Trellus Health Share Discussion Threads

[discojames] 06/9/2023 18:02

How much debt does the company have

[hatfullofsky] 01/9/2023 13:06

Breakeven is on the IMC slide deckAt $100 per patient per month, breakeven at 6200 members (2.5% of TAM)Cash at $19m 2022 v $24m 2021, burn below $700k per month in 2023, cash into 2025 (at current revenue levels and capital investment)In early and late stage discussions with several health plans 2023 expecting revenue take off as 2022 pilot contracts roll into commercial agreements.130 patients currently enrolled (a long way to 6200)TRLS need to announce contracts and enrolment numbers for this to recover

[sharw] 15/8/2023 14:24

It was $19m (not £). If you listen to the last IMC presentation they say they were getting through $1m a month so that would last until the end of July 24. However, they have undertaken a cost control exercise to reduce this and in the annual report say "Our management team continues to focus on good cash control and our net cash position of $19.1 million as of 31 December 2022 is sufficient to provide a runway into at least 2025 (on conservative growth assumptions)".

The key question with this company is When will breakeven come? If you listen to the presentation from 13m 20s in (slide 11) you may well decide that it is at present uncertain. So the next question is Will the cash run out before that?

[seadog40] 15/8/2023 11:06

Yes, there's something very odd going on here!
Anyone got a theory?
I loaded up on Friday at 5p. Thinking of adding yet more.

[hatfullofsky] 14/8/2023 14:56

MCAP £9m / Cash £19m !!!! WTF ?

[wan] 14/5/2023 07:38

Worthy of note -

FDA’s Landmark Guidance on Decentralized Clinical Trials (DCTs) Signals a New Era of Patient-Centered Research

With the FDA’s acceptance and encouragement of decentralized trials, we can expect to see a continued shift towards remote trial conduct, virtual sites, and the use of innovative digital technologies.
By JONATHAN COTLIAR

May 11, 2023

DCTs are no longer just a novelty or an experimental approach but a legitimate and encouraged approach to clinical trial conduct. Virtual clinical trials enhance patient participation while reducing patient burden, ultimately providing a more flexible trial model. The successful implementation of these trials requires a well-trained team that can navigate the complexities of remote study conduct and ensure the quality and integrity of the data collected.

With the FDA’s acceptance and encouragement of decentralized trials, we can expect to see a continued shift towards remote trial conduct, virtual sites, and the use of innovative digital technologies. As the industry continues to embrace these advancements, we can look forward to a future where clinical research is more accessible, patient-centered, and ultimately more successful in delivering breakthrough therapies to those who need them most.

Full story -

Relevance -

Recall the following from the Half-year Report:

We are in late-stage discussions with two large pharmaceutical companies in the US, one for patient support services and another for clinical trials screening, and we are in ongoing discussions with two patient services partners who deliver programs to pharmaceutical companies as part of a centralized patient support hub. We believe that our methodology will help pharmaceutical companies to improve patient adherence behaviors, encourage customer loyalty and engagement, and support clinical trial screening. Success under our B2B2C model will see those organisations driving their own members to the Trellus platform.
(END)

Food for thought, as Trellus Health's digital offerings appears to also align quite well with the shift to DCT's.

[casholaa] 11/5/2023 20:22

Hahahaha dunno, but, my investment appears to be perking up, I think it's starting to make me feel better.

[idomeneo] 25/4/2023 18:23

This might not be the bottom but I bought £5k here. There are lots of negatives, but there is time and cash (it qualifies as a Ben Graham Net Net which has returned 460% over the last 11 years). They may need a stock market oriented CEO who is prepared to do the things which creates the noise to get people interested, but in the meantime we have a results day plus hopefully an "Investor Meet Company" or similar following that. There was no liquidity for that £5k, so it is just available to private punters at this price. No guarantee at all of a long term win, but that doesn't have to matter. Could tank to 4p if they come with nothing to say.

[casholaa] 11/4/2023 17:02

IBS in many cases is down to stress and fear. Reminds me of that line in Ben-Hur 'row well, and live'. We're all slaves to the State and are compelled to take part in its mad circus.

[mikemine1] 11/4/2023 09:31

TRLS seems to fit right in there with the Commission's view of the future. Well done Wan.

[wan] 11/4/2023 08:13

A very large and growing global market (unfortunately) awaits the 'combination' of technology and drugs that can deliver affordable and impactful care -

EDITORIAL| VOLUME 8, ISSUE 5, P391, MAY 2023

The economic burden of inflammatory bowel disease
The Lancet Gastroenterology & Hepatology
Published:May, 2023

Globally, the burden of inflammatory bowel disease (IBD) is increasing. Although the incidence of IBD in many western countries appears to be stabilising, it remains high (eg, around 50 cases per 100 000 in northern Denmark in 2020), and as an incurable, chronic condition set against a backdrop of ageing populations, prevalence is rising. Data from Lothian, Scotland, for instance, suggest that one in 125 individuals had IBD in 2018, which is projected to rise to one in 98 by 2028 (and one in 65 for those >80 years).

This continued growth in prevalence will inevitably lead to increased use of health-care resources by patients with IBD, particularly as populations age and management becomes more complicated. Although there have been welcome developments in our therapeutic armamentarium against IBD, many of these new drugs will be expensive, and greater use of biologics and small molecule drugs, aggressive early treatment strategies, and intensive disease monitoring will place a heavy burden on health-care resources that are already stretched in the wake of the COVID-19 pandemic. And besides such direct costs, indirect costs—ie, those related to disabilities or impairments that result in work productivity loss—are likely to rise too.

The aim of The Lancet Gastroenterology & Hepatology Commission on the cost of IBD in high-income settings, published in this issue, was to examine the current costs of care for IBD and the drivers involved in its increasing economic burden, and to explore means to deliver affordable, equitable care for those with IBD in the future. Estimation of the true costs of IBD was not feasible, given the heterogeneity of health-care systems and a lack of transparency in how prices for medications and services are set across the world. Nonetheless, the Commission found that IBD has exerted an increasing financial burden in almost all high-income countries, primarily driven—as anticipated—by new, expensive drugs and intensive disease monitoring and treatment approaches. In addition, the Commission identified societal and structural factors—eg, inequalities in access to care—that also drive costs.

The Commission proposes a wide range of actions that should be explored to deliver affordable IBD care. One particularly timely option is the greater adoption of biosimilars. Although savings with the introduction of infliximab biosimilars were not as great as anticipated, between eight and ten adalimumab biosimilars are anticipated to enter the market in the USA this year, which could help drive down costs. Other options include task shifting of care, for instance involving greater use of IBD nurses, and the adoption of digital technology to simplify patient–health-care provider communication and disease monitoring. Continued research into personalised IBD medicine is essential.

[mikemine1] 06/3/2023 10:11

Very good RNS. The company is now in to commercialisation, the product is very well received, funding should last in to 2025 and growth and new opportunities are forecast. Apart from a report of a huge revenue stream, I don't know what else they could have achieved.

I think clinicians will drive the adoption of Trellus's system as, from what I've heard from sufferers, the current treatments are not well organised and fragmented and this is leading to a moral sapping environment for them to work in. Everybody likes to have successful workplace experiences and clinicians are no different.

[wan] 06/3/2023 07:17

We now have the Trading Update, which is welcomed.

Revenues are set to grow throughout 2023, albeit from a low base, from the existing and other projects under discussion (which may also included the unmentioned pharma discussions) -

"With early revenue generation having commenced, the Company expects this to grow throughout FY 2023 as a greater number and range of projects are both underway and under discussion. The continued generation of data allows for larger scale discussions and agreements to be reached over time, including more material B2B2C contracts."

[wan] 28/2/2023 10:11

Well, do we assume that the delay of around 6 weeks in launching the D2C IBS offering (still ahead of the originally expected launch for IBS in H1 2023) has had a bearing on the delayed TU?

Not to mention the progression to late-stage discussions with several pharma co.'s and patient services partners who deliver programs to pharmaceutical companies, is perhaps also taking longer, and I can see that some pharma's have an interest in addressing IBS (and IBD e.g. Takeda), and that a certain patient service partner covers IBS, but not IBD.

I am trying to remain somewhat optimistic (but it's wearing thinner by the day) but in any regard, the share price performance since admission to AIM has been utterly uninspiring, and thus the management have a 'lot' to do to change that!

[idomeneo] 28/2/2023 09:02

So the last day of February and apparently nothing to report on progress. No RNS. At an all time low. Can't they make something up?!

[casholaa] 24/2/2023 15:00

Look. IMVHO, this is not a business to public thing. As a result there are vested interests in maintaining the status quo with a wide variety of vested interests from billing for direct in-person treatment to pension funds and pharma and medical tools. This is a grower, not a show-er. No sense in drawing attention to it. It looks happy enough in my ISA 😎

[wan] 24/2/2023 14:47

Idomeneo...I agree that the CEO is excellent.

Certainly the share price performance appears to be reflecting disappointment, and not reporting as guided is clearly not helping matters. And lets face it, whilst the recent updates have been encouraging, none of them have been game changing, but they should nonetheless contribute positively this year.

The increasing interest from pharmaceutical companies and the progression to late-stage discussions (with at least two), might change the dynamics if they can successfully conclude something material.

Perhaps those discussions are taking longer, and they had hoped to include them as part of the detailed trading update, which in turn would imply they might be close to concluding?

I also have my eye on larger entities in the healthcare space where partnering with Trellus in addressing chronic conditions (initially IBD & IBS), could make a good fit strategically (expanding to address other chronic conditions, and/or some already covered by those entities), especially given that Trellus Health is the first and only digital health company to offer a 'scientifically validated', personalised resilience-based self-management training program for people living with chronic conditions which has been proven to reduce unplanned hospitalizations by 94%.

After the disappointingly slow progress to date though, and the market in a state of being very unforgiving, updates of only incremental progress will hardly be well received given the early stage Trellus is at.

[casholaa] 24/2/2023 13:03

I am just sitting tight. In my mind what is being sold is time and money for health professionals and estalishments. Best kept under the radar for now 😃

[idomeneo] 24/2/2023 12:34

"The Company expects to provide a more detailed trading update by early February 2023." It's late February and so far nothing.
CEO was saying on the 3rd October call that she had been "strategically insulated" but there would now be a lot more news flow and evidence of the financial benefits. Since October the best news has been the agreement with New York State-based health
insurer to offer the Trellus IBD program to up to 50 of its members over a
12-month period. So they just need another 7020 more to break even.
As far as I can tell nothing is happening with the b2c with the app which is surely where some money should be coming in. The downloads are negligible, so I don't see what will change to make this increase. In theory they the app is being pushed by the relevant IBD groups, but for whatever reason this is not translating into downloads (and therefore payments). If you are not being "sold" the Trellus System why would you choose it of your own volition?
I'm really scratching my head with this one. The CEO appears competent and dynamic but it would appear that the company will need all the funding it has and more to get this off the ground. After the call I was expecting that before now there would have been at least one announcement in the vein of "we have signed up XYZ Insurance Scheme which covers 3 million people and they will offer it to their 9000 IBD clients" All we have so far is a trial, which doesn't sound like they have been able to sell what they do without the insurer checking it for themselves despite the clinical evidence.

At a launch price of 40p: "The Company expects to generate initial revenue in 2021 through demonstration projects with healthcare payers in the New York City metropolitan area". So what happened to that? Why isn't that generating revenue now? Agreements and understandings mean nothing without a clear indication of the likely imminent revenue.

Has anybody any evidence of better actual financial news? Wouldn't it have been better to have made an announcement explaining why they were delaying the promised early Feb update?

[mikemine1] 21/2/2023 15:56

This is not the first I've heard from unfortunate people like LondonMarket about a the shambolic and disjointed approach the health service has to treating IBS and IBD. I doubt it's much better in the States so I reckon TRLS's offering will go down a storm over there and welcomed as a gift from the gods by clinicians who are probably frustrated at their inability to treat to their own satisfaction. The NHS is a different matter because it's turgid bureaucracy is a real block to innovation.

[londonmarket] 19/2/2023 22:04

As someone with IBD (Crohn's) I would love for the NHS IBD management teams to start using platforms such as the one Trellus are developing.

Currently, it's a mix of emails, phone calls and letters for long-term IBD management (monitoring, testing & treatment) which aside from being costly, timely and probably more expensive it's also a massive security risk. More than once I've received messages or blood test forms meant for another patient under the team. It's an antiquated way of managing patients which could be easily fixed and improved with the Trellus system from what I understand

[wan] 17/2/2023 07:41

Further news today regarding the inclusion of IBS as well as IBD, and also the expansion of one of their existing agreements with the Mount Sinai Health System. In short, the Trellus Method is now available to a much larger target patient population by addressing resilience in IBS as well as IBD.

In my view, the increase in the generation of real-world evidence of the health and economic outcomes from expanding into both IBD and IBS, will not only support B2B2C engagement, but potentially provide further support to expand into other chronic conditions. Trellus has already stated that they believe its methods have utility across a number of other chronic conditions.

Recall also that The Company expects to provide a more detailed trading update this month.