That is good news. Looks like the comment period runs thru 7/24. Just having it up for public comment onCMS should help the GHDX staff with negotiating payment for tests already sold.
Thanks for the explanation. Beleive I may have seen some discussion of this reservoir interconnection project on the website. The interconnection is critical since it is apparent that the Cantareira reservoir does not recover at the same rate as some of the other reservoirs.
Bit of a share price down draft the last couple days but the support just above 6 held. Going into the dry season it would be irresponsible to relax the draught incentives just because the reservoir is more than twice as full as last year. Long story short, we are probably looking at another depressed revenue year since SBS will probably continue to encourage reduced use.
The market does not appear to be receiving the latest PR all that well. My problem with the PR statements is that they focus on the shift in decision making as the most important factor, rather than what is the false negative rate (ie. agressive cancer cases missed by the test). This is probably a function of the fact that this can play out over several years or a decade. Such data should become available in the next few years. Unfortuantely until such quantifyable data is available, some physicians will take a pass. The billing code approval will be a huge help but I think definative false negative rate data at 5yr, 10yr etc. will probably mark an even larger threshold. It will probably need to be judged as GPS score vs the time without metastases to bone or other organs.
Looks like additional showers have been firing up today as well.
Funny thing is that the two critical reservoirs (Cantareira & Altotiete) don't seem to recover significantly after significant rainfall events. It seems like they must have very minimal watersheds. At some point it nay be necessary to rework parts of the supply system to add pump stations and piping to lift water from some of the other reservoirs that recover and maintain a more stable supply.
In my experience most take overs occur at the point where it becomes immediately apparent that the acquisition will be accretive to the bottom line. I've only been in GHDX for about a year. During that time they have given guidance of slow revenue growth and losses while they ramp the sales force for prostate and establish a foothold in Europe.
I actually see the recent downdraft as a positive. Many of my most profitable investments have been slammed down as major holders try to trip stop loss sales to free up shares. Either way the next quarter or two should indicate if things break the way GHDX has guided.
Again this is backward looking. What I'm interested in is whether the forward guidance is correct. I know that they are significantly increasing costs to market in Europe and detail the new prostate test in the US. This is occuring at a time when revenues are growing at low single digit rates. Hence the loss. GHDX is guiding to an inflection point mid year where growth will increase well into the double digits (20% or so). Can you offer a reason why this guidance should not be beleived?
Still indicating double digit Rev growth in 2nd half 2015 and a return to profitability for full yr 2015. Obviously this is based on receipt of CPT reimbursement code for prostate test during the 2nd qtr. They did indicate that they reserve the right to update guidance midyear. You can expect that they will do so if the reimbursement code is not received.
So far I have not seen any reason to doubt the GHDX guidance. Anybody else?
Looks like an attractive opportunity to add shares.
I live in Illinois and the past couple weeks have been a all out media blitz to try to cajole state legislature to back the low carbon energy initiative. I'd say the commercials are running about 8 for to 1 against. The commercials are based almpsed exclusively on the negative economic impacts to the state if EXC closes some of the Nuc plants. Unfortunately, I think they are missing an important consideration - the nucs ran at 95% capacity during each of the polar vortexes last year where coal and nat gas experienced issues (freight train delays, nat gas demand related shortages etc.).
The oposition paints it as a State bailout for EXC, however they miss the point that much of the problem is the State and Fedsubsidy supported wind energy results in times when electricity generated by EXC has 0 value. In a sence, the subsidies are only correcting the previous meddling by the government.
Unfortunately, with an ever increasing proportion of its business being derived from Western Europe GHDX will be vulnerable to the currency headwind that is hitting the large multinational companies. The reimbursement code for prostate has the potential to provide alot of relief in the near term, so I don't think GHDX will get slammed too hard if there is a currency related miss.
Hard to use traditional valuation models since there are so many moving parts. Right now GHDX has to fight for a much of their reimbursements which means a certain percentage of their sales are either non-recoverable or they receive payment for a fraction of what they are seeking. The COGS is still fixed so the profitability is getting trashed in the short term. This can change quickly with the reimbursement codes.
Roche acquired FMI shares at a 109% premium to the pre-announcement price. GHDX is probably less likely to be pursued by a big pharma company (maybe LH or DGX). Since there are few barriers to stop competitors from developing similar tests, I think the premium would be substantially less. Generally companies like LH like to acquire the technology and conduct the tests at many of their labs. The GHDX model is to maintain propriety by testing all samples at a single facility. Thus, it would not be easy to cut the costs through synergies.
I think there would be major resistance to anything less than the typical 30% premium commonly seen for biotech and innovative health care companies. It is all hypothetical. Some demonstrated sucess in liquid biopsy or prostate reimbursement could change the valuation dynamics quickly.
There would undoubtedly be minority shareholder lawsuits if the terms of the go private were not beneficial to the minority share holder. The potential for litigation would make far less likely.
I've had concerns about the going private issue in the past. It is always an issue when more than 50% of the shares are consolidated in just a couple hands. However, I think the relatively stagnant share price is more a function of inefficiencies. Without the Medicare/Medicaid reimbursement codes payments from insurance companies, Medicare, even individual patients are resolved on an individual basis usually requiring too much time and effort. Western Europe is actually growing quicker because they have a more streamline reimbursement model. The US is a couple years behind Europe on many of these issues (biogenerics legislations, reimbursement of genomic testing, etc.).
Just stating that your projection is much higher than the Company's own guidance. I think the $1B by 2020 that GHDX offers as guidance is based on prostate projection based on the growth trends observed in Onco DX Breast. Prostate might well be greater since there is actually a greater need since a high % of the disease cases are indolent and are unlikely to kill the patient. Furthermore, GHDX may be lowballing in UPOD mode. Mid 20% growth vs 50% growth is a stretch. If things go right (competitor tests such as prolaris are proved inferior, etc.) , $2B is possible Especially if they expand to diseas management, reoccurence, monitoring etc.
With regard to liquid biopsy (LB), it appears to be the Holy Grail. There are a lot of firms working on this. Some of which may be better funded or have top notch partners (FMI). I think GHDX should definately pursue LB but it is presently hard to prescribe a $ to this effort.
I'm listening to the MNTA call (one of my other holdings that just got approval for generic copaxone). My theme of investing in companies that save health care costs (like GHDX) keeps playing out positively (also hold NVS partially for the Sandox biogenerics business). This theme sould have a 10 yr or more tail since the need for cost controls will only become more apparent as the baby boom generation all over the word retires.
Good Luck FL
One of those Whale sites has the BB institutional holdings in GHDX as $422,390,000 and 13,656,319 shares. When I divide it out I come up with just under $31. Either way the market cap is relatively low (less than $1B) and the potential market for actionable information in prostate alone is more than $5B (I beleive this is the figure I recall from the MYGN Website) just on the cost savings from unneccesary treatment. So I think there is plenty of reward for those buying at today's prices.
Look at how EXACT sciences responded to the approval of reimbursement codes. I have as full of a position as I'm comfortable with, but If I desired more, I would not hesitate to add them at these prices.
If you compare GHDX to the QQQ over the Yahoo max time frame (about 10 yrs for GHDX) you get about 170% increase for both. So it has been an OK investment to date. I'm investing because I beleive prostate and changes in the way health care are managed in the US and Europe will be game changers. Obamacare mandates that hospitals get compensated for outcomes rather than per test or treatment has created the incentive to make more informed decisions using whatever tools are avaiolable. I beleive that Europe is a couple years ahead of the US on squeezing the costs out of the system (Based on NICE, and biogeneric legislation adoption). This explains why GHDX is finding it easier to grow in western Europe. Getting on the phone and haggling for individual patient reimbursements is not a profitable model. I'm pretty certain that is changing (based on review of info on the Palmetto site) and based on the recent summit at the white house. My other reason for investing is that my father died of prostate cancer in 1995. Methods to predict the agressiveness of this disease in individual patients is one of the greatest unmet needs in oncology. I'm rooting that the test is very helpful in manageing the decision process since I may need it at some point in my life.
With regards to the BB holdings, I just devided the total $ invested by the shares held to arive at the average. I don't think it should be too biased since I don't think the institutional accounts receive options etc.
CSI through out a sales figure of $2B in 5 years. This is about twice the guidance offered by the company. I definately don't think it is impossible, but I beleive this is a profitable investment even based on the $1B guidance offered by GHDX. This would entail mid 20% growth at a time when there is not much growth to be found at a reasonable price.
I looked for the ML downgrade and did not see it. TD Ameritrade is not pulling up links to analyst downgrade. I think their network is being worked on tonight. Found the attached upgrade though. Scotia is not exactly a big name. There are a lot of calls being made based on Macro situation and the anticipated currency direction. Commodity consuming economies like India get upgraded and exporters get downgraded.
Saw a video from another large protest demanding impeachment of Dilma. Political situation may have played into the downgrade.
I'm of the mind that SBS is a long term hold, but I don't think this will be a great year for SBS (i.e. probably won't bounce back to predrought usage volumes). While the critical reservoir is about 2.5 times greater capacity than last year, it is still not at a point where usage should return to predrought normal levels. It is likely that the economic incentives for reduced usage will continue through this year's dry season. SBS is spending money on capital improvements that should improve the system functionality, but will eat into profits. I expect that tariffs to compensate for these improvements will likely continue. The reality that water and sanitary services are a necessity and may cost more will sink in.
SBS has been beaten down, if the currency situation stabilizes a decent recovery of the share price should ensue. If not, SBS might bump along this bottom for awhile.
9:39 EDT SBS SABESP upgraded to Outperform from Sector Perform at Scotia Capital
I recall the Baker Bros adding shares into the Mid 30's and when I calculate their ave pps I come up with $31.98, so it really has not run up like alot of biotechs. I don't think most investors realize the critical need for actionable test data in treating prostate cancer. I first bought in when the Cleveland Clinic Urology paper came out. The process plays out slowly as study data is collected and papers confirming the results are presented. However, prostate looks to be following if not slightly ahead of the Onco DX Breast. The critical inflection points are the reimbursement codes. I'm optomistic since they just built a Onco Dx Prostate sales force a little over a year ago and have 1400 Docs using the test with more than 50% (need to go back to the cc for the exact #s) reordering. I recall a 160% increase in the volume of tests ordered.
Seems like Europe is more in tune with the the GHDX marketing pitch to reduce overall treatment costs by eliminating patients that will not benefit. I think there is presently a fair amount of resistence to this in the US. Hospitals are supposed to be graded on outcomes not proceedures. This should help. Obama had a roundtable meeting at the White House touting the need for this type of testing to improve treatment cost effectiveness. However, like alot of things it is mostlysound bites but they did not ramp staffing to get the tests reviewed and approved.
Not sure if you are aware that GHDX owns 10% of NVTA which went public about two months ago. I don't think this is reflected in the share price.
Got to Go .