Brocair Partners Advises Hyperbaric Oxygen Therapy Company on Sale to Private Equity Group

Brocair Partners Advises Hyperbaric Oxygen Therapy Company on Sale to Private Equity Group – September 2009

Brocair Partners advised a Hyperbaric Oxygen Therapy Company (“The Center”), a private New York company, on its sale to Candescent Partners, a consortium of private equity purchasers. Candescent Partners, a private equity firm based in Massachusetts acted as the lead investor along with co-investors Harbert Management Corporation, based in Tennessee, and Gemini Investors, based in Massachusetts.

Josh Giesey, Associate at Brocair, explained the key issues of the transaction, “We think this transaction is tremendously beneficial to all parties involved. The transaction was exciting considering that the hyperbaric oxygen therapy industry is in its infancy stage and presents great potential for growth. We believe Candescent brings a wealth of experience in transforming regional firms into multi-state operating entities. Personally, it was a pleasure to work with all parties involved and I am excited to see the new company grow.”

Gregg Blake, Managing Partner of Brocair, said the transaction was successful, despite the difficult economy. “The past twelve months have been an extremely challenging environment for healthcare M&A. But even in tough times, solid, rapidly growing, cash-flow positive companies have continued to be attractive assets. That was certainly our experience with The Center.”

The company develops and operates comprehensive wound care centers and hyperbaric oxygen therapy (“HBOT”) facilities within hospitals. The company commenced operations in 2005 and has operations mainly on the east coast of the US as well as in select Midwest states. In addition to hyperbaric oxygen therapy the company offers state-of-the-art wound care therapies for individuals with chronic skin ulcers.

Candescent Partners, based in Boston, MA, provides capital solutions to growth companies in the middle market. The firm was started by Steve Jenks and Sandy McGrath, who collectively have over 20 years of investing experience with more than $600 million in over 40 companies.

Harbert Mezzanine Capital, a division of Harbert Management Capital, is based in Nashville, Tennessee. The Mezzanine Capital group typically provides $3 million to $15 million in subordinated debt to companies for the purposes of growth, acquisitions, recapitalizations or management buyouts.

Gemini Investors is a private equity firm based in Wellesley, MA. Gemini was established in 1993 and has invested in over 60 middle market companies. Gemini invests over a wide range of industries, which include technology, business services, consumer services, healthcare, education, manufacturing and distribution.

Ambulatory Surgical Centers Market, July 2009

Ambulatory Surgery Centers, also known as ASCs, are facilities that perform surgeries which do not require hospitalization. 35% of facilities are multi-specialty providers that perform a mix of surgical services; the rest are solely dedicated to a specific type of surgery, such ophthalmology or gastroenterology.

In the U.S. over 22 million procedures are performed annually, at one of over 5,000 ASCs. ASCs are highly regulated in the U.S.: 43 states require ASCs to be licensed and specify criteria with which ASCs must comply, the Centers for Medicare and Medicaid (CMS) also certifies ASCs in the U.S. State and federal authorities review ASCs regularly to ensure compliance with standards.

In 1982, CMS agreed to pay reimbursements for surgeries performed at ASCs. Today over 2,400 procedures have been approved for reimbursement when performed at an ASC. Significant cost reductions can be achieved when patients do not require overnight care in a hospital. However, CMS also pays lower reimbursements for procedures performed at an ASC versus a hospital.

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Generic Pharmaceuticals Market, May 2009

A generic drug is a bioequivalent to a brand name drug in dosage form, safety, strength, route of administration, performance characteristics, and intended use.

After Patents or other periods of exclusivity expire, companies can apply to the FDA to sell generic versions in the United States. However, the approval process for generic drugs differs from the approval process for new drugs. To market a generic drug, drug companies must submit an abbreviated new drug application (ANDA) for approval. The ANDA process does not require the drug sponsor to repeat clinical research on ingredients or dosage forms already approved by the FDA for safety and effectiveness.

The United States represents approximately 40% of the global generics market. In the United States, nearly 35 "blockbuster drugs" are expected to lose exclusivity by 2012. Similar trends are expected in other major markets such as France, Germany, and the United Kingdom.

While a generic drug is equivalent to its branded counterpart, the generic version is usually sold for less than the branded price. As a result, generic medicines account for approximately 70% of all prescriptions dispensed in the United States, while only representing 20% of all dollars spent on prescriptions.

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Aesthetic Medical Device Market, February 2009

  • According to the American Society for Aesthetic Plastic Surgery (ASAPS), Americans spent $13.2 billion on aesthetic treatments in 2007.
  • The market for energy-based aesthetic devices is estimated to exceed $1 billion by 2011, and it has been growing by 20% annually, although the slump in retail spending is likely to reduce that rate in the short/medium term.
  • Clustering: There are three important geographic areas where innovation has been occurring in this industry – the Boston, Massachusetts, region, the Silicon Valley region in Northern California, and Israel.
  • The fastest growing segments are skin resurfacing and skin tightening, which together account for 36.6% of sales.
  • Aesthetic medical devices are used in body contouring, dermal tightening, dermal resurfacing, acne prevention, the reduction of skin pigmentation blemishes, and age-related vascular/dermal lesions as well as hair removal.
  • There are a wide range of devices and tools for addressing the above conditions, including: microdermal abraders, dermal lasers, light emitting diodes (LEDs), intense pulsed light devices, infrared devices, radio frequency-based devices, dermal fi llers, and implants.
  • Factors influencing the adoption of aesthetic medical devices include the aging of the large Baby Boomer population which continues to demand anti-aging medical techniques. Cosmetic procedures are also gaining acceptance as a respected subsector within the large and quickly developing health and wellness sector.

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Urological and Gynecological Devices Market, January 2009

Various medical devices are used in the treatment of urological and gynecological conditions. Participants in the market include both companies which operate across other segments of the healthcare industry and more specialized "pure-play" companies.

The Brocair Partners report contains a matrix of conditions covered by the companies, an overview of the participants in the industry, short company profiles of selected companies, a market and valuation analysis, and an overview of recent corporate transactions.

Urolithiasis, incontinence in men and women, benign prostate hyperplasia, prostate cancer and erectile dysfunction in men and associated devices for treatment are addressed by the report. Gynecological devices treating menorrhagia, fibroids, pelvic inflammatory disease, uterine prolapse, endometriosis, chronic pelvic pain and uterine cancers are also discussed.

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Surgical Sealants Market, September 2008

Surgical sealants are typically used after a surgery or a traumatic injury, to bind or hold external tissue such as skin as well as internal tissue such as blood vessels. The key types of surgical sealants are fibrin sealants, synthetic agents, collagen-based compounds and tissue adhesive glues such as glutaraldehyde glues and hydrogels. Among these, fibrin sealants have broad applications throughout the medical community. Recently, a great deal of research and innovation has focused on collagen compounds and hydrogels.

Participants in the surgical sealants market include both large public companies which operate across other segments of the healthcare industry and more specialized "pure-play" companies. Four companies profi led in this report are publicly traded and have a diversified product mix: Cryolife, Omrix, Vascular, and Zymogenetics. One additional public company, Haemacure, focuses exclusively on sealants. The remaining six companies also focus exclusively on sealants but, unlike Haemacure, are private.

Five of the profiled companies make products in the fibrin sealant categories. Additionally, Omrix, Cryolife and Haemacure have invested in R&D for applications based on protein extraction for tissue engineering and immunotherapy. Three have hydrogel-based polymer products, and each of these received FDA approval or a CE mark (an EU health and safety certification) in 2006 and 2007.

Most large public companies operate in multiple product segments and have grown through acquisition of manufacturing and distribution licenses or acquisition of smaller firms. In Section 6 forty-five recent transactions are detailed, including private placements and eleven merger/acquisition transactions.

Vascular Solutions raised $20.9 million in 2007, Omrix raised $99.7 million in 2006 and Zymogenetics raised $126.9 million in 2005. In 2007, Neomend raised $6.0 million and Vivostat raised $9.5 million, both in private placements. In 2008, Haemacure raised $12.5 million through a private placement to fund new product development and Cryolife secured a credit facility with GE Healthcare financial services for $15.0 million.

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Brocair Partners Chairs Panel “Cross Border M&A in BioPharma” at TiECON East 2008

May 29th, 2008 – Brocair Partners LLC, an investment banking firm serving the healthcare industry, recently chaired a panel at TiECON East on focused on Cross Border M&A in BioPharma.

Members of the Panel also included Johannes Burlin, President & CEO, Advanced Bioscience Laboratories; Vipin Garg, President & CEO, Tranzyme Pharmaceuticals; Ajit Mahadevan, Partner, Business Advisory Services, Ernst & Young Pvt. Ltd.; and Bruce Raphael, Partner, Edwards, Angell, Palmer & Dodge.

Rusty Ray, Partner at Brocair Partners explained, "I think the panel was able to offer the audience a wide array of experiences as they relate to cross-border transactions. The discussions around the mechanics of completing a multi-national transaction were well received; the points addressed included how to avoid legal pitfalls, ensuring financing, and structuring the deal. While the audience found those aspects of cross-border M&A interesting, I believe it was the discussion on the softer elements of these transactions that made the most impact on the audience, such as addressing cultural differences and the successful integration of varied business models."

"Overall, it was a terrific opportunity to share some of our own experiences and compare notes with colleagues who have worked in varying capacities on multinational deals. The TiECON East conference was a terrific venue for the exchange of those kinds of ideas."

TiE is a global not-for-profit organization with a mission to foster and support entrepreneurship. It is an active, vibrant organization with 48 chapters in 15 countries with over 12,000 members globally. TiE represents a diverse set of industries, including software and information technologies, biotech, financial services and other services.

Brocair Partners Interviewed in Acquisitions Monthly Magazine

Indians Go Global, 1 May, 2008

Indian companies are gaining ever-greater confidence to flex their substantial financial muscle on the world stage, writes Christopher Spink.

The Indian economy has passed a critical stage over the past two years, firmly establishing itself on an equal footing with its former masters in the West.

No longer is the sub-continent considered merely a useful source of cheaper labour for more developed economies. Now the tiger is biting back, challenging those that outsource this work and even acquiring such companies.

Since the start of last year, the value of acquisitions by Indian companies of overseas businesses, at US$28.3bn, has outstripped the value of purely domestic deals by more than 50%.

Larger acquisitions dominate this crop, including such landmark deals as Hindalco’s US$5.8bn purchase of US aluminium group Novelis and Ford’s recent US$2.3bn sale of Jaguar and Land Rover to Tata Motors.

Some of the UK’s most sacred items have also been taken East, such as Scottish whisky group Whyte & Mackay, acquired by Kingfisher beer entrepreneur Vijay Mallya for US$1.18bn. Even English cricket is under threat by the lucrative Indian Premier League.

"2007 was a turning point. There have been a number of bigger ticket transactions," says Ralph Voltmer, a partner at US law firm Covington Burling, which has advised telecom-focused conglomerate Reliance. "Many large Indian companies are truly multinational now. I expect this trend to continue," he says.

The acquisitions of such trophy assets inevitably grab the limelight, drawing attention away from the more prosaic deals that have happened over the past 18 months. There have been 369 in all, which is still half the number of domestic deals. Ian Gomes of KPMG says there are "scores of deals in the US$50m to US$60m range".

"Over the last four years there have been lots of smaller deals, where Indian companies have bought overseas, but these have slowly been getting larger," says Ian Scott, a partner at lawyer Ashurst, which has had an office in India for 14 years.

Andy Currie, managing director of Catalyst, has noticed a distinct rise in interest from Indian potential purchasers of UK assets, saying: "Five years ago, we had no Indian interest when running disposal mandates, but now 80% of such deals will have interest from India."

The UK mid-market adviser is part of cross-border network Mergers Alliance, whose Indian member Singhi recently organised a conference in Delhi attended by more than 300 Indian corporates, keen to learn about doing overseas acquisitions.

"A third of Indian money invested overseas goes into the UK," says Currie, citing the cultural links through the Empire and the English language as important reasons for this. He has sold building product, construction and IT businesses to Indian buyers.

Drugs seeking targets

One of Singhi’s bigger deals this year involved advising an Indian pharmaceutical client, Plethico, on the acquisition of Natrol, a US herbal medicine maker.

"We were brought in to find targets for Plethico to buy outside India," says Abhijeet Biswas, head of Singhi’s dedicated cross-border M&A team.

"Plethico’s strategy is quite different from that of Ranbaxy or other Indian makers of generic drugs, who make products under license from Western companies. As a maker of herbal medicines, Plethico already had exports into unregulated markets such as CIS countries, the Gulf and South East Asia. Now it wanted to move into regulated markets.

"Herbal treatments are popular in the US and Germany, so these were the places where we drew up a good set of targets," says Biswas. "Plethico decided to target the US first as it was a much bigger market, then other smaller ones. We then approached Merger Alliance’s US partner Brocair, which is a healthcare specialist.

"The search was then narrowed down to Natrol, as it was a Nasdaq company, principally owned by institutions that were willing to sell. This made it easier to acquire than a herbal business that was privately owned or part of a larger corporation. Natrol is a top 10 business in the US and a good platform for future growth," he says

"This was very much a stepping stone. Indian pharma companies want to get into the US in order to gain FDA approval for their processes. This will take a lot of time to do from a standing start, so acquiring an existing approved facility makes sense."

This trend is continuing. Jubilant Organosys, which bought two US research businesses, Target Research Associates and Trinity Laboratories, in 2005, acquired Hollister-Stier Laboratories for US$122.5m a year ago. And last month it announced plans to buy Draxis Health of Canada for US$255m. This enhances its presence in regulated markets.

Rusty Ray at Brocair, Singhi’s US partner firm, notes that Indian pharma companies are also looking to buy US developers of drugs, rather than just established products, saying: "Major Indian companies are definitely interested in buying US pharmaceutical companies in the development space."

Ranbaxy, best known for making copies of off-patent drugs developed in the West, is spinning off its development arm this summer and smaller rivals, such as Wockhardt, are also expanding in this field.

A year ago, Wockhardt bought French developer Negma Laboratories for US$265m. Negma has 172 patents connected to drugs in development. Wockhardt has now made five European acquisitions.

Vineet Aneja is a partner in the largest Indian law firm by number of lawyers, Fox Mandal Little. "We remain busy with Indian companies still looking overseas, principally at the US and Europe," he says.

Aneja still sees the drive for many of these deals as the opportunity to relocate the manufacturing facilities acquired in the West back to lower-cost India. Others detect a trend away from this motive.

"The high profile Tata acquisition of Jaguar and Land Rover had nothing to do with buying IT and technology. It was a traditional M&A deal driven by the desire to invest in the global market place," says Nikhil Mehta, partner at Cleary Gottlieb Steen & Hamilton.

The firm knows about this dynamic, as it advised Mittal on the takeover of Arcelor. Steel and materials continues to be an extremely active sector. Mehta again emphasises that the recent deals have been done to give Indian companies and their products access to a global market place, saying: "Tata already had lots of expertise when it bought Corus".

IT issues

Ian Gomes of KPMG reckons there are several reasons why Indian companies want to make acquisitions overseas. "They either want a Western brand name to use globally; access to an established distribution network throughout Europe and the US; or are looking to acquire hi tech design or intellectual property," he says.

Gomes highlights the pharmaceutical, automotive and IT sectors as being particularly active. Some of the dominant Indian companies in the latter area, such as Infosys, Wipro, Satyam and Tata Computer Systems have long been linked with possible targets in Western Europe and the US, such as SAP and Cap Gemini.

However, Anthony Miller, a partner at Arete Research who has long tracked the fortunes of these companies, notes that shareholders have become disenchanted with how they have integrated purchases already made in the West. Their share prices have all fallen over the past two years, even though their revenues have on average doubled.

This is partly because investors already link these stocks inextricably with the US and EU economies, as most of their income is received from companies in these developed markets deciding to send IT contracts offshore. A fear that a downturn in the US economy will dampen such activity seems to have gripped these investors.

Wipro chairman Azim Premji said last month: "The global economic outlook has changed significantly since the beginning of this calendar year. It poses challenges and at the same time, opens up new opportunities. Given the uncertainty in the environment, we remain cautious but resilient."

KPMG’s Gomes disagrees. "Yes, all IT companies have been affected by the US downturn hitting top-line growth. However, that’s a short-term issue. Many US operators are also going to be urged to cut costs, so more offshoring to India may take place in the long term." Another issue has been the increasing labour costs these IT giants face.

Arete’s Miller notes that some of the deals that saw Western companies buy Indian ones in the last two years appear to have turned sour, citing Cap Gemini’s US$1.25bn purchase of Kanbay in October 2006 and EDS’s US$380m purchase of Mphasis in June the same year.

Both have since seen many Indian IT consultants leave, after seeing the disparity in pay between themselves and colleagues in developed economies. The deals have effectively been regarded as reverse takeovers internally. This is making Indian companies wary about buying in countries where labour costs are higher.

However, some continue to make moves overseas. Most notably, last August Wipro bought Nasdaq-listed Infocrossing for US$673m, nearly three times its annual revenues. Infocrossing stores data for US clients, notably in the healthcare sector, on servers at five remote locations in the US.

The logic behind this deal was reasonably traditional. Wipro president Suresh Vaswani said: "This acquisition of an acknowledged industry leader broadens the data centre and mainframe capabilities of Wipro Technologies to uniquely position us in the remote infrastructure management space."

Satyam’s acquisition of Bridge Strategy Group in January for US$35m was much smaller but highly significant, says Arete’s Miller, as Bridge is a high-end management consultant rather than a provider of commodity IT services.

This means Bridge is definably different from Satyam, making integration less of a problem. The hope is that Bridge’s 36 fee earners could generate offshore contracts too through their contact with senior management in US companies.

Financial forays

Religare, a financial services group majority owned by pharmaceutical giant Ranbaxy, has also established a bridgehead in the West, through its recently announced acquisition of Hichens, Harrison for £55.5m. Hichens is an AIM-listed stockbroker specialising in advising and raising money for businesses on London’s junior market.

Hichens finance director Brian Rowbotham believes the deal will provide benefits for both parties, saying: "We have expanded in the emerging markets lately, trying to become broker of choice for mid-market companies seeking a listing in London. Religare has over 500,000 clients, many of whom have businesses that could seek a listing."

Andrew Perkin of PricewaterhouseCoopers advised Religare on the deal. "Large Indian companies are becoming acquisitive outside India," he says. "Smaller ones are equally interested in expanding beyond their domestic borders, but many are beneath the radar of the larger investment banks and commercial banks."

He says this was the first of several acquisitions planned for Religare, previously a tax and audit client of PwC. "They have been active in Australia but are also keen to buy in the US," he says. "Religare has ambitions to be a global company."

Some have accused Religare of paying over the odds for Hichens but Perkin says: "Religare is not bothered. This is a long term play for the business." Indeed, an AIM brokerage seems worth paying for, judging by recent activity from the sub-continent.

Robert Ogilvy-Watson, a partner at Ashurst, says: "Lots of Indian companies are floating in London via the Isle of Man." One London listed Indian company is Vedanta Resources, which has made the most of its quote to buy a 79% stake in a Zambian copper miner Konkola for US$700m.

There have been some setbacks for Indian acquirers of foreign assets. Last year, Suzlon bought a majority stake in German wind power group ReEnergy for US$1.7bn in a complicated two-stage process.

Suzlon is one of the world’s biggest makers of wind turbine blades and is hoping to take advantage of the move to greener forms of power generation. However, the group is facing manufacturing quality problems at present, having recalled most of its blades sold in the US.

It is also having problems securing access to ReEnergy’s product designs, according to reports. This is because technically it only holds a minority stake in the German group, as two major shareholders, while already ceding votes, have yet to transfer their equity to Suzlon.

The acquisition of Jaguar and Land Rover from Ford could also prove a challenge to Tata in the current environment. The two UK marques employ 16,000 and Tata might be looking to reduce costs, particularly as it had to take out a US$3bn bridge loan to finance the acquisition. As part of the deal Ford paid US$600m into the brands’ pension schemes.

That said, there were fears about Tata’s financing of its Corus purchase, which proved unfounded, notes Ashurst’s Scott. "The refinancing of the Tata Corus deal has been tricky to get away but it hasn’t stopped the company from buying Jaguar and Land Rover," he says.

Speaking of the current financial climate, Scott adds: "Our Indian office is as busy as ever but some deals have fallen over. However, I am not expecting a huge slowdown in M&A deals. Smart money will back places where fast growth will be."

KPMG’s Gomes is equally positive, because of the strong relationships Indian corporates have with their clients. "Indian banks know their acquirers well and so are happy to help them. Many of these banks, such as ICICI, now have London offices," he says. "They can price risk more appropriately for Indian acquirers."

Singhi’s Biswas agrees, saying: "The impact of the sub-prime crisis is limited. Not many Indian banks are affected. It has certainly slowed down the process of doing M&A but it has not stopped. I have seen one deal shelved recently. But if you find the right company you can still conclude the transaction."

At present, Indian acquirers are remaining positive.

Brocair Partners Helps Indian Pharmaceuticals Firm Deliver on US Acquisition Strategy

Brocair Partners Helps Indian Pharmaceuticals Firm Deliver on US Acquisition Strategy – December 2007

Brocair Partners LLC, an investment banking firm serving the healthcare industry, advised Plethico Pharmaceuticals Limited, an Indian public company, on its acquisition of Natrol, Inc., a Nasdaq-listed company based in California.

The two-step acquisition was effected by means of a front-end, cash tender offer by a wholly owned subsidiary of Plethico for all of the outstanding shares of Natrol’s common stock, at $4.40 net per share in cash, followed by a second-step, cash-out merger in which untendered Natrol shares were acquired at the same net cash price per share. All Natrol stock options received cash equal to the excess, if any, of $4.40 over their exercise price.

Rusty Ray, Partner at Brocair, explained the key issues of the transaction, “We think this transaction will be tremendously beneficial to both parties. The transaction itself was quite interesting when viewed from the perspective that Plethico, an Indian-based company, has chosen to expand into the US market through the acquisition of a highly regarded, well-established brand. We believe this is a trend that will continue across the healthcare sector.”

Plethico Pharmaceuticals Limited (BSE: 532739/BO: PLETHICO) is an herbal/ nutraceutical-focused Indian company that engages in the manufacture, marketing and distribution of pharmaceutical and allied healthcare products in India and internationally. The company’s product portfolio includes: herbal health care products, such as Travisil® and Mountain Herbz® food supplements; consumer healthcare products and neutraceuticals, which include sports nutrition (Coach’s Formula®), confectionary (Byte®, Actifresh®), pharma-OTC (Effertabs®, Therasil®) and pharmaceutical formulations. The Company today operates in Commonwealth of Independent States (CIS), Africa, South East Asia, Latin America and certain gulf countries. Plethico was founded in 1991 and has its corporate office in Mumbai, India.

Brocair Acts as Financial Advisor to Nutrijoy

Brocair Acts as Financial Advisor to Nutrijoy in Their International Licensing Agreement with Ruchi’s – 2007

Brocair Partners LLC, an investment banking firm serving the healthcare industry, advised NutriJoy, Inc. on its international licensing agreement with Ruchi Soya Industries Limited, a public company headquartered in India.

The licensing agreement will grant Ruchi Soya the right to manufacture and market NutriJoy’s key products throughout India and much of Asia. The partnership will enable Ruchi to execute on its strategy to develop healthcare-focused consumer products and expand upon the markets the company already serves. NutriJoy Inc. and Ruchi Soya expect to deepen their partnership as both companies work to develop new products that incorporate NutriJoy’s underlying proprietary technologies and know-how for functional beverages and healthy snacks.

Rusty Ray, Partner at Brocair, commented, “We are excited at the prospects of taking NutriJoy’s products global. We think the Asian market is very receptive to new products that incorporate healthy benefits and that a multi-billion dollar company like Ruchi Soya will do quite well with this technology. Brocair has led a number of transactions where a large-scale international player has acquired cutting-edge technology from the U.S. We expect this is a trend that will continue and are pleased that Brocair is in a position to offer our clients direct access to a multinational group of acquirers and not simply limit their possibilities to US-based buyers.”

NutriJoy, Inc. is based in Manhattan, Kansas and uses proprietary technology to deliver superior nutritional and appealing food and beverage products to consumers. The Company was incorporated in 2000 and launched its Cal-C brand in April 2002 and GoodBites brand in 2004.

Ruchi Soya Industries Limited (Public BSE: 500368), through its subsidiaries, engages in the manufacture and sale of edible oils, vanaspati, bakery fats, and soya food in India. It also offers soya chunks, granules, and soya flour products and exports products to Asia, Europe, and the Middle East. Ruchi Soya Industries was founded in 1972 and is headquartered in Indore, India. As part of the Ruchi Group, 2007 revenues for Ruchi Soya were approximately $2.3 billion.