As the new year gets under way, investment bank Jefferies says there is a generally upbeat mood in medtech.
Analyst Raj Denhoy met last week with executives from several of his buy-rated investment picks, including the CEOs of Abiomed, Edwards Lifesciences, AxoGen, Hologic and Teleflex, and identified the growth drivers to watch for these companies and others in a report to clients.
Denhoy said meetings with the CEOs of two sector top performers, heart specialists Abiomed and Edwards, were especially encouraging. Nerve repair device maker AxoGen is undervalued, he said, while Hologic is refocusing on its core breast health and molecular diagnostics segments. Teleflex should benefit from earlier-than-expected regulatory approval in Japan of its UroLift treatment for enlarged prostate.
Here is the analyst's take on what will drive growth in the year ahead at eight medtechs in Jefferies' coverage universe.
Abiomed. The maker of the Impella heart pump in January preannounced a 30% increase in fiscal third-quarter revenue, exceeding Jefferies' 25% growth projection. Beyond the outperformance of its core business, an underappreciated potential catalyst for Abiomed is a study now under way of Impella in ST elevation myocardial infarction (STEMI) patients, Denhoy said. The study ultimately could lead to an additional 250,000 patients being eligible for the therapy, doubling the existing patient pool.
AxoGen. A fourth-quarter revenue miss was a blow to the maker of nerve repair products, but the stock's valuation could be putting in a floor at 3.5 times 2020 sales, which is well below where a company with AxoGen's growth should trade, Denhoy argues. The company attributed the stumble to a change in its sales leadership in December, and concerns linger about a continued impact on sales, the analyst noted. But "with a restoration of faith in the outlook and size of the opportunity, that multiple will likely go much higher," he said.
Edwards Lifesciences. The market in severe aortic stenosis is much larger and will support growth for longer than previously thought, Denhoy said. The market for transcatheter aortic valve replacement (TAVR) is expected to reach $7 billion by 2024, a 12% compound annual growth rate from the $3.5 billion in 2018. The market could move aggressively toward TAVR for low-risk patients even if pending data does not show superiority over surgery, the analyst said.
Teleflex. The approval in Japan in November of the UroLift system for treatment of benign prostatic hyperplasia (BPH), or enlarged prostate, came about a year earlier than expected and will add upside to the company's growth forecasts particularly in fiscal 2020. Teleflex is accelerating SG&A and R&D investments in the product and exited 2018 with more sales reps than originally planned.
Haemonetics. The company is moving from turnaround mode to growth as it rolls out its NexSys plasma collection system. Feedback from users of the new device has been bullish, "lending comfort to our bull thesis that the rollout likely carries substantial upside to EPS as it kicks into high gear," Denhoy said in the report.
Hologic. The company's core breast health and molecular diagnostic segments outperformed in the first quarter while the aesthetics business, acquired from Cynosure, disappointed again. Hologic is stabilizing the laser treatments business and has scaled back ambitions for it, with the result likely being steady mid-single-digit revenue growth. "Maybe it isn't as sexy as before and it will be little more boring, but consistent execution should create value over time," Denhoy wrote.
Medtronic. The medtech giant is sticking with long-range targets of 4% organic revenue growth and 8% EPS growth despite weakness in its cardiac and vascular group (CVG) and a projected higher tax rate. The sales slowdown stems from concerns about a rise in mortality rates with use of the drug paclitaxel in peripheral artery disease treatments, and from a guideline change that is shifting heart transplant patients from left ventricular assist devices to alternative therapies. Medtronic expects strength in other divisions to offset the CVG shortfall.
ViewRay. The maker of the MRIdian system, which combines MRI and external-beam radiation therapy to both image and treat cancer patients, preannounced fourth-quarter result that were slightly ahead of Jefferies' expectations. New Chief Commercial Officer James Alecxih, an Intuitive Surgical sales veteran, is expected to employ the "tried-and-true approach of his alma mater" to engage hospital customers and drive the company's expansion.