Specialist
Former VP at ViewRay Inc
Agenda
- ViewRay’s (NASDAQ: VRAY) customer profile and installation ease and costs vs those of players such as Elekta (STO: EKTA B) and Philips (AMS: PHIA)
- Key purchasing criteria – MR Linac vs traditional and alternatives
- M&A opportunities, competitive analysis and new market entrants
- Impact of Siemens Healthineers' (ETR: SHL) 2021 acquisition of Varian on ViewRay's radiation oncology market position
- 2022 expectations, RO-APM (Radiation Oncology Alternative Payment Model) outlook and other regulatory hurdles
Questions
1.
Could you outline the key trends in the US radiation oncology market and where you would place ViewRay within that market?
2.
Who are ViewRay’s key customers in the US and how diverse is its customer base relative to competitors’?
3.
What do you see as a key growth driver within ViewRay’s customer base in the short-to-medium term? What might drive demand for the MRIdian devices?
4.
How do you assess ViewRay’s commercial capabilities vs those of Elekta and others? How competitive is ViewRay as a sales team?
5.
Could you elaborate on ViewRay’s specific design advantages to utilise existing rooms?
6.
Some of the MRIdian’s advantages we’ve heard are ease of use, installation speed and ease of installation in existing rooms, as you highlighted. How do you think that higher ease of installation, for example, is driving demand for the MRIdian?
7.
You said certain aspects of the MRIdian’s installation and running fall more on the client. How detrimental to the client is having more of that burden on them compared to Elekta? Do you think that will be a deciding factor for a customer?
8.
What’s the installation cost difference between Elekta’s Unity and ViewRay’s MRIdian?
9.
How would you compare the MRIdian and the Unity on safety, efficacy and more generally?
10.
We’ve previously heard from specialists that the Unity is 1.5 tesla. How much of a differentiator for customers is this larger tesla magnet? Will it move the needle in a decision process, particularly considering the larger installation process that comes with that larger magnet?
11.
To confirm, you expect large academic hubs, research-focused hubs and university hospitals to be focused more towards the Elekta Unity vs ViewRay over the next 3-5 years?
12.
What’s your 3-5-year customer focus outlook for ViewRay? What type of customer might it target if Elekta is perhaps focusing on academic hospitals?
13.
ViewRay management said in its most recent earnings that it expects to double the number of programmes and quadruple the number of patients treated in a short time frame. What time frame should we consider and what will be the key drivers of this growth and uptake?
14.
What are your thoughts on a potential time frame for RO-APM [Radiation Oncology Alternative Payment Model] implementation? It was supposed to be implemented in January 2022, but some specialists believe it might never happen.
15.
How could APM impact adoption of MRIdian and Unity, if at all, even if it’s only implemented in disease states such as prostate?
16.
The recent MIRAGE clinical trial results comparing MRIdian MRI-guided vs CT-guided SBRT [stereotactic body radiotherapy] for localised prostate cancer seemed to be quite strong. The trial was ended early and the required number of patients enrolled was halved. How impressive were these results? They seemed to be more impressive than expected vs traditional radiotherapy.
17.
What is your outlook for MRIdian as a first-line treatment in prostate cancer?
18.
What other indications could move the needle for the MRIdian or Unity besides pancreatic cancer?
19.
What is ViewRay’s capability to meet demand for its machines over the next 1-2 years, considering the supply issues impacting the wider medtech industry?
20.
How do you perceive ViewRay’s management vs competitors such as Elekta’s? You have experience at both.
21.
Who would make strategic sense to acquire ViewRay? You listed GE, Toshiba and Siemens.
22.
How should we think about ViewRay’s R&D investment vs players such as Elekta’s? Is it enough to maintain its competitiveness?
23.
Are there any technologies that could be disruptive to the MRIdian or the Unity?
24.
Which players are developing the FLASH [ultra-high dose rate] radiotherapy technology you think could be disruptive?
