Wright Medical Group, Inc. and Tornier N.V.; Analysis To Aid Public Comment, 60902-60905 [2015-25604]
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Federal Register / Vol. 80, No. 195 / Thursday, October 8, 2015 / Notices
be filed pursuant to section
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the information submitted on and with
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Abstract: On June 4, 2012, the Federal
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(Regulation OO) in the Federal Register
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Report title: Request for Proposal and
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Agency form number: RFP and RFPQ.
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Subcontractor report: 50 hours.
Estimated average hours per response:
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Subcontractor report: 20 minutes.
Number of respondents: RFP: 350;
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General description of report: The
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Act) requires the Federal Reserve to
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procedures to assess the diversity
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Current Actions: On July 23, 2015, the
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the Federal Register (80 FR 43777)
requesting public comment on the
proposed extension, with revision, of
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Board of Governors of the Federal Reserve
System, October 5, 2015.
Robert deV. Frierson,
Secretary of the Board.
[FR Doc. 2015–25664 Filed 10–7–15; 8:45 am]
BILLING CODE 6210–01–P
FEDERAL TRADE COMMISSION
[File No. 151 0018]
Wright Medical Group, Inc. and Tornier
N.V.; Analysis To Aid Public Comment
Federal Trade Commission.
Proposed consent agreement.
AGENCY:
ACTION:
The consent agreement in this
matter settles alleged violations of
federal law prohibiting unfair methods
of competition. The attached Analysis to
Aid Public Comment describes both the
allegations in the draft complaint and
the terms of the consent order—
embodied in the consent agreement—
that would settle these allegations.
DATES: Comments must be received on
or before October 30, 2015.
ADDRESSES: Interested parties may file a
comment at https://ftcpublic.comment
works.com/ftc/wrighttornierconsent
online or on paper, by following the
instructions in the Request for Comment
part of the SUPPLEMENTARY INFORMATION
section below. Write ‘‘Wright Medical
Group, Inc. and Tornier N.V.—Consent
Agreement; File No. 151 0018’’ on your
comment and file your comment online
at https://ftcpublic.commentworks.com/
ftc/wrighttornierconsent by following
the instructions on the web-based form.
If you prefer to file your comment on
paper, write ‘‘Wright Medical Group,
Inc. and Tornier N.V.—Consent
Agreement; File No. 151 0018’’ on your
comment and on the envelope, and mail
your comment to the following address:
Federal Trade Commission, Office of the
Secretary, 600 Pennsylvania Avenue
NW., Suite CC–5610 (Annex D),
Washington, DC 20580, or deliver your
comment to the following address:
Federal Trade Commission, Office of the
Secretary, Constitution Center, 400 7th
Street SW., 5th Floor, Suite 5610
(Annex D), Washington, DC 20024.
FOR FURTHER INFORMATION CONTACT:
Aylin M. Skroejer (202–326–2459),
Bureau of Competition, 600
Pennsylvania Avenue NW., Washington,
DC 20580.
SUPPLEMENTARY INFORMATION: Pursuant
to Section 6(f) of the Federal Trade
Commission Act, 15 U.S.C. 46(f), and
FTC Rule 2.34, 16 CFR 2.34, notice is
hereby given that the above-captioned
consent agreement containing consent
order to cease and desist, having been
SUMMARY:
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Federal Register / Vol. 80, No. 195 / Thursday, October 8, 2015 / Notices
filed with and accepted, subject to final
approval, by the Commission, has been
placed on the public record for a period
of thirty (30) days. The following
Analysis to Aid Public Comment
describes the terms of the consent
agreement, and the allegations in the
complaint. An electronic copy of the
full text of the consent agreement
package can be obtained from the FTC
Home Page (for September 30, 2015), on
the World Wide Web, at https://
www.ftc.gov/os/actions.shtm.
You can file a comment online or on
paper. For the Commission to consider
your comment, we must receive it on or
before October 30, 2015. Write ‘‘Wright
Medical Group, Inc. and Tornier N.V.—
Consent Agreement; File No. 151 0018’’
on your comment. Your comment—
including your name and your state—
will be placed on the public record of
this proceeding, including, to the extent
practicable, on the public Commission
Web site, at https://www.ftc.gov/os/
publiccomments.shtm. As a matter of
discretion, the Commission tries to
remove individuals’ home contact
information from comments before
placing them on the Commission Web
site.
Because your comment will be made
public, you are solely responsible for
making sure that your comment does
not include any sensitive personal
information, like anyone’s Social
Security number, date of birth, driver’s
license number or other state
identification number or foreign country
equivalent, passport number, financial
account number, or credit or debit card
number. You are also solely responsible
for making sure that your comment does
not include any sensitive health
information, like medical records or
other individually identifiable health
information. In addition, do not include
any ‘‘[t]rade secret or any commercial or
financial information which . . . is
privileged or confidential,’’ as discussed
in Section 6(f) of the FTC Act, 15 U.S.C.
46(f), and FTC Rule 4.10(a)(2), 16 CFR
4.10(a)(2). In particular, do not include
competitively sensitive information
such as costs, sales statistics,
inventories, formulas, patterns, devices,
manufacturing processes, or customer
names.
If you want the Commission to give
your comment confidential treatment,
you must file it in paper form, with a
request for confidential treatment, and
you have to follow the procedure
explained in FTC Rule 4.9(c), 16 CFR
4.9(c).1 Your comment will be kept
confidential only if the FTC General
Counsel, in his or her sole discretion,
grants your request in accordance with
the law and the public interest.
Postal mail addressed to the
Commission is subject to delay due to
heightened security screening. As a
result, we encourage you to submit your
comments online. To make sure that the
Commission considers your online
comment, you must file it at https://
ftcpublic.commentworks.com/ftc/wright
tornierconsent by following the
instructions on the web-based form. If
this Notice appears at https://www.
regulations.gov/#!home, you also may
file a comment through that Web site.
If you file your comment on paper,
write ‘‘Wright Medical Group, Inc. and
Tornier N.V.—Consent Agreement; File
No. 151 0018’’ on your comment and on
the envelope, and mail your comment to
the following address: Federal Trade
Commission, Office of the Secretary,
600 Pennsylvania Avenue NW., Suite
CC–5610 (Annex D), Washington, DC
20580, or deliver your comment to the
following address: Federal Trade
Commission, Office of the Secretary,
Constitution Center, 400 7th Street SW.,
5th Floor, Suite 5610 (Annex D),
Washington, DC 20024. If possible,
submit your paper comment to the
Commission by courier or overnight
service.
Visit the Commission Web site at
https://www.ftc.gov to read this Notice
and the news release describing it. The
FTC Act and other laws that the
Commission administers permit the
collection of public comments to
consider and use in this proceeding as
appropriate. The Commission will
consider all timely and responsive
public comments that it receives on or
before October 30, 2015. You can find
more information, including routine
uses permitted by the Privacy Act, in
the Commission’s privacy policy, at
https://www.ftc.gov/ftc/privacy.htm.
1 In particular, the written request for confidential
treatment that accompanies the comment must
include the factual and legal basis for the request,
and must identify the specific portions of the
comment to be withheld from the public record. See
FTC Rule 4.9(c), 16 CFR 4.9(c).
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Analysis of Agreement Containing
Consent Order To Aid Public Comment
Introduction
The Federal Trade Commission
(‘‘Commission’’) has accepted, subject to
final approval, an Agreement
Containing Consent Order (‘‘Consent
Agreement’’) from Wright Medical
Group, Inc. (‘‘Wright’’) and Tornier N.V.
(‘‘Tornier’’) designed to remedy the
anticompetitive effects resulting from
the proposed merger of Wright and
Tornier. Under the terms of the
proposed Decision and Order (‘‘Order’’)
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contained in the Consent Agreement,
the parties are required to divest to
Integra Lifesciences Corporation
(‘‘Integra’’) all of Tornier’s rights and
assets related to the following
reconstructive joint markets: (1) Total
ankle replacements; (2) total silastic big
toe joint replacements; and (3) total
silastic toe joint replacements for the
second through fifth ‘‘lesser’’ toes.
The proposed Consent Agreement has
been placed on the public record for
thirty days for receipt of comments by
interested persons. Comments received
during this period will become part of
the public record. After thirty days, the
Commission will again review the
Consent Agreement and the comments
received, and decide whether it should
withdraw from the Consent Agreement,
modify it, or make it final.
Pursuant to an Agreement and Plan of
Merger dated October 27, 2014, Wright
and Tornier propose to merge in an allstock transaction valued at
approximately $3.3 billion (the
‘‘Proposed Merger’’). The Commission’s
Complaint alleges that the Proposed
Merger, if consummated, would violate
Section 7 of the Clayton Act, as
amended, 15 U.S.C. 18, and Section 5 of
the Federal Trade Commission Act, as
amended, 15 U.S.C. 45, by substantially
lessening competition in the U.S.
markets for total ankle replacements and
total silastic toe joint replacements. The
proposed Consent Agreement will
remedy the alleged violations by
preserving the competition that
otherwise would be lost in these
markets as a result of the Proposed
Merger.
The Parties
Headquartered in Memphis,
Tennessee, Wright is a global orthopedic
company that divides its business into
three categories: foot and ankle
hardware; upper extremity
reconstructive devices; and biologics
products.
Tornier is a global medical device
company based in Amsterdam, the
Netherlands, with U.S. operations
headquartered in Bloomington,
Minnesota. Tornier’s U.S. products
include those for the upper extremity
joints; lower extremity joints; sports
medicine; and biologics.
The Relevant Products and Structure of
the Markets
I. Total Ankle Replacements
Total ankle replacements are used to
treat end-stage ankle arthritis, which
develops when cartilage on the bones of
the ankle joint wears away and causes
bone-on-bone grinding down of the joint
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surface. Patients with end-stage ankle
arthritis experience pain and swelling at
the ankle along with difficulty walking.
Total ankle replacements reduce the
pain while maintaining the motion at
the ankle joint. They replace damaged
bone and cartilage with a metal tibial
tray, a metal talar dome, and a
polyethylene bearing. In a fixed bearing
total ankle replacement, the
polyethylene bearing is locked to the
tibial component, while in a mobile
bearing system it moves independently.
Physicians and their patients would not
switch to an alternative product or
therapy in response to a small but
significant increase in the price of total
ankle replacements.
Wright, Tornier, and Stryker
Corporation (‘‘Stryker’’) are the only
significant suppliers in the U.S. market
for total ankle replacements, accounting
for 44%, 19%, and 31% of 2014 sales,
respectively. Wright and Tornier are
each other’s closest competitor. These
companies both offer fixed bearing
technologies and the only options for
revision surgeries, i.e., surgeries to redo
a prior total ankle replacement
procedure. The other leading supplier,
Stryker, supplies the only mobile
bearing system in the United States,
making it a more distant competitor to
Wright and Tornier. The only other U.S.
supplier of total ankle replacements,
Zimmer Holdings, Inc. (‘‘Zimmer’’)
offers a technology that typically is used
only in specialized cases. Zimmer
maintains a fringe position in the
market.
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II. Total Silastic Toe Joint Replacements
Total big toe joint replacements treat
severe cases of hallux rigidus, an
arthritic condition in the first
metatarsophalangeal (‘‘MTP’’) joint of
the big toe. Pain and inflammation at
the first MTP joint restricts movement of
the big toe and leads to difficulty
walking. Total big toe joint
replacements relieve pain and preserve
motion in the big toe.
There are two types of total big toe
joint replacements: Metal and silastic.
Total silastic big toe joint replacements
are a distinct antitrust market. Surgeons
that favor total silastic big toe joint
replacements over metal implants do so
for the silastic implants’ flexibility and
longevity. The silastic implants are also
significantly less expensive than total
metal big toe joint replacements.
Physicians and patients do not view
total silastic and total metal big toe joint
replacements as reasonably
interchangeable. A small but significant
increase in the price of total silastic big
toe joint replacements would not cause
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physicians or patients to switch to other
products or therapies.
The U.S. market for total silastic big
toe joint replacements is highly
concentrated. Wright and Tornier are
the only significant suppliers of the
product, accounting for approximately
60% and 38% of the market,
respectively. The next closest
competitor to Wright and Tornier—
Sgarlato Med LLC—accounts for a
nominal share of the market.
Although more rare than in the big
toes, severe arthritis also occurs in the
MTP joints of the lesser toes. Physicians
and patients who use total silastic lesser
toe joint replacements would not switch
to any other product or procedure in
response to a small but significant
increase in the price of the total silastic
toe joint implants. Wright, Tornier, and
OsteoMed supply total silastic lesser toe
joint replacements in the United States,
and Wright and Tornier are each other’s
closest competitor. The Proposed
Merger would result in a combined
market share of approximately 76%.
The relevant geographic market for
total ankle replacements and total
silastic toe joint replacements is the
United States. These products are
medical devices regulated by the U.S.
Food and Drug Administration (‘‘FDA’’).
Medical devices sold outside of the
United States, but not approved for sale
in the United States, do not provide
viable competitive alternatives for U.S.
consumers.
Entry Conditions
Entry in the relevant markets would
not be timely, likely, or sufficient in
magnitude, character, and scope to deter
or counteract the anticompetitive effects
of the Proposed Merger. To enter or
effectively expand in any of the relevant
markets successfully, a supplier would
need to design and manufacture an
effective product, obtain FDA approval,
and develop clinical history supporting
the long-term efficacy of its product.
The new entrant or expanding firm
would also need to develop and foster
product loyalty and establish a
nationwide sales network capable of
marketing the product and providing
on-site service at hospitals nationwide.
Establishing a track record for quality,
service, and consistency is difficult,
expensive, and typically spans several
years.
Competitive Effects of the Merger
The Proposed Merger would likely
result in significant competitive harm to
consumers in the markets for total ankle
replacements and total silastic toe joint
replacements. As particularly close
substitutes in each relevant market,
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Wright and Tornier respond directly to
competition from each other with
improved products, better service, and
lower prices. By eliminating this direct
and substantial head-to-head
competition, the Proposed Merger likely
would allow the combined firm to
exercise market power unilaterally,
resulting in less innovation and higher
prices for consumers.
The Consent Agreement
The Consent Agreement eliminates
the competitive concerns raised by the
Proposed Merger by requiring the
parties to divest to Integra all of the
rights and assets needed for it to become
an independent, viable, and effective
competitor in the U.S. markets for total
ankle replacements and total silastic toe
joint replacements. The divestitures will
maintain the competition that currently
exists in each of the relevant markets.
Integra is well positioned to restore
the competition that otherwise would be
lost through the Proposed Merger.
Headquartered in Plainsboro, New
Jersey, Integra is a global medical device
company that has experience
manufacturing, marketing, and
distributing orthopedic devices in the
United States, and a track record for
quality, service, and consistency.
Integra’s lower extremity product
portfolio is also highly complementary
to Tornier’s total ankle replacements
and total silastic toe joint replacements.
The Order requires Tornier to divest
all U.S. assets and rights related to the
relevant products, including intellectual
property, manufacturing technology,
and existing inventory. In order to
ensure continuity of supply, the Order
requires that the parties supply Integra
with total ankle replacements for up to
three years and total silastic toe joint
replacements for up to one year while
Integra transitions to independent
manufacturing and works to obtain FDA
approval.
To ensure that the divestitures are
successful, the Order requires the
parties to enter into a transitional
services agreement with Integra to assist
the company in establishing its
manufacturing capabilities and securing
all necessary FDA approvals. Further,
the Order requires that the parties
transfer all confidential business
information to Integra, as well as
provide access to employees who
possess or are able to identify such
information. Integra also will have the
right to interview and offer employment
to employees associated with the
relevant products.
The parties must accomplish these
divestitures and relinquish their rights
to Integra no later than ten days after the
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Proposed Merger is consummated. If the
Commission determines that Integra is
not an acceptable acquirer, or that the
manner of the divestitures is not
acceptable, the proposed Order requires
the parties to unwind the sale of rights
to Integra and then divest the products
to a Commission-approved acquirer
within six months of the date the Order
becomes final. The proposed Order
further allows the Commission to
appoint a trustee in the event the parties
fail to divest the products as required.
The Order also requires the parties to
appoint Quantic Regulatory Services,
LLC as interim monitor to ensure the
parties comply with the obligations
pursuant to the Consent Agreement and
to keep the Commission informed about
the status of the transfer of the assets
and rights to Integra.
The purpose of this analysis is to
facilitate public comment on the
Consent Agreement, and it is not
intended to constitute an official
interpretation of the proposed Order or
to modify its terms in any way.
By direction of the Commission.
Donald S. Clark,
Secretary.
[FR Doc. 2015–25604 Filed 10–7–15; 8:45 am]
BILLING CODE 6750–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[60Day–16–15BHD; Docket No. CDC–2016–
0088]
Proposed Data Collection Submitted
for Public Comment and
Recommendations
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
ACTION: Notice with comment period.
AGENCY:
The Centers for Disease
Control and Prevention (CDC), as part of
its continuing efforts to reduce public
burden and maximize the utility of
government information, invites the
general public and other Federal
agencies to take this opportunity to
comment on proposed and/or
continuing information collections, as
required by the Paperwork Reduction
Act of 1995. This notice invites
comment on Congenital Heart
Surveillance to Recognize Outcomes,
Needs and well-being (CHSTRONG).
CDC seeks to collect data for the
purpose of providing insight into the
public health questions that remain for
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SUMMARY:
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the population and to develop services
and allocate resources to improve longterm health and wellbeing.
DATES: Written comments must be
received on or before December 7, 2015.
ADDRESSES: You may submit comments,
identified by Docket No. CDC–2016–
0088 by any of the following methods:
• Federal eRulemaking Portal:
Regulation.gov. Follow the instructions
for submitting comments.
• Mail: Leroy A. Richardson,
Information Collection Review Office,
Centers for Disease Control and
Prevention, 1600 Clifton Road, NE.,
MS–D74, Atlanta, Georgia 30329.
Instructions: All submissions received
must include the agency name and
Docket Number. All relevant comments
received will be posted without change
to Regulations.gov, including any
personal information provided. For
access to the docket to read background
documents or comments received, go to
Regulations.gov.
FOR FURTHER INFORMATION CONTACT: To
request more information on the
proposed project or to obtain a copy of
the information collection plan and
instruments, contact the Information
Collection Review Office, Centers for
Disease Control and Prevention, 1600
Clifton Road NE., MS–D74, Atlanta,
Georgia 30329; phone: 404–639–7570;
Email: omb@cdc.gov.
SUPPLEMENTARY INFORMATION: Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), Federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. In addition, the PRA also
requires Federal agencies to provide a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each new
proposed collection, each proposed
extension of existing collection of
information, and each reinstatement of
previously approved information
collection before submitting the
collection to OMB for approval. To
comply with this requirement, we are
publishing this notice of a proposed
data collection as described below.
Comments are invited on: (a) Whether
the proposed collection of information
is necessary for the proper performance
of the functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
agency’s estimate of the burden of the
proposed collection of information; (c)
ways to enhance the quality, utility, and
clarity of the information to be
collected; (d) ways to minimize the
burden of the collection of information
on respondents, including through the
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use of automated collection techniques
or other forms of information
technology; and (e) estimates of capital
or start-up costs and costs of operation,
maintenance, and purchase of services
to provide information. Burden means
the total time, effort, or financial
resources expended by persons to
generate, maintain, retain, disclose or
provide information to or for a Federal
agency. This includes the time needed
to review instructions; to develop,
acquire, install and utilize technology
and systems for the purpose of
collecting, validating and verifying
information, processing and
maintaining information, and disclosing
and providing information; to train
personnel and to be able to respond to
a collection of information, to search
data sources, to complete and review
the collection of information; and to
transmit or otherwise disclose the
information.
Proposed Project
Congenital Heart Surveillance To
Recognize Outcomes, Needs, and Wellbeing (CHSTRONG)—New—National
Center on Birth Defects and
Developmental Disabilities (NCBDDD),
Centers for Disease Control and
Prevention (CDC).
Background and Brief Description
Congenital heart defects (CHDs) are
the most common type of structural
birth defects, affecting approximately 1
in 110 live-born children. In prior
decades, many CHDs were considered
fatal during infancy or childhood, but
with tremendous advances in pediatric
cardiology and cardiac surgery, at least
85% of patients now survive to
adulthood and there are approximately
1.5 million adults with CHD living in
the United States. With vast declines in
mortality from pediatric heart disease
over the past 30 years, it is vital to
evaluate long term outcomes and quality
of life issues for adults with CHD.
However, U.S. data on long term
outcomes, quality of life issues, and
comorbidities of adults born with CHD
are lacking. U.S. data is needed to
provide insight into the public health
questions that remain for this
population and to develop services and
allocate resources to improve long-term
health and wellbeing.
For this one-year project, we will use
data from U.S. state birth defect
surveillance systems to identify a
population-based sample of individuals
18 to 45 years of age born with CHD. We
will then use state databases and online
search engines to find current addresses
for those individuals and mail surveys
to them inquiring about their barriers to
E:\FR\FM\08OCN1.SGM
08OCN1
Agencies
[Federal Register Volume 80, Number 195 (Thursday, October 8, 2015)]
[Notices]
[Pages 60902-60905]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-25604]
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FEDERAL TRADE COMMISSION
[File No. 151 0018]
Wright Medical Group, Inc. and Tornier N.V.; Analysis To Aid
Public Comment
AGENCY: Federal Trade Commission.
ACTION: Proposed consent agreement.
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SUMMARY: The consent agreement in this matter settles alleged
violations of federal law prohibiting unfair methods of competition.
The attached Analysis to Aid Public Comment describes both the
allegations in the draft complaint and the terms of the consent order--
embodied in the consent agreement--that would settle these allegations.
DATES: Comments must be received on or before October 30, 2015.
ADDRESSES: Interested parties may file a comment at https://ftcpublic.commentworks.com/ftc/wrighttornierconsent online or on paper,
by following the instructions in the Request for Comment part of the
SUPPLEMENTARY INFORMATION section below. Write ``Wright Medical Group,
Inc. and Tornier N.V.--Consent Agreement; File No. 151 0018'' on your
comment and file your comment online at https://ftcpublic.commentworks.com/ftc/wrighttornierconsent by following the
instructions on the web-based form. If you prefer to file your comment
on paper, write ``Wright Medical Group, Inc. and Tornier N.V.--Consent
Agreement; File No. 151 0018'' on your comment and on the envelope, and
mail your comment to the following address: Federal Trade Commission,
Office of the Secretary, 600 Pennsylvania Avenue NW., Suite CC-5610
(Annex D), Washington, DC 20580, or deliver your comment to the
following address: Federal Trade Commission, Office of the Secretary,
Constitution Center, 400 7th Street SW., 5th Floor, Suite 5610 (Annex
D), Washington, DC 20024.
FOR FURTHER INFORMATION CONTACT: Aylin M. Skroejer (202-326-2459),
Bureau of Competition, 600 Pennsylvania Avenue NW., Washington, DC
20580.
SUPPLEMENTARY INFORMATION: Pursuant to Section 6(f) of the Federal
Trade Commission Act, 15 U.S.C. 46(f), and FTC Rule 2.34, 16 CFR 2.34,
notice is hereby given that the above-captioned consent agreement
containing consent order to cease and desist, having been
[[Page 60903]]
filed with and accepted, subject to final approval, by the Commission,
has been placed on the public record for a period of thirty (30) days.
The following Analysis to Aid Public Comment describes the terms of the
consent agreement, and the allegations in the complaint. An electronic
copy of the full text of the consent agreement package can be obtained
from the FTC Home Page (for September 30, 2015), on the World Wide Web,
at https://www.ftc.gov/os/actions.shtm.
You can file a comment online or on paper. For the Commission to
consider your comment, we must receive it on or before October 30,
2015. Write ``Wright Medical Group, Inc. and Tornier N.V.--Consent
Agreement; File No. 151 0018'' on your comment. Your comment--including
your name and your state--will be placed on the public record of this
proceeding, including, to the extent practicable, on the public
Commission Web site, at https://www.ftc.gov/os/publiccomments.shtm. As a
matter of discretion, the Commission tries to remove individuals' home
contact information from comments before placing them on the Commission
Web site.
Because your comment will be made public, you are solely
responsible for making sure that your comment does not include any
sensitive personal information, like anyone's Social Security number,
date of birth, driver's license number or other state identification
number or foreign country equivalent, passport number, financial
account number, or credit or debit card number. You are also solely
responsible for making sure that your comment does not include any
sensitive health information, like medical records or other
individually identifiable health information. In addition, do not
include any ``[t]rade secret or any commercial or financial information
which . . . is privileged or confidential,'' as discussed in Section
6(f) of the FTC Act, 15 U.S.C. 46(f), and FTC Rule 4.10(a)(2), 16 CFR
4.10(a)(2). In particular, do not include competitively sensitive
information such as costs, sales statistics, inventories, formulas,
patterns, devices, manufacturing processes, or customer names.
If you want the Commission to give your comment confidential
treatment, you must file it in paper form, with a request for
confidential treatment, and you have to follow the procedure explained
in FTC Rule 4.9(c), 16 CFR 4.9(c).\1\ Your comment will be kept
confidential only if the FTC General Counsel, in his or her sole
discretion, grants your request in accordance with the law and the
public interest.
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\1\ In particular, the written request for confidential
treatment that accompanies the comment must include the factual and
legal basis for the request, and must identify the specific portions
of the comment to be withheld from the public record. See FTC Rule
4.9(c), 16 CFR 4.9(c).
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Postal mail addressed to the Commission is subject to delay due to
heightened security screening. As a result, we encourage you to submit
your comments online. To make sure that the Commission considers your
online comment, you must file it at https://ftcpublic.commentworks.com/ftc/wrighttornierconsent by following the instructions on the web-based
form. If this Notice appears at https://www.regulations.gov/#!home, you
also may file a comment through that Web site.
If you file your comment on paper, write ``Wright Medical Group,
Inc. and Tornier N.V.--Consent Agreement; File No. 151 0018'' on your
comment and on the envelope, and mail your comment to the following
address: Federal Trade Commission, Office of the Secretary, 600
Pennsylvania Avenue NW., Suite CC-5610 (Annex D), Washington, DC 20580,
or deliver your comment to the following address: Federal Trade
Commission, Office of the Secretary, Constitution Center, 400 7th
Street SW., 5th Floor, Suite 5610 (Annex D), Washington, DC 20024. If
possible, submit your paper comment to the Commission by courier or
overnight service.
Visit the Commission Web site at https://www.ftc.gov to read this
Notice and the news release describing it. The FTC Act and other laws
that the Commission administers permit the collection of public
comments to consider and use in this proceeding as appropriate. The
Commission will consider all timely and responsive public comments that
it receives on or before October 30, 2015. You can find more
information, including routine uses permitted by the Privacy Act, in
the Commission's privacy policy, at https://www.ftc.gov/ftc/privacy.htm.
Analysis of Agreement Containing Consent Order To Aid Public Comment
Introduction
The Federal Trade Commission (``Commission'') has accepted, subject
to final approval, an Agreement Containing Consent Order (``Consent
Agreement'') from Wright Medical Group, Inc. (``Wright'') and Tornier
N.V. (``Tornier'') designed to remedy the anticompetitive effects
resulting from the proposed merger of Wright and Tornier. Under the
terms of the proposed Decision and Order (``Order'') contained in the
Consent Agreement, the parties are required to divest to Integra
Lifesciences Corporation (``Integra'') all of Tornier's rights and
assets related to the following reconstructive joint markets: (1) Total
ankle replacements; (2) total silastic big toe joint replacements; and
(3) total silastic toe joint replacements for the second through fifth
``lesser'' toes.
The proposed Consent Agreement has been placed on the public record
for thirty days for receipt of comments by interested persons. Comments
received during this period will become part of the public record.
After thirty days, the Commission will again review the Consent
Agreement and the comments received, and decide whether it should
withdraw from the Consent Agreement, modify it, or make it final.
Pursuant to an Agreement and Plan of Merger dated October 27, 2014,
Wright and Tornier propose to merge in an all-stock transaction valued
at approximately $3.3 billion (the ``Proposed Merger''). The
Commission's Complaint alleges that the Proposed Merger, if
consummated, would violate Section 7 of the Clayton Act, as amended, 15
U.S.C. 18, and Section 5 of the Federal Trade Commission Act, as
amended, 15 U.S.C. 45, by substantially lessening competition in the
U.S. markets for total ankle replacements and total silastic toe joint
replacements. The proposed Consent Agreement will remedy the alleged
violations by preserving the competition that otherwise would be lost
in these markets as a result of the Proposed Merger.
The Parties
Headquartered in Memphis, Tennessee, Wright is a global orthopedic
company that divides its business into three categories: foot and ankle
hardware; upper extremity reconstructive devices; and biologics
products.
Tornier is a global medical device company based in Amsterdam, the
Netherlands, with U.S. operations headquartered in Bloomington,
Minnesota. Tornier's U.S. products include those for the upper
extremity joints; lower extremity joints; sports medicine; and
biologics.
The Relevant Products and Structure of the Markets
I. Total Ankle Replacements
Total ankle replacements are used to treat end-stage ankle
arthritis, which develops when cartilage on the bones of the ankle
joint wears away and causes bone-on-bone grinding down of the joint
[[Page 60904]]
surface. Patients with end-stage ankle arthritis experience pain and
swelling at the ankle along with difficulty walking. Total ankle
replacements reduce the pain while maintaining the motion at the ankle
joint. They replace damaged bone and cartilage with a metal tibial
tray, a metal talar dome, and a polyethylene bearing. In a fixed
bearing total ankle replacement, the polyethylene bearing is locked to
the tibial component, while in a mobile bearing system it moves
independently. Physicians and their patients would not switch to an
alternative product or therapy in response to a small but significant
increase in the price of total ankle replacements.
Wright, Tornier, and Stryker Corporation (``Stryker'') are the only
significant suppliers in the U.S. market for total ankle replacements,
accounting for 44%, 19%, and 31% of 2014 sales, respectively. Wright
and Tornier are each other's closest competitor. These companies both
offer fixed bearing technologies and the only options for revision
surgeries, i.e., surgeries to redo a prior total ankle replacement
procedure. The other leading supplier, Stryker, supplies the only
mobile bearing system in the United States, making it a more distant
competitor to Wright and Tornier. The only other U.S. supplier of total
ankle replacements, Zimmer Holdings, Inc. (``Zimmer'') offers a
technology that typically is used only in specialized cases. Zimmer
maintains a fringe position in the market.
II. Total Silastic Toe Joint Replacements
Total big toe joint replacements treat severe cases of hallux
rigidus, an arthritic condition in the first metatarsophalangeal
(``MTP'') joint of the big toe. Pain and inflammation at the first MTP
joint restricts movement of the big toe and leads to difficulty
walking. Total big toe joint replacements relieve pain and preserve
motion in the big toe.
There are two types of total big toe joint replacements: Metal and
silastic. Total silastic big toe joint replacements are a distinct
antitrust market. Surgeons that favor total silastic big toe joint
replacements over metal implants do so for the silastic implants'
flexibility and longevity. The silastic implants are also significantly
less expensive than total metal big toe joint replacements. Physicians
and patients do not view total silastic and total metal big toe joint
replacements as reasonably interchangeable. A small but significant
increase in the price of total silastic big toe joint replacements
would not cause physicians or patients to switch to other products or
therapies.
The U.S. market for total silastic big toe joint replacements is
highly concentrated. Wright and Tornier are the only significant
suppliers of the product, accounting for approximately 60% and 38% of
the market, respectively. The next closest competitor to Wright and
Tornier--Sgarlato Med LLC--accounts for a nominal share of the market.
Although more rare than in the big toes, severe arthritis also
occurs in the MTP joints of the lesser toes. Physicians and patients
who use total silastic lesser toe joint replacements would not switch
to any other product or procedure in response to a small but
significant increase in the price of the total silastic toe joint
implants. Wright, Tornier, and OsteoMed supply total silastic lesser
toe joint replacements in the United States, and Wright and Tornier are
each other's closest competitor. The Proposed Merger would result in a
combined market share of approximately 76%.
The relevant geographic market for total ankle replacements and
total silastic toe joint replacements is the United States. These
products are medical devices regulated by the U.S. Food and Drug
Administration (``FDA''). Medical devices sold outside of the United
States, but not approved for sale in the United States, do not provide
viable competitive alternatives for U.S. consumers.
Entry Conditions
Entry in the relevant markets would not be timely, likely, or
sufficient in magnitude, character, and scope to deter or counteract
the anticompetitive effects of the Proposed Merger. To enter or
effectively expand in any of the relevant markets successfully, a
supplier would need to design and manufacture an effective product,
obtain FDA approval, and develop clinical history supporting the long-
term efficacy of its product. The new entrant or expanding firm would
also need to develop and foster product loyalty and establish a
nationwide sales network capable of marketing the product and providing
on-site service at hospitals nationwide. Establishing a track record
for quality, service, and consistency is difficult, expensive, and
typically spans several years.
Competitive Effects of the Merger
The Proposed Merger would likely result in significant competitive
harm to consumers in the markets for total ankle replacements and total
silastic toe joint replacements. As particularly close substitutes in
each relevant market, Wright and Tornier respond directly to
competition from each other with improved products, better service, and
lower prices. By eliminating this direct and substantial head-to-head
competition, the Proposed Merger likely would allow the combined firm
to exercise market power unilaterally, resulting in less innovation and
higher prices for consumers.
The Consent Agreement
The Consent Agreement eliminates the competitive concerns raised by
the Proposed Merger by requiring the parties to divest to Integra all
of the rights and assets needed for it to become an independent,
viable, and effective competitor in the U.S. markets for total ankle
replacements and total silastic toe joint replacements. The
divestitures will maintain the competition that currently exists in
each of the relevant markets.
Integra is well positioned to restore the competition that
otherwise would be lost through the Proposed Merger. Headquartered in
Plainsboro, New Jersey, Integra is a global medical device company that
has experience manufacturing, marketing, and distributing orthopedic
devices in the United States, and a track record for quality, service,
and consistency. Integra's lower extremity product portfolio is also
highly complementary to Tornier's total ankle replacements and total
silastic toe joint replacements.
The Order requires Tornier to divest all U.S. assets and rights
related to the relevant products, including intellectual property,
manufacturing technology, and existing inventory. In order to ensure
continuity of supply, the Order requires that the parties supply
Integra with total ankle replacements for up to three years and total
silastic toe joint replacements for up to one year while Integra
transitions to independent manufacturing and works to obtain FDA
approval.
To ensure that the divestitures are successful, the Order requires
the parties to enter into a transitional services agreement with
Integra to assist the company in establishing its manufacturing
capabilities and securing all necessary FDA approvals. Further, the
Order requires that the parties transfer all confidential business
information to Integra, as well as provide access to employees who
possess or are able to identify such information. Integra also will
have the right to interview and offer employment to employees
associated with the relevant products.
The parties must accomplish these divestitures and relinquish their
rights to Integra no later than ten days after the
[[Page 60905]]
Proposed Merger is consummated. If the Commission determines that
Integra is not an acceptable acquirer, or that the manner of the
divestitures is not acceptable, the proposed Order requires the parties
to unwind the sale of rights to Integra and then divest the products to
a Commission-approved acquirer within six months of the date the Order
becomes final. The proposed Order further allows the Commission to
appoint a trustee in the event the parties fail to divest the products
as required.
The Order also requires the parties to appoint Quantic Regulatory
Services, LLC as interim monitor to ensure the parties comply with the
obligations pursuant to the Consent Agreement and to keep the
Commission informed about the status of the transfer of the assets and
rights to Integra.
The purpose of this analysis is to facilitate public comment on the
Consent Agreement, and it is not intended to constitute an official
interpretation of the proposed Order or to modify its terms in any way.
By direction of the Commission.
Donald S. Clark,
Secretary.
[FR Doc. 2015-25604 Filed 10-7-15; 8:45 am]
BILLING CODE 6750-01-P