Alphatec ECONOMIC

Target: Alphatec Holdings, Inc. (NASDAQ: ATEC), including Alphatec Spine, SafeOp Surgical, EOS imaging, and relevant controlling principals.

Evidence cutoff: 26 October 2026.

Period examined: Historical records through October 2026, with particular attention to commercial activity after 19 July 2024 and November 2024.

Supply Chain & Sourcing Relationships

Business and sourcing context

Alphatec Holdings operates through medical technology subsidiaries, including Alphatec Spine, SafeOp Surgical, and EOS imaging; its documented products concern spinal surgery, surgical neuromonitoring, medical imaging, and related clinical technology. ¹

Alphatec’s 2024 Form 10-K describes supplier qualification procedures, supplier quality reviews, medical-device manufacturing requirements, and international regulatory compliance obligations. ¹

Direct Israeli suppliers

No public evidence identified of Alphatec purchasing products or components from a specifically named Israeli manufacturer, agricultural supplier, medical-device producer, or technology subcontractor.

No public evidence identified of direct commercial relationships with Mehadrin, Hadiklaim, Galilee Export, or Agrexco successors.

Verified historical Israeli customer relationship

[pre-2020] On 5 April 2017, EOS imaging announced its first Israeli sale of an EOS medical imaging platform to Tel Aviv Sourasky Medical Center, with installation expected during April 2017 at Dana-Dwek Hospital. The announcement established a named Israeli institutional customer and product but did not disclose the contract value, importer, distributor, or subsequent service terms. ²

The 2017 sale occurred before Alphatec acquired EOS imaging; Alphatec completed the acquisition of EOS during 2021 and subsequently consolidated the company as a wholly owned operating subsidiary. ^{3, 4}

No public evidence identified confirming that the 2017 hospital relationship continued after Alphatec’s 2021 acquisition or remained commercially active during 2024–2026.

Importer-of-record arrangements

No public evidence identified of a named Israeli importer of record for Alphatec Spine, SafeOp, or EOS imaging products.

No public evidence identified of an Israeli joint venture or wholly owned import subsidiary acting as importer of record.

Third-party distributors

[pre-2020] A historical SEC disclosure records Alphatec’s September 2016 sale of international distribution operations and agreements to Globus Medical Ireland Ltd. and affiliates. This identifies a historical international distribution transaction but does not identify a specific Israeli customer or distributor. ⁵

Alphatec’s later annual disclosures record the termination of the associated international supply agreement with Globus Medical in August 2021. ⁴

No public evidence identified of a current named Israeli distributor, reseller, or integrator handling Alphatec products.

Seasonal sourcing

No public evidence identified of seasonal Israeli procurement patterns, including recurring December–April purchases.

Indirect sourcing and private-label arrangements

No public evidence identified of Israeli-origin goods entering Alphatec’s supply chain through identified white-label manufacturers, third-party distributors, private-label brands, or indirect sourcing arrangements.

Military or defence-related supply chains

SafeOp’s acquisition and subsequent product development documentation identify a surgical neuromonitoring business and medical-device applications. ^{6, 7}

No public evidence identified of a SafeOp, EOS, or Alphatec product contract with the Israel Defense Forces or Israeli Ministry of Defence.

Settlement supply-chain nexus

No public evidence identified of procurement, distribution, importing, or manufacturing undertaken by Alphatec or its identified subsidiaries in Israeli settlements in the West Bank, East Jerusalem, or Golan Heights.

[2023–2026] BesTech Ltd (בסטק בע”מ), Israeli company number 514338664, publicly identifies EOS imaging among its “Exclusive Partners” in the Imaging & Navigation category. BesTech describes EOS imaging’s portfolio as low-dose 2D/3D medical imaging systems, imaging software and Advanced Orthopedic Solutions (AOS), spanning imaging, surgical planning and postoperative assessment. The Israeli Ministry of Health independently identifies the same BesTech legal entity as the named single-source supplier for EOS equipment servicing at Tel Aviv Sourasky Medical Center in 2026 and EOS equipment repair at Sheba Medical Center in 2023. Together, these records establish a publicly represented EOS–BesTech commercial partnership and demonstrate BesTech’s role as an Israeli institutional supplier or service intermediary for EOS equipment after Alphatec’s 2021 acquisition. They provide strong evidence of an active Israeli service-channel relationship, although they do not independently establish the terms of formal manufacturer authorisation.^{8, 9, 10}

[2018–2026] The EOS–BesTech relationship predates Alphatec’s acquisition. Israeli Ministry of Health exemption notice 615365, updated 26 April 2018, names BesTech as supplier for an EOS spinal and limb imaging system at Sheba Medical Center, with a stated procurement value of ₪3,741,566 and a contractual period from 16 April 2018 to 16 April 2020. Subsequent Sheba procurement in 2023 and Sourasky procurement in 2026 show that BesTech continued to be publicly identified as the supplier for EOS-related equipment services after EOS became an Alphatec subsidiary. The records establish continuity of the named supplier relationship across the acquisition, but do not independently prove that the original distribution agreement remained legally unchanged.^{9, 10, 11}

[2023–2026] - no public evidence identified: the reviewed BesTech partnership disclosure and Israeli procurement notices do not publish an EOS–BesTech distribution or service agreement, manufacturer authorisation certificate, appointment date, defined exclusive territory, sales quotas, wholesale prices, contractual margins, warranty allocation, spare-parts purchasing arrangements or termination provisions. BesTech’s designation of EOS imaging as an “Exclusive Partner” is a public representation by BesTech; the available records do not independently establish whether exclusivity applies throughout Israel, to particular product lines, or to defined customers. The demonstrated product scope includes EOS imaging systems and related institutional repair or maintenance services, while the broader territory and commercial terms remain unverified.^{8, 9, 10}

Product Origin, Labeling & Regulatory Compliance

Product categories and origin

Alphatec’s documented commercial portfolio comprises spinal surgery technology, implants, clinical support systems, and medical imaging products. ^{1, 12}

The EOS imaging business develops medical imaging and surgical planning technology, which Alphatec integrated into its broader spine-surgery technology portfolio following the 2021 acquisition. ³

Historical Israeli-market medical equipment

[pre-2020] EOS imaging’s April 2017 announcement identified an EOS imaging platform sold to Tel Aviv Sourasky Medical Center in Israel; the disclosed transaction involved medical imaging equipment rather than agricultural produce or consumer groceries. ²

Settlement-origin products

No public evidence identified of products manufactured in Israeli settlements being sold, sourced, relabeled, or distributed by Alphatec or its identified subsidiaries.

Country-of-origin labeling

Alphatec’s 2024 annual report describes the FDA and other medical-device regulatory requirements applying to manufacturing, identification, labeling, storage, importation, and distribution. ¹

No public evidence identified of an Alphatec-specific finding, prosecution, customs assessment, or regulatory enforcement action concerning the origin labeling of settlement-produced goods.

UK or EU customs enforcement

No public evidence identified of a UK DEFRA, HMRC, EU customs, or equivalent regulatory finding concerning Alphatec’s labeling of Israeli-origin or settlement-origin products.

Corporate sourcing and labeling policy

No public evidence identified of a published Alphatec policy specifically addressing procurement from Israeli settlements or the labeling of products originating in occupied territories.

Israeli medical-device regulatory registrations

No public evidence identified establishing a specific current Israeli Ministry of Health registration, product license, or authorized representative for Alphatec, SafeOp, or EOS imaging.

Medical technology and surgical applications

[pre-2020] Alphatec announced FDA clearance of its automated SafeOp neuromonitoring system in 2019, describing technology intended to monitor neurological function during spinal surgery. ⁷

No public evidence identified that SafeOp’s medical-device clearance established authorization, distribution, or procurement by an Israeli government institution.

Investment, Capital & Financial Exposure

Corporate acquisition history

[pre-2020] Alphatec announced its acquisition of SafeOp Surgical on 8 March 2018, including upfront cash consideration of $15 million, a $3 million convertible note, equity, warrants, and contingent consideration. ⁶

On 16 December 2020, Alphatec announced a renewed agreement to acquire EOS imaging for $79.7 million plus retirement of $37.2 million of debt, in an all-cash transaction. ¹³

EOS imaging’s contemporaneous announcement specified an offer price of EUR 2.45 per ordinary share and identified Fosun, Bpifrance, the founder, and the CEO among supporting shareholders. ¹⁴

In January 2021, transaction counsel Gide confirmed the planned cash tender offer and identified the principal transaction advisers. ¹⁵

Alphatec acquired a controlling interest in EOS imaging on 13 May 2021 and the remaining ordinary shares in June 2021, achieving 100% ownership. ⁴

Alphatec’s second-quarter 2021 announcement confirmed completion of the EOS acquisition and commencement of operational integration. ³

Acquired Israeli operating companies - I-ECON Acquired-Identity

The identified wholly owned operating businesses include Alphatec Spine, SafeOp Surgical, and EOS imaging; the available corporate disclosures do not establish any of these businesses as an Israeli-incorporated operating company. ¹

No public evidence identified of Alphatec acquiring or holding a controlling interest in an Israeli operating company.

No acquisition date, price, Israeli manufacturing location, Israeli workforce, Israeli revenue, or national-market position could therefore be verified for an acquired Israeli operating subsidiary.

Foreign direct investment in Israel

No public evidence identified of Alphatec establishing or acquiring an Israeli factory, warehouse, office, technology centre, data centre, or real-estate investment.

Research and development investments

Alphatec’s 2024 annual report identifies research and development as a component of its medical technology operations and reports consolidated research and development expenditure. ¹

No public evidence identified of an Alphatec-operated Israeli research centre, accelerator, technology laboratory, or Israeli government-funded innovation programme.

Parent and beneficial ownership

Alphatec Holdings is a Delaware-incorporated, publicly traded holding company with operating subsidiaries; the 2026 proxy identifies multiple institutional, executive, and other beneficial shareholders rather than a single disclosed Israeli controlling parent. ^{1, 16}

The 2026 proxy reports BlackRock beneficial ownership of 5.01% and a Squadron Capital-related reporting group beneficial ownership of 6.76%. ¹⁶

The same proxy identifies Squadron Capital LLC, Squadron Capital Holdings LLC, Jennifer N. Pritzker, and David R. Pelizzon in interconnected beneficial-ownership disclosures. ¹⁶

Patrick S. Miles had reported beneficial ownership of 3.20%, while David R. Pelizzon had reported beneficial ownership of 6.98%, using the proxy’s methodology as of April 2026. ¹⁶

No public evidence identified establishing Israeli beneficial control of Alphatec Holdings.

Controlling-principal investments

The 2026 proxy identifies Patrick S. Miles, David R. Pelizzon, and other directors and senior officers with relevant ownership or governance positions. ¹⁶

No public evidence identified of a material personal or family-office investment by Alphatec’s identified controlling principals in a named Israeli company.

No public evidence identified linking an Alphatec director’s personal investment vehicle to a named settlement enterprise.

Portfolio investments

No public evidence identified of direct Alphatec investment holdings in Israeli-domiciled companies, Israeli sovereign bonds, Israel-focused funds, or settlement-operating companies.

Financing the Israeli state

Alphatec’s recent financial reporting describes a medical technology business and corporate financing activities; its May 2026 results announcement also described refinancing through a bank facility. ¹⁷

No public evidence identified of Alphatec underwriting Israeli sovereign bonds, distributing Israel Bonds, lending directly to Israeli state institutions, insuring Israeli military operations, or arranging Israeli defence-sector financing.

Passive shareholder exposure

The 2026 proxy identifies BlackRock and Squadron-related entities as beneficial shareholders, but that disclosure alone does not establish any particular investment transaction by Alphatec into the Israeli economy. ¹⁶

No public evidence identified of direct Israeli portfolio assets held by Alphatec itself.

Operational Presence & Market Activity

Historical physical customer presence

[pre-2020] EOS imaging’s 5 April 2017 announcement identified Tel Aviv Sourasky Medical Center as its first Israeli EOS system customer and described the expected installation at Dana-Dwek Hospital. ²

The historical announcement provides evidence of an Israeli customer sale but does not identify an EOS-owned Israeli premises or employee establishment. ²

Current offices and facilities

Alphatec’s corporate materials identify its Carlsbad, California headquarters and its operating businesses in spinal surgery and imaging technology. ¹²

No public evidence identified of a current Alphatec-owned Israeli office, warehouse, manufacturing site, service centre, or logistics hub.

Israeli employment

No public evidence identified of a current Israeli employee count for Alphatec, SafeOp, or EOS imaging.

No public evidence identified of an Israeli payroll subsidiary or established Israeli employment operation.

Taxation and regulatory registration

Alphatec’s filings identify its Delaware incorporation and US principal executive offices. ¹⁸

No public evidence identified of Israeli corporate tax residency, Israeli Preferred Technology Enterprise status, or a separately quantified Israeli corporate-tax contribution.

Israeli market activity

[pre-2020] EOS imaging described its April 2017 sale to Tel Aviv Sourasky Medical Center as the company’s first sale in Israel and stated that its imaging platform had been sold in 33 countries. ²

Alphatec’s August 2026 results announcement reported consolidated second-quarter revenue of approximately $214 million, including approximately $196 million of surgical revenue. ¹⁹

No Israel-specific portion of these reported consolidated results was established.

Market positioning

Alphatec’s 2025 financial-results release reported full-year revenue of approximately $764 million and highlighted growth in its spine technology business. ²⁰

Its third-quarter 2025 financial-results announcement reported quarterly revenue of approximately $197 million and surgical revenue of approximately $177 million. ²¹

No public evidence identified of Alphatec describing Israel as a strategic growth market, principal international hub, or material national market.

Israeli public procurement

[pre-2020] The 2017 EOS imaging announcement establishes a sale to Tel Aviv Sourasky Medical Center, a named Israeli medical institution, without disclosing a government procurement contract number or tender award. ²

No public evidence identified of a current Israeli government tender, Ministry of Defence procurement award, or Israeli critical-infrastructure designation naming Alphatec.

Settlement markets

No public evidence identified of Alphatec operating a retail, healthcare, commercial, or logistical facility in an Israeli settlement.

No public evidence identified of a named Alphatec customer, sales agent, distributor, or franchisee based in a West Bank settlement, East Jerusalem settlement, or Golan Heights settlement.

Activity after 19 July 2024

No public evidence identified establishing that the historical EOS imaging relationship with Tel Aviv Sourasky Medical Center involved continuing sales, maintenance contracts, upgrades, or other commercial payments after 19 July 2024.

Activity after November 2024

No public evidence identified establishing that the historical EOS imaging relationship continued through a new or renewed contract after November 2024.

[2023] Israeli Ministry of Health procurement notice 4000579960, published and updated on 13 December 2023, identifies Chaim Sheba Medical Center at Tel Hashomer as an additional Israeli institutional customer using EOS imaging equipment after Alphatec acquired EOS in 2021. The notice concerns repair of an “EOS IMAGING SYSTEM” through BesTech Ltd (company number 514338664), with a stated procurement value of ₪400,000 and an engagement period from 27 November 2023 to 27 November 2025. It identifies the single-supplier exemption under Israeli Mandatory Tenders Regulations 3(29). An earlier notice, 4000577836, published on 8 November 2023 and updated on 27 November 2023, identifies the same supplier, procedure 12399652, equipment, value and period. The December notice is therefore a subsequent publication within the same procurement procedure, rather than evidence of a separate ₪400,000 transaction. These records establish a second named Israeli institutional EOS equipment relationship after the acquisition, distinct from Tel Aviv Sourasky Medical Center.^{10, 22}

[2026] Israeli Ministry of Health procurement notice 4000618315, published on 15 June 2026 and updated on 22 July 2026, identifies Tel Aviv Sourasky Medical Center (Ichilov) as the procuring institution for a proposed 36-month EOS imaging system service agreement with BesTech Ltd (company number 514338664). The notice specifies €300,546 including VAT, an engagement period from 14 July 2026 to 14 July 2029, and the hospital’s right to increase or decrease the engagement scope by up to 100%. It invokes the single-supplier exemption under Regulation 3(29). This is direct evidence of a new proposed EOS equipment service procurement involving the institution that purchased an EOS system in 2017, demonstrating continuing institutional demand for EOS-related services after both Alphatec’s 2021 acquisition and November 2024.⁹

[2026] The July 2026 procurement update does not itself establish that the proposed Sourasky service agreement was executed. The official notice is classified as a procurement exemption and records that the submission deadline has passed. The independent Open Budget procurement entry for procedure 265638 identifies the same hospital, supplier and procurement number but states that a committee decision had not yet been received in its published dataset. Accordingly, the available public records establish a documented procurement process and proposed service term, but do not conclusively establish a signed agreement, final approval, commencement of paid services or completed financial settlement.^{9, 23}

Corporate Structure & Foundational Ties

Legal identity

Alphatec Holdings, Inc. is incorporated in Delaware, United States, and maintains its principal executive offices in Carlsbad, California. ¹⁸

Alphatec’s corporate governance materials identify Patrick S. Miles as Chairman and Chief Executive Officer, with service in those positions beginning in October 2017. ²⁴

Founding in Israel - Israeli-Nexus Floor

No public evidence identified that Alphatec Holdings was founded or originally incorporated in Israel.

Israeli headquarters or principal management

The company’s SEC filings identify its principal executive offices in California. ¹⁸

No public evidence identified of an Israeli headquarters, dual headquarters, or principal management office in Israel.

Israeli tax residency or PTE status

No public evidence identified of Israeli tax residency or Preferred Technology Enterprise qualification for Alphatec Holdings or its identified operating subsidiaries.

Israeli capital ownership or control

Alphatec’s April 2026 proxy identifies BlackRock, Squadron Capital-related entities, Patrick S. Miles, and David R. Pelizzon among its disclosed significant beneficial owners and management shareholders. ¹⁶

No public evidence identified demonstrating that Israeli capital exercises beneficial control over Alphatec.

Subsidiary ownership

Alphatec’s 2024 annual report identifies Alphatec Spine, SafeOp Surgical, and EOS imaging as wholly owned operating subsidiaries. ¹

EOS imaging became wholly owned in June 2021 following Alphatec’s acquisition of its remaining ordinary shares. ⁴

No public evidence identified of an Israeli-incorporated subsidiary controlled by Alphatec.

Historical group restructuring

[pre-2020] Alphatec’s historical financial disclosures record the September 2016 transfer of its international distribution operations and agreements to Globus Medical Ireland Ltd. and affiliates. ⁵

The associated international supply agreement was subsequently terminated in August 2021. ⁴

No public evidence identified establishing that this divestment transferred a specifically identified Israeli operating entity.

Board and governance

The 2026 proxy identifies Patrick S. Miles, Mortimer Berkowitz III, Quentin Blackford, David Demski, Karen K. McGinnis, David R. Pelizzon, and Keith Valentine among its directors. ¹⁶

The company’s governance disclosures describe board oversight and committee arrangements for its publicly traded medical technology business. ¹²

No public evidence identified of an Israeli government appointee, Israeli state-owned controlling shareholder, or Israeli government golden share.

Defence-industry and state affiliations

No public evidence identified of a verified contractual or governance relationship between Alphatec’s identified controlling principals and the Israeli Ministry of Defence.

No public evidence identified of an Alphatec governing document requiring support for Israeli state policy or military programmes.

Structural governance restrictions

No public evidence identified of founder-share rights, charter provisions, special voting securities, or mission restrictions connecting Alphatec’s governance to the Israeli state.

Profit Repatriation & Economic Contribution

Consolidated financial scale

Alphatec reported revenue of $611.562 million for 2024, compared with $482.262 million for 2023. ¹

For 2025, Alphatec reported consolidated revenue of $764.155 million, representing approximately 25% growth over 2024. ²⁰

For the six months ended 30 June 2026, Alphatec reported consolidated revenue of $405.621 million, compared with $354.724 million for the corresponding 2025 period. ¹⁸

International revenue

Alphatec’s 2024 annual report presented $40.295 million of international revenue in 2024, compared with $36.911 million in 2023; these figures represent geographic aggregates and do not separately disclose Israeli revenue. ¹

No public evidence identified of a reliable Israel-specific revenue breakdown for Alphatec or EOS imaging during 2021–2026.

Historical Israeli revenue

[pre-2020] EOS imaging announced an Israeli system sale in April 2017, but the announcement did not provide a transaction price, recurring payment schedule, or country-specific profit figure. ²

No public evidence identified of the original customer’s subsequent purchases or recurring payments after the 2021 acquisition.

Profit repatriation

Alphatec Holdings operates as a holding company, with financial reporting consolidated across its operating subsidiaries; its 2024 annual report describes dependence on subsidiary distributions and other payments for holding-company cash obligations. ¹

No public evidence identified of profits generated by Alphatec’s global operations being repatriated to an Israeli parent entity.

No public evidence identified quantifying profits generated in Israel and subsequently distributed to Alphatec Holdings or another foreign parent.

Israeli tax contribution

No public evidence identified of a separately disclosed Israeli corporation-tax payment, employer contribution, government royalty, or other tax remittance by Alphatec or its identified subsidiaries.

Israeli investment income

No public evidence identified of dividends, bond interest, portfolio gains, or fund distributions received by Alphatec from identifiable Israeli investments.

Government payments

No public evidence identified of Alphatec paying Israeli state royalties, settlement municipal fees, or government concession payments.

National economic role

[pre-2020] EOS imaging’s 2017 announcement described Tel Aviv Sourasky Medical Center as an important Israeli medical institution and national referral centre, establishing the institutional context of the historical equipment sale. ²

No public evidence identified of Alphatec being designated a strategic Israeli employer, national infrastructure provider, major Israeli medical-device manufacturer, or essential Israeli defence supplier.

Settlement-derived revenue

No public evidence identified of revenue generated through Alphatec products, services, facilities, distribution, or licensing arrangements in Israeli settlements.

Post-July 2024 economic contribution

No public evidence identified quantifying Israeli economic activity by Alphatec after 19 July 2024.

Post-November 2024 economic contribution

No public evidence identified establishing a renewed Israeli contract, additional Israeli capital expenditure, or settlement-related economic transaction after November 2024.

[2023–2026] Two post-acquisition Israeli Ministry of Health procurement records identify proposed financial engagements involving EOS imaging equipment and BesTech Ltd: ₪400,000 for repair of Sheba Medical Center’s EOS system over the stated 2023–2025 period, and €300,546 including VAT for Sourasky’s proposed 2026–2029 EOS system service agreement. These are disclosed institutional procurement values, not verified revenue received by EOS imaging or Alphatec. The 2026 government notice explicitly denominates the Sourasky amount in euros; the independent Open Budget entry displays the figure with a shekel symbol, creating a secondary-source currency inconsistency. The original Ministry of Health notice provides the stronger evidence for the €300,546 denomination.^{9, 10, 23}

[2023–2026] - no public evidence identified: the reviewed procurement notices, Open Budget entry and BesTech partnership disclosure do not establish whether BesTech purchased spare parts, software, warranties, technical support or other services from EOS imaging, whether EOS receives licensing fees or contractual revenue shares, or whether BesTech remits any portion of hospital service payments to EOS imaging or Alphatec Holdings. No executed manufacturer–distributor contract, invoice, payment confirmation, transfer-pricing schedule or Israel-specific revenue allocation was identified in those records. Consequently, the procurement values cannot be attributed to Alphatec’s consolidated revenue or profits, and no quantified upstream financial benefit to EOS imaging or Alphatec can be established from these sources.^{8, 9, 10, 23}