Tom Tamberrino
Analyst · Lake Street Capital Markets. Your line is open
Thank you, Mathieu. The era of interventional MR is here, driven by patient demand for fast recovery, no blood loss and AI based high precision treatment, as stated in Mathieu's remarks. The evolution of MR within prostate cancer has been happening over the course of several decades, but we stand at the frontier of where we are able to bring the MR into the intervention space to treat prostate disease, not just diagnostics and not just track it. TULSA PRO is the key to unlock the original equipment manufacturers of MR devices into the urology call point because of the fact that we now have Level 7 reimbursement from CMS that went live here January 1, 2025. We have introduced, as was mentioned at AUA, the TULSA+ program, which provides a turnkey solution to those urologists who would like to use our technology, but may not have the means to do so based on their current place of service. By doing this, we are enabling the pathway to adoption to accelerate and also providing the original equipment manufacturers the capability to provide a positive cash flow for those that are obtaining the MR plus TULSA solution. This pathway has been developing over a period of time, and we're ecstatic to be able to build off of the profound clinical services that have made this technology what it is today, which is a technology being demanded by patients. That pool is creating enough tension within the marketplace that we are receiving interest from physicians that we may not be calling on ourselves. The Siemens Magnetom FreeMax 0.55 Tesla is the perfect solution for the TULSA+ program for those physicians that may not have a place of service with a magnet to use. It is lightweight. It has the largest bore in the world of 80 centimeters, and it has a significant reduction in price such that when you combine it with TULSA+, you're able to substantiate the cost of ownership very easily. How so and why? Well, the service, the operations, the product itself and the installation associated with a 1.5 Tesla or larger Tesla strength is reduced by almost half, roughly 48%, when you look at the Magnetom FreeMax compared to the likes of a 1.5 Tesla. This fits in a space as small as 250 square feet. When you combine that with the ability to introduce AI, Siemens Deep Resolve, you're able to obtain images that are quality enough for intervention, but also for diagnostics. We have a complete solution for any site of service. This includes a mobile solution that we can provide in the interim for those customers that would like to start treating TULSA patients now as opposed to waiting for the completion of a brick and mortar operation. Reimbursement across all channels in terms of a place of service, office based laboratories, ambulatory surgery centers and hospitals. The feasibility of meeting the cash flow positive required to meet the TULSA+ solutions baseline is built off of the following assumptions, a 50% Medicare and a 50% private insurance split. The example I'm about to quote is specific to Chicago, Illinois, specifically in ASC. And if you were to try to justify the acquisition of TULSA+ and MRI and the full TULSA+ solution, it would require a minimum of 60 MRI diagnostic procedures a week. Compare that with doing TULSA procedures only, and that cost of ownership is met with only two TULSA procedures per week, so less than 100 per year. Obviously, we don't believe that it would be one or the other exclusively. We believe it would be a combination as suggested by the fact that the MR is becoming the gold standard and the epicenter of prostate disease care, inclusive of not only diagnosis, but also guiding in more biopsies, of course, TULSA-PRO as an intervention if required for malignant or benign tissue and then the follow-up thereafter in terms of tracking the disease state in conjunction with PSA levels. TULSA-PRO opens up MRI feasibility in urology, one day per week with two to four pulses and the other four days with 7 to 10 diagnostic scans can cover the monthly capital lease costs, the construction service, full time equivalents and marketing associated with the TULSA+ program. This is based again on assumptions of 50% Medicare and 50% private insurance, where the Medicare rate is 1.5x for private insurance and the diagnostic scan rate is 2.0x for private insurance against Medicare rates. All of this is also combined with the fact that TULSA-PRO is a zero day global and all the medical interventions that come before and after are billable events. The convergence of market dynamics will create this transformative growth. As mentioned, the Urology Society guidelines, the increased adoption of MRI within the urology specialty, These next generation interventional MRI platforms, along with their associated reduced price point, the key to unlocking this all is the TULSA-PRO reimbursement that went live January 1. We now have the killer app that will enable commercial interventional MRI expansion. Thank you for your time and continued interest in our company. I would now like to turn it over to Arun.