80_FR_61097 80 FR 60902 - Wright Medical Group, Inc. and Tornier N.V.; Analysis To Aid Public Comment

80 FR 60902 - Wright Medical Group, Inc. and Tornier N.V.; Analysis To Aid Public Comment

FEDERAL TRADE COMMISSION

Federal Register Volume 80, Issue 195 (October 8, 2015)

Page Range60902-60905
FR Document2015-25604

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.

Federal Register, Volume 80 Issue 195 (Thursday, October 8, 2015)
[Federal Register Volume 80, Number 195 (Thursday, October 8, 2015)]
[Notices]
[Pages 60902-60905]
From the Federal Register Online  [www.thefederalregister.org]
[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 http://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 http://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).
---------------------------------------------------------------------------

    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 http://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 http://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 http://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



                                                  60902                        Federal Register / Vol. 80, No. 195 / Thursday, October 8, 2015 / Notices

                                                  be filed pursuant to section                            procedures to assess the diversity                      Board of Governors of the Federal Reserve
                                                  241.3(b)(3)(i) is covered in specific                   policies and practices in all business                System, October 5, 2015.
                                                  memoranda relating to those forms.                      and activities of the agency at all levels,           Robert deV. Frierson,
                                                  With respect to the ‘‘Registration of a                 including procurement, insurance, and                 Secretary of the Board.
                                                  Securities Holding Company’’ form                       all types of contracts. (12 U.S.C.                    [FR Doc. 2015–25664 Filed 10–7–15; 8:45 am]
                                                  required pursuant to section 241.3(a)(1),               5452(c)(1)). ‘‘Such procedure shall                   BILLING CODE 6210–01–P
                                                  the information submitted on and with                   include a written statement, in a form
                                                  the form is normally public. However, a                 and with such content as the Director
                                                  company may seek confidential                           [of OMWI] shall prescribe . . . that a                FEDERAL TRADE COMMISSION
                                                  treatment for any such information that                 contractor shall ensure . . . the fair
                                                  it believes is exempt from disclosure                   inclusion of women and minorities in                  [File No. 151 0018]
                                                  under FOIA (5 U.S.C. 552(b)(1)–(9)). A                  the workforce of the contractor and, as
                                                                                                                                                                Wright Medical Group, Inc. and Tornier
                                                  determination of confidentiality would                  applicable, subcontractors.’’ (12 U.S.C.
                                                                                                                                                                N.V.; Analysis To Aid Public Comment
                                                  be made on a case-by-case basis.                        5452(c)(2)).
                                                     Abstract: On June 4, 2012, the Federal                  Proposals from vendors that are not                AGENCY:    Federal Trade Commission.
                                                  Reserve published a final rulemaking for                accepted and incorporated into                        ACTION:   Proposed consent agreement.
                                                  Securities Holding Companies                            contracts with the Federal Reserve
                                                  (Regulation OO) in the Federal Register                 would be protected from Freedom of                    SUMMARY:    The consent agreement in this
                                                  (77 FR 32881). Regulation OO                            Information (FOIA) disclosure by 41                   matter settles alleged violations of
                                                  implements section 618 of the Dodd-                     U.S.C. 4702, which expressly prohibits                federal law prohibiting unfair methods
                                                  Frank Act, which permits nonbank                        FOIA disclosure of these proposals.                   of competition. The attached Analysis to
                                                  companies that own at least one                         Moreover, during the solicitation                     Aid Public Comment describes both the
                                                  registered securities broker or dealer,                 process vendors are permitted to mark                 allegations in the draft complaint and
                                                  and that are required by a foreign                      information contained in their proposals              the terms of the consent order—
                                                  regulator or provision of foreign law to                that is proprietary or confidential with              embodied in the consent agreement—
                                                  be subject to comprehensive                             the label RESTRICTED DATA. For                        that would settle these allegations.
                                                  consolidated supervision, to register                   information so marked, the Federal                    DATES: Comments must be received on
                                                  with the Board and subject themselves                   Reserve also may determine on a case-                 or before October 30, 2015.
                                                  to supervision by the Board.                            by-case basis whether FOIA exemption                  ADDRESSES: Interested parties may file a
                                                     Current Actions: On July 23, 2015, the               4, which applies to ‘‘trade secrets and               comment at https://ftcpublic.comment
                                                  Federal Reserve published a notice in                   commercial or financial information,’’                works.com/ftc/wrighttornierconsent
                                                  the Federal Register (80 FR 43777)                      would protect information from                        online or on paper, by following the
                                                  requesting public comment on the                        disclosure pursuant to a FOIA request (5              instructions in the Request for Comment
                                                  proposed extension, without revision, of                U.S.C. 552(b)(4)).                                    part of the SUPPLEMENTARY INFORMATION
                                                  the FR 2082. The comment period for                        Abstract: The Federal Reserve uses                 section below. Write ‘‘Wright Medical
                                                  the notice expired on September 21,                     the RFP and the RFPQ as appropriate to                Group, Inc. and Tornier N.V.—Consent
                                                  2015. The Federal Reserve did not                       obtain competitive proposals and                      Agreement; File No. 151 0018’’ on your
                                                  receive any comments on the proposal,                   contracts from approved vendors of                    comment and file your comment online
                                                  and the FR 2082 will be extended                        goods and services. This information                  at https://ftcpublic.commentworks.com/
                                                  without revision as proposed.                           collection is required to collect data on             ftc/wrighttornierconsent by following
                                                     Final approval under OMB delegated                   prices, specifications of goods and                   the instructions on the web-based form.
                                                  authority of the extension, with                        services, and qualifications of                       If you prefer to file your comment on
                                                  revision, of the following report:                      prospective vendors.                                  paper, write ‘‘Wright Medical Group,
                                                     Report title: Request for Proposal and                                                                     Inc. and Tornier N.V.—Consent
                                                                                                             Current Actions: On July 23, 2015, the
                                                  Request for Price Quotations.                                                                                 Agreement; File No. 151 0018’’ on your
                                                                                                          Federal Reserve published a notice in
                                                     Agency form number: RFP and RFPQ.                                                                          comment and on the envelope, and mail
                                                     OMB control number: 7100–0180.                       the Federal Register (80 FR 43777)
                                                                                                          requesting public comment on the                      your comment to the following address:
                                                     Frequency: On occasion.
                                                                                                          proposed extension, with revision, of                 Federal Trade Commission, Office of the
                                                     Reporters: Vendors of goods and
                                                                                                          the RFP and RFPQ. In connection with                  Secretary, 600 Pennsylvania Avenue
                                                  services.
                                                     Estimated annual reporting hours:                    the RFP and RFPQ process, the Federal                 NW., Suite CC–5610 (Annex D),
                                                  RFP: 17,500 hours; RFPQ: 4,400 hours;                   Reserve proposed to require prime                     Washington, DC 20580, or deliver your
                                                  Subcontractor report: 50 hours.                         contractors to submit a Subcontracting                comment to the following address:
                                                     Estimated average hours per response:                Report that would collect information                 Federal Trade Commission, Office of the
                                                  RFP: 50 hours; RFPQ: 2 hours;                           about their subcontractors’                           Secretary, Constitution Center, 400 7th
                                                  Subcontractor report: 20 minutes.                       commitments toward diversity and                      Street SW., 5th Floor, Suite 5610
                                                     Number of respondents: RFP: 350;                     inclusion of minority-owned and                       (Annex D), Washington, DC 20024.
                                                  RFPQ: 2,200; Subcontractor report: 150.                 women-owned vendors in the                            FOR FURTHER INFORMATION CONTACT:
                                                     General description of report: The                   subcontractor’s activities. The comment               Aylin M. Skroejer (202–326–2459),
                                                  RFP and RFPQ are required to obtain a                   period for the notice expired on                      Bureau of Competition, 600
                                                  benefit and are authorized by Sections                  September 21, 2015. The Federal                       Pennsylvania Avenue NW., Washington,
                                                                                                                                                                DC 20580.
mstockstill on DSK4VPTVN1PROD with NOTICES




                                                  10(3), 10(4), and 11(1) of the Federal                  Reserve received one comment, which
                                                  Reserve Act (12 U.S.C. 243, 244, and                    stated that contracting programs should               SUPPLEMENTARY INFORMATION: Pursuant
                                                  248(l)). With regard to the                             be open to all and that no one should                 to Section 6(f) of the Federal Trade
                                                  Subcontracting Report, Section 342(c) of                be discriminated against nor granted                  Commission Act, 15 U.S.C. 46(f), and
                                                  the Dodd-Frank Wall Street Reform and                   preferential treatment because of skin                FTC Rule 2.34, 16 CFR 2.34, notice is
                                                  Consumer Protection Act (Dodd-Frank                     color, national origin, or sex. The RFP               hereby given that the above-captioned
                                                  Act) requires the Federal Reserve to                    and RFPQ will be extended with                        consent agreement containing consent
                                                  develop and implement standards and                     revision as proposed.                                 order to cease and desist, having been


                                             VerDate Sep<11>2014   16:41 Oct 07, 2015   Jkt 238001   PO 00000   Frm 00031   Fmt 4703   Sfmt 4703   E:\FR\FM\08OCN1.SGM   08OCN1


                                                                                Federal Register / Vol. 80, No. 195 / Thursday, October 8, 2015 / Notices                                           60903

                                                  filed with and accepted, subject to final                  confidential only if the FTC General                 contained in the Consent Agreement,
                                                  approval, by the Commission, has been                      Counsel, in his or her sole discretion,              the parties are required to divest to
                                                  placed on the public record for a period                   grants your request in accordance with               Integra Lifesciences Corporation
                                                  of thirty (30) days. The following                         the law and the public interest.                     (‘‘Integra’’) all of Tornier’s rights and
                                                  Analysis to Aid Public Comment                                Postal mail addressed to the                      assets related to the following
                                                  describes the terms of the consent                         Commission is subject to delay due to                reconstructive joint markets: (1) Total
                                                  agreement, and the allegations in the                      heightened security screening. As a                  ankle replacements; (2) total silastic big
                                                  complaint. An electronic copy of the                       result, we encourage you to submit your              toe joint replacements; and (3) total
                                                  full text of the consent agreement                         comments online. To make sure that the               silastic toe joint replacements for the
                                                  package can be obtained from the FTC                       Commission considers your online                     second through fifth ‘‘lesser’’ toes.
                                                  Home Page (for September 30, 2015), on                     comment, you must file it at https://                   The proposed Consent Agreement has
                                                  the World Wide Web, at http://                             ftcpublic.commentworks.com/ftc/wright                been placed on the public record for
                                                  www.ftc.gov/os/actions.shtm.                               tornierconsent by following the                      thirty days for receipt of comments by
                                                     You can file a comment online or on                     instructions on the web-based form. If               interested persons. Comments received
                                                  paper. For the Commission to consider                      this Notice appears at http://www.                   during this period will become part of
                                                  your comment, we must receive it on or                     regulations.gov/#!home, you also may                 the public record. After thirty days, the
                                                  before October 30, 2015. Write ‘‘Wright                    file a comment through that Web site.                Commission will again review the
                                                  Medical Group, Inc. and Tornier N.V.—                         If you file your comment on paper,                Consent Agreement and the comments
                                                  Consent Agreement; File No. 151 0018’’                     write ‘‘Wright Medical Group, Inc. and               received, and decide whether it should
                                                  on your comment. Your comment—                             Tornier N.V.—Consent Agreement; File                 withdraw from the Consent Agreement,
                                                  including your name and your state—                        No. 151 0018’’ on your comment and on                modify it, or make it final.
                                                  will be placed on the public record of                     the envelope, and mail your comment to                  Pursuant to an Agreement and Plan of
                                                  this proceeding, including, to the extent                  the following address: Federal Trade                 Merger dated October 27, 2014, Wright
                                                  practicable, on the public Commission                      Commission, Office of the Secretary,                 and Tornier propose to merge in an all-
                                                  Web site, at http://www.ftc.gov/os/                        600 Pennsylvania Avenue NW., Suite                   stock transaction valued at
                                                  publiccomments.shtm. As a matter of                        CC–5610 (Annex D), Washington, DC                    approximately $3.3 billion (the
                                                  discretion, the Commission tries to                        20580, or deliver your comment to the                ‘‘Proposed Merger’’). The Commission’s
                                                  remove individuals’ home contact                           following address: Federal Trade                     Complaint alleges that the Proposed
                                                  information from comments before                           Commission, Office of the Secretary,                 Merger, if consummated, would violate
                                                  placing them on the Commission Web                         Constitution Center, 400 7th Street SW.,             Section 7 of the Clayton Act, as
                                                  site.                                                      5th Floor, Suite 5610 (Annex D),                     amended, 15 U.S.C. 18, and Section 5 of
                                                     Because your comment will be made                       Washington, DC 20024. If possible,                   the Federal Trade Commission Act, as
                                                  public, you are solely responsible for                     submit your paper comment to the                     amended, 15 U.S.C. 45, by substantially
                                                  making sure that your comment does                         Commission by courier or overnight                   lessening competition in the U.S.
                                                  not include any sensitive personal                         service.                                             markets for total ankle replacements and
                                                  information, like anyone’s Social                             Visit the Commission Web site at
                                                                                                                                                                  total silastic toe joint replacements. The
                                                  Security number, date of birth, driver’s                   http://www.ftc.gov to read this Notice
                                                                                                                                                                  proposed Consent Agreement will
                                                  license number or other state                              and the news release describing it. The
                                                                                                                                                                  remedy the alleged violations by
                                                  identification number or foreign country                   FTC Act and other laws that the
                                                                                                                                                                  preserving the competition that
                                                  equivalent, passport number, financial                     Commission administers permit the
                                                                                                                                                                  otherwise would be lost in these
                                                  account number, or credit or debit card                    collection of public comments to
                                                                                                                                                                  markets as a result of the Proposed
                                                  number. You are also solely responsible                    consider and use in this proceeding as
                                                                                                                                                                  Merger.
                                                  for making sure that your comment does                     appropriate. The Commission will
                                                  not include any sensitive health                           consider all timely and responsive                   The Parties
                                                  information, like medical records or                       public comments that it receives on or                 Headquartered in Memphis,
                                                  other individually identifiable health                     before October 30, 2015. You can find                Tennessee, Wright is a global orthopedic
                                                  information. In addition, do not include                   more information, including routine                  company that divides its business into
                                                  any ‘‘[t]rade secret or any commercial or                  uses permitted by the Privacy Act, in                three categories: foot and ankle
                                                  financial information which . . . is                       the Commission’s privacy policy, at                  hardware; upper extremity
                                                  privileged or confidential,’’ as discussed                 http://www.ftc.gov/ftc/privacy.htm.                  reconstructive devices; and biologics
                                                  in Section 6(f) of the FTC Act, 15 U.S.C.                  Analysis of Agreement Containing                     products.
                                                  46(f), and FTC Rule 4.10(a)(2), 16 CFR                     Consent Order To Aid Public Comment                    Tornier is a global medical device
                                                  4.10(a)(2). In particular, do not include                                                                       company based in Amsterdam, the
                                                  competitively sensitive information                        Introduction
                                                                                                                                                                  Netherlands, with U.S. operations
                                                  such as costs, sales statistics,                              The Federal Trade Commission                      headquartered in Bloomington,
                                                  inventories, formulas, patterns, devices,                  (‘‘Commission’’) has accepted, subject to            Minnesota. Tornier’s U.S. products
                                                  manufacturing processes, or customer                       final approval, an Agreement                         include those for the upper extremity
                                                  names.                                                     Containing Consent Order (‘‘Consent                  joints; lower extremity joints; sports
                                                     If you want the Commission to give                      Agreement’’) from Wright Medical                     medicine; and biologics.
                                                  your comment confidential treatment,                       Group, Inc. (‘‘Wright’’) and Tornier N.V.
                                                  you must file it in paper form, with a                     (‘‘Tornier’’) designed to remedy the                 The Relevant Products and Structure of
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                                                  request for confidential treatment, and                    anticompetitive effects resulting from               the Markets
                                                  you have to follow the procedure                           the proposed merger of Wright and                    I. Total Ankle Replacements
                                                  explained in FTC Rule 4.9(c), 16 CFR                       Tornier. Under the terms of the
                                                                                                                                                                     Total ankle replacements are used to
                                                  4.9(c).1 Your comment will be kept                         proposed Decision and Order (‘‘Order’’)
                                                                                                                                                                  treat end-stage ankle arthritis, which
                                                     1 In particular, the written request for confidential   and must identify the specific portions of the
                                                                                                                                                                  develops when cartilage on the bones of
                                                  treatment that accompanies the comment must                comment to be withheld from the public record. See   the ankle joint wears away and causes
                                                  include the factual and legal basis for the request,       FTC Rule 4.9(c), 16 CFR 4.9(c).                      bone-on-bone grinding down of the joint


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                                                  60904                        Federal Register / Vol. 80, No. 195 / Thursday, October 8, 2015 / Notices

                                                  surface. Patients with end-stage ankle                  physicians or patients to switch to other             Wright and Tornier respond directly to
                                                  arthritis experience pain and swelling at               products or therapies.                                competition from each other with
                                                  the ankle along with difficulty walking.                   The U.S. market for total silastic big             improved products, better service, and
                                                  Total ankle replacements reduce the                     toe joint replacements is highly                      lower prices. By eliminating this direct
                                                  pain while maintaining the motion at                    concentrated. Wright and Tornier are                  and substantial head-to-head
                                                  the ankle joint. They replace damaged                   the only significant suppliers of the                 competition, the Proposed Merger likely
                                                  bone and cartilage with a metal tibial                  product, accounting for approximately                 would allow the combined firm to
                                                  tray, a metal talar dome, and a                         60% and 38% of the market,                            exercise market power unilaterally,
                                                  polyethylene bearing. In a fixed bearing                respectively. The next closest                        resulting in less innovation and higher
                                                  total ankle replacement, the                            competitor to Wright and Tornier—                     prices for consumers.
                                                  polyethylene bearing is locked to the                   Sgarlato Med LLC—accounts for a
                                                                                                          nominal share of the market.                          The Consent Agreement
                                                  tibial component, while in a mobile
                                                  bearing system it moves independently.                     Although more rare than in the big                    The Consent Agreement eliminates
                                                  Physicians and their patients would not                 toes, severe arthritis also occurs in the             the competitive concerns raised by the
                                                  switch to an alternative product or                     MTP joints of the lesser toes. Physicians             Proposed Merger by requiring the
                                                  therapy in response to a small but                      and patients who use total silastic lesser            parties to divest to Integra all of the
                                                  significant increase in the price of total              toe joint replacements would not switch               rights and assets needed for it to become
                                                  ankle replacements.                                     to any other product or procedure in                  an independent, viable, and effective
                                                                                                          response to a small but significant                   competitor in the U.S. markets for total
                                                     Wright, Tornier, and Stryker
                                                                                                          increase in the price of the total silastic           ankle replacements and total silastic toe
                                                  Corporation (‘‘Stryker’’) are the only
                                                                                                          toe joint implants. Wright, Tornier, and              joint replacements. The divestitures will
                                                  significant suppliers in the U.S. market
                                                                                                          OsteoMed supply total silastic lesser toe             maintain the competition that currently
                                                  for total ankle replacements, accounting
                                                                                                          joint replacements in the United States,              exists in each of the relevant markets.
                                                  for 44%, 19%, and 31% of 2014 sales,                                                                             Integra is well positioned to restore
                                                  respectively. Wright and Tornier are                    and Wright and Tornier are each other’s
                                                                                                          closest competitor. The Proposed                      the competition that otherwise would be
                                                  each other’s closest competitor. These                                                                        lost through the Proposed Merger.
                                                  companies both offer fixed bearing                      Merger would result in a combined
                                                                                                          market share of approximately 76%.                    Headquartered in Plainsboro, New
                                                  technologies and the only options for                                                                         Jersey, Integra is a global medical device
                                                                                                             The relevant geographic market for
                                                  revision surgeries, i.e., surgeries to redo                                                                   company that has experience
                                                                                                          total ankle replacements and total
                                                  a prior total ankle replacement                                                                               manufacturing, marketing, and
                                                                                                          silastic toe joint replacements is the
                                                  procedure. The other leading supplier,                                                                        distributing orthopedic devices in the
                                                                                                          United States. These products are
                                                  Stryker, supplies the only mobile                                                                             United States, and a track record for
                                                                                                          medical devices regulated by the U.S.
                                                  bearing system in the United States,                                                                          quality, service, and consistency.
                                                                                                          Food and Drug Administration (‘‘FDA’’).
                                                  making it a more distant competitor to                                                                        Integra’s lower extremity product
                                                                                                          Medical devices sold outside of the
                                                  Wright and Tornier. The only other U.S.                                                                       portfolio is also highly complementary
                                                                                                          United States, but not approved for sale
                                                  supplier of total ankle replacements,                                                                         to Tornier’s total ankle replacements
                                                                                                          in the United States, do not provide
                                                  Zimmer Holdings, Inc. (‘‘Zimmer’’)                                                                            and total silastic toe joint replacements.
                                                                                                          viable competitive alternatives for U.S.
                                                  offers a technology that typically is used                                                                       The Order requires Tornier to divest
                                                                                                          consumers.
                                                  only in specialized cases. Zimmer                                                                             all U.S. assets and rights related to the
                                                  maintains a fringe position in the                      Entry Conditions                                      relevant products, including intellectual
                                                  market.                                                    Entry in the relevant markets would                property, manufacturing technology,
                                                  II. Total Silastic Toe Joint Replacements               not be timely, likely, or sufficient in               and existing inventory. In order to
                                                                                                          magnitude, character, and scope to deter              ensure continuity of supply, the Order
                                                    Total big toe joint replacements treat                or counteract the anticompetitive effects             requires that the parties supply Integra
                                                  severe cases of hallux rigidus, an                      of the Proposed Merger. To enter or                   with total ankle replacements for up to
                                                  arthritic condition in the first                        effectively expand in any of the relevant             three years and total silastic toe joint
                                                  metatarsophalangeal (‘‘MTP’’) joint of                  markets successfully, a supplier would                replacements for up to one year while
                                                  the big toe. Pain and inflammation at                   need to design and manufacture an                     Integra transitions to independent
                                                  the first MTP joint restricts movement of               effective product, obtain FDA approval,               manufacturing and works to obtain FDA
                                                  the big toe and leads to difficulty                     and develop clinical history supporting               approval.
                                                  walking. Total big toe joint                            the long-term efficacy of its product.                   To ensure that the divestitures are
                                                  replacements relieve pain and preserve                  The new entrant or expanding firm                     successful, the Order requires the
                                                  motion in the big toe.                                  would also need to develop and foster                 parties to enter into a transitional
                                                    There are two types of total big toe                  product loyalty and establish a                       services agreement with Integra to assist
                                                  joint replacements: Metal and silastic.                 nationwide sales network capable of                   the company in establishing its
                                                  Total silastic big toe joint replacements               marketing the product and providing                   manufacturing capabilities and securing
                                                  are a distinct antitrust market. Surgeons               on-site service at hospitals nationwide.              all necessary FDA approvals. Further,
                                                  that favor total silastic big toe joint                 Establishing a track record for quality,              the Order requires that the parties
                                                  replacements over metal implants do so                  service, and consistency is difficult,                transfer all confidential business
                                                  for the silastic implants’ flexibility and              expensive, and typically spans several                information to Integra, as well as
                                                  longevity. The silastic implants are also               years.                                                provide access to employees who
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                                                  significantly less expensive than total                                                                       possess or are able to identify such
                                                  metal big toe joint replacements.                       Competitive Effects of the Merger                     information. Integra also will have the
                                                  Physicians and patients do not view                       The Proposed Merger would likely                    right to interview and offer employment
                                                  total silastic and total metal big toe joint            result in significant competitive harm to             to employees associated with the
                                                  replacements as reasonably                              consumers in the markets for total ankle              relevant products.
                                                  interchangeable. A small but significant                replacements and total silastic toe joint                The parties must accomplish these
                                                  increase in the price of total silastic big             replacements. As particularly close                   divestitures and relinquish their rights
                                                  toe joint replacements would not cause                  substitutes in each relevant market,                  to Integra no later than ten days after the


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                                                                               Federal Register / Vol. 80, No. 195 / Thursday, October 8, 2015 / Notices                                         60905

                                                  Proposed Merger is consummated. If the                  the population and to develop services                use of automated collection techniques
                                                  Commission determines that Integra is                   and allocate resources to improve long-               or other forms of information
                                                  not an acceptable acquirer, or that the                 term health and wellbeing.                            technology; and (e) estimates of capital
                                                  manner of the divestitures is not                       DATES: Written comments must be                       or start-up costs and costs of operation,
                                                  acceptable, the proposed Order requires                 received on or before December 7, 2015.               maintenance, and purchase of services
                                                  the parties to unwind the sale of rights                ADDRESSES: You may submit comments,                   to provide information. Burden means
                                                  to Integra and then divest the products                 identified by Docket No. CDC–2016–                    the total time, effort, or financial
                                                  to a Commission-approved acquirer                       0088 by any of the following methods:                 resources expended by persons to
                                                  within six months of the date the Order                    • Federal eRulemaking Portal:                      generate, maintain, retain, disclose or
                                                  becomes final. The proposed Order                       Regulation.gov. Follow the instructions               provide information to or for a Federal
                                                  further allows the Commission to                        for submitting comments.                              agency. This includes the time needed
                                                  appoint a trustee in the event the parties                 • Mail: Leroy A. Richardson,                       to review instructions; to develop,
                                                  fail to divest the products as required.                Information Collection Review Office,                 acquire, install and utilize technology
                                                     The Order also requires the parties to               Centers for Disease Control and                       and systems for the purpose of
                                                  appoint Quantic Regulatory Services,                    Prevention, 1600 Clifton Road, NE.,                   collecting, validating and verifying
                                                  LLC as interim monitor to ensure the                    MS–D74, Atlanta, Georgia 30329.                       information, processing and
                                                  parties comply with the obligations                        Instructions: All submissions received             maintaining information, and disclosing
                                                  pursuant to the Consent Agreement and                   must include the agency name and                      and providing information; to train
                                                  to keep the Commission informed about                   Docket Number. All relevant comments                  personnel and to be able to respond to
                                                  the status of the transfer of the assets                received will be posted without change                a collection of information, to search
                                                  and rights to Integra.                                  to Regulations.gov, including any                     data sources, to complete and review
                                                     The purpose of this analysis is to                   personal information provided. For                    the collection of information; and to
                                                  facilitate public comment on the                        access to the docket to read background               transmit or otherwise disclose the
                                                  Consent Agreement, and it is not                        documents or comments received, go to                 information.
                                                  intended to constitute an official                      Regulations.gov.                                      Proposed Project
                                                  interpretation of the proposed Order or                 FOR FURTHER INFORMATION CONTACT: To
                                                  to modify its terms in any way.                                                                                 Congenital Heart Surveillance To
                                                                                                          request more information on the                       Recognize Outcomes, Needs, and Well-
                                                    By direction of the Commission.                       proposed project or to obtain a copy of               being (CHSTRONG)—New—National
                                                  Donald S. Clark,                                        the information collection plan and                   Center on Birth Defects and
                                                  Secretary.                                              instruments, contact the Information                  Developmental Disabilities (NCBDDD),
                                                  [FR Doc. 2015–25604 Filed 10–7–15; 8:45 am]
                                                                                                          Collection Review Office, Centers for                 Centers for Disease Control and
                                                                                                          Disease Control and Prevention, 1600                  Prevention (CDC).
                                                  BILLING CODE 6750–01–P
                                                                                                          Clifton Road NE., MS–D74, Atlanta,
                                                                                                          Georgia 30329; phone: 404–639–7570;                   Background and Brief Description
                                                                                                          Email: omb@cdc.gov.                                      Congenital heart defects (CHDs) are
                                                  DEPARTMENT OF HEALTH AND
                                                                                                          SUPPLEMENTARY INFORMATION: Under the                  the most common type of structural
                                                  HUMAN SERVICES
                                                                                                          Paperwork Reduction Act of 1995 (PRA)                 birth defects, affecting approximately 1
                                                  Centers for Disease Control and                         (44 U.S.C. 3501–3520), Federal agencies               in 110 live-born children. In prior
                                                  Prevention                                              must obtain approval from the Office of               decades, many CHDs were considered
                                                                                                          Management and Budget (OMB) for each                  fatal during infancy or childhood, but
                                                  [60Day–16–15BHD; Docket No. CDC–2016–                   collection of information they conduct                with tremendous advances in pediatric
                                                  0088]                                                   or sponsor. In addition, the PRA also                 cardiology and cardiac surgery, at least
                                                  Proposed Data Collection Submitted                      requires Federal agencies to provide a                85% of patients now survive to
                                                  for Public Comment and                                  60-day notice in the Federal Register                 adulthood and there are approximately
                                                  Recommendations                                         concerning each proposed collection of                1.5 million adults with CHD living in
                                                                                                          information, including each new                       the United States. With vast declines in
                                                  AGENCY: Centers for Disease Control and                 proposed collection, each proposed                    mortality from pediatric heart disease
                                                  Prevention (CDC), Department of Health                  extension of existing collection of                   over the past 30 years, it is vital to
                                                  and Human Services (HHS).                               information, and each reinstatement of                evaluate long term outcomes and quality
                                                  ACTION: Notice with comment period.                     previously approved information                       of life issues for adults with CHD.
                                                                                                          collection before submitting the                      However, U.S. data on long term
                                                  SUMMARY:   The Centers for Disease                      collection to OMB for approval. To                    outcomes, quality of life issues, and
                                                  Control and Prevention (CDC), as part of                comply with this requirement, we are                  comorbidities of adults born with CHD
                                                  its continuing efforts to reduce public                 publishing this notice of a proposed                  are lacking. U.S. data is needed to
                                                  burden and maximize the utility of                      data collection as described below.                   provide insight into the public health
                                                  government information, invites the                        Comments are invited on: (a) Whether               questions that remain for this
                                                  general public and other Federal                        the proposed collection of information                population and to develop services and
                                                  agencies to take this opportunity to                    is necessary for the proper performance               allocate resources to improve long-term
                                                  comment on proposed and/or                              of the functions of the agency, including             health and wellbeing.
                                                  continuing information collections, as                  whether the information shall have                       For this one-year project, we will use
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                                                  required by the Paperwork Reduction                     practical utility; (b) the accuracy of the            data from U.S. state birth defect
                                                  Act of 1995. This notice invites                        agency’s estimate of the burden of the                surveillance systems to identify a
                                                  comment on Congenital Heart                             proposed collection of information; (c)               population-based sample of individuals
                                                  Surveillance to Recognize Outcomes,                     ways to enhance the quality, utility, and             18 to 45 years of age born with CHD. We
                                                  Needs and well-being (CHSTRONG).                        clarity of the information to be                      will then use state databases and online
                                                  CDC seeks to collect data for the                       collected; (d) ways to minimize the                   search engines to find current addresses
                                                  purpose of providing insight into the                   burden of the collection of information               for those individuals and mail surveys
                                                  public health questions that remain for                 on respondents, including through the                 to them inquiring about their barriers to


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Document Created: 2015-12-15 08:42:21
Document Modified: 2015-12-15 08:42:21
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionProposed consent agreement.
DatesComments must be received on or before October 30, 2015.
ContactAylin M. Skroejer (202-326-2459), Bureau of Competition, 600 Pennsylvania Avenue NW., Washington, DC 20580.
FR Citation80 FR 60902 

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