“Healthcare’s Next Big Game-Changer”

A Quick Look at an Andy Obermueller teaser for Game-Changing Stocks

By Travis Johnson, Stock Gumshoe, February 13, 2014

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We’re well on our way to piling another foot of snow here atop Gumshoe Mountain, so I’ll keep today’s missive brief — there’s sledding to do, after all, and little Gumshoes out of school and craving amusement.

I was skimming through a recent teaser pitch by Andy Obermueller for his Game-Changing Stocks letter, and it’s one of those “laundry list” teaser presentations that talks about an almost endless roll of companies that will change the world and make you rich. I’m not going to tell you about all of them, partly due to lack of time and partly because you can figure most of them out on your own, but here’s a rapid rundown before we get to today’s “main event:”

“The Biggest Game-Changer On Earth” — the one that’s going to topple the “big three” carmakers, is Google (GOOG), with special attention paid to Google Glass and their driverless car program. I own Google stock and think it’s a wonderful investment (if no longer super cheap at the moment), but mostly because it’s the world’s best advertising platform — that other stuff won’t mean much for a while.

“This Company Could Kill the Gasoline Engine” — that one is Westport Innovations (WPRT), with their natural gas fuel injectors that let big rigs run on nat gas and get the same kind of power as diesel engines. This one will always be teased and touted, it’s a great story but also an over-promise and under-deliver management team and a story that has churned through hundreds of millions in R&D and other costs but still needs subsidies and massive outside investment in infrastructure to make their technology scalable.

“The Second Industrial Revolution Is Under Way” — that’s about 3D printing, which finally took a lump this month as the very clear overvaluation of all of those stocks finally hit their shares. I won’t go into 3d printing in detail, I love the long-term potential but the stocks got way, way ahead of themselves, but the three companies he hints are are almost certainly the major duopoly of 3D Systems (DDD) and Stratasys (SSYS), plus relatively new ExOne (XONE), though there are other new contenders taking advantage of investor enthusiasm (like Voxeljet, VJET) and will be more IPOs soon even after — this story will likely keep exciting investors for a while despite recent setbacks. I suggested taking profits in DDD and SSYS in January 2013, for what it’s worth, because I thought they were getting unsustainable way back then after doubling in six months — we’ll see how it shakes out.

And then we get to the healthcare one that I hadn’t heard of, and wanted to take a look at — here’s how Obermueller teases it:

Healthcare’s Next Big Game-Changer

“Forbes ranks a company called Intuitive Surgical as the world’s third most innovative firm. It’s easy to see why…

“It makes a revolutionary surgical system called Da Vinci that has mind-blowing technologies….

“Thanks to this game-changing device, Intuitive Surgical is up 1,900% since it went public in 2000. The S&P has advanced all of 20%.

“And given its expanding footprint, I think Intuitive Surgical looks like a solid long-term investment.

“That being said, I think the company’s earth-shattering gains are behind it. It’s pretty well-known, and it’s expensive.

“So instead of putting a lot of money in Intuitive Surgical and hoping for a 5% increase every year, I’d rather make a small investment in a company that looks a lot like Intuitive Surgical before it took off.

“That’s where a company I call ‘Healthcare’s Next Big Game-Changer’ comes in.”

Intuitive Surgical (ISRG) is one that I sold way, way, way too early a few years back, too, so I’ll try not to be too bitter as I sniff out the stock he’s teasing with the implication that it’s the “next ISRG” … how about some more clues on this one?

“It’s a true ‘ground floor’ opportunity… and I’m confident that the triple-digit gain it’s posted since I first recommended it in February will be just the beginning.

“Like Intuitive Surgical, its specialty is robotics.

“In fact, it is the only company with FDA approval for robotic spinal procedures. In other words, it basically owns the market. And it’s not a small market — about $14 billion.

“The company’s robotic system uses 3-D image models and tiny tools to work very close to the spine.

“To date it has a 100% safety record. In no documented case have the robots caused permanent nerve damage. That is particularly impressive given that the company’s case volume has grown by more than 500% in the past four quarters alone!

“These amazingly precise robotic instruments decrease the need for re-operations by HALF. That is very important, because under new Medicare rules, if a patient is readmitted for the same reason within a certain length of time, the hospital must eat the cost of the second surgery.”

OK, so I’ve got an inkling of this one — any more little tidbits for us to chew on?

“It increased its user base from 39 hospitals to 54, which is a huge increase given that each system costs about $1 million….

… it got its first repeat order”

And …

“This company was only added to the Nasdaq in May”

So…. who is it? This is … Mazor Robotics (MZOR)

Which is indeed a May IPO on the Nasdaq as they raised money and awareness for their expansion goals, though it was publicly traded before that in Israel. And it has graced the pages of Gumshoe before, just not by me — we had a commenter suggest it back in November. It’s up more than 25% since then, and has been on a ride almost straight up (albeit with some real volatility) since the Nasdaq listing last year.

This is now a $400 million company, and their business model is extremely similar to Intuitive Surgical’s — they sell a machine for roughly a million dollars to the hospital, then sell their proprietary disposable tools for each surgery performed with the machine. The “robot” is essentially a combination of a 3D imaging device and a mounted minimally invasive portal with probes that can go into the spine and make adjustments or put in screws or implants or whatever it is that these surgeries require. It looks like they have a very high level of accuracy, 98%+, and the key arguments for use of this device include the reduction in the amount of radioactive imaging fluid required (which would theoretically cut down on the cancer risk), the improved accuracy, and the ability to make some surgeries less invasive, which would be expected to cut down on infections that are a major cause of re-admission after spine surgery.

It’s awfully early to tell if it will take off with mass adoption, but they’re doing quite well so far and seem to be focusing on the right things — focused geographic expansion, a good direct sales force, and making the advantages clear through published studies. Spinal surgeries are not as simple or common as prostatectomies, which was the surgery that drove the da Vinci from ISRG into wide acceptance, but they have high reimbursement levels already so cost might perhaps be less of a concern for hospitals … and I’ve seen at least one ad for the “spine robot” that was aimed at consumers, so it’s possible that they could ride the wave that really led to rapid adoption of da Vinci (that wave being consumer demand, driven by really effective marketing as well as by sometimes disputed clinical results, which made hospitals compete with each other to offer robotic prostatectomies).

If Mazor follows an adoption curve similar to that of Intuitive Surgical — which looks possible but far from certain, I have no idea what other competing systems might exist — then it would be expected that they’d continue to be quite volatile over the next couple years as the results fluctuate dramatically due to the unpredictable and lumpy nature of system sales that drive revenue in the early years. Using this business model, you can’t hope to get somewhat smooth and sustainable revenues until the installed base is large enough that the sale of disposables and ongoing service contracts make up a bigger chunk of their cash flow (right now system sales are approximately 70% of revenue). They’re small enough that they’re still seeing meaningful jumps in revenue by selling just a few new systems each quarter, so the real question is whether the adoption curve steepens and they start to sell a lot more systems and see a lot more procedures done in the next few years. This isn’t going to be a profitable company in the next year or two, but they might post some strong revenue growth numbers — and if they are able to boost system sales substantially with the expanded sales force, and then successfully launch their newer brain application for deep brain stimulation, particularly for Parkinson’s Disease, the sky could get a bit bluer.

That’s about all I know on Mazor right now, and I don’t know much about the competitive landscape for spinal surgery systems just yet, but color me intrigued so far — you can see their latest CEO letter here, and their latest investor presentation here if you want to get started on understanding the company.

Got an opinion on Mazor or any of these other stocks, or any other faves? A big game-changer of your own for 2014? Let us know with a comment below.

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30 Comments on "“Healthcare’s Next Big Game-Changer”"

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Dr. KSS MD PhD
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0
karmaswimswami
February 13, 2014 11:08 am
I will look into this one. A thing that has dogged ISRG (which I have been long in since soon after its debut) are all the rumors of competing robotic systems being devised. I am aware of some preclinical Japanese work in this regard, but still am not aware of a serious threat overall to ISRG. ISRG is nowhere near its all time highs because of some disputation in the literature, that maybe patients with it have no better outcomes. I feel that recenter publications are laying to rest those fears. Last I read, ISRG had acquired a cosmetology application… Read more »
edski
Irregular
8
February 13, 2014 11:44 am

……because of some disputation in the literature, that maybe patients with it have no better outcomes. I feel that recenter publications are laying to rest those fears……….
Man, I got all swolled up at them thar lines, karma.

highnesska
Member
4
highnesska
February 13, 2014 12:31 pm

Dear Ed:
I love Gumshoe for many reasons, and read comments when time permits. Your very amusing comment on the already funny formulations of the language, reminiscent of Gollum’s style from The HOBBIT, is truly hilarious and made my day. I just wanted to tell you. Lots of tears here, from laughing. Thank you.

Frenchy
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0
Frenchy
February 13, 2014 11:46 am

Even if MZOR does not follow ISGR’s path to greatness and follows a more slower and problematic path like MAKO did, MAKO surgical was still bought out in the end for three times their share price from $10 to $30. Looks interesting to me. Thanks Travis and as usual, thanks to Dr. KSS as well for looking into this first.

charleroi6o40
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0
February 13, 2014 12:20 pm

i am following MZOR for over two month it is a israeli compagny wich is starting to get somme concurrence from a french compagny wich as already developed and sold few brain surgical robot and are now developing a new robot for spine surgical the compagny is medtech and you can find it on the euronext . another french compagny as developed a artificial heart not much biger than a natural one and is working on a men since last december you can see it on their site http://www.carmatsa.com.

Solyom
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0
Solyom
February 13, 2014 12:44 pm

Their fair value is a negative figure but their chart will fulfill my technical criterion when the stock hits 25.65 per share. I too am intrigued. I am much more comfortable when fundamentals and technicals agree. If I buy a few shares at 26.5 I will be setting my stop at 23.4. That is where I think major support is and if it goes through that I want out. Technicals for me predict a slow rise.

dick
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0
dick
February 13, 2014 7:34 pm

It makes sense, double top and dropping MACD. Wait a bit.

Squarelogic
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0
Squarelogic
February 13, 2014 12:52 pm
Having learnt so many interesting things from Gumshoe and its frequent commentators,I would like to give something back: I have a very interesting prospect to share,which is in my line of work.I am talking about OPHT,which is in phase III trials of an injectable PDRGF(platelet derived growth factor) for Age Related Macular Degeneration.The current standard of therapy is antiVEGF injections,Lucentis from Genentech/Novartis and Eylea from Regeneron/Bayer.Lucentis grossed around 4 bil.last year,while the newer contestant Eylea made more than 1 bil.and rising.Both,as well as the off label used Avastin,are anti VEGF drugs,and despite the phenomenal decrease in vision disability they have… Read more »
Robert
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Robert
February 15, 2014 5:02 pm

Thanks SL, I’m going to read up about this. Any idea when the phase III trial will be finished? I’m also in the medical device for ophthalmology business and it’s good to get share tips for companies close to home

SL
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0
SL
February 15, 2014 6:55 pm

Phase III has already started…primary endpoint visual gain in 12 months…
http://www.ophthotech.com/wp-content/uploads/Fovista_Fact_Sheet.pdf

john
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0
john
February 13, 2014 1:26 pm

why are these stocks always touted when they are at their highs???

vivian lewis
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0
February 13, 2014 4:35 pm

dear Doc
what is anti-VEGF please? some of us are laypeople

SL
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0
SL
February 13, 2014 6:32 pm

Anti Vascular endothelial growth factor: did not explain it as it makes no difference to a lay person.I sometimes wish wall str.types explained as well the parameters of their line of business.
🙂

SL
Guest
0
SL
February 13, 2014 6:38 pm

Until the emergence of these antiVEGF drugs,if you were diagnosed with “wet” AMD,you were practically condemned to lose central vision,meaning not being able to read at all,and seeing only around of whatever you are focusing at…Bilateral involvement was guaranteed to lead to legal blindness.

Sam
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Sam
February 13, 2014 9:21 pm
This is a very interesting article. After seeing, “A Game Changer by Andy Obermuller”, I was hoping that it is “MZOR”. Indeed it is……….. A couple of months ago Gumshoe had a teaser with subject on Robotics (I can’t remember the details unless I dig it out). At the bottom of the article in responses, there was a response from one lady who suggested this stock could be better than the one in the teaser. I did my research and bought it. Since then it has gone 25% up and I am going to keep it for ever. Just like… Read more »
Bill
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0
June 7, 2014 1:40 pm

Looking for a true “REAL” game changer? Then do your research on Quantum Dot Nanotechnology. I posted this in 2011 related to a startup that is finally coming to light.
http://www.linkedin.com/today/post/article/20140607170906-61215283-game-changing-stocks-qtmm-set-to-lead-quantum-dot-nanotechnology
Regards,
Bill

sassykind
Member
27
sassykind
February 15, 2014 9:46 am
Hi Travis, I just did a whole thing on Aussie company called Admedus Ltd (ASX:AHZ), formerly Allied Healthcare Group. and “something” disappeared it. ( I REFUSE to think that I had ANYTHING to do with it!!!) I think company has great product – CardioCe l- and more in pipeline. I refer you to Proactive Investors, Australia issue 13/12/13. It comes out of UK. Over here Admedus is only about 0.17 share and MC of abt $200.88M. CardioCel is a regenerative tissue product currently used to repair heart deformities incl. repair and reconstruction of heart valves. It was already producing product… Read more »
bigafrodaddy
Member
8
bigafrodaddy
February 19, 2014 3:28 am

Great tip sassy. I’ll definitely look into this company.

max kalbert
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0
max kalbert
February 15, 2014 10:48 am

What about Imris (IM)? –a robotic system for brain surgery. Still flopping around just over two dollars. FdA approved for their newest system. It is expensive and seems worthy, but has not taken off. Anyone have a comment?

MP
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0
MP
June 15, 2014 11:39 pm
Could use your advice and experience – What about MRI Interventions (MRIC) IMRI Interventions, Inc. (MRIC), a commercial stage medical technology company focused on creating innovative platforms for performing the next generation of minimally invasive surgical procedures in the brain and heart.. It recently has taken a real drop (not sure why?) ,however, it seems that this technology, ClearPoint(R) Neuro Intervention System should take off and they have shown it safe and being used by top Neuro experts and Medical Centers. What is keeping it back? I am invested. It hasn’t taken off yet ,but I think it will. Your… Read more »
petro173
Member
0
petro173
June 16, 2014 3:13 am
What about MRI Interventions (MRIC) IMRI Interventions, Inc. (MRIC), a commercial stage medical technology company focused on creating innovative platforms for performing the next generation of minimally invasive surgical procedures in the brain and heart.. It recently has taken a real drop (not sure why?) ,however, it seems that this technology, ClearPoint(R) Neuro Intervention System should take off and they have shown it safe and being used by top Neuro experts and Medical Centers. What is keeping it back? I am invested. It hasn’t taken off yet ,but I think it will. Your thoughts? The ClearPoint system’s role is in… Read more »
Beefheart
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0
Beefheart
February 15, 2014 11:40 am

MZOR should release 2013Q4 earnings on Feb 17. Consensus ranges from -0.01 to -0-34, mean value (of 5 analists covering) is -0.11
2013Q3 earnings -0.18 (consensus -0.14).
FY2013 earnings are estimated to be -0.74 (in case 2013Q4 earnings meet consensus).
FY2014 and FY2005 earnings consensus is -0.24 and -0.10
The data that MZOR will release next Monday (2013Q4 and FY2013 final) will let us know a bit more about how the management is doing.
[Apologize my english]

Chris Hughes
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0
Chris Hughes
February 15, 2014 2:31 pm

In response to a previous posting, I have posted a link below to latest announcement from Admedus Limited AHZ.ASX. IMHO this company has a product with enormous growth potential, and will be a ready TO target for one of the majors in not too distant future.
Do your own reasearch. I currently own the stock.
http://www.admedus.com/au/wp-content/uploads/sites/4/2014/02/140211-Wall-Street-Journal-Cardiocel-FDA-Approval.pdf

Chris Sartore
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0
February 15, 2014 6:28 pm

Travis any thoughts on a Motley Fool plug for “R.I.P. Internet: 1 Explosive InterWorld Stock to Profit HUGE When the Web Goes Dark.” Thanks, Chris

microcapwiz
Member
0
microcapwiz
February 21, 2014 9:56 am

LED Medical – any thoughts from anyone?

Frenchy
Guest
0
Frenchy
February 22, 2014 10:56 am

re # 15: Chris, that MF tease is Sierra Wireless.

yan
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yan
February 24, 2014 8:13 am

the stock andy actually recommended, to be accurate, is MAZOR SURGICAL ROBOTICS, trading over the counter as MZRTF….. thats the stock i purchased following his recommendation in his newsletter…. MZRTF and MZOR seem to be the same company or at the least a division of MZOR. anyone has any idea? I am left wondering if i should sell my stocks of MZRTF and purchase MZOR! Any thoughts?

yan
Guest
0
yan
February 24, 2014 11:58 pm

thanks for the response. i have decided to convert my shares.

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