Thanks for the reply. Your explanation fits with my understanding but Vonpessal seemed to be describing something different. Just wanted to make sure I wasn't missing something. There seems to be a trend towards more sales which they refer to as capital sales vs installations under the "placement" model which was lower risk for the hospital but more costly. The placement model meant that NVDQ had to pony up for the hardware. This shift should make expansion less costly for NVDQ. All in all it sounds like they are successfully building confidence in their product and technology. The salesforce build out seems to be fairly aggressive which the market opportunities would seem to support. Now we just need to see if their new sales team can execute. Sounds like they are following ISRG's model of using a separate class of clinical field reps whose job it is to drive procedure volume. Now lets see what they plan to do with all that cash. My guess is that they are going to try to lock up significant IP, probably thought acquisition but possibly through licensing. Then again maybe they just want some of that cash to fund placements under the placement model.
Vonpezel, Thanks for your post. One question. What do you mean when you say "hospitals buying the systems, not just the devices"
guess your sub 300 Monday was a bit off the mark. Gotta stop drinking your own kool-aid
They must include that because they don't have additional funds right now but should the need arise they would have no problem raising capital
To see that you would have to know what they are going to say. This is beaten down on the assumption that things would continue to deteriorate. Considering that there was no warning this qtr there is a chance that things have not continued to deteriorate. Any hint of stability and this moves up from here. Will that happen? Not sure but your "economy not that strong tobe buying expensive equipment" argument is an old and tired one that was barely true during the worst of the economic crisis. The issue is not the the economy, it's the trends in surgery. If there is a trend towards less surgical intervention for benign hysterectomy then sales will continue to suffer for a while.
I have read only a few of your posts so far so forgive me if I asked something you have made clear in a recent post. You have made several comments about the over application of robotic surgery to benign hysterctomy. For the record, I don't necessarily disagree with you. But just so I am clear, what is it that you see as the future for benign hysterectomy? Are you a proponent of open surgery for these procedures or of standard lap? The reason I ask is that there are studies for prostatectomy that would suggest that they should all still be done as open procedures. I'm sure there are similar papers for benign hysterectomy. Just wanting to be clear on where you are coming from. Thanks you for your posts
This is a shelf registration. not a particular offering. In other words they are laying the groundwork for a future offering or series of offerings that may or may not happen and may represent all or a small fraction of this entire amount. Under "Use of Proceeds" here's what they had to say.
"Unless otherwise specified in a Prospectus Supplement, the net proceeds from the sale of the Securities will be used for general corporate purposes, including funding potential future acquisitions, capital expenditures, the investments required to commercialize PINPOINT and LUNA, the procurement of raw material supply and for future research and development of new product hardware and software and new imaging molecules such as those required for nerve imaging. The use of proceeds from the sale of any Securities will be described in a Prospectus Supplement relating to the specific issuance of Securities."
much is boilerplate including the "potential future acquisitions"
not that I doubt they will.
Under the not boilerplate part I would list
investments required to commercialize PINPOINT and LUNA
future research and development of new product hardware and software and
new imaging molecules such as those required for nerve imaging
Jut checked EDGAR DB and there is nothing there. What is the alleged date of this filing and what form is it filed under?
Thank you for sharing your detailed analysis of NVDQ and ISRG. Regarding NVDQ I think the share price may moderate between now and earnings and maybe afterwards as well. I think they are a strong mid to long term winner but some subset of retail investors will look no further than higher expenses and the fact that NVDQ has not yet reached profitability. The market typically undervalues investment in future growth in part because often it is just companies throwing money at a product because it is not gaining traction. I don't believe that will be the case here. I think their product offerings and value prop are VERY strong. I still have some non-specific concerns about the effectiveness of their home grown sales organization. That is to say that I have no specific reason to be negative. Only that it is not a forgone conclusion that they can build an effective sales organization from scratch on the first try, or at all. Again,, I have no reason to think it is not going well, only that this is an areas I am watching carefully. I have a significant position (for me) in NVDQ which I have held for several years. If I didn't I would definitely consider adding on dips.
In an earlier presentation about their stapler plans they were touting a stapler that could be fired multiple times per deployment without being retracted and reinserted for staple reload. Does anyone know if they are still developing this technology and which product will include it?
Hey endo good to hear from you. Been very busy with other things, not spending as much time on the boards these days. NVDQ is doing well. Just waiting to see how their own salesforce efforts unfold. Things are looking to be on track so far. I'm looking hard at CRDC these days. I think they are likely to get FDA approval for their new stapler and when they do they will do very well. There may be a better entry point for new investors but time is running out to take a position. I think something good is likely to happen in the next 3 to 6 months.
They have cited this several times. I did a quick search of my notes and the citation that came up was from a Sept 2010 Baird presentation. I'm pretty sure they have brought it up since then although their focus is clearly not on cardiac surgery at this point.
Independent cost saving data from CMS. For multiple years they have demonstrated that the savings for CABG is $2000-$4000 per procedure. If SPY was used on all CABG done each year in the US (est 250k) it would save $650M per year.
CABG = Coronary Artery Bypass Graft surgery.
They cited cost saving data from 2008 CMS data and then mentioned it again when the 2009 data was published. As I recall the 2008 data showed an avg savings of $2000-$3000 and the 2009 data showed $2000-$4000. As far as I know data on other procedures had not been compiled but based on other studies it seems clear that validation of the cost savings for other procedures is only a matter of time. As I said, this is precisely the kind of thing they have said they hope to encourage to save costs. Dissemination of best practices to improve the cost effectiveness of health care spending.
It is likely to be the opposite of a roadblock. Some of the best evidence of the effectiveness of Novadaq's technology in cardiology comes from statistics compiled by medicare. This is the kind of thing they are likely to encourage or maybe even require.