Keep the stock price moving up, and at a nice steady pace so insiders can dump. Check the Insider sales to back this up.
Once the stock gets high enough, then announce a secondary to get more cash. Talk it up that you are cash flow positive but in part due to the tremendous amount of insider option proceeds from the exercise of options.
In case the market doesn't like the above, make sure you have some solid "silver bullet" press releases to put out in the market to support your plans. The secondary was going to suck, and the new release gives it some juice.
Not only can NXTM manage their product, but I think they can manage their stock price.
You have a problem with automatic exercise and sales? They have to file their intent long before the actions take place, and it looks to me like these are very typical transactions, not some tomfoolery designed to dupe others.
Boy, that sounds pretty jaded. You are aware that when stock options are granted, especially to higher tiered executives with track records of success in building a company, there are often pretty tight restrictions on how and when their options are allowed to be exercised, vested, and sold. I have been watching the activity from the inception of the company since I am one of the originals and I don't really see much that surprises me about the stock price or stock option activity. I am confused as to what you expected to see. I see capitalism at its best, fueling innovation and profit. I see no victim here, only healthier patients. The market is only going to get larger as the Baby Boomers become Type II diabetic and need dialysis. They have the money to fund alternative therapies. Go NxStage...
Granted there are huge benefits to all of mankind here. We all get that. Insider sales leading up to a secondary? Let me boil this down. "hey man! We need some cash around here. Quick, anyone on the table with options, you need to start selling before we announce this secondary."
Maybe it didn't happen that way, that much I'll give you. BUT....what I would like to see is more insider selling now that the news is out. This would back up your statement that the sales were methodical and planned. If they were planned, then the INSIDER SALES should be occurring at the same pace before and after the news of the secondary.
I love this stock don' get me wrong. I love watching insiders sell.