Inspiremd, Inc. annual report, FY2015

InspireMD, Inc. — FY2015 Form 10-K

Reporting period: Fiscal year ended December 31, 2015. This is an annual report, not a standalone fourth-quarter report; separate Q4 results are not clearly provided in the filing text. Unless otherwise noted, financial amounts are in U.S. dollars.

Business context

InspireMD is a medical-device company developing and commercializing its MicroNet mesh-covered stent technology. CGuard EPS is its carotid product; MGuard Prime EPS is a bare-metal coronary stent. Both are sold internationally, but none of the company’s products was approved for sale in the United States. CGuard received a full European market launch through distributor Penumbra in 2015. The company’s neurovascular flow-diverter candidate remained in preclinical development.

Financial performance and liquidity

MetricFY2015FY2014
Revenue$2.31 million$2.82 million
Gross profit (loss)$(0.30) million$0.78 million
Gross margin(12.8)%27.8%
Research and development$3.64 million$8.74 million
Selling and marketing$3.18 million$6.61 million
General and administrative$6.39 million$9.13 million
Operating loss$(14.49) million$(23.70) million
Net loss$(15.59) million$(25.10) million
Basic and diluted loss per share$(2.23)$(7.09)
Cash used in operating activities$11.60 million$19.36 million

Revenue declined 18.1%. MGuard sales fell 42.6% to $1.61 million, partly offset by CGuard revenue of $0.70 million, up from $0.02 million in 2014. MGuard represented about 70% of FY2015 revenue. Lower research, selling and administrative spending helped reduce the net loss, but gross results weakened: inventory write-offs, product mix, lower MGuard prices and underused manufacturing capacity contributed to the gross loss. The filing reports $1.0 million of restructuring and impairment expense, including a $0.58 million impairment of the MGuard royalty buyout asset.

At December 31, 2015, cash and cash equivalents were $3.26 million, total current assets $4.63 million, and current liabilities $6.92 million. Working capital was negative $2.29 million. Total reported loan liabilities were $5.33 million ($4.23 million current and $1.10 million long-term); the loan is secured by substantially all company assets other than intellectual property. Cash decreased by $3.04 million during 2015. The company reported an accumulated deficit of $123.0 million and capital deficiency of $2.95 million.

Changes, outlook and material risks

  • Management implemented cost reductions in 2015, focused development spending on carotid and neurovascular products, and shifted toward third-party distributors. R&D expense fell 58.3%; selling and marketing fell 51.9%.
  • The company curtailed MGuard bare-metal development as market demand shifted toward drug-eluting stents. MGuard DES development was tabled because of limited resources; MASTER II was not resumed as an FDA registration trial.
  • Management expected continued losses and negative operating cash flows until products—primarily CGuard—achieve commercial profitability. The auditor’s report includes a going-concern explanatory paragraph; management stated that available resources were insufficient to fund operations beyond May 2016 and that substantial doubt existed about the company’s ability to continue as a going concern.
  • March 21, 2016 public and private offerings generated approximately $1.4 million in aggregate net proceeds, which management said would fund operations only for a short period. The filing said additional capital would be needed no later than May 2016 absent strategic or other non-dilutive funding. Further financing could be unavailable, costly or dilutive.
  • Key risks include weak demand for bare-metal stents, dependence on CGuard commercial adoption and regulatory approvals, intense competition, reliance on certain single-source suppliers, and manufacturing concentration at the company’s Israel facility. Currency movements, reimbursement, and regional political or security disruptions in Israel are additional risks.
  • The 2014 voluntary MGuard field action followed reports of stent dislodgements. The company resumed shipments after modifying the securement process, but distributor claims remained: one sought about $160,000; another’s potential claim was described as reasonably possible in a range from a minimal amount to €1.075 million. Separately, a service provider sought $1.965 million; management said loss or settlement was not probable but could not estimate the outcome.
  • The filing also reports a NYSE MKT equity-listing deficiency plan, with compliance required by July 20, 2016. Failure to regain compliance could lead to delisting proceedings.

Most important facts for investors to verify

  1. Cash runway and financing needs after the March 2016 offerings, including whether the company secured additional capital before the stated May 2016 deadline.
  2. Subsequent cash burn, revenue trends and gross margins, especially CGuard sales and distributor orders versus MGuard declines.
  3. Status and financial exposure of the MGuard field-action-related distributor claims and the $1.965 million service-provider demand.
  4. Debt repayment obligations, collateral and covenant compliance, as well as progress toward the NYSE MKT listing requirements.
  5. Regulatory and clinical progress for CGuard and the neurovascular candidate, and whether planned development can be funded.