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  "documentTitle": "Progyny, Inc. (PGNY)",
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  "authorName": "Spruce Point Capital Management",
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  "presentationDate": "2023-02-07 00:00:00",
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  "notes": "Uses a combination of a bar chart with overlaying line and percentage callouts to show rising pharmacy revenue per cycle despite declining total revenue per cycle.",
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      "kind": "callout",
      "text": "We note that “minimal stimulation”, or mini-IVF, is an accepted protocol for women under certain circumstances. SART notes several advantages... Interestingly, PGNY clearly deemphasizes the less lucrative mini-IVF...",
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      "kind": "callout",
      "text": "Specialty pharmacies are notorious for overcharging on patients with insurance, thereby wiping out their lifetime maximum benefit. Patients can typically procure drugs from abroad and have them imported for exactly half of the cost as in the US.",
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      "text": "We also estimate that PGNY customers are paying almost double for the pharmacy benefit in FY22 versus the 2019 cohort.",
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      "text": "Medication Costs per Assisted Reproduction Technology (ART) Cycle",
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      "text": "Pharmacy Revenue / ART: $8,050",
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      "kind": "paragraph",
      "text": "We estimate the unit economics for PGNY's core fertility benefit have decreased from $14K per ART cycle to $12K. How did PGNY offset the reduced growth profile of its core business? We believe that PGNY just pushed higher priced and/or more drugs...",
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      "kind": "quote",
      "text": "Specialty pharmacies are notorious for overcharging on patients with insurance, thereby wiping out their lifetime maximum benefit. Patients can typically procure drugs from abroad and have them imported for exactly half of the cost as in the US. — FertilityIQ.com",
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      "kind": "source-note",
      "text": "Sources: PGNY 3Q22 Transcript, FY19 10-K, FY20 10-K, FY21 10-K, 3Q22 10-Q, Fertilityspace.io, fertilityiq.com, SART, PGNY website",
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      "kind": "title",
      "text": "Is PGNY Overcharging For Fertility Medications? Are They Deemphasizing Less Lucrative IVF Protocols?",
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