Thanks Mikko for the good clarification, and indeed it’s perfectly understandable that no one has an unlimited amount of liquid assets.
I have now thoroughly reviewed the annual report and consequently updated my own forecast for this year. For this, I would welcome challenge and comments from all who are able.
Let’s try to comment on your table:
Sales of therapy devices could be expected to remain at least the same as last year, one could even expect robust growth, which has been seen in recent years (-23 7 devices → -24 17 devices). Last year, 5 devices were undelivered, and this year 4 sold (2NBS6 and 2NBS5) + Sinaptica’s test device have already been announced. Since sales pipelines for diagnostic devices are long, I recall from somewhere that it’s about 1.5 years, so it’s assumed that old distributors will secure deals, and not all of these will go through Brainlab. Therefore, I significantly increased the estimate for Nexstim’s own diagnostics sales, for example, to a high estimate of 2 million, because the low estimate has already been exceeded.
In my opinion, the recurring revenue figures for therapy are too low in your table. In 2024, 17 devices were sold, and a large part of them did not have a full year of operation. Based on the figures, -23 and -24 therapy devices generate recurring revenue of approximately 24K per device, and at the end of -24, 107 were in use. Based on devices sold last year alone, an increase of closer to 500K could be expected, as sales were concentrated towards the end of the year. This year, 2 have been sold early in the year, and undelivered devices from -24 are presumably also therapy devices. Thus, even on these grounds, recurring revenue for therapy is at the average of the table. I consider it likely that recurring revenue for therapy is closer to the upper end of the table or even higher. In the years 23–>24, with the sale of 7 therapy devices, recurring revenue increased by 560K.
Diagnostic devices generated recurring revenue of 5-6K per device in use, so for that part, I suspect more moderate growth, and we won’t even reach the average you stated in the table. I guess it will be 100-200K short.
Regarding Magnus Medical, I dare not say anything at all. One can always hope, but I currently value it at zero. I would not factor anything into the result from this.
Regarding Sinaptica, I naturally hope for as much as possible this year, but there is no actual contract in hand, so the probability and the amount of 4050K are, in my opinion, a bit much. Of course, if everything goes perfectly, it’s entirely possible.
I believe costs will remain moderate, as the CEO emphasizes cost discipline and profitable growth, and I don’t think there’s anything groundbreaking in the air.
With these considerations, I would place Nexstim’s result for next year somewhere around 5 million, without massive revenues from Sinaptica. If Sinaptica were to materialize in all its glory, then the situation would be completely different.
I’ll add that now that I’ve been pondering those numbers, the continuous revenue from therapy is very interesting. If there were 1000 of these in use, the revenue would be 24 million. Of course, there are only 107 now, but scalability is possible here too.
I assume that the Alzheimer’s treatment equipment also has good continuous revenue, so the Sinaptica launch might bring a lot of good in terms of continuous revenue.
After today’s reflections, Nexstim’s future value increased in my mind. 
Interesting analysis, Jatast and Kyhnykeisari. I myself have recently become interested in this stock.
Jatast, where do those sold unit numbers for the devices come from, and where does the estimated unit price come from?
Do you have any idea what healthcare professionals using these devices think of Nexstim’s products vs. others? User experience also matters quite a lot. If professionals say that the product is excellent and they want more of these, then it probably carries weight in purchasing decisions as well.
Another thing I’m wondering is how price-competitive the TMS device sector is?
Do you see Nexstim’s device sales being primarily limited by awareness and sales channels, or do competitors’ devices have better features, a lower price, etc., which would make a hospital want to buy them instead of Nexstim’s? I’m mainly considering this from a long-term growth perspective, as Nexstim’s device sales are still quite small and growth is rather moderate, so what causes this smallness? And how much can it grow just by increasing awareness or through Brainlab and other potential partners and advertising?
The number of units sold comes from annual reports. They specify units sold and those currently in use. By calculating from that, one gets indicative figures. Of course, they are not 100% accurate, but rather an average. In my opinion, quite sufficient for this type of analysis.
I don’t have information on how many devices Nexstim has compared to others. I guess Nexstim is still a relatively small player, but that’s precisely my point here. Nexstim’s device is more expensive than others and is sold with a good margin. There’s something special about it, but what it is, I can’t assess myself. Top universities and hospitals are buyers, and this has been the case for a long time. The important question is why would they buy a more expensive device if there were no special benefit? Well, they wouldn’t. In one public procurement tender (Hilma), it was stated that no similar device is available. For this reason, I have been invested for some time with at least a reasonable stake relative to my own portfolio.
I believe that one limiting factor is certainly that not everyone knows about Nexstim’s device. On the diagnostics side, I expect Brainlab’s sales channels to be many times more effective than Nexstim’s own. Regarding therapy, there was an excellent opening with Magnus Medical, but in my opinion, it is now even negative for Nexstim if the agreement restricts the use of the Saint protocol in the USA. TMS therapy is still in its infancy worldwide anyway, but the growth opportunities are enormous.
Additionally, these Sinaptica-type openings create added value for the future. I expect more of these. In my mind, I somehow think along the lines that Nexstim’s current value is 20% and future value is 80%, or 10/90. In any case, we are invested because of the future value. Whether this will materialize in 3, 5, or 10 years, that’s hard to know. Now the company will presumably start operating on its own, so I’m not so worried about when the actual future value will materialize in the share price.
One often notices on this forum that the slowness of the health technology sector is not understood. Equipment acquisitions are not made just like that, especially in the public sector, but they are budgeted for the coming years. For this reason, even Nexstim’s sales focus on the end of the year. And it also takes time for doctors to warm up to new treatment methods. Once there is enough data and evidence and the treatment methods become treatment recommendations, then the path is open.
Even in Finland, there are many older doctors who, even under threat of dismissal, want to use archaic devices or systems. Even at the wellbeing services county level, they have the power to throw a wrench in the works even for large and cost-saving acquisitions. They threaten to leave if they have to learn something new, and they cannot afford to be lost. Having owned and followed Nexstim for almost 6 years, I think this is progressing very well and in a manner typical for the industry.
I’d also like to add this for those considering investing:
Nexstim has immense potential because it introduces a completely new treatment method for depression. In the same way that X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) have been key imaging methods for decades, Nexstim’s technology can become a permanent part of treatment practices. Not to mention Alzheimer’s treatment, etc.
Nexstim leverages precise brain mapping and targeted transcranial magnetic stimulation (nTMS) in the treatment of depression. This means that the treatment can be precisely targeted to the exact right spot in the brain, making it more effective and personalized compared to traditional treatment methods, such as medication or electroconvulsive therapy. Nexstim is creating a completely new form alongside these treatment methods, a field that others can then enter to compete after decades of development work.
If Nexstim’s treatment succeeds, it can become a long-term standard in the treatment of depression, just as traditional imaging methods have maintained their place in medicine for decades. Healthcare develops slowly, so new effective treatments can remain in use for a long time before being replaced by even better methods. And indeed, depression is just one of these for which a completely new treatment method is being developed.
P.S. I only used imaging as an example because they are familiar concepts to the layman. Of course, Nexstim’s device also performs imaging for brain surgeons, so why wouldn’t it also stand alongside those.
Right, and as I understand it, Nexstim has a fair amount of patented technology, so if everything went tremendously well, for example, that Alzheimer’s treatment might be something others simply can’t replicate.
Somehow, I imagine the MM case is about something similar. They surprisingly snagged a couple of new partners after acquiring some important technology from Nexstim, and at the same time, contractually shut out the toughest competitor from the market. Of course, this is rather nasty speculation, but the timing of MM’s new contracts and FDA approvals don’t really align with the idea that they were seriously developing that treatment with Nexstim.
So, the goal here is to expand these treatments, for example, to the treatment of normal age-related memory decline. There’s a market there many times over, in addition to Alzheimer’s.
A recent overview of the TMS field for those interested in weekend reading. There were also a couple of mentions of Nexstim.
Magnus Medical had filed a notice with the SEC about an ongoing funding round. Over 40 million dollars already raised in this round. From that, it’s suitable to pay a settlement to Nexstim, so they can focus on growing the business instead of litigating.
Can it be determined somewhere what amount of shares that 58.99 million represents in relation to the total number of shares? So, what is the value of the entire company at the moment?
That information does not seem to be available in public sources. One could assume that 10-20% of the company will be distributed in that offering. Calculated that way, that would be 245-590 million dollars.
Does anyone in the thread know if the US company Magnus Medical has sold / how a potential sale has started regarding this device, about which the parties disagree whether it contains Nexstim technology / about licensing fees?
Nexstim as a guest of Brainlab;
A big thank you to the Brainlab team for their hospitality when Nexstim’s management team visited their Munich headquarters last week!
Great to see how Brainlab presents Nexstim nTMS to visitors from all over the world.
Special thanks to Vera Hug, Rainer Corn, Tobias Schalkhaußer, Florian Hoffmann, Martin Immerz, Jana Guggenberger and everyone else for hosting our team. We look forward to working with you to shape the future of nTMS in neurosurgery!
If you want to read more about our collaboration: LinkedIn
#nTMS #brainmapping #neurosurgery nexstim #brainlab
It’s really hard to grasp the magnitude of the Sinaptica opportunity. It’s ridiculously huge in scale compared to Nexstim’s current business. We just have to keep our fingers crossed that they get FDA approval, then the path will be wide open for both Nexstim and Sinaptica.
- Over 55 million people worldwide are living with dementia, with numbers expected to triple by 2050 due to aging populations.
- Nearly 10 million new cases of dementia are diagnosed each year.
- Age-Related Risk – Dementia primarily affects older adults, with prevalence increasing significantly after 65 years of age.
- Alzheimer’s disease is the most common type of dementia, accounting for 60-80% of cases.
- Women are at a higher risk than men, likely due to longer life expectancy and hormonal factors.
- High-income countries have higher reported prevalence, but cases are rising rapidly in low- and middle-income countries (LMICs) due to aging populations and limited healthcare access.
- Family history, cardiovascular diseases, diabetes, and unhealthy lifestyles (smoking, poor diet, lack of exercise) contribute to dementia risk.
- Dementia-related costs are projected to exceed $1.3 trillion annually, placing a heavy burden on healthcare systems and caregivers.
- Mortality Rate – Dementia is a leading cause of death, ranking among the top five causes of mortality in many developed nations.
- Though rare, dementia can occur before 65 years of age, accounting for about 5-10% of all cases.
Of course, depression patients are also a huge target group. ”Approximately 280 million people in the world have depression.”
The newsletter aimed at professionals listed quite a number of events in which Nexstim participates. In addition, there were again references to several new scientific studies involving Nexstim’s technology.
Nexstim on LinkedIn;
In this review article, authors from King’s College Hospital provide an overview of various assessments and therapeutic strategies using nTMS for spinal cord injury (SCI) and describe their effectiveness.
The authors state that nTMS has shown encouraging preliminary results in both clinical assessment and rehabilitation (motor and pain) in SCI patients, but more standardized data is needed.
They distinguish nTMS for measuring outcomes:
Combination with existing scales (SCIM III, WISCI II, GRASSP and others)
Prediction
Treatment selection
And nTMS for therapeutic purposes:
Peripheral nerve stimulation
Single-pulse TMS
High-frequency rTMS
Combinations with tsDCS
Paired associative stimulation, a combination of PNS and TMS
If you want to read more, you can find the full article here: LinkedIn