed in federal court in Boston, plus he was arrested on charges he participated in a scheme to bribe doctors to prescribe a potent pain medication while he was at Insys.).

https://global.handelsblatt.com/companies/german-fresenius-medical-care-akorn-923437

Also, with the NxStage medical they probably overpaid for this company (5-6 x sales @ $2B acquisition price) and they were not yet profitable. However, as Dr. Chan pointed out on the call, Fresenius is agressively expanding into critical care and wants to expand it's foot print in that area as well as geographically here in the US. With the Next Stage, Novalung and Xenios acquisitions they "would now be squarely in neck-and-neck position with Baxter, Gambro, and be very well positioned to help gain market share in the U.S. market.". Cytosorb will work in this expanded installed base of dialysis machines owned by Fresenius plus Fresenius doesn't really have a product that reduces inflammation (ECMO he stated is more of a supported therapy).

Having said all this Fresenius will be more cautious and strategic about their next acquisition. Cytosorbents having a strong balance sheet with a hefty cash balance and little to no debt, along with increasing margins (some of the highest in the industry) along with operating profitability, will make it harder on Fresenius to strike any kind of deal. I agree with your assessment that an if an acquisition offer were to come, it would come much later after FDA approval, however in the interim we could see a substantial licensing agreement and investment coming from Fresenius.