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NxStage Medical, Inc.(NXTM)

 
123Jump Rating: - Value Gap   Underwriters: Merrill Lynch & Co.
      Thomas Weisel Ptrs. LLC
Status: Priced  
 
Address: FiledDate: 07/19/2005
     
  Filed Price Range ($): $11-12
       
Telephone: Filed Offer Amount ($ Million): $75.00
       
Fax: Shares Offered (Millions): 6
       
Websites: Shares Outstanding (Millions):
       
Management: IPO Date: 10/27/2005
     
  Final Offer Price ($): $10.00
       
Industry: Healthcare Final Offer Size (Millions of Shares): 0.00
       
Employees: Final Offer Amount ($ Million): $0.00
       
Competitors: S-1 Forms:
     
   
       
     
     
     
       
 
- Avoid        - Value Gap        - Short-Term Growth        - Long-Term Growth        - Long-Term Value

Company Links
Executives Products Services
Quarterly Performance   

Qtr Ended

Revenues Net Income EPS
03 / 2003 13980 -2474223 -0.729999999999999982236431605997495353221893310546875
06 / 2003 20794 -2601896 -0.7600000000000000088817841970012523233890533447265625
09 / 2003 58385 -2424531 -0.6999999999999999555910790149937383830547332763671875
12 / 2003 192795 -2707849 -0.7800000000000000266453525910037569701671600341796875
03 / 2004 262262 -3648561 -1.04000000000000003552713678800500929355621337890625
06 / 2004 453819 -3445647 -0.979999999999999982236431605997495353221893310546875
09 / 2004 441940 -3631599 -1.04000000000000003552713678800500929355621337890625
12 / 2004 726548 -4115875 -1.1699999999999999289457264239899814128875732421875
Major Stock Holders   (Prior To Offering)

Name

Class A
Bruce L. Booth 7.20%
David S. Utterberg 13.20%
Jean-Francois Formela, M.D 17.30%
Philippe Chambon, M.D., Ph.D. 36.50%
Sprout Group 36.50%

Business Environment

The prevalence of end-stage renal disease, or ESRD, particularly in the United States, has increased in recent years due to the heightened incidence of contributing diseases such as diabetes, hypertension and obesity, overall aging of the population, decreasing mortality from conditions such as cardiovascular disease, and increasing use of drugs and other treatments for serious medical conditions that can cause damage to kidneys. According to the United States Renal Data System, or the USRDS, the number of patients in the United States diagnosed with ESRD has almost doubled in the past decade to approximately 431,000 patients in 2002 from approximately 228,000 patients in 1992. According to the Journal of the American Society of Nephrology, the ESRD patient population in the United States is expected to continue to increase at a rate of 6% annually, reaching approximately 650,000 patients by 2010. Worldwide, the total diagnosed ESRD patient population is estimated to be almost four times that of the United States at 1.7 million in 2003.

Acute kidney failure, the temporary loss of kidney function, frequently occurs in conjunction with other serious medical conditions, particularly loss of other organ functions, severe infection, poisoning or post-surgical trauma. Regardless of the cause, patients experiencing acute kidney failure require some form of kidney replacement therapy, and will die if untreated. It is estimated that there are over 200,000 cases of acute kidney failure in the United States each year. Congestive heart failure, or CHF, is a common form of heart failure that typically results in fluid overload, a patient’s inability to dispose of fluids, often leading to swelling of the legs and ankles and congestion in the lungs. Fluid overload can result in further impairment of heart function, which, in turn, further reduces the patient’s ability to remove fluid. If untreated, fluid overload from CHF will lead to death. Approximately five million people in the United States suffer from CHF, and the incidence of CHF is increasing. According to the American Heart Association, it is estimated that 550,000 new cases of CHF are diagnosed in the United States annually. There are approximately one million patients discharged from hospitals annually for the treatment of fluid overload associated with CHF.

Company Strategy
A medical device company that develops, manufactures and markets innovative systems for the treatment of ESRD and acute kidney failure.

Product/Services Portfolio
The Company’s primary product, the System One, is a small, portable, easy-to-use hemodialysis system, which incorporates multiple design technologies and design features. The System One is comprised of the following components: a compact portable electromechanical device containing pumps, control mechanisms, safety sensors and remote data capture functionality; a single-use, integrated treatment cartridge that loads simply and easily into the cycler. The cartridge incorporates a proprietary disposable volumetric fluid management system and includes a pre-attached dialyzer. This fully disposable design eliminates any contact between the dialysis machine and the dialysate, thereby avoiding complex disinfection requirements associated with traditional systems; the System One uses high-purity, premixed dialysate for hemodialysis applications. The volume of fluids used varies with treatment options and prescription, but typical weekly volumes are similar to the amount of dialysate used by a patient on PD therapy.

For the ESRD market, the System One, which is specifically FDA cleared for hemodialysis use in the home, is designed to make home treatment and more frequent treatment easier and more practical. Although not performed using the Company’s product, studies suggest that therapy administered five to six times per week, commonly referred to as daily therapy, better mimics the natural functioning of the human kidney and can lead to improved clinical outcomes, including reduction in hypertension, improved anemia status, reduced reliance on pharmaceuticals, improved nutritional status, reduced hospitalizations and overall improved quality of life as patients feel better. Other published literature also supports the clinical and quality of life benefits associated with home dialysis therapy. The Company believes traditional equipment cannot satisfy the demand for home and more frequent treatment due to its complexity, lack of portability, size and infrastructure requirements. The costs of delivering more frequent therapy in center, as well as clinic scheduling limitations, present further obstacles to the broader adoption of more frequent therapy, and the Company believes the System One addresses many of the barriers to more frequent and home therapy.

For the critical care market, the Company’s System One is designed to offer clinicians an alternative that simplifies the delivery of acute kidney replacement therapy and makes longer or continuous critical care therapies easier to deliver. Because of its small size, portability and lack of infrastructure requirements, the Company’s system can be easily moved between patient rooms, set up and taken down. It can also be easily moved from the ICU to the CCU or telemetry floor to treat patients with fluid overload. The Company’s use of volumetric balancing rather than scales eliminates the frequent nursing interventions required by existing ICU dialysis systems. The ability of the Company’s system to perform hemofiltration, for which the System One is also FDA cleared in addition to hemodialysis, is advantageous, as many clinicians choose to prescribe this therapy for patients with acute kidney failure.

Investment Analysis
Revenues increased by 294% to $1.0 million for the three months ended March 31, 2005 from $262.3 thousand for the three months ended March 31, 2004.

Cost of revenues increased by 255% to $1.8 million for the three months ended March 31, 2005 from $502.6 thousand for the three months ended March 31, 2004.

Research and development expenses decreased by 5% to $1.4 million for the three months ended March 31, 2005 from $1.5 million for the three months ended March 31, 2004.

Interest income increased by 173% to $72.1 thousand for the three months ended March 31, 2005 from $26.5 thousand for the three months ended March 31, 2004.

Interest expense increased to $145.8 thousand for the three months ended March 31, 2005 from $4.3 thousand for the three months ended March 31, 2004.

Income Data 
Year Revenues Costs Oper Income Taxes Net Income EPS
2002 29524 10758570 0.00 0.00 -10980023 -3.410000000000000142108547152020037174224853515625
2003 285954 9608144 0.00 0.00 -10208499 -3
2004 1884569 13403223 0.00 0.00 -14841681 -4.25
2005 1033792 4087021 0.00 0.00 -4909133 -1.399999999999999911182158029987476766109466552734375
*As of period Ended March 31, 2005

Balance Sheet Data

Year

Cash Acct Recv. Inventory Total Cur Assets Total Cur Liability PPE Total Assets LT Debt SH Equity
2003 8880618 148686 3150349 12230240 1115536 810518 13612581 29872 -43478439
2004 5639499 524265 4410253 23108602 3903580 759008 25454934 3005717 -5739997
2005 6754967 665700 5133180 17585061 4488001 886090 20825454 2692275 -62300436
*As of period Ended March 31, 2005

Cash Flow Summary

Year

Net Cash-Ops Net Cash-Inv Net Cash-Fin Net Change
2002 -13013157 -501448 -94033 -13612189
2003 -10772408 -141586 15769221 4852757
2004 -14081219 -13892282 24704098 -3241119
2005 -5094853 6438726 -191665 1115468
*As of period Ended March 31, 2005
 

 


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