{ "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": 32, "pageCount": 100, "prevPage": 31, "nextPage": 33, "slideType": "expose_contradiction", "function": "expose_contradiction", "density": "overcrowded", "nDataPoints": 0, "notes": "Uses a combination of regulatory guidelines and expert testimony to undermine the product's long-term value proposition.", "elementsJson": [ "headline_text", "callout_box", "paragraph", "screenshot", "quote_block" ], "metadataConfidence": 1, "imagePath": null, "slideHref": "/slides/019dd923-622c-750b-8b99-9ee2a1e788fb/32", "deckHref": "/decks/019dd923-622c-750b-8b99-9ee2a1e788fb", "deckJsonHref": "/decks/019dd923-622c-750b-8b99-9ee2a1e788fb.json", "deckAnchorHref": "/decks/019dd923-622c-750b-8b99-9ee2a1e788fb#slide-32", "components": [ { "bbox": { "h": 0.08, "w": 0.24, "x": 0.02, "y": 0.32 }, "kind": "callout", "text": "The Science Remains Unsettled", "attrs": null, "subkind": "primary", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "8655fb8b-6d29-4584-ae63-2e91d44c807e", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "callout", "text": "Despite its uptake, the long-term science around Aquablation remains unsettled. Thus, the procedure receives only a conditional recommendation and a lower evidence level grade versus TURP by the AUA.", "attrs": null, "subkind": null, "toolName": "Visual emphasis", "toolSlug": "visual-emphasis", "confidence": null, "componentId": "019dd952-ee35-7258-b4d9-ff807d0478a4", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.08, "w": 0.96, "x": 0.02, "y": 0.17 }, "kind": "paragraph", "text": "Despite its uptake, the long-term science around Aquablation remains unsettled. Thus, the procedure receives only a conditional recommendation and a lower evidence level grade versus TURP by the AUA. Given the hype cycle related to BPH treatments, we find some urologists were simply more comfortable waiting for more information on long-term efficacy.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "4e48550f-79f1-4a9e-ab25-6d8ab6f5e0c6", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.71, "x": 0.27, "y": 0.32 }, "kind": "paragraph", "text": "While we acknowledge that Aquablation is approved by the FDA and presented as a viable treatment option by the AUA, the longer term impacts and durability have not been extensively studied. For this reason, the AUA BPH Treatment Guidelines still give Aquablation a “Conditional Recommendation; Evidence Level: Grade C”. This compares unfavorably to TURP, which has received a “Moderate Recommendation; Evidence Level: Grade B”.", "attrs": null, "subkind": "paragraph", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "d6461a9d-2119-48d6-a6af-03445aa4feb4", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.18, "w": 0.73, "x": 0.25, "y": 0.75 }, "kind": "quote", "text": "there are different frameworks for looking at the same issue. Objectively, it's true that it's a shorter procedure with presumably lower incontinence rates and ejaculatory dysfunction. But I think that there will remain other procedural options there for a lot of men. And I think that another big thing to consider with Aquablation is that the long-term data is just not out there yet. And so we don't know 10-year data on recurrence rates of prostate regrowth...I just feel hesitancy because, in the history of the BPH marketplace, so many procedures come out every five or ten years and most of them don't stick.", "attrs": null, "subkind": "testimonial", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "9abcd7fe-ecdf-47c1-97f0-e42aa4bbce08", "frameworkName": null, "frameworkSlug": null }, { "bbox": null, "kind": "quote", "text": "there are different frameworks for looking at the same issue. Objectively, it's true that it's a shorter procedure with presumably lower incontinence rates and ejaculatory dysfunction. But I think that there will remain other procedural options there for a lot of men. And I think that another big thing to consider with Aquablation is that the long-term data is just not out there yet. And so we don't know 10-year data on recurrence rates of prostate regrowth...I just feel hesitancy because, in the history of the BPH marketplace, so many procedures come out every five or ten years and most of them don't stick. — Spruce Point Interview with Community Hospital Urologist, Nov 2024", "attrs": null, "subkind": null, "toolName": "Authority citation", "toolSlug": "authority-citation", "confidence": null, "componentId": "019dd952-ee35-7258-b4da-03bb8a0da9ad", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.02, "w": 0.65, "x": 0.02, "y": 0.97 }, "kind": "source-note", "text": "Source: AUA Treatment Guidelines for BPH, Procept October 2024 investor presentation, Procept SEC filings, Spruce Point research", "attrs": null, "subkind": null, "toolName": null, "toolSlug": null, "confidence": null, "componentId": "a5218c76-1983-4c4c-b718-d734488b82fd", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.12, "w": 0.96, "x": 0.02, "y": 0.54 }, "kind": "table", "text": "39. Robotic waterjet treatment (RWT) may be offered as a treatment option to patients with LUTS/BPH provided prostate volume 30-80g. (Conditional Recommendation; Evidence Level: Grade C)", "attrs": null, "subkind": "data", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "da03bf2d-dafb-4179-b4c8-0fc045f62a1d", "frameworkName": null, "frameworkSlug": null }, { "bbox": { "h": 0.08, "w": 0.65, "x": 0.31, "y": 0.03 }, "kind": "title", "text": "Procept Glosses Over That Aquablation’s Long Term Results Remain Unproven", "attrs": null, "subkind": "headline", "toolName": null, "toolSlug": null, "confidence": null, "componentId": "d5650aef-f8a4-4474-85ac-60dc5d37fa3f", "frameworkName": null, "frameworkSlug": null } ], "metrics": [], "tools": [], "frameworks": [], "arcBeats": [], "loops": [], "imagePathAlt": null, "thumbSrc": null, "thumbSrcAlt": null, "locked": true }