Inspiration Healthcare Share Discussion Threads

[hastings] 06/5/2020 10:08

I haven't had time to digest fully the new broker note this morning, but suffice to say that a continued positive performance on the back of this mornings update should result in an upgrade.


Anyway, penned this for interest, was earmarked for my column but I'll probably write that again now.


No share, or very rarely does one tick all the boxes, but when a number of factors come together positively, it is usually worth delving deeper and considering its investment merits.

The first thing to note with IHC is that it operates in a market that is in many ways somewhat insulated from the effects of any impending recession or the inevitable downturn.
That is because the company is a supplier of life saving medical devices in areas of neonatal intensive care and patient warming, which by their nature are pretty much non negotiable, perhaps even more so in these strange times.

More on that in a while, but in addition to operating in what can be seen as a constant market place, IHC is firstly profitable, holds net cash of £4.5m, stands on a PEG of 0.42 and in its most recent results delivered impressive organic growth of 12%.
There are a few potential negatives if you use the likes of Stockopedia or other platforms, but as I always like to add, it is worth remembering that such tools are largely lagging, working on historic numbers/data and often do not take into account the most recent events or data related to a company's prospects.

Admittedly though, at the current price of 62p the shares trading on a forward PER of 14 probably look priced about right at present, particularly in such uncertain times.

However, IHC appears to have some really excellent growth prospects and it is interesting to note that it has, over the last few years cemented a very strong relationship with the NHS as demonstrated by recent news which is now assisting the company in further delivering on its business plan.

Regarding the recent news here, having announced on the 16th March that it was to supply ventilators to the NHS for the fight against Covid19 which was a positive in itself, it subsequently went on to announce additional orders for other medical equipment and further ventilators to the value of £4m.
Then, last Friday, confirming that a first batch of ventilators had arrived in the UK the company added that it had extended its 24 hour helpline facility to clinical staff at all UK hospitals in relation to access to qualified personnel employed directly by IHC relating specifically to the ventilators.

Broker Cenkos described the news as a hugely significant announcement for the company and highlights the close relationship the team has developed with both the NHS and its commercial partners.

Further positive news was also forthcoming last month too concerning a collaboration with Genedrive regarding its anibiotic induced hearing loss test across the UK and Ireland.

The companies also expect to expand the scope of the contract over time to engage Inspiration Healthcare's network of more than 50 neonatal-focused sub-distributors around the world.
The Genedrive MT-RNR1 AIHL test is the world's first point-of-care genetic test designed for use in a neonatal intensive care setting. The test screens newborns for a genetic mutation called mt-RNR1 that can cause lifelong and irreversible deafness to a child upon administration of certain antibiotics.
“Our agreement with Inspiration Healthcare combines genedrive's innovative first-to-market AIHL product, with a thought-leading healthcare company with a specialist emphasis on neonatal care,” David Budd, Genedrive's chief executive officer said in a statement.
“Inspiration Healthcare has a strong track record in the introduction of new technologies and over many years they have developed an extensive network of key opinion leaders that will be very beneficial as we bring the Genedrive AIHL test to market together,” he added.
Neil Campbell, the CEO of Inspiration Healthcare, said the company was “delighted to be able to work with genedrive”.
“Our focus has always been products that can have a profound effect on the patient outcome and we look forward to working with genedrive to make this test the standard of care in the UK and the wider neonatal community around the world,” he added.

Having also released its full year results last month, revenue for full year 2020 came out at £17.8m which saw the critical care market provide for £11.4m of sales which enjoyed a 7% increase where its AlphaCore5 warming system for patients in neonatal intensive care units was a key driver.

Sales for Operating Theatres came out at £1.7m whilst Home Healthcare revenues jumped by 50% year on year which now sees the company distributing Micrel parenteral feeding products.

With a decent mix of its own brands complementing others, both of which are focused on disruptive innovative technologies the company looks well set to continue on a growth trajectory which is likely to boost impressive organic growth by timely made acquisitions.

To this end, it made its first purchase last year in the form of Viomedix for £4m (placing) and given the prevailing climate, this looks to be an excellent acquisition as the acquired business provides innovative solutions to resolving patient problems in the respiratory care market.

What's more, it is very much specialised in the designing and supplying of disposable respiratory products and sterile medical consumables including
breathing circuits, perforators and surgical markers.

Returning to the neonatal area where the company is very much focused, it is worth noting that according to various industry reports, particularly that of Grand View Research Inc, the fetal and neonatal care equipment market is expected to be worth some $10.6b by 2026 based on an expanding compounded annual growth rate of 6.9%.

Although IHC is already making sound progress in this sector it isn't resting on its laurels and has, within its pipeline of novel products/devices a very recently US (recently patent granted) project named Project Wave.

The company entered into a licence agreement in 2019 with a major US West Coast University to develop what is described as a new ground breaking device that will target apnea of prematurity which is defined as the cessation of breathing by a premature infant that lasts for more than 20 seconds and is accompanied by often very serious complications.

Treatments that have been used for almost three decades have raised concerns of long term negative effects, so IHC looks to have identified a positive health and commercial opening with what is described as a ground breaking respiratory device that is now expected to move quickly to trials this summer.

Research at the university involved has found that the device could help to normalise an infant’s breathing rate and reduce apnoea associated with prematurity.

Inspiration Healthcare have indicated that over 1.5 million babies suffer from apnoea of prematurity (or require respiratory support) each year, indicating a potential market size for Project Wave of over $60m per year.

A significant feature of Inspiration Healthcare’s business strategy is, according to broker Cenkos a focus on the neonatal intensive care market.
This is an essential, non-elective market where – premature and unwell newborns in western markets will be treated regardless of economic pressures.

The company, which was once a pure distributor of medical equipment has now grown into a fully integrated medtech technology company within the neonatal intensive care setting, which doesn't appear to be reflected in its market valuation where many still seem to perceive it as pure distribution play.
In that context, the current market cap of £24m looks pretty modest, particularly in light of an increasing proportion of Inspiration’s revenues (46%) and profits being generated from the sale of equipment under its own brand.
This provides the company with greater product control and the generation of improved margins.
With an already established footprint across the UK and Ireland the company will look to expand that further whilst it is also actively looking to increase its presence across international markets which at present only accounts for circa 12% of revenue.

Looking ahead to the financial year in play, Cenkos is expecting revenue of £20.4m, Ebitda £2.83m and adjusted pre-tax profits of £1.88m providing for EPS of 4.2p aND net cash is expected to improve to £4.7m.

The 52 week range of the shares is a low of 55p against a high of 90p, which suggests that if future progress is maintained as expected, alongside another timely acquisition, then investors eyeing the medium-longer term could be suitably rewarded.

Obviously there are some big name players also operating in the space but given the number of active smaller players gives it something of a fragmented look, suggesting a ripe environment for consolidation.

IHC has clearly made solid progress in recent years and the management appear sound with a conservative approach, as revenues largely organic driven have improved from £9.5m in 2015 (listing year, via reverse into (Inditherm) up to the recently reported £17.8m.

Pre-tax profits have also in the last three years begun to build momentum and the board has already stated an intention to commence a progressive dividend policy as of next year.

[lammylover] 06/5/2020 09:58

Good RNS, but not great RNS. Why oh why, can't they start with we are PLEASED to announce Q1 revenue up 27%? Other companies believing that they are undervalued (which I believe IHC is significantly) would have really sold this uplift! And this is before the additional £5m order (recently fulfilled) for ventillators for the NHS. Good company, still cheap IMO at 65p. Got to be worth 70p+ now and probably 90-100p by the end of year. Rich

[vprt] 06/5/2020 08:38

Yes, Hastings, come on, please...

I wish that today's RNS - obviously great news - had specified how much of that impressive 27% growth was organic, as the 2019 acquisition of Vio added quite a bit of revenues (and some of Vio's ca £2.5m p.a. was "internal", as Vio was a supplier). Still plenty of organic growth, I would think? (Any guesses from anyone?)

[troutisout] 06/5/2020 08:37

Extracts from the report tweeted by IHC yesterday....I think they have been trying to tell us they feel undervalued....

"The global neonatal infant care equipment market is estimated to account for US$ 3,330.5 Mn in terms of value by the end of 2027."

"Key Takeaways:

The Thermoregulation Devices segment in the global neonatal infant care equipment market was valued at US$ 968.0 Mn in 2019 and is expected to reach US$ 1,642.4 Mn by 2027 at a CAGR of 6.8% during the forecast period. Increasing incidences of preterm births in developed and developing regions during the fore".

"Lack of neonatal infant care equipment in developing economies is expected to offer lucrative growth opportunities for players in the market."

[hastings] 06/5/2020 08:25

Ok I'll pop up mid morning. I've taken a position here, I feel it's got decent mid-long term prospects.

[troutisout] 06/5/2020 08:23

Yes please Hastings. I remember your pieces on SDI.

[hastings] 06/5/2020 08:20

I penned some comment and thought on this for elsewhere at the weekend, if there is any interest I’ll pop it here too.

[troutisout] 06/5/2020 07:55

Could this be the catalyst to breakout upwards from that wedge???

[jock363636] 06/5/2020 07:16

Good positive RNS

[troutisout] 05/5/2020 22:56

Update on the chart, note the lovely hammer from today,


free stock charts from uk.advfn.com

[troutisout] 05/5/2020 21:50

vprt,
Looking at it, Miton had roughly 10% in redemptions last year,there was no TR1 from them, so any selling here was small.
They were recently selling IHC in January and then bought over 3.5m shares on 20th Feb this year.

I am not sure that there will be lots of redemptions as Miton explain in their RNS that they are likely to use a redemption pool to sell some of their investments and redeem to shareholders. This could take time and will lead to reduced prices for their share sells, then they may have to pay Income tax on this, rather than CGT on selling shares in the Trust. In effect they seem to be putting as many hurdles in the way of people redeeming.

[vprt] 05/5/2020 20:09

Hi troutisout:

I'm not an expert on investment trusts and have not spent time pondering such "what if" questions (as I don't own MINI) - others might have better views on that. But I don't think an annual redemption clause is a standard thing, and possibly quite unusual. The point is that I believe there is quite some risk of IHC shares being sold in the market, but it is unclear how many, and how gently/slowly or brutally/quickly this will happen.

Miton give themselves lots of leeway on the "how", as the following extract from the RNS illustrates. (It seems to me that they are trying to shelter long term holders i.e. those who are not redeeming by letting the "Redemption Pool" take most of the pain from any low-valued sales, if they choose to carve up the assets in advance in that way):

"Shareholders submitting valid requests for the redemption of Ordinary Shares will have their shares redeemed at the Redemption Price which is calculated on either of the following bases:

I. The Directors may elect to divide each of the Company's portfolio holdings in proportion to the percentage of shareholders opting for redemption and set them aside in a Redemption Pool to be sold via the stock market. When complete, the realisation proceeds after deduction of costs would be distributed to shareholders pro rata. It should be noted that the liquidation of a Redemption Pool can be expected to take some weeks or months, and the final capital sum may not amount to the initial valuation of the Redemption Pool. As highlighted in the Company's Half Year Report, published on 13 December 2019, shareholders should note that this is the method most likely to be used; or

II. If the percentage of the Company's shares that opt for redemption is a modest proportion of the Company the Directors can set a Redemption Price that is equal to the Net Asset Value per Ordinary Share (including current period revenue) (the "Dealing Value") prevailing on the last business day prior to the Redemption Point.

The Directors may elect, at their absolute discretion, to calculate the Redemption Price on the bases set out above, or the Company may arrange for such shares to be sold in the market at the Dealing Value (subject to the Directors' discretion). At the date of writing the share price of the Company is standing at a discount to the Net Asset Value, and if this was the case at the Redemption Point, then it is unlikely that there would be willing buyers of the redeemed shares at the Dealing Value.

The Directors are minded to approve all redemption requests unless there are exceptional reasons why this would be contrary to the interests of all shareholders. " ...

[troutisout] 05/5/2020 19:01

Neonatal Infant Care Equipment Market to Witness Robust Expansion Throughout the Forecast Period 2019 - 2027

buff.ly/3dhJOUN

[troutisout] 05/5/2020 16:59

vprt,
Thank you for your comments, I hadn't seen the Miton discount. Can I ask a few questions on that please?

If everyone redeemed and Miton had to sell their holdings then that would trash the SPs and give those redeeming a much smaller return?
If the NAV is higher than the Trust share price when they redeem do they do that instead of selling the Trust shares?
If so surely they are better off waiting until the share price rises towards the NAV, or is it lower as so many people are trying to exit?
Looking at the IHC holding it is #3 on their list, but most of their investments are FTSE, not AIM, so wouldn't they try and sell those down first, especially as it seems almost impossible to get any decent size in the market from the MMs?
Why assume there will be a lot of redemptions, surely this is an annual occurrence, do we know there will be lots of redemptions this time round?

As you can see I am not quite au fait with Investment Trusts, I have tended to invest on my own say and have had success and failure, but still seemed to have outdone some of these Investment Managers a lot of the time.

[troutisout] 05/5/2020 16:38

Thankfully not, Neil Campbell, don't know where that came from? Trying to multi-task too much here....

[cockerhoop] 05/5/2020 14:19

Thankfully not Neil Hamilton :-)

[vprt] 05/5/2020 12:12

Thanks troutisout and geovest, good comments.

I suspect that the IHC shares are being held back somewhat by being (or by other investors knowing that it is) the #3 holding of the struggling (high NAV-discount) investment trust with ticker MINI which is bound by its own rules to offer its shareholders an annual redemption opportunity which might trigger further IHC sales. (Catch 22 situation?)



hxxps://resources.mitongroup.com/srp/lit/71YPDg/Fact-sheet_Miton-UK-MicroCap-Trust-plc-Miton-UK-MicroCap-Trust-plc-Ordinary-Shares_31-03-2020.pdf

Worth keeping in mind. This might present an opportunity for long term IHC-investors, but it might perhaps also get worse before it gets better - see the dates in the RNS.

I hold IHC but not MINI. DYOR.

[troutisout] 05/5/2020 11:44

Proactive interview with Neil Hamilton

tinyurl.com/y7akw8a9

[troutisout] 05/5/2020 11:33

So at £3.5m for UK and Ireland and £35m for global revenues, this looks to be a decent revenue stream for IHC. Unlike a normal Distributor, IHC are tasked with introducing the test to it's network of experts and opinion leaders to get acceptance of the test as the standard of care in Neonatal ICUs so I would hope they will receive a greater margin than just for distributing the products. Not sure this news has sunk in, looking at the current share price

[troutisout] 05/5/2020 11:32

From the IHC RNS,
"Neil Campbell, Chief Executive Officer of Inspiration Healthcare commented "We are delighted to be able to work with genedrive plc with this novel testing device for new born babies that could suffer hearing loss due to anti-biotics given to them on admission into neonatal intensive care. Our focus has always been products that can have a profound effect on the patient outcome and we look forward to working with genedrive to make this test the standard of care in the UK and the wider neonatal community around the world."

"David Budd, Chief Executive Officer of genedrive plc, said: "Our agreement with Inspiration Healthcare combines genedrive's innovative first-to-market AIHL product, with a thought leading healthcare company with a specialist emphasis on neonatal care. Inspiration Healthcare has a strong track record in the introduction of new technologies and over many years they have developed an extensive network of key opinion leaders that will be very beneficial as we bring the Genedrive AIHL test to market together."

[troutisout] 05/5/2020 11:31

This was in the Genedrive placing RNS today, note the projected revenues for this test.

"Antibiotic-Induced Hearing Loss ("AIHL")
Around one in 500 infants carry a genetic mutation that's puts them at risk of suffering lifelong profound hearing loss after exposure to gentamycin, a commonly used antibiotic. genedrive has developed world's first rapid point-of-care genetic test for neonatal intensive care. There are no other point-of-care tests commercially available for AIHL and the Directors believe genedrive's test could support a new standard of care for all urgent case infants.

genedrive's AIHL test has a high clinical accuracy with 100% sensitivity and 100% specificity. Implementation trials for the test are progressing at Manchester and Liverpool but, as announced on 25 March 2020, have not been able to continue at the same pace as previous months as a result of NHS resources being diverted to address COVID-19.

On 24 April 2020, genedrive announced that it had entered into a distribution agreement with Inspiration Healthcare Group plc for the distribution of genedrive's AIHL test in the UK and Ireland. The Directors estimate the UK and global markets for this test to be worth up to £3.5 million and £35 million per year, respectively, to genedrive based on a price of £2,000 per Genedrive® unit and £35 per test."

[garth] 04/5/2020 10:28

Geovest,

Thank you very much. A knowledgeable contribution in an atmosphere of lots of short wave noise. Good stuff. Forecast PE looks much better. I haven't used EV/EBITDA - I wil run it over some of my stocks and see how it looks!

Kind regards,

G.

[grannyboy] 04/5/2020 10:21

There's going to be plenty of testing for covid19 in the future, either to show those who have had it, and those who might have it ... And there are many companies claiming to have/looking to develop theses tests ... But there is a company, EKF Diagnostics(EKF) That would benefit greatly from any/all companies involved in this covid19 gold rush, by supplying the 'Picks and Shovels' needed.. DYOR!

[geovest] 04/5/2020 10:02

Garth, for the sake of clarity: Your PE of 28 is based on last years basic results which included exceptional cost (acquisition cost of Vio and write down of investment in Neuroprotexion, both which are really exceptional cost). Excluding this underlying EPS was 3.4p and next year forecast is 4.2. That gives a historic PE of 18 and a Forecast PE of 15.

Sometimes a better and more consistent comparison between companies is to look at Enterprise value/EBITDA. Forecast EV/EBITDA is 10, which is relatively cheap.

There has been a lot of speculation and hot air around this company in the last few weeks, just look at the number of posts since Feb on both threads compared to the number since listing. Thankfully the rampers and trolls have now departed (mostly). Forget ventilators etc, they are one-off and probably low margin.

This is an interesting business in a specialised field. Some good products, good relationships and interesting pipeline of product development. Good long term potential but at a 10 - 15% growth per year plus potential acquisitions. Good as a long term investment, not for those looking to trade.

[garth] 03/5/2020 14:09

28x earnings. Not cheap. About 15% cash.

Genuinely interested if someone wants to take the time to justify what looks like a heady rating - even in a strong market.

G.