Orchestra BioMed is a pre-revenue biomedical company that develops medical device and drug-device combination products, then licenses them to large medical device partners in exchange for revenue-sharing arrangements. Rather than commercializing products itself, Orchestra BioMed advances candidates through late-stage clinical trials and hands off commercialization to established partners with existing manufacturing, sales, and distribution infrastructure. The company has two flagship product candidates. The first, AVIM Therapy, is a bioelectronic therapy delivered as a firmware upgrade to standard cardiac dual-chamber pacemakers, designed to lower blood pressure in pacemaker patients with uncontrolled hypertension — without a separate implant or patient compliance requirement. Orchestra BioMed has an exclusive collaboration with Medtronic to commercialize AVIM Therapy if approved, under which Orchestra BioMed expects to receive $500–$1,600 per AVIM-enabled pacemaker sold. The second candidate, Virtue SAB, is a drug-device combination balloon that delivers sirolimus directly to the artery wall during angioplasty to treat coronary in-stent restenosis, without leaving a permanent implant. Terumo, the prior commercialization partner for Virtue SAB, terminated its arrangement in late 2025, leaving Orchestra BioMed to find a new partner after trial completion. Neither product has regulatory approval or generates product revenue today. Ligand Pharmaceuticals paid Orchestra BioMed $35M for the right to receive tiered payments on future net sales of both products — providing non-dilutive capital today. Beyond its two flagship programs, Orchestra BioMed also owns FreeHold Surgical (hands-free laparoscopic retractors) and Motus GI (a colonoscopy visualization device), both early-stage.