Robotic Spine Surgery [TASE]: MZOR
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1 Robotic Spine Surgery [TASE]: MZOR Nov. 2012
2 Forward Looking Statements Any forecast and/or forecasting statement, included in this presentation, is based on the Management's assessment at its discretion. However, these forecasts and/or statements are based on the Company's expectations at the time of this Presentation and do hold in store a number of uncertainties and risk to consider. It is important to emphasize that actual results may differ substantially from expectations in these forecasts and/ or forecasting statements, resulting from various factors. The Company does not make any representations regarding the accuracy and achievement of the forecasts and/or forecasting statements. In addition, forecasts and/or forecasting statements relate to the date of this Presentation only and the Company is not under any obligation to update or correct any of the forecasts and/or forecasting statements to reflect events or circumstances after the date of this Presentation. 2
3 Corporate Overview CORPORATE CORE PRODUCT & REGULATORY STATUS USER BASE SALES STRATEGY COMPETITION 80 Employees; Offices in Orlando, FL and Caesarea Israel Renaissance, Mazor Robotics Surgical Guidance system FDA & CE cleared 39 units in leading clinical sites; over 3,000 live cases & 25,000 implants Direct in the US (Ex-ISRG team) + International Distributors No other FDA-cleared robotics technology competitor for spine surgery REVENUES 2011 Revenues =$5.5M; H1/2012 Revenues = $5.3M Gross Profit Margin: 75%; 75% of revenues from the US FINANCING YTD financing: $56M; Cash balance: $20M Q2/12: Investment round completed - up to $15M led by Oracle Investment Management (Larry Feinberg) LISTING TASE: MZOR since 2007 Planned ADR listing on the NASDAQ early
4 Pedicle Screws Inserted Free-Hand are Misplaced in 10% of Cases Pedicle Screw Placement Accuracy: a Meta-Analysis Kosmopoulos V, Schizas C.; Spine 2007 Feb 1;32(3):E
5 Major Medical Complications were Reported in 5.2% of Complex Fusion Procedures Trends, Major Medical Complications, and Charges Associated With Surgery for Lumbar Spinal Stenosis in Older Adults. JAMA April 2010 Misplaced Pedicle screw Revision 5
6 Volume (# Procedures, USA) The Business Opportunity 400, , , ,000 Hip Replacement Spinal Fixation 200, , ,000 50,000 Prostatectomy Radical Hysterectomy Partial Knee Replacement Sphere sizes represent opportunity 0 0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000 50,000 Average DRG (2011, $ ) 6
7 US Annual Surgical Robotics Market = $1.9B Other (Mako Surgical, Mazor Robotics, Hansen and other) 9% Intuitive Surgical 91% 7
8 1.5 mm Accuracy Predictable surgical results per surgical plan Reduced intra-operative exposure to X-ray radiation Enabling minimally invasive spinal surgeries Facilitating complex spine operations 8
9 Spine Surgery with Renaissance Step 1: Plan Step 2: Mount Step 3: Operate Pre-operative blueprint of the ideal surgery is created in a virtual 3D environment 9
10 Four Mounting Platforms 1 Clamp Mount 2 Bed Mount 1 Hover T Mount 2 Multi-Directional Bed Mount 10
11 Spine Surgery with Renaissance Step 1: Plan Step 2: Mount Step 3: Operate Tools and implants are guided to the planned trajectory with 1 mm accuracy 11
12 Renaissance in Leading Medical Centers Around the World 39 Renaissance Installations Globally >3,500 surgeries; >25,000 implants No cases of permanent nerve damage 12
13 Clinical Support: Game Changer 28% 45% Converting to MIS >50% degenerative cases are MIS (vs. 13%) radiation exposure ~80% 6% 21% Percutaneous Revisions Deformity Open Cases Facilitating deformity Flatten the anatomy Improved clinical outcomes 13
14 Mazor Robotics Technology: Clinical Evidence 98.3% Accuracy of 3,271 implants in 635 cases in 14 medical centers with 49% of implants placed percutaneously (typically 10%-20% of spine surgeries are MIS) Devito DP, Kaplan L, Dietl R, et al. Clinical acceptance and accuracy assessment of spinal implants guided with SpineAssist surgical robot: retrospective study. Spine J. 2010;35(24): Compared to freehand surgery, in 112 cases Mazor Robotics-guided surgery significantly: Improved implant accuracy by 70% Reduced X-ray dosage by 56% Reduced complication rates by 48% Reduced re-operations 46% Reduced average length of stay 27% Kantelhardt SR, Martinez R, Baerwinkel S, Burger R, Giese A, Rohde V. Perioperative course and accuracy of screw positioning in conventional, open robotic-guided and percutaneous robotic-guided, pedicle screw placement. Eur Spine J. 2011;20(6):
15 Revenue Model Robot disposable $1.5K per procedure Renaissance Surgical System 4 Operate $829K Service agreement $83K per year 15
16 Product Price / AVG DRG Millions Attractiveness to the Hospital Admin Product Price / AVG DRG $ Product Price [M$'s] Prostatectomy & Hysterectomy Knee or Hip Replacement Spine Fixation 16
17 US Market: Current Install Base and Opportunity US Sales Organization: Q3/12 Total of 17 (6 Capital + 11 Clinical Sales Reps) Q1/2013: Total of 25 (10 Capital + 15 Clinical Sales Reps) Focus on 15 largest metropolitan areas 17
18 Early Stage in Building an Install Base Q1/2010 Q2/2010 Q3/2010 Q4/2010 Q1/2011 Q2/2011 Q3/2011 Q4/2011 Q1/2012 Q2/2012 Q3/2012 Installed Base - DACH & ISR Installed Base - US Installed Base -ROW 18
19 Number of sold kits Number of insall base Cases Volume Growth > 500% in 4 quarters Total # sales - US Installed Base - US
20 NUMBER OF CASES Utilization per System: >200% Growth Over 6 Quarters Q1/2011 Q2/2011 Q3/2011 Q4/2011 Q1/2012 Q2/2012 Q3/
21 Frequency % 10 70% of accounts have >3 surgeons using Renaissance % 9 8 Average # of Surgeon users per site = % % % 3 Cumulative % Frequency 20.00% % 0 More # of Surgeons using Renaissance Per Site 21
22 Case Study: Dr. Richard Francis Orthopedic surgeon Houston, Texas Impact on practice Incremental change after introducing Renaissance New daily patients Amount of surgeries Intra operative radiation exposure Impact of referral surgeons dinner (part of Renaissance marketing kit) Web site activity 40% increase 15% increase from last quarter 50% decrease at least 4 surgeries from doctors who did not refer in the past 10% increase 22
23 In the Pipeline Intended Use Regulatory Status (Anticipated) Brain Surgery Precise positioning of tools and implantable devices during brain surgery Target procedures: DBS, biopsy, shunt placement FDA cleared CE marked Expected Launch Late
24 Investment Consideration Established technology with new product and application expansion pipeline Proven business model with significant operating leverage Global footprint with experienced sales and management team Solidified capital base with PIPE financing 24
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