7 Comments
Nov 19, 2023Liked by Trung Nguyen @SWIs

slow and steady wins the race :)

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yes, and with as little attention as possible. just quietly winning surgeons' heart (pun intended) in new markets.

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Nov 16, 2023Liked by Trung Nguyen @SWIs

Aren't you concerned that the organic growth was negative and only FX gains leading to the +6.5% in Q3? Furthermore, the number of CBAG surgeries are slightly declining due to the increased use of stents.

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Nov 16, 2023·edited Nov 16, 2023Author

Hi Rocko, great comment, thank you! I am not worried, I have factored reasonable growth for the next 10 years with an assumption that Medistim remains as a leader.

That implies the installed base to rise steadily, maybe tougher for this year with tighter budgets at hospitals but the long-term trend supported by the increased penetration of assisted technologies used in bypass surgeries which is supported by the motivation for better patient outcome/reducing costs & readmission, and preference for minimal invasive procedures.

Stents will increase as it's also effective and shorter recovery, however that doesn't mean it will replace bypass surgeries, if doctors have to choose between the two, bypass surgeries is their choice, particularly in more serious cases, or when patients have diabetes. I'm not qualified to judge the nuances, but, I believe in the long-term and that if it takes 30 years to convince surgeons to use TTFM and imaging technologies in 3.7/10 procedures, it will take many many years to leave it or switch to other technologies.

I'll leave you a quote here, please let me know what you think. I could be very well wrong on Medistim :). Thank you!

"For three-vessel coronary disease, bypass now has been shown to be superior to stenting, with the possible exception of some cases in which the narrowing in the artery is very short," Cutlip says. "But by and large the debate is settled that bypass surgery is better."

https://www.health.harvard.edu/heart-health/bypass-or-angioplasty-with-stenting-how-do-you-choose

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Great breakdown of the business model and your approach to valuation.

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Thank you Amrita!

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What do you think about the poor Q4 numbers? -17% (currency-adjusted) is quite tough. Do you have a view how GLP-1 may be impacting their business?

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