13D Activist Fund: Integer Holdings ($ITGR) Investment Case

In their Q4 2025 investor letter, 13D Activist Fund highlights a new position in Integer Holdings Corporation ($ITGR), a US activist campaign by Irenic Capital Management. The fund views Integer as a high-quality medical device contract manufacturer whose stock decline of over 40% year-to-date has created a compelling opportunity, particularly given the company’s strong competitive moat and what the fund sees as limited justification for remaining in the public markets. With Irenic disclosing a more than 3% position in December 2025, 13D believes the activist’s strategic playbook — focused on board refreshment and exploring a potential sale — aligns well with Integer’s situation.

Investment Highlight: Integer Holdings Corporation ($ITGR)

Business Overview

• Integer Holdings is a medical device contract development and manufacturing organization (“CDMO”) that acts as an outsourced design and development partner for major OEMs such as Medtronic, Boston Scientific, and J&J
• The fund describes Integer as the largest such company and the only publicly traded pure-play medical device CDMO
• From an end-market perspective, the company specializes in cardiovascular and neuromodulation applications, which 13D characterizes as highly sticky due to their interventional nature
• The fund notes that stringent regulatory and FDA approval requirements create very high barriers to change for competitors

Stock Decline and Growth Air Pocket

• Integer’s share price fell over 40% year-to-date following its most recent quarterly report, which disclosed that market demand for three specific products fell short of OEM expectations, causing those OEMs to significantly reduce orders
• The fund notes Integer is now facing a growth air pocket in 2026, with projected organic growth of -2% to 2% versus the company’s typical 6-8% target
• 13D observes that management has provided assurances this is temporary and growth will normalize in 2027, but cannot offer transparency into its pipeline or customer identities due to confidentiality constraints
• According to the fund, this opacity contributed to the severity of the stock decline, as a development like this with management assurances would not normally result in a 40% drop

Activist Thesis and Strategic Rationale

• Irenic Capital announced a more than 3% position on December 18, 2025, calling for board refreshment and exploration of a potential sale
• The fund identifies several reasons why a sale makes strategic sense: as the only public pure-play medical device CDMO, Integer has no public comps and suffers from limited investor and analyst understanding
• 13D notes that a company required to maintain opacity around its sales and customers is much easier operated and grown in a private setting, where a buyer subject to a confidentiality agreement could fully diligence Integer’s products, contracts, and pipeline
• The fund highlights that in 2024, Integer explored strategic alternatives and reportedly received bids at a premium to the then-current share price, estimated in the $110-$115 per share range

Valuation and Comparable Transactions

• 13D points to several comparable transactions suggesting significant upside: Teleflex Medical’s recent sale of its OEM business at approximately 4.7x revenue and 16-17x EBITDA, GTCR’s acquisition of CeramTec Medical at a similar multiple, and Integer’s largest competitors (Resonetics and Confluent Medical) being acquired at valuations exceeding 20x EBITDA
• The fund notes Integer currently trades at roughly 2.1x revenue and 10x EBITDA, and extrapolating peer multiples would equate to an acquisition price north of $120 per share

Board Refreshment and Governance

• Irenic is seeking a board refreshment to include directors with medical OEM experience and financial acumen
• The fund notes that of Integer’s 11 directors, five will have served at least 10 years by the next Annual Meeting, including Chair Pamela Baily at nearly 25 years
• 13D views fresh perspectives as materially improving the board’s ability to assess options for maximizing shareholder value on a risk-adjusted basis
• The fund observes that while Irenic is capable of running a proxy contest, the firm has historically received board representation via settlements and would likely seek the same result here

Activist Track Record

• 13D notes that Irenic Capital was founded by Adam Katz, a former portfolio manager at Elliott Investment Management, and has significant experience in strategic activism
• The fund describes Irenic’s playbook as identifying companies struggling in the public markets and helping implement spinoffs and sales of businesses, often to private equity
• According to the fund, Integer fits Irenic’s playbook perfectly, and it is hard to recall a company with less justification for remaining in the public market

13D Activist Fund views Integer Holdings as a high-quality medical device CDMO whose unique attributes — including confidentiality constraints, lack of public comps, and limited analyst coverage — make it better suited for private ownership. The fund believes Irenic Capital’s strategic activism, focused on board refreshment and a potential sale, could unlock substantial value given comparable transactions suggesting an acquisition price well above current levels. With the nomination deadline opening January 21, the fund expects Irenic’s next steps to emerge soon, with the activist likely seeking a settlement for board representation or, should the current board initiate a formal strategic review, de-emphasizing governance concerns in favor of a value-accretive transaction.

Click here for the full Pro Investor Letter.