{ "docId": "019dd923-622c-750b-8b99-9ee2a1e788fb", "docSlug": "1233d0b05ad9", "documentTitle": "PROCEPT BioRobotics Corporation (PRCT)", "authorId": "54_Spruce_Point_Capital", "authorName": "Spruce Point Capital Management", "documentKindSlug": "activist-deck", "documentKindLabel": "Activist deck", "sourceTypeSlug": "short_seller", "sourceTypeLabel": "Short seller", "presentationDate": "2025-01-16 00:00:00", "orientation": "landscape", "aspectRatio": 1.3333334, "pageNumber": 19, "pageCount": 100, "prevPage": 18, "nextPage": 20, "slideType": "preempt_rebuttal", "function": "preempt_rebuttal", "density": "overcrowded", "nDataPoints": 0, "notes": "The slide uses a two-column comparison structure to categorize factors influencing BPH treatment decisions.", "elementsJson": [ "headline_text", "paragraph", "bullet_list", "footnote" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b99-9ee2a1e788fb/19", "deckHref": "/decks/019dd923-622c-750b-8b99-9ee2a1e788fb", "deckJsonHref": "/decks/019dd923-622c-750b-8b99-9ee2a1e788fb.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b99-9ee2a1e788fb#slide-19", "components": [ { "bbox": { "h": 0.04, "w": 0.96, "x": 0.02, "y": 0.89 }, "kind": "callout", "text": "Insurance coverage: Resective procedures are generally only pursued when indicated (severe LUTS).", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "bcdc97ce-7ab1-4d37-9f66-8b3322ca2ca8", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "callout", "text": "We believe Procept mischaracterizes the landscape for BPH procedures, both by suggesting that resective surgical procedures can displace drugs and MISTs and that Aquablation has the potential to be the \"one-size-fits-all\" treatment for all BPH sufferers.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd952-ee35-7258-b4d9-59095cf5b860", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.55, "w": 0.48, "x": 0.51, "y": 0.32 }, "kind": "list", "text": "Standard of care: Physicians will adhere to the accepted standard of care. Practice profile and procedure financial profile: Relative to salaried hospital staff, many private practice urologists are more sensitive to reimbursement rates and procedural efficiency. About half of practicing US urologists are in private practice, and those physicians strongly prefer MISTs since they get higher reimbursement, take less time, involve lower procedure risks and side-effects, and can be performed in-office. Expertise: Surgeons with highly specialized expertise, such as with HOLEP, often have a bias for that procedure, as well as a desire to retain their skills. Receptivity to new techniques: Over half of US urologists are over 55, and 29% are over 65. Moreover, many urologists hold strong opinions on the merits of different procedures based on their experience. Therefore, many urologists may not be open to learning new procedures. Generalizability: Physicians may prioritize/learn techniques applicable to a larger proportion of patients.", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "6ef87312-f570-49fd-8030-58cae626edc8", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.04, "w": 0.48, "x": 0.51, "y": 0.27 }, "kind": "list", "text": "Physician Factors", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "b1ebd95e-c270-4441-a1f6-fb25748910b9", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.04, "w": 0.48, "x": 0.02, "y": 0.27 }, "kind": "list", "text": "Patient Factors", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "c780ffc3-427b-494c-81e3-24bfc891db34", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.55, "w": 0.48, "x": 0.02, "y": 0.32 }, "kind": "list", "text": "LUTS: Patients with less severe symptoms are less likely to pursue treatment and incur the risks of side effects (irreversible for resective surgeries). Age: Since the average age of men undergoing surgical procedures for BPH is 71, procedure tolerability, morbidity risk, recovery time/ease, and anticipated lifespan are material considerations. Level of sexual activity and prioritization of sexual function: Some patients may be sexually inactive or not prioritize ejaculatory function. Other health conditions: Patients with high bleeding risk or taking blood thinning medications may seek/require procedures with lower bleeding risk. Prostate size: Certain procedures are either limited to smaller prostates or enable the treatment of larger prostates for various reasons. Affordability: MISTs can be more expensive than resective procedures. Retreatment considerations: Some patients, either due to age or personal preference, may willingly accept higher retreatment risk over a multi-year period.", "attrs": null, "subkind": "bullet", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "f92ce2ae-f26e-48fd-bb3e-2f69c8419615", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.09, "w": 0.96, "x": 0.02, "y": 0.17 }, "kind": "paragraph", "text": "We believe Procept mischaracterizes the landscape for BPH procedures, both by suggesting that resective surgical procedures can displace drugs and MISTs and that Aquablation has the potential to be the \"one-size-fits-all\" treatment for all BPH sufferers. There are valid medical and non-medical reasons why Aquablation may never even be the leading resective treatment.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "c1e3e5df-1766-4a8e-83fa-e9591c1f9098", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.04, "w": 0.96, "x": 0.02, "y": 0.95 }, "kind": "source-note", "text": "Source: AUA Treatment Guidelines for BPH, Urology Care Foundation BPH overview, \"National Trends in Surgical Management for Benign Prostatic Hyperplasia From 2013 to 2019 in the United States\", Feiertag and Clark, Spruce Point research", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "b1104add-ae58-40a1-a930-4cdab3688d35", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.08, "w": 0.65, "x": 0.31, "y": 0.03 }, "kind": "title", "text": "Multiple Patient and Physician Issues Drive Treatment Selection; No \"One-Size-Fits-All\"", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "e1be1c05-d0b3-4d56-b5b0-63fa7bd57f0f", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [ { "to": 20, "from": 11, "name": "Cost Of Inaction", "slug": "27-cost-of-inaction", "bestFor": "Urgent budget requests, compliance, risk mitigation", "matchId": "7ffce90f-7469-4962-8ccc-f8b71e2baf08", "evidence": "Analysis of the BPH treatment market and the trade-offs of BPH treatments", "position": 0, "objective": "Highlighting the risks and limitations of Procept's Aquablation procedure", "structure": "The Status Quo -> The Hidden Costs Accumulating -> The Future State of Inaction -> The Tipping Point", "confidence": 0.7, "description": "Quantify what happens if the audience does nothing" } ], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }