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  "documentTitle": "PROCEPT BioRobotics Corporation (PRCT)",
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  "authorName": "Spruce Point Capital Management",
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      "kind": "callout",
      "text": "Teleflex Is Very Focused on Addressing UroLift Positioning in the Current BPH Market",
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      "text": "We believe Aquablation competes poorly with UroLift unless resective actions are indicated.",
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      "text": "We note that many Aquablation supporters with whom we have spoken are often dismissive of MISTs for use on prostates except for the smallest sizes (often below 30g). However, we note that Teleflex views 40g to 80g as UroLift's sweet spot, which directly overlaps with the current AUA BPH treatment guidelines that limit Aquablation to prostates ranging from 30g to 80g. We believe Aquablation competes poorly with UroLift unless resective actions are indicated.",
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      "text": "As the data we presented shows, and Teleflex management has confirmed, UroLift volumes have suffered over the past few years due to both a multi-year reduction in reimbursement rates and the emergence of other MISTs, such as Rezum and iTIND. Based on our research, we believe investors should (1) view the reimbursement change impact on UroLift as foreshadowing for what could happen to Aquablation if it suffered a similar change, and (2) refrain from assuming that the decline of UroLift is either a result of the adoption of Aquablation or presents an opportunity for Aquablation to participate in share capture from UroLift.",
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      "text": "Our sweet spot is, call it, 40 grams to 80 grams...office [volumes have] been significantly impacted...we have moved heaven and earth trying to fix this product... But the encouragement is that any third party analysts that is doing research with urologists, the feedback comes back consistently the product works. There's a sweet spot for this product in those smaller glands, and that's the majority of the market. So that's encouraging. But every research that's done that we've read all of them, the final sentence is, but I don't make as much money as I used to. And it's the economics argument that has challenged in the office side of service.",
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      "text": "Our sweet spot is, call it, 40 grams to 80 grams...we put in a rebate every year since the reimbursement change came into being. We followed that up with a volume rebate this year. We put in a preauthorization for docs in the office side of service to make sure that they would get paid. We supported the product with clinical data to ensure that the retreatment rates would become a nonissue. And I haven't heard anything about retreatment. I'm sure in your checks, you probably haven't heard much either in the past. And we made changes to the management team...But the encouragement is that any third party analysts that is doing research with urologists, the feedback comes back consistently the product works. There's a sweet spot for this product in those smaller glands, and that's the majority of the market. So that's encouraging. But every research that's done that we've read all of them, the final sentence is, but I don't make as much money as I used to. And it's the economics argument that has challenged in the office side of service. — Teleflex CEO Kelly at Piper Sandler Healthcare Conference, 12/3/24",
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      "text": "Source: Teleflex presentation at the Piper Sandler Healthcare Conference 12/3/24, AUA Treatment Guidelines for BPH",
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      "text": "Investors Should View UroLift’s Decline As A Risk For Aquablation Rather Than An Opportunity",
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