Plain Yogurt
@plainyogurt21
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Future MD, Bioengineer, Investor, Member at , Call Leader @Slingshot_Invst , ,
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Let's look at a behemoth in medical Devices, $ISRG Intuitive Surgical. with 5000+ words in the write-up, a twitter thread isn't viable for all of the research.
Link to the post here which includes a linked excel model and easier to navigate word doc:
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For any Ronnie Coleman fans out there who's stocks are down on earnings.
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This weekend's company breakdown is Intellicheck, a company I'm bullish on. It's both a high growth SaaS stock and a reopening play. I believe the assumptions priced in are conservative.
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Some recent buzz around $MYO so I thought I would do a thread to summarize my research. Read at your own peril. :)1/
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New writeup posted: This one's on the twitter fav $CLPT. Most of the info might not be new for those following the story closely. However, I think it's the first write-up to put a valuation on the biologics side.
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I created a website (very barebones, don't laugh), to allow you to receive email updates on elinical trial changes for companies.
If you A) create an account and B) input a list of tickers, you can receive a daily email on any changes in the last 2 days for your coverage list
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Imagine if everything in investor presentations actually happened.
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$MYO, spoke with the CEO yesterday and I updated my write-up with my takeaways here:
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Thought I’d join the Fintwit weightlifting 🏋️♂️ club: finally hit a 405 deadlift, 155BW.
@lhamtil
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This month, the deep dive is into Transmedics $TMDX. Founder led, at an inflection point, platform tech with disposable recurring revenue. Priced at 25x Sales, it is worth it? Check out the post here:
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A new post with some companies I'm watching in 2024 and my thoughts on each/why I'm interested. Ones I like right now are $CNTA, $AMLX, $LYRA, $TARS, $BBIO, $RCKT, $INZY, $ALNY, although I'm rethinking some positions with recent frothiness.
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Found a founder led company with insider ownership > 30%
Retention rate of > 97%
Trades at P/E < 15 look through earnings
Reopening play but stayed profitable through the pandemic.
Best in class product
Still working on the TAM and room for expansion.
Got any guesses?
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I don't hold the stock, because I expect short to medium term underperformance, but they're building a platform which could easily make it a coffee can stock. See my thoughts and valuation here:
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Thread on a nanocap: illiquid as hell but the best risk reward I see in the market currently. TableTrac $TBTC.
30% founder/ceo ownership.
Reopening play
Sticky SaaS component to product makes churn < 5%.
Best in class product for their target base, slightly boosted by covid.
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What are some of your favourite micro caps that have gone on sale? I’m looking at $smlr, $icad, $neph, $strm, $pfmt among others
I sent this out to the
@MicroCapClub
community. This is a great time to do some holiday shopping.
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Really excited about a new microcap company: $RSSS. Leader among their competition in a niche market in need of disruption.
Shifting to a higher margin SaaS offering
Led by an experienced owner-operator with significant skin in the game.
Long thread but very interesting Co. 1/
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I've had something nagging at me the past couple weeks and I wanted to look at the answer: what have the best stocks in MedTech looked like for the last 5 years? Were they the same as the previous 5? Here is some rough data on those companies. 1/
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Odd timing, but new write-up on liquidia. Wish I could have published a month ago when i bought shares or a week ago along with
@GalahadCapital
who co-wrote this. Still $LQDA is an interesting company with upside from here.
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$KROS
New case report on potential long term issues (GI bleeding) with Sota use in patients with connective tissue disorders (underrepresented in the STELLAR trial). Issues stopped after Sota stopped.
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Essentially, Liquidia has a better product targeting a possibly 5B market as a duopoly. The lawsuit has progressed in their favor and I believe will ultimately rule in their favor. Here's a summary of the bull case in meme form.
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Turns out someone has already done this stats analysis to assess powering in win ratio based trials. a 2021 dissertation titled: "CALCULATING POWER FOR THE FINKELSTEIN AND SCHOENFELD TEST STATISTIC" by Thomas Zhou
To set the case up for the pending $BBIO ATTR-CM readout in July - it is important to look at the baseline vs the $PFE and $ALNY ATTR=CM trials - .. esp. wrt NYHA Class III - which is 32% in PFE, 16% in BBIO and 8% in ALNY - ...(short thread here, so bear with me - goodies at
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Sometime a picture is worth a thousand words:
$IDN is a reopening play with a strong (partially monopolistic) moat and about to turn profitable. It is circled in red on the chart, valued at ~15x trailing GP. Disclosure: I added earlier this week at $8.
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This resonated
@SuperMugatu
encapsulated what I'm trying to do with healthcare right now.
Start at the top, work your way down, know the history, know the nuances. Become an expert so any new idea can be evaluated easily.
Fantastic Pod
@marketplunger1
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A new post on why I sold $LQDA. it's an undifferentiated product fighting an uphill commercialization battle. I break down why I think the product isn't better and my thoughts on RR:
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$SMTI Ho hum 55% growth,
Nothing to see here. 5X 22 Sales (without recent accretive acquisition).
Expect cash flow breakeven soon.
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@AKWilk
Screening for micro caps also seems to be useless Just look through every stock in an industry you like and you’ll likely find something
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I get bored as hell reading $SMLR's quarterlies.
40% growth, new products, 50% net margins, on repeat. Like clockwork.
This is a good problem to have. I wish every company was this 'boring'.
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@iancassel
$STXS Robotic endovascular surgery. New catheter in Europe will add 2k/case and replaces 15 year old tech. Management is aligned. They've starting selling new units after years of stagnation. Utilization on new units is high. The tech has a niche and should improve over time.
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@iancassel
$STRM, They sell software to hospitals to optimize billing procedures. They're essentially moving the revenue cycle upstream. The platform is rules based (not algorithm) so scalability is a ?, but they have strong MGMT, large TAM, and macro tailwinds. Profitable next year
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APRIL Portfolio Update: Since it's the end of the month, I thought I would hop on the train and post my positions and sizing. I don’t know if people care about my portfoli with all the great fund letters out there, but I I'm putting it out there nonetheless.
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"If you've done nothing for anyone else, you've failed that day"
As we begin 2022, keep this in mind as a guiding factor to stay unselfish and in service of others.
Happy New years to everyone! Wish everyone a better 2022 than 2021
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New stock breakdown: Redbubble(ASX: $RBL, $RDBBY). Less a stock pitch than a breakdown of the company. started buying on the platform last year and I like the product, but I can't tell if it's covid boosted or a long term winner, heard smart arguments for both sides 1/
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$SMLR epitome of quality. I...... I'm speechless every time the company reports, 93% GM, 74% YoY growth for firt half, 42% Net margin, trades at 34x P/E if first half numbers are doubled for the year.
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$LNTH,
Reported Q3 results and I'm puzzled at the weakness.
It trades at ~12X PE and should grow high SD even with new competition and potential price deterioration on PSMA agents. Not counting SPLASH
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I'm part of an investing club and we've recently initiated a short position in the Joint Corp. Check it out here:
In a nutshell, management is gaslighting us about growth as terrible working conditions has led to supply constraints in the business.
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$SMLR Q1 Earnings Update: Revenues of 13 million up 40% YoY with GM of 88%.
Fixed rate rev: $7.2 mil, up 11%
Variable rate rev: $5.7 mil, up 109%.
And here's the kicker: EPS (diluted) of $0.60 with Net Margins of 37%. Annualized, this is $2.40 or a P/E of 47.5
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@iancassel
Either $tbtc or $pfmt. Tbtc: 2% churn, profitable, 30% insider ownership, less than 15x earnings, improved by covid.
Pfmt: growing 30% healthcare biz, trades at less than 5x sales margins at maturity are 30%
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$PNT The discrepancy between management quality on execution and BD......... Acquisition looks good on the surface, but you're basically buying manuf and cash at that price.
PNT2002 success is expected soon
PNT2004 is progressing well.
Wonder why they sold.
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$MYO Earnings out Today:
Rev Growth YoY 98%
Gross Margin 73%
Cash Runway into 2022
Direct billing is 90% of the pipeline,
About 400k is pulled forward revenue
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Just a friendly reminder that $MYO trades at 7.8 TTM P/Sales and is growing 50%+, getting closer to breakeven with catalysts this year. Thread here:
Some recent buzz around $MYO so I thought I would do a thread to summarize my research. Read at your own peril. :)1/
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$SMLR on the NasDaq as of tomorrow. Wow, I wonder what the nasdaq will pay for a 40% grower with a large TAM, product expansion, and 50% net margins.
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$goss
Phase 3 posted
6MWD< 450M and reveal score >=5 for inclusion.
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$TARS
Blowout results it seems, 13M in revenue is a strong first 3 months.
More interesting: 6000 ECP have started patients with 50% repeat prescibers (feb 23). That's up from 4k prescribers on Jan 4. Repeat prescribers up from 2k to 3k.
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New stock: Performant Financial $PFMT. Thread here, but the blog post goes into more detail. Gotta give a shoutout for
@chcap2016
for this one, he's been pounding the table. Blog post here:
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$KROS, so it seems like they have a slightly worse luspatercept in the works…..
Mainly ESA naive population and update had no additional responses in non RS patients
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After all the $ANTX hype, when does $SPRO get some of the love? SPA for Tebipenem and a fully funded trial from GSK. EV = 0. Maybe P2a hits in 2H24, maybe it doesn't, but the upside/downside is up 5x/down 25%? If it fails, they can just close up shop a la MACK h/t
@Biotenic
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Stats model for $LNTH on splash trial using clinical trials based on a constant enrollment rate and the days teh sites were added.
Assuming 12 mo PFS for PNT2002, 6 mo for control (NVS has 12 mo and 6 mo respectively), 5% censoring rate, Then SPLASH will be complete Dec 1.
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@DeepSailCapital
@MicroCapClub
has a yearly conference. Hands down highest Signal to Noise ratio
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@AltaFoxCapital
What’s the best way to go about doing channel checks as an individual investor?
On a similar note, best way to get calls with domain experts?
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@IntrinsicInv
$SWAV, $TMDX, $PGNY, $CTKB, $LNTH. Other companies in HC trade at a premium to what one would expect based on only growth too.
It's scarcity: these companies are often the only pure-play public equities bets on large trends (CGM, Robotic surgery, etc. )
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Food Take: People don't like Veggies because they don't know how to make them.
As an Indian, we have solved this problem
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$GOSS, Blah Blah Blah, they diluted 100%+, lots of debt, but let's do a little post hoc analysis...Looks like The delta in the Phase 3 pop at 24 Weeks is 42-4 = 38m.
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@InvestmentTalkk
$trmr, less than half the valuation of magnite with what I think is better positioning in adtecb
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$AMLX TUDCA Results out. "The TUDCA-ALS study did not meet the primary endpoint, measured by ALSFRS-R scores (a measure of functional and motor changes in ALS). There were also no significant differences observed across secondary endpoints."
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@Sports_bios
Have you considered writing a case study based history of biotech? You’re a wealth of historical information from the past. The names change, the times change, but history often repeats
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I need people to stop creating shitcoins so my ticker searches on twitter for obscure microcaps aren't so clogged with shitcoin posts. I want to look at shitcos not shitcoins.
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Did you miss the $ISRG boat? Well, $STXS is another surgical robotics company which has had its fair share of troubles, but is mid turnaround, Optically expensive, the company can still be attractive if they execute 1/
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$LQDA stay denied, sold some, expecting unfavorable ruling on 793 leading to a delay in launch.
Thought stay was most straightforward path. LQDA should prevail upon appeal with an unfavorable ruling though
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Took token position in $SAGE. I think it's approved for both PPD and MDD.
1) Base rate of FDA approval is 85%. Always start there.
2) priority review means FDA does see drug as beneficial.
3) CFO has commented that FDA review has progresses as usual as late as May
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Interesting lesson I learned today: talking to a sales team is more useful than talking to IR for product info.
Especially true in some medtech, I just had an 8 min call with $IRMD sales and got more info than I could ever get from an IR department on product.
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@JoshuaTai0427
$PFMT growing 30% a year while trading at < 4x Sales. Maturity EBITDA margins will be in the 30-40% range. TAM is in the billions with a MC < 300m.
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$BBIO, Why not throw one more amateur hat into the ring? I created a google sheet for the trial to calcualte the win ratio based on just a few assumptions.
- Mortality rates
- % of patients who die first on treatment
- Manual distribution of CVH
- Mean and SD of 6MWD declines
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$IDT I know Kevin personally and he's done some great diligence on IDT. Give this article a look if you're interested in the company
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Quote: $SMLR Earnings call, CEO: asked about gross margin "You get over 90%, and you have to say -- look at yourself and say....is not a possibility that you can expect it to be sustainable. That being said, it is what it is." just an amazing business.
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For the whole write-up: check out my blog here. 25/
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For the unrolled full writeup check out my blog:
@CJOppel
@GuiPhilipps
let me know if I missed anything! Y'all introduced me to this one.
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@parekhshubham9
@CapitalCatalyst
Yup, already seen all the fintwit research on $CLPT and done my own due diligence. grown into my largest position at >20% of portfolio at one point, trimmed a little at 27, cost basis 7. Will add if it gets below 20, still my largest holding.
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@DakotasTwits
@HonestInvesting
Yes, There are a few things:
- management ran a similar playbook at Syneron before that failed
- Their sales are primarily devices (80%+) thus saturation is inevitable and these aren't recurring
- The tech isn't that differentiated.
- They can be unethical with sales (imo)
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$LQDA: Okay, after a volatile few days, let's break down what happened.
The judge ruled Claim 1 of patent 066 invalid and claim 8 non infringed (inly two independent claims)
However, the 793 patent was ruled by the district court as valid and infringed.
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I'm just now realizing why CTV is so big. The way I understand it now is that regular TV ads have no way to track performance or effectiveness. CTV gives advertisers a trove of data. It the difference between targeting and not targeting $TRMR
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Myomo $MYO: An Update
8 months on from my original write-up, here's an update on operations, their path for Medicare coverage, and how they might reach profitability.
Check out the update here:
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Goes through different trial designs, efficacy etc. Still open question whether TUDCA is driving all of the effect, but it sure seems like it's having one. $AMLX
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The lack of reaction in $SPRB to the $NBIX data surprises me......The drugs aren't the same, but NBIX jumped 500M in cap on the positive CAH announcement and $SPRB didn't move at all.
85M Market Cap and Cash 120M
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$TRMR
If you want to know about Adtech, give this a listen. learned a lot about Tremor and the adtech industry as a whole.
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$BBIO, $SAGE. Please make stop wasting immense amounts of time on this. I need a passage from the odyssey to really make my decision.
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$RCKT.
.
Study posted for Danon Disease. Patients>8 YO, LV mass index and LAMP2 expression Co primary (as expected). Troponin, NT-proBNP, EFS all key secondaries. Two sites up and recruiting. Primary completion september 2025.
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@LukeWolgram
Oh no, I’m starting to feel it, the kiss of death is coming: $TBTC is becoming a fintwit favorite
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@IntrinsicInv
$SMLR, being able to diagnose a disease with drastic consequences earlier is important for insurance companies. Not only that, but having the ability to diagnose and upcode risky patients leads to additional revenue for insurance companies supplying Medicare advantage plans
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Does March count as beginning of 2024? Will Phoenix come before TUDCA-ALS? IDK, but here's a nice review article from last december of published data using TUDCA in ALS:
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New slides for $CGEM, focusing on the CD19 bispecific in front of zipalertinib. One new slide:
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New biotech commandment: “thou shalt not use a commercial bear thesis for a drug reporting P2 results ”.
@pharmafather123
Funny enough this has been the case for years in NASH. You have one KOL call: the doc says "my patients don't want to do subQ weekly much less 2x a month for something that doesn't impact them, to benefit them 5-10 years from now"
We don't hear the truth, only when we want to..
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@warder128
@hiddensmallcaps
For those who don't have a barron's subscription: . Outline is a great resource for news stories. Thanks for the article!
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$CLRB, Do the longs have a source for the 4-12% response rate post BTKi?
We know Iopofosine has 75% ORR, 61% MRR with mPFS not reached at 8 months in a population 3/4 are single refractory to either rituxan or BTKi. DoR probably > 11 months. Grade 3/4 Thombrocytopenia 73%
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For biotech assets, what peak sales multiple do y’all use? Check back in a day to see answers. Comment if y’all use something different/modality specific
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Interesting to see the variability.
Multiple ways to skin the valuation cat, but if you assume 15% DR, 40% peak margins and ramp to peak sales in 6-8 year, the value of the P3 asset is about the expected Peak sales (200M peak = 200M value). These are base case a la pharmagellan
For biotech assets, what peak sales multiple do y’all use? Check back in a day to see answers. Comment if y’all use something different/modality specific
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$CELC, Leading a Call in 15 mins (11:30 ET) with
@Slingshot_Invst
on the data to date and phase 3 expected results. Hopefully we'll get a better understanding how much IV vs Oral matters and expectations for WT vs MT subtypes.
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$AVTE New slides with baseline info. Bodes well for the trial given worse than TORREY patient population. PBO adj change in PVR was 21% in Class 3 patients vs 10% in class 2 patients for GOSS.
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@StockJabber
@LukeWolgram
does great microcap work.
Would like to nominate myself too. I publish 1 stock pitch and 1 deep dive into a medical device company/month. I use memes too! Check out my recent posts on $ISRG and $PFMT
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Notes from the orthodontists office $ALGN. They’ve all but stopped using Invisalign and moved to spark due to cost and quality of moving teeth. They prefer spark. However they still use the iTero scanner. Wonder what happens if align decides to go exclusive? Who has the leverage?
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I have still yet to come up with a credible bear case for $CLPT other than valuation/new products. "less doctor demand" is a weak one and innovation is always a risk but takes time. It seems like a story of when, not if. Call me old school, but has anyone done a model of the co?
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$SMLR We have one more piece of a very Fascinating Puzzle:
Semler's new product is for Heart Failure.
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Posted this about $LQDA yesterday but have cleared it up since. Thank you to everyone in the comments and twitter for the help.
Brief explanation on why I'm not as worried (about the banking situation, I'm still always paranoid about something)
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There are 34 stocks in total. The top five, excluding cash, make up ~43% and the top ten positions, excluding cash make up ~62%.
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Came upon this great tweet thread. Valuation matters. If you want a company to be a generational winner, it won't be at > 20x P/Sales. It's a lot harder to grow revenue at 30% for 15 years than it is to grow at 15% with multiple expansion.
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I would point out we just developed a vaccine in less than a weekend (not counting the one year to approval time) using mRNA tech as one example of how much we’ve improved. Anyone saying tech is regressing or innovation has severely slowed down isn’t paying attention
You used to be able to cross the Atlantic in 3 hours with the Concorde in 1976.
We landed on the moon in 1969.
And in 2022 we don’t and can’t.
Instead we have Instagram models, TikTok dances and serfs delivering food to PPT-email-workers. Is real technology going backwards?
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