Matthew Thompson, Endologix - Innovative Interventions for Vascular Diseases | LSI USA '24

Matthew Thompson  0:03  
Thanks very much. So I'm Matt Thompson. I'm CEO of Endologix. And I'm delighted to be here to tell you a little bit about our company today. So, Endologix. We're a privately owned company by Deerfield management, we're actually just up the road in Irvine. We're a commercial stage medical device company within the interventional vascular field. At a high level, our aims to improve the lives of patients with vascular disease through disruptive solutions, and we very much concentrate on a patient population who has unmet clinical needs. So we try to challenge the status quo. And we're very much not a me too company. In terms of where we're at commercially, by the end of this year, we're trying to have revenue at scale, over 120 million have double digit top line growth, and as I'll go through, have a pathway to profitability. This is really our journey of the current company started in 2020 when we went private. Since that time, we've been transforming the business by stabilizing and growing the revenue associated with our abdominal aortic aneurysm products. We've also broadened the product portfolio and reduced our cash burn. What we're trying to do is get ourselves in a position to IPO. When the market opens, we want to get revenue at scale, double digit growth have a pathway to profitability. And as we're moving towards that scenario, we're having a debate about whether we raise a crossover round to invest in the parameters that you can see on the slide. But the very end of the talk today, I'll talk a little bit about our strategy for continued growth. So these are our currently commercially available product lines. We have two products for use in endovascular repair of abdominal aortic aneurysms, the Alto and the graft and a FX to globally the total addressable market for these devices is around 2 billion with about 38,000 procedures done last year in the US. More recently, we acquired a company PQ bypass in 2021. And we're now commercializing percutaneous transmural arterial bypass with the digital system. This has a large global tam of around 5 billion. And around 50% of that addressable market is within the US where there are around 100,000 procedures done a year for patients who have long superficial femoral artery occlusions. So a little bit more about the products now we have two platforms. To treat patients with abdominal aortic aneurysms both disruptive, we have the Alto endograft, which is an amazing piece of technology. It uses liquid polymer that is hardened inside to to give structure to the graft and produce a customized aortic seal. This graft is the lowest profile and the graft on the market and has the broadest applicability with excellent long term durability data. We also have the ASX 200 graft that was approved by the FDA in 2016. This is a device that's very easy to use. It produces a reproducible quick procedure with a low radiation dose and is particularly suitable for patients who've got narrowing of the aortic bifurcation. So coexisting peripheral vascular and aneurysm all disease in terms of how we see the triple A market this is a relatively stable market for us at the moment. epidemiologically aneurysms are relatively flat across the world. The numbers are coming back after COVID. But the market is relatively well established. We have two good quality, high quality under graphs. And within the US we have the third position in the market have around 10% of market share, as I said in 2023 will do around 100 and $10 million globally in aneurysm revenue. And as we go forward, we plan to grow that around 5% year over year, we think this is a stable good market, the market is very unlikely to be disrupted given the barriers to entry. And as I'll explain as we build out our commercial sales force, we plan to take share in the AAA market. going to spend a little bit more time now talking about P tab percutaneous transmural arterial bypass using the detour system. This is a system within a procedure that consists of an end across catheter as you can see on the top of the screen here, and torus PTFE nitinol covered stent grafts. These are used in conjunction to perform femoral popliteal bypass but in an endovascular route, and you can see on the diagram here, blood is being routed around the femoral artery occlusion, not using an intra arterial route as all other endovascular procedures do. So this is a very differentiated procedure. So why would we do that? Well, for patients who have long occlusions of their femoral artery, most professional society guidelines will recommend open femoral popliteal bypass surgery. This has great durability, but it's invasive patients are in hospital for a long period of time and their recovery takes months rather than days. For that reason, physicians tend to use endovascular solutions off label and whilst successful in the short term. These procedures are simply not durable. And what we're trying to do really is offer the best of both worlds. To put some numbers on those parameters. If you compare the detour procedure to open femoral popliteal bypass surgery, you can see that the detailed procedure has significant advantages in terms of length of stay risk of infection, 30 day readmission rates and morbidity whilst the durability of detour and open surgery is very similar. If you look at a comparison to endovascular surgery, again, if you look at patients with long occlusions you'll see that the detailed procedure has an approximate 40% One year patency advantage. So how are we doing in terms of our launch, well, detour had FDA breakthrough device designation. We had the graft approved with an original PMA, in June of 2023, we went through a targeted market release through the majority of 23 to reduce and reduce the risk of reimbursement getting through value analysis committees and our commercial model that was very successful. And we're now in a full market release this year, where we're trying to penetrate that 100,000 procedure tam around 1% in 2024. Our initial outcomes with this procedure have been very good, really good technical success. Procedural duration is coming down with a learning curve. We have attractive reimbursement with a CPT code, and two tariff uplifts and Tappen CPT and from therapy introduction perspective, we've been very careful to build a P tab community. Little word now on how we commercialize our products within the US. We're commercializing the AAA platforms and the digital platform directly. We have around 65 reps and specialists at the moment in the US and plan to add another 15 this year to support the digital launch. And to drag some AAA revenue through with that. outside of the US our revenue is largely split between Japan and Europe where we have a hybrid model in Europe and an indirect model in Japan. So in terms of our revenue ramp, this is what it looks like. Over the next few years, as I said we did around 110 million in triple A revenue in 2023. The aneurysm revenue will grow approximately three to 5% year over year. And you can see that our double digit top line growth comes from the detour procedure. Until terms of our pipeline, you can see on the left hand side of this slide, we've got our three currently commercialized products. We will be making some small iterations to the end across and Taurus catheters for detail as we get feedback from our therapy launch. And we're constantly looking for m&a opportunities, as well as partnering with the Deerfield Catalyst group to produce an endograft for the treatment of aortoiliac occlusive disease. So finally, I'll just leave you with our investment highlights as we get through 2024 and then consider an IPO when the market opens. Thanks very much for your attention.