INTUITIVE SURGICAL INC annual report, FY2013

Intuitive Surgical, Inc. — FY 2013 Form 10-K

Reporting period: Fiscal year ended December 31, 2013. The filing also provides unaudited fourth-quarter results. Intuitive designs, manufactures, and sells da Vinci surgical systems, instruments, accessories, and service; it reports as one business segment.

Financial and operating performance

MetricFY 2013FY 2012Change
Revenue$2,265.1 million$2,178.8 million+4%
Gross profit / margin$1,594.2 million / 70%$1,570.3 million / 72%Margin down about 2 percentage points
Operating income / margin$852.5 million / 38%$878.1 million / 40%Income down 3%
Net income / diluted EPS$671.0 million / $16.73$656.6 million / $15.98Net income +2%; EPS +5%
Operating cash flow$880.0 million$814.2 million+8%
Cash, cash equivalents, and investments$2,753.9 million$2,920.5 millionDown $166.6 million
  • Revenue mix shifted toward recurring sales: instruments and accessories revenue rose 14% to $1,032.9 million, and service revenue rose 16% to $397.3 million. Recurring revenue was $1,430.2 million, or 63% of total revenue, versus 57% in 2012.
  • System revenue fell 11% to $834.9 million; systems sold declined to 546 from 620. The installed base grew to 2,966 systems from 2,585.
  • Approximately 523,000 procedures were performed, up 16%. U.S. procedures increased to about 422,000; international procedures to about 101,000.
  • FY 2013 fourth-quarter revenue was $576.2 million, gross profit $398.0 million, and net income $166.2 million. In Q4 2012, the respective figures were $609.3 million, $437.9 million, and $174.9 million.
  • At year-end, total assets were $3,950.3 million and stockholders’ equity was $3,501.4 million. Current assets were $1,932.4 million versus current liabilities of $380.9 million. The balance sheet lists no borrowings or debt; total liabilities were $448.9 million.

Changes and drivers

  • Revenue growth slowed from 24% in 2012 to 4% in 2013. Slower U.S. benign gynecology growth and fewer U.S. system sales were principal factors; international system and procedure growth partly offset them.
  • Product gross margin declined to 70.9% from 73.0%, reflecting the 2.3% U.S. medical-device excise tax, which added $21.0 million to product cost of revenue, and lower initial margins on newer instruments.
  • Operating expenses rose 7% to $741.7 million, including a 10% increase in SG&A to $574.0 million, driven partly by organizational growth, regulatory work, and legal costs. R&D was $167.7 million, down slightly from $170.0 million.
  • Net income included favorable tax items: the 2013 tax provision included $26.7 million from reversals of unrecognized tax benefits and an $8.2 million R&D-credit benefit. The effective tax rate was 23.0%, compared with 26.5% in 2012.

Outlook, risks, and unusual items

  • No specific numerical revenue or earnings guidance is provided. Management expected benign-procedure growth to remain below 2012 levels and said it could decline further; it also anticipated continued substantial R&D investment and potentially higher R&D expense.
  • Management cited slower hospital capital spending, a lengthening system-sales cycle, economic and health-care reform uncertainty, negative media coverage, and payer preferences for conservative or outpatient treatment as factors that could restrain demand.
  • U.S. prostatectomy procedures continued to face pressure from reduced PSA screening and changes in treatment of low-risk prostate cancer. U.S. dVP volumes appeared to stabilize in 2013, with a gradually decreasing trend.
  • The FDA issued a July 2013 Warning Letter following a facility inspection that identified quality-system and documentation observations. Intuitive reported corrective actions but could not assure FDA acceptance or rule out further findings. The letter could delay certain clearances and registrations.
  • Intuitive disclosed about 76 individual product-liability lawsuits, a related purported class action, securities litigation, a False Claims Act case, and two insurer actions seeking rescission of product-liability coverage. The company said it could not estimate a possible loss or range of loss for pending or threatened litigation.
  • A field action involving certain EndoWrist Monopolar Curved Scissors followed potential micro-crack formation. Replacement product shipments began in May 2013; the company reported no confirmed attributable patient injuries and no material impact on procedure volume.
  • FY 2013 financing cash outflow included $1,109.2 million used to repurchase 2.6 million shares. Cash generation remained strong, but the cash-and-investment balance declined. Approximately $669.2 million of cash and investments were held by foreign subsidiaries and management said it had no current plans to repatriate foreign earnings.

Most important facts for investors to verify

  • Whether procedure growth—particularly benign gynecology—and system sales recover, and whether recurring revenue continues to offset weaker capital sales.
  • Progress and consequences of FDA Warning Letter remediation, follow-up inspection, and any related regulatory or product-supply restrictions.
  • Developments, insurance coverage, and potential financial exposure from product-liability claims and other pending litigation; loss estimates were not determinable in the filing.
  • Drivers of gross-margin pressure, including the medical-device excise tax and newer-product economics, and whether margins improve as volumes scale.
  • Cash and investment deployment, including future repurchases, and the tax implications of foreign earnings and discrete tax benefits.