Ultrasound Imaging Opportunity June 6 2012 Ver 2
Transcript of Ultrasound Imaging Opportunity June 6 2012 Ver 2
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Wide Aperture UltrasonicImaging Opportunity
Presented byKim Bui
June 8, 2012
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Market Overview
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OverviewStructural shifts in global consumption and key macro trends create long-term growth opportunities
Aging population in developed world
Accelerating healthcare spending from emerging markets
Healthcare is a large and growing market globally
Expenditure driven by demographic factors: Rising income levels and increasing instances oflifestyle diseases
US is the largest healthcare market globally (16% of GDP on healthcare increasing to 20% in2020)
Medical device market expected to grow in proportion with living standards, healthcare systems,and medical insurance
Fastest growing global markets in healthcare today
Ultrasound imaging represents a low cost and effective technology that continues to helpradiologists and clinicians collect diagnostic data
Advancements in imaging technology capable of producing high-quality images at lower pricepoints
Flexibility, ease of use, relative lower cost, trend to miniaturization and wide adoption of portableultrasound equipment represents key accelerators
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Global medical device marketUS, Japan, and five major European countries (Germany, France, Italy UK and Spain) account for 14%of the global population and 70% of global medical device use today
Emerging markets (including BRIC) account for half the world population but only 7% of the global
medical device market
Developed markets delivering mid single-digit rates of growth
Emerging markets (including China and MENA) delivering 15~25% growth in the past severalyears
Recent FDA reforms will shift supplier focus towards non US markets to drive and sustain growth
.
Worldwide medical device market by segmentTotal market size in 2009: US$234bn
Worldwide medical device market by geography(market size and growth)
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China Medical Device & Equipment market expected togrow 20%
China is strengthening its position in theinternational market
Low cost and improved R&D acceleratingmanufacturing relocation to China.
Chinese firms actively involved in contractmanufacturing
MNCs expanding presence with JVs.
Chinas medical device exports totaled $12.2bn, up 10.4% YoY despite 13.9% decline ofoverall foreign trade in 2009.
Ultrasound Market in China
Valued at around $589 million(~RMB4.0bn)in 2009
13% of the global ultrasound market
expected to grow 15-20% over the medium term
Long term growth driven by replacement ofblack and white ultrasound equipment withhigher-priced color ultrasound systems
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The Brazilian Medical Market is projected to grow to $3.6billion by 2014Demographics
Population: 193 million
Annual GDP growth: 6%
Health Service Coverage: 100% ofpopulation
Population Forecast 2050: 233 million
Life expectancy: M: 69 F: 76
Current Situation
Continued government efforts to widenpublic access to health care
Increasing cardiovascular disease, cancer,respiratory diseases and diabetes
Continued government spending to improve
public health. Public health expenditures of $116 billions
in 2011
Health Tourism expected to grow further
Medical Market by Category (2009)
Opportunities:
Increased cost-consciousness within thepublic health system to improve foreignaccess to the domestic market
Growing market for preventive healthprograms and products combating non-communicable diseases
Source: Source: BMI; Brazil Pharmaceuticals & Healthcare Report Q3 2010, WHO Health and SocialDeterminants Brazil, Health Affairs no.4 2007, Hospitialar.com,Health-tourism
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Problem Statement/ Immediacy of Market Demand
U.S. still majority of the market followed byWestern Europe
Asian economies (China and India), EastEuropean nations, MENA, and Brazil representshigh growth regions
Aging population and increase chronic diseasedriving imaging market growth
GE Healthcare, Philips, and Siemens constitutethe market
Philips market share equaled to GE due toincreased focus in emerging markets
Other players include Toshiba (Japan),Hitachi (Japan), and Mindray (China)
Market sizingStand-alone and portable ultrasound machineswas worth $3.19 billion globally and forecast toreach $6.27 billion in 2017
European market represents $1.53 billionand forecast to reach $3.2 billion by 2017
Chinese market will be more than $1.29
billion by 2017, growing of 9% CAGR MENA is currently $120 million and
predicted to reach $264.14 million by 2017
Compact ultrasound imaging systems was worth$908.72 million in 2010 and estimated to reach$1.6 billion in 2017
U.S. market was $276 million in 2010 and
expected to reach $828 million in 2017
Ability to provide increasingly subtle information, such as the internal architecture of complex cysts,improves with its ability to resolve smaller and smaller areas
Source: Trimark Research, 2011
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Impact to Middle East NorthAfrica Regions
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The MENA region spent $65.6 billion (4.3% of GDP) on healthcare in 2009
Estimated to reach $125 billion by 2015
Key Demand Drivers
High population growth: 214 million people projected to reach 233 million by 2015 and 272 million
by 2025 (much higher than the global average)
Increased life expectancy: 71 years in 2009 compared to 59 years in 1980 (elderly population
increase to 20 million by 2025)
Lower mortality: 26 per 1,000 live births compared to 90
Prevalence lifestyle diseases such as diabetes, cardiovascular ailments and certain forms of cancer
Growing awareness of health insurance: adopting insurance to finance medical expenditure.
Introduction of mandatory health insurance Saudi Arabia, Abu Dhabi and Kuwait
Insufficient healthcare infrastructure
Diagnostic and Imaging centers offer growth opportunities for healthcare and medical technology
investments going forward
MENA Healthcare At a Glance
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Underinvestment in Healthcare provides opportunities todrive growth
Healthcare infrastructure far below the developed economies
Ratio of hospital beds (per 10,000 people) and number of physicians (per10,000 people) are poor compared to the US
Healthcare market isrelatively small andunderdeveloped
Spent 4.3% of GDP(about $66 billion) onhealthcare or $315 perperson
Healthcare spending in
the Gulf CooperationCouncil was at 3.8% ofthe GDP (about $35billion) or $913 perperson in 2009
Country US MENA GCC
Total healthcare spending as a %of GDP
16.2% 4.3% 3.8%
Total healthcare spending, on aper capita basis (USD)
7,410 31.5 91.3
No. of Hospital Beds per 10,000people
31.0 21.6 20.2
No. of Physicians per 10,000people
26.7 18.3 13.0
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Ultrasound Markets in MENA
Keeping pace with the developed world in acquiring and applying new technologies in healthcare
X-ray machine introduced in 1902
CT scanner installed in 1978
Ultrasound in 1975, MRI in 1983 and PET in 1996
Ultrasound imaging market estimated to be $119.5 million in 2010
Predicted to reach $264.14 million in 2017
Entry of multinational companies addressing low-end of the market, expanding product linesand creating sales channels
Little option but to import medical equipment and supplies due to limited production capability andlack of technical know-how
Opportunities to establish technology centers of excellence in the GCC for advance imagingresearch and development
Create new knowledge based industries and skill jobs in MENA regions
Emphasis on R&D and high profit margin industries
Leveraging long term investment horizons and move upstream along the Medical device valuechain
High demand for sophisticated medical equipment driving high imports of medicalequipment, including MRI and ultrasound
Source: TriMark, UltraSound Markets, 2011.
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Company Profile
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Company Overview
Hana Research is an intellectual property licensing company that designs, develops, licenses andmarkets innovative solutions used in high resolution and small form factor clinical ultrasound
The Company provides specific innovation, patent development, and licensing around wide apertureultrasound technologies
RadiologyProbes
CardiacProbes
Intra cavityProbes
4D Imaging
Wide aperture probe enables ultrasound anywhere
Superiorinvestment
returnsCore IP
Highly experienced management team,strategic advisors and technical teams
Increasedsafety/Reliability
Proprietary technology Strong patent portfolio
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Business Model
Built around three core functions of technology development, out-licensing to partners, and systemsintegration
Patents
Engineeringand DesignKnow How
IntegrationExpertise
Branded Systems(Siemens, GE,
Philips)
ContractManufacturer(Flextronics/
Celestica)
Components(Texas
Instruments/Freescale)
Hospitals/Doctors office
Imaging Clinics
Universities/ResearchFacilities
Hana Research
Medical ImagingDevice
ManufacturersEnd Users
Manufacturing
Agreements
Licensing
(Solutio
ns&
Patents)
EquipmentLeasing
Companies
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Innovation and Licensing Model
Hana Research licenses the right to use wide aperture ultrasound and associated software to itsOEM/ODM partners
Patents will continue to be relevant in future products and modalities
Coupled with standard components from partners FPGA suppliers, these licenses enable a
complete wide aperture ultrasound solution
Licensing technology rather than taking on internal product/device development allows salesgrowth without increasing investment/cost
OEM/ODM clients are responsible for product manufacture, including the costs and logisticsand support
Direct resources toward the development of innovative new solutions for ultrasound testequipment and industrial applications
WAAB Wide aperture adaptive beam
forming algorithms to provide
high image resolution forultrasound systems
Ultrasonic TestEquipment
IndustrialApplication
Licensing
Patent Development
Innovation
Field ProgrammableGate Array containingalgorithm and code canbe incorporated into alicensees system
Allows Company toprotect the IP thatlives on the chip
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Technology/ProductOverview
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High end systems performance at fraction of cost and size
Large and expensive
More practical to bring patients to theultrasound machine
Portable ultrasound technologies emerged, butachieving image quality on a par with the largerdevices proved to be a challenge
Physicians see ultrasound as cost effective andmobile alternative to CT and MRI scanners
High-quality handheld systems enable routinebedside scanning and emergency medicine
Innovations in software and miniaturization ofcomponents enable high performance HCUsystems
Relatively cheaper and more flexible
Replacing cart-based systems
Improves patient access to safe, noninvasivediagnostic medicine
Reduces time and costs
Wide Aperture Ultrasound enables:
High level of reliability and stability indiagnostics
High-resolution images
Existing TechnologyNext Generation Hand Carried UltrasoundSystems
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Financial Overview
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Financial Highlights
Remain focused on overall operations profitability and maintaining control of working capital Growth of annuity income stream and support revenues
Maintaining strong margins (GM% 95, EBITDA +47%)
Continued investment in Sales & Marketing and R&D (33% and 14% of revenues)
On going recruitment in key growth segments and regions
$1 $2 $7 $24$55
$100 $130$165 $185
0 0 0.51
410
30 60
80
0
100
200
300
2011 2012 2013 2014 2015 2016 2017 2018 2019
$Milli
on
RevenuesTest and Industrial
Core Wide AperatureUltrasound
-$2 -$2 $1 $7$21 $33
$47$68 $87
-50
0
50
100
2011 2012 2013 2014 2015 2016 2017 2018 2019$Million EBITDA
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Financial ProjectionsDCF Assumptions
Risk Free Rate 2.15% Debt Spread (bps) 285
Market Risk Premium 8.09% Cost of Debt 5.0%
Beta 1.20 D/V 23.0%
Capex/Cyclical risk Premium 0.00% WACC 10.2%Cost of Equity 12%
Perpetuity Growth Rate 4% WACC Used 10.2%
Period - 1 2 3 4 5 6 7 8 9
In $ Millions 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Core Wide Aperature Ultrasound 0.5$ 2.0$ 7$ 24$ 55$ 100$ 130$ 165$ 185$ 200$
Test and Industrial -$ -$ 0.50$ 1$ 4$ 10$ 30$ 60$ 80$ 120$
Total Revenues 0.5$ 2.0$ 8$ 25$ 59$ 110$ 160$ 225$ 265$ 320$
Y/Y Growth 300% 275% 233% 136% 86% 45% 41% 18% 21%
Gross Margins $ 0$ 2$ 7$ 24$ 56$ 105$ 152$ 214$ 252$ 304$
Opex
R&D 2$ 3$ 4$ 6$ 6$ 17$ 24$ 34$ 40$ 48$
SG&A 1$ 1$ 2$ 8$ 19$ 36$ 48$ 68$ 80$ 86$
Total Opex 3$ 4$ 6$ 14$ 25$ 53$ 72$ 101$ 119$ 134$
EBITDA (2)$ (2)$ 1$ 10$ 31$ 52$ 80$ 113$ 133$ 170$
EBITDA -405% -105% 9% 38% 52% 47% 50% 50% 50% 53%
Capex (1)$ (1)$ (2)$ (3)$ (3)$ (3)$ (3)$ (3)$ (3)$ (3)$
Cash Taxes (2)$ (6)$ (10)$ (24)$ (34)$ (40)$ (51)$
Free Cash Flow (3)$ (3)$ (1)$ 5$ 21$ 38$ 53$ 76$ 90$ 116$
% Growth FCF 2% -56% -441% 367% 79% 38% 43% 18% 29%
PV Cash Flow ($3) ($3) ($1) $3 $15 $24 $30 $38 $41 $48
PV (FCFF) $192 sum of PV payments
Terminal value 779$ Stable Growth and Terminal Value = Expected cash flow at end of next period/ (WACC - Estimated Terminal Grow
PV (Terminal value) 325$ Implied Terminal Value /(1+ WACC)^N period
Firm Value $517
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Exit Strategy/ M&A Environment in Medical Devices
Meaningful acceleration of acquisition activity as
big companies seek growth in medical devicemarket
Half of Medical device deals involve privatecompanies
Lack of innovation and scarcity ofbreakthrough technologies
Expect significant acceleration in acquisitionactivity
Slowing growth rates and cash-rich balancesheets at larger cap companies
More difficult FDA approval process
M&A activity has heated up across several
healthcare subsectors with significant valuecreation
Premiums on companies with well developedFDA process
Deep pocketed large caps medical devicesuppliers placing premium valuation oncompanies with technology already through
or nearly through the FDA process
Exit Strategy M&A Catalyst
Exit with enterprise value of $500-$600M by2014-2015
Represents ~12x TTM revenues by 2014-15
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Summary
Wide aperture ultrasound is a core technology enabling broad adoption of hand-carried ultrasoundsystems and will play a vital role in fueling the overall market growth for medical imaging devices
Ultrasound scanners undergoing rapid evolution as integration makes it possible to use manychannels in parallel for greater resolution and usability
Wide adoption by healthcare institutions give rise to new market opportunities for manufacturers
Hana Research is uniquely positioned to bring high resolution, low cost, patient safe, portableimaging to the world
Vast population base, urbanization process and an aging population should boost demand for nextgeneration ultrasound devices in emerging markets
As the US regulatory environment becomes more challenging with FDA reforms, emerging marketsare preferred market for medical device companies to launch new products
We expect high exit value due to premium valuation on companies with capital efficient licensingmodel and technology already through or nearly through the FDA process
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Back Up
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Ultrasound Imaging Highlight
Criteria Ultrasound Imaging Devices
Investment Highlights New use cases in ER medicine and battlefield medicine Growth driven by mid/low-end product Demands in the short-term and by product replacement and
upgrading needs in the long-term
Development Trends Intensified information processing in medical imaging center Integrated solutions/ Portable devices Advanced IT technology and services
Development Strategy Upgrade to an integrated solution provider amid increasingdemand in emerging markets
Benefit from domestic hospital medical equipment upgrading,Medical equipment platform consolidation
Keys to success Technology, R&D, comprehensive service ability
2009-2017 CAGR 10% (0~2% for advanced market,7~9% for emerging markets)
Leading Companies GE, Siemen, Philips, Mindray, Hitachi, Toshiba
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Healthcare spending in the MENA and the GCCHealthcare spending in the MENA region to reach $125 billion by 2015
Assumed per capita spending on healthcare through 2015 would mirror the growth of 9.0%CAGR achieved between 2000 and 2009.
Healthcare spending inthe MENA region toreach $125 billion by2015
Large population andgrowing middle class(100 million people)who can afford modernhealthcare
Remainingpopulation areprovided withhealthcare bygovernment funded
hospitals
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Healthcare Spending
Healthcare expenditure is low both in terms of
percentage of GDP and on a per capita basis.
Spends 4.3% of the GDP on healthcare
Per capita healthcare spend stands at $315.
Lower than GCC of $913 and much belowdeveloped countries such as the US ($7,410),Canada ($4,380), and the UK ($3,285)
3.8%
4.2%
4.3%
4.6%
5.4%
8.3%
8.5%
9.1%
9.4%
10.9%
11.4%
11.7%
16.2%
0% 5% 10% 15% 20%
GCC
India
MENA
China
Russia
Japan
Australia
Brazil
UK
Canada
Germany
France
USA
Healthcare as % of GDP
$45
$169
$315
$475
$734
$913
$3,285
$3,321
$3,867
$4,380
$4,629
$4,798
$7,410
0% 200000% 400000% 600000% 800000%
India
China
MENA
Russia
Brazil
GCC
UK
Japan
Australia
Canada
Germany
France
USA
Per Capita Healthcare Spend
Healthcare sector in the MENA is likely to grow
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Healthcare sector in the MENA is likely to growsignificantlySaudi Arabia is the largest healthcare market in the GCC ($18.5 Billion) followed by Egypt ($9.0Billion)
Top six countries represent more than three-quarters of the total healthcare market in MENA
Healthcare spending inthe MENA region standsat $65.6 billion
UAE: $7.5 billion
Algeria: $6.3 billion
Morocco:$5.0 billion
Kuwait: $4.3 billion
Major healthcare projects underway across the GCC
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Major healthcare projects underway across the GCCregion
Projects Country Value (Million)
Sidra Medical and Research Centre Qatar $2,300
Al-Wakra Hospital Qatar $500
Cleveland Clinic Hospital UAE $1,900
Al Mafraq Hospital UAE $871
Mohammed bin Rashid al Maktoum AMC UAE $572
Danat Al Emarat Women & Childrens Hospital UAE $200
Jaber Al Ahmed Al Sabah Hospital Kuwait $1,200
Sabah Medical Area in Shuwaikh Kuwait $270
Bahrain Health Oasis Bahrain $1,000
King Hamad General Hospital Bahrain $130
MDC Healthcare City Oman $800
Jalan Bani Bu Hassan Hospital Oman N/A
Ajyad General Hospital Development Saudi Arabia $600
King Saud University Medical City Saudi Arabia $400
Healthcare infrastructure worth $14 billion are underway in the GCC supporting healthy pipeline forinnovation and investment growth
109 active healthcare projects in the region according to the Middle East Economic Digest (MEED)
Saudi Arabia accounts for 56, UAE 24, Kuwait 17, and Qatar, Oman and Bahrain 12
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Strategic Priorities
Intellectual property
Fortifying patent assets around ultrasonic imaging technology using Wide Aperture AdaptiveBeam forming
Product Development
Prioritize R&D investment to meet new product launch target
Transition from proof of concept to customer wins
Actively explore external opportunities for technologies and products
Regulatory Approval
Anticipate and plan for potential FDA reform on approval process
Partners Increase investment and direct sales to capture early OEM design wins
Focus on emerging markets (China, India, and MENA Region)
Capitalize on government focus on upgrading hospitals and increasing healthcare insurancecoverage
Intellectualproperty
ProductProof of
Concept
RegulatoryApproval
PartnersLaunch and
Support