
Hi Novocaine
Hope others QUICKLY see that LMA is undervalued and mop up all those shares @ below IPO price. Once they dry up, LMA shd recover. Without the support of the masses, LMA will remain as "lethargic" as any other shares. Imagine, it dipped today after recovering for a short while when most other shares which are way above IPO prices are moving north or holding firm - can't understand why.
Thanks for sharing your learned opinion. Shocking that, and just can't understand why LMA shares have been below its IPO price for some time, compared to smaller companies with weak fundamentals. .
Hi Novocaine
Sorry. The subject shd be LMA, not GV. LMA has been running on the spot and seem to have just turned around. What is your take?
Hi Novocaine
How long more must investors run before GV breasts the finishing line? Until all operators and investors lose their breath and die of heart seizure? GV has been running on the spot for such a long time. Any FA or TA specialist care to comment on the possible time frame for a break out? The charts seem to reflect that it shd turn around soon?
LMA looks good in long run..should hit one dollar and beyond in long term..just MHO.. :)
Hi Hulumas
At least you have more confidence now in LMA as a company. At least the fund mangers and operators will now sit up and take a look at LMA. It isn't a junk company, is it?
Dear Novocaine,
I agree with you. I won't sell mine not untill the price reachs Sgd. 1.00 or above!!
The OCBC report..sorry very big la..tink got some errors posting..
Also Dow Jones reports that in a recent interview management states confidence in earnings upgrade due to expansion and new products introduction.
And this is not taking into account the millions of damages expected from the case against Ambu and the effects of the patent reinforcement in protecting their products..
So I think its time this counter move back towards its IPO price and beyond..
MITA No. 033/06/2006
Please refer to the important disclosures at the back of this document.
SINGAPORE
Company ReportKelly Chia
(65) 6531 9817
e-mail: kelly@ocbc-research.com
30 March 2007
Initiating Coverage
BUY
S$0.56
Fair Value: S$0.80
Stock Code:
Reuters: LMAI.SI
Bloomberg: LMA SP
Event: Initiate Coverage
General Data
Issued Capital (m) 581
Mkt Cap (S$m/US$m) 328/216
Major Shareholder Venner Capital
(32.1%)
Free Float (%) 55%
NAV per share (US$) 0.126
Daily Vol 3-mth (?000) 1,596
52Wk High (S$) 0.940
52Wk Low (S$) 0.515
Market leading yet undervalued
at about US$4.5m/quarter and it has a healthy cash balance of US$28m
with no debt. LMA trades at an unwarranted 78% discount of 8.5x PER
when compared to its comparable medical peers' average of 38.9x PER.
Admittedly, its present main business of laryngeal masks is not breaking
headline news but it continues to generate strong clinician end-user
conversion to its products and repeated loyalty. Average FY06 gross profit
margin was outstanding at >70% and EBIT margin at >27%. LMA's peers'
average gross margin was at 52.7% and EBIT margin at 14.7%.
. LMA's core operations generate cashM&As and new management.
dividends and we are expecting a major M&A to occur soon with the cash
pile of US$28m in its balance sheets. We expect the acquisition to be
along the theme of other operating theatre respiratory instrumentation or
urology to synergise with LMA's current infrastructure and knowledge of
these market segments. We are expecting the next acquisition's gross
margin to be in line with LMA Stonebreaker's 70% range. Newly appointed
CEO, Michael Ashton, is largely focusing on this aspect.
Management has not paid out any2007 looks brighter.
restructuring in major markets was completed in 2006. We expect that
going into 2007, the key markets in US, Japan, Germany and Australia
will show better performances. In particular, Germany's 4Q06 sales showed
an encouraging 21% YoY growth due to the conclusion of hospital strikes
and management changes.
Management has indicated that corporatePositioned for a good year.
high standards of safety, strong IP and establishing its International
marketing infrastructure to achieve long term growth. Although we forecast
revenue growth of 8.3% YoY to US$98.1m for FY07, we anticipate improved
earnings quality with net profits expanding 12% YoY to US$25.2m. Based
on a substantial 70% discount to its peers, we derive a conservative fair
value of S$$0.80 at reasonable FY07 PE ratio of 12x PER. This presents
an attractive 43% potential upside from its current share price and an
opportunity to get into this stock prior to positive and earnings accretive
news flow via impending M&As. We initiate coverage on LMA with a
LMA continues to set barriers of entry throughBUYrating.
Undervalued and ready for long term growth
LMA International NV
Year to Turnover Gross Profit Net Profit EPS EPS Growth PER Net Div Yield
31 Dec (US$m) (US$m) (US$m) (US cents) (%) (x) (%)
FY 05 86.3 64.0 -2.5 4.3 - 8.6 -
FY 06 90.6 64.2 22.5 4.1 -2.9 8.8 -
FY 07F 98.1 70.8 25.2 4.4 5.0 8.4 -
FY 08F 109.9 78.8 27.8 4.8 10.2 7.6 -
Page 2 30 March 2007
LMA International NV
INVESTMENT HIGHLIGHTS
LMA International NV (LMA) designs, develops, markets and distributes
medical equipment, principally the LMA
supraglottic airway management devices. These devices are used by
physicians to allow respiration, provide ventilation to, and support the airway
of patients undergoing surgical procedures and life-saving interventions.
LMA's first product, the LMA-Classic
in the United States in 1991 and has since grown its portfolio of laryngeal
mask airway products to a strong stable of 8 products.
TM laryngeal mask airway range ofTM, was approved by the FDA for useMarket leading.
technology is authenticated by a strong portfolio of about 315 patents and
applications to protect its intellectual property (IP). LMA has been
aggressively defending its IP against competitors since 2005. In Nov 06,
LMA announced that it is filing to claim about US$4m plus costs in damages
against German competitor AMBU for the territory of Germany. LMA will
continue to pursue claims in all other EU territories that AMBU infringes its
IP.
LMA's forerunner status in the laryngeal mask airwayCash generative and diversifying.
at about US$4.5m/quarter and it has a healthy cash balance of US$28m
and no debt. The LMA Stonebreaker from LMA Urology is the first product
outside LMA's core airway management product and was launched in Feb
07. We estimate that revenues for the Stonebreaker will contribute US$3m
in FY07 and grow 120% YoY to US$6.5m in FY08.
LMA's core operations generate cashM&As and better management.
that M&As will be a key theme for LMA in 2007 to give earnings the next
boost. We expect LMA to work on the urology arena to synergise its
operations with Stonebreaker's infrastructure. New management has also
been put in place in key markets such as US, Germany and Japan. With
LMA's optimism in urology, the group's COO, Paul Malloy, has been put in
charge of this segment to accelerate its growth.
We have indication from managementMore market share coming up
anaesthetists are also demanding better products to mitigate complications
from endotracheal (ET) tubes which are the present state of the art. On
average, there are about 600 deaths/year directly related to the use of the
ET tube. The laryngeal mask has had zero fatalities directly linked to its
300m uses worldwide.
. As technology surges ahead for surgeons,Good macro trends.
will grow by 12.3% CAGR (2005-2012) and the US market will grow at
27.9% CAGR (2004-2011). These macro trends for laryngeal mask bode
well for LMA as the leader in this market segment.
F&S reports that the EU market for laryngeal masksPage 3 30 March 2007
LMA International NV
Overview of recent performance
Admirable performance in a competitive FY06.
its FY06 results with a marginal 5% YoY rise in revenue to US$90.6m but
recorded a flat net profit of US$24.1m (excluding non-recurring stock
compensation charges). Despite maintaining a 20-30% price premium,
facing aggressive price competition and a slowing conversion of reusables
to single use masks, LMA sales still grew 3% in the US and 7% in the
International market, authenticating its market leadership position.
LMA recently reportedGood trends in units sold.
good growth in units sold and sales of 30% YoY to 4.78m units and 13%
YoY to US$43m respectively. The reuseables saw a decline of about 9%
YoY units sold to 217.2k units, but only a marginal 0.5% YoY drop in ASP
demonstrating LMA?s sustainable price premium. Taking the net effect of
price depression and increase in units sold, we are encouraged to see a
continued uptrend in sales.
In FY06, LMA single use masks experiencedStrong gross margins.
its quality medical products and continues to maintain a price premium
above its competitors. Although there are 36 various brands of laryngeal
masks in the market, of which 19 are made in China, management has
indicated that even the Chinese hospitals are continuing to use LMA branded
masks.
LMA continues to enjoy >70% gross margins for2007 looks brighter.
in major markets was completed in 2006. We expect that going into 2007,
the key markets in US, Japan, Germany and Australia will show better
performances. In particular, Germany?s 4Q06 sales showed an encouraging
21% YoY growth in sales due to the conclusion of hospital strikes and
management changes.
Management has indicated that corporate restructuringPage 4 30 March 2007
LMA International NV
Figure 1: Revenue breakdown by products (US$?000)
Source: Company, OIR estimates
Why use a laryngeal mask?
Main alternative ? Endotracheal (ET) tube.
the nose or the mouth into the trachea, in order to establish a definitive
airway, for the purpose of ventilating the lungs during anaesthesia or intensive
care. This procedure is known as intubation, and the physician inserts the
tube with the aid of a laryngoscope (allows physician to see where he?s
going) introduced into the mouth and upper airway. The purpose of the tube
is not only to maintain a patent airway, but also to protect the lower airway
from aspiration and to allow the suction of secretions and other foreign
materials, which could obstruct the airway. Placing an ET tube generally
requires a high degree of skill to insert it correctly and if not, will induce
tracheal tears and sore throats. It also requires the use of a laryngoscope
and requires more drugs to sedate a patient. There are also about 600
deaths/year directly linked to the use of the ET tube.
ET tubes are inserted throughThe better and safer way ? Laryngeal mask.
without the use of a laryngoscope, less drugs needed for sedation and
most importantly 300m uses without a single fatality directly linked to the
LMA mask. The LMA laryngeal mask stands out as a revolutionary product
in the anaesthetic field. In fact, the laryngeal mask is so easy to use that
paramedics and critical care nurses can use it without guidance from the
anaesthetist.
Quicker and easier insertion4 9 , 2 4 2
2 7 , 2 5 7
4 6 , 3 5 0
3 7 , 9 6 7
4 2 , 2 3 8
4 2 , 9 9 3
3 9 , 8 6 8
4 6 , 9 0 8
0%
20%
40%
60%
80%
100%
2004 2005 2006 2007F
Reusables Single Use Others Urology
Page 5 30 March 2007
LMA International NV
Figure 2: LMA Classic
Source: Company
Figure 3: LMA Endotracheal tube
Source: Company
Page 6 30 March 2007
LMA International NV
Key product range
1. Reusable Airway Management Products
Trends cause units to decline.
in units sold primarily due to the trend of use-and-throw (single use). This is
mainly due to concerns of cross infections and increasing costs of
sterilisation. However, markets in the emerging economies have tended to
reuse LMA?s masks beyond the mandated 40 times due to pressures on
bottomline. The combined effect of cross infection concerns in developed
economies and over reuse of the mask in emerging economies have steadily
reduced the number of reusable units sold. However, ASP remains strong
and we estimate that the reusables still command a strong gross margin of
>75%.
LMA?s reusable products have been fallingCompetition.
in the anaesthetist community and it will be challenging for competitors to
take market share without taking a big hit in their margins. However, the
quality of LMA may be its own undoing, as feedback within the industry of
reusing the masks for more than 40 times due to its high quality of build.
We expect that better education of void warranties and clinical proof of
significant breakdowns past 40 uses of its reusable products will reduce
this trend of overuse.
We view LMA?s brand name and quality as well entrenchedSales of ?Others?.
Mcgrath and is segmented as these are sold as capital equipment to the
hospitals. We see very promising uptake of the Ctrach in the past quarters
in the US and continue to see good traction in this product line in the years
ahead. For FY07, we forecast a 72% YoY swell to US$8.4m sales.
This segment consists of sales of the Ctrach andForecasts for resuables.
profitably to the group but at a steadily declining rate. It was a point of
inflexion of sales mix in FY06 as single use devices overtook reusables for
the first time. For FY07, we anticipate reusables to contribute about 41%
of total sales, a marginal decline of about 6% YoY to US$39.9m but to
retain its gross margins of >75%.
We expect reusables to continue to contributePage 7 30 March 2007
LMA International NV
Figure 4: Resuable units sold and ASP
Source: Company, OIR estimates
210
220
230
240
250
260
270
280
290
300
2004 2005 2006 2007F
162.0
164.0
166.0
168.0
170.0
172.0
174.0
US$
Reusable units sold in '000 (LHS) Reusables ASP (RHS)
2. Single-use Airway Management Products
Always sterile, always new.
medical products due to its inherent advantages. First, cross contamination
is the main concern whereby more viruses are easily passed on via contact.
Fluid contact devices like syringes, needles and sutures are now designed
to be disposable to stem the tide of diseases. LMA?s single use masks are
delivered sterile and ready to use. This reduces high overheads for
sterilisation costs, logistical tracking of number of uses and ease in planning
for inventory.
There is an evident trend towards disposableSupremacy has arrived.
in Singapore and Australia. The LMA Supreme complements the range of
single use offerings in LMA?s stable as its most advanced product with a
built-in drainage tube. Made in Singapore, this new device is expected to
spur conversions from reusable into single use products and to wrest more
market share from the ET tube with its gastric access feature. Management
has indicated that the scenario is being prepared for the Supreme to be
launched in the US in 1H07.
LMA has recently launched the LMA SupremeStabilisation of average ASP.
new product, we are likely to see the net effect of good cost controls,
decreasing ASP and increasing units sold to be positive in stabilising the
downward trend of the single use units. We expect that when Supreme is
launched in the US in 2H07, economies of scale would kick in as volume
increases.
With the introduction of the Supreme as aPage 8 30 March 2007
LMA International NV
Forecast for single-use.
units sold in FY06 showed it is the way to go for laryngeal masks. We are
conservative in our estimation and forecast 20% YoY rise in the number of
single use units sold for FY07 translating to a 9% YoY increase in sales to
US$47m. We think that the price compression will be mitigated with Supreme
and with new management in place in the key markets.
The 31% YoY jump in the number of single useFigure 5: Single use units sold and ASP
Source: Company, OIR estimates
-
1,000
2,000
3,000
4,000
5,000
6,000
7,000
2004 2005 2006 2007F
-
2
4
6
8
10
12
14
US$
Single Use units sold in '000 (LHS)
Single Use ASP (RHS)
Figure 6: LMA airway products
Source: Company
LMA Supreme
LMA McGrath
Page 9 30 March 2007
LMA International NV
3. Urology Products
Urology market potential.
addressing the urinary tract stone problem. Each year, more than 600k
Americans, mostly aged between 30 and 60 suffer from urolithiasis (the
process of stones forming in the kidney, bladder and/or urethra). These
stones range in consistency (soft to hard) and size (speck-sized to walnutsized).
LMA has opted to enter the urology market by?Stone hard? facts:
- 12% of Americans will have a kidney stone some time in their life
- Prevalence of urolithiasis in the American population is 5.2% (up
from 3.8% from 30 years ago)
- In 2000, 600k Americans went to the emergency room for stone
related pain
- 1/3 of all visits to a urologists are for kidney stones
- The development of the stones is related to decreased urine volume
or increased excretion of stone-forming components such as
calcium, oxalate, urate, cystine, xanthine, and phosphate. It is
expected to be increasingly prevalent.
Emerging markets are calling.
Pacific HQ in Singapore is due to the proximity of major emerging markets
of China (2.1b people) and India (1.1b people). Stone burden is large and
complex systems are costly and are only available at large hospitals,
rendering the majority of the rural population without an adequate solution.
The Stonebreaker will give urologists a compact, portable and self powered
device to address this huge rural need.
A primary reason that LMA has its AsiaPage 10 30 March 2007
LMA International NV
Table 1: LMA urology product comparison
Source: Company
Figure 7: LMA Stonebreaker (portable hand held size)
Source: Company
LMA?s Stonebreaker (CE marked) Competitive products
Lower cost: Higher costs:
US$5-10k per Stonebreaker unit Shockwave: US$60k-300k per machine
US$45-90 per probe (consumable) Laser: US$50k per machine
US$5-10 per CO
(consumable)
Ballistic: US$20k per machine
FDA 510K certification expected in
1H07
No electricity needed Mains electrical power needed
About 20 shocks per patient Shockwave system requires 4000
shocks. Ballistic systems requires
hundred of shocks.
No probe movement. Little
retropulsion (stone will not move
away)
Ballistic systems cause severe
retropulsion
Chiselled fragments. No clouding
gives clear vision
Micro fragments from jack hammer
movement clouds vision
Laser and ballistic systems (20kg),
Shockwave system (300kg).
Translates 30 bar of pressure into
energy from small disposable
cartridge.
Wall gas outlet only provides 6 bar of
pressure. Wall gas not readily available
at smaller hospitals.
Portable and lightweight (500g).
Ideal for rural mobile clinic use
2 cartridgePage 11 30 March 2007
LMA International NV
Figure 8: Stonebreaker with probes
Source: Company
Positive clinician feedback.
positive for LMA. When we visited the 18
held in Singapore (1-3 Mar 07), we were impressed by the positive feedback
from the end user clinicians on the ease of use and efficacy of the
Stonebreaker. We also investigated competing devices from Dornier
MedTech (shockwave technology), Lumenis (laser technology) and the
Swiss Lithoclast (pneumatic technology) and came away with the impression
that these machines cost more and/or took a longer period of time to break
stones (less efficient).
We view this diversification into urology asth Video Urology world congressEnergy delivery system.
Stonebreaker is the method which the device is able to transfer energy to
the tip of the probe which will be in contact with the stone. The kinetic
energy delivered to the stone then utilises the natural faults in the stone to
fragment it into manageable sized fragments for removal. There is minimal
probe movement thus reducing stone movement away from the probe
(retropulsion).
The key Intellectual Property (IP) behind the1
come from the sales of the device. With an average sale price of US$7500,
it comes much more affordable than other lithotripsy machines. Capital
good purchases typically have a threshold below US$10,000 so hospitals
or small urology centres will be able to easily get their hands on the
Stonebreaker without much paperwork. The Swiss Lithoclast has an
estimated installed base of about 5000 worldwide and we expect LMA to
be aggressive in taking its market share and to promote this in the Asian
region due to its portability and lower price point.
st phase revenue stream. The Stonebreaker?s 1st phase of revenue willPage 12 30 March 2007
LMA International NV
2
expect to see higher usage and thus an increase in revenue of the
consumable probes and CO2 cartridges. Management has highlighted that
these consumables are difficult to replicate for the Stonebreaker to deliver
the same performance. We note that the likelihood of re-use of probes is
more probable than buying cheaper 3
has mentioned that new flexible probes are being designed as an additional
offering to the present straight probe.
nd phase revenue stream. With an increase in the installed base, werd party consumables. ManagementEndorsement of product.
LMA has signed an exclusive distributorship agreement with EDAP. EDAP,
with more than 25 years of experience in sales and distribution, has a
strong knowledge of the medical community in France. The company has
significant expertise in the domestic lithotripsy market and a dedicated
distribution network.
As a show of quick marketing execution footwork,Current Stonebreaker capacity.
are able to produce Stonebreakers by the ?hundreds? from their Switzerland
plant but it would be simple to replicate the production line and thus
quadrupling capacity if necessary.
Management has indicated that theyForecast for Urology.
for the Urology segment. As guided, we forecast that the Stonebreaker will
grow exponentially from its small base to contribute about US$3m in FY07
and grow 120% YoY to contribute US$6.5m in FY08.
Management is confident of achieving strong growthManufacturing and distribution
Low cost centre advantage.
its single use products, including the high yielding new Supreme product,
in Singapore. The EU and US still continue to produce the reusable products
as ASP compression in that segment does not weigh in on costs. LMA
also utilises Singapore?s status as a global transport hub to efficiently ship
products all over the world and a launch pad to reach the rest of Asia as
key emerging markets like China, India and Australia are within an 8-hour
flight radius.
LMA compresses costs as it produces all ofPage 13 30 March 2007
LMA International NV
Figure 9: LMA?s global presence
Source: Company, OIR
Industry and growth prospects
Increase in surgical procedures.
surgical procedures done in a year all over the world and is growing at the
rate of 20% (per year till 2012). The market for airway management devices
is dependant mainly on the number of surgical procedures conducted. Every
procedure conducted with general anesthesia has to use an airway
management device. This boosts the need for airway management devices
and hence acts as a driver to the market. LMA management estimates
that they take up about 38% of the total airway management products
used in surgeries.
F&S reports that there are over 170mMore day surgeries.
down on costs as they do not need to spend a night in the hospital as
surgical procedures improve. Laryngeal masks are easier to use and unlike
ET tubes, the patient has to take less drugs for sedation and thus patient
can come out of sedation quic
Hi Happyseah,
Where you saw the JP Morgan report ? Care to share ?