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  "documentTitle": "TransMedics (TMDX)",
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  "authorName": "Scorpion Capital",
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  "presentationDate": "2025-01-10 00:00:00",
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  "notes": "The slide uses anecdotal evidence from a 'prominent surgeon' to support a bearish thesis on TransMedics.",
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      "text": "Our research indicates that TransMedics is in the middle of an accelerating customer exodus.",
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      "text": "contribution margin: 60%",
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      "text": "Our research indicates that TransMedics is in the middle of an accelerating customer exodus. One transplant center after another indicated that 1) using TransMedics wipes out their margin on transplant cases; 2) that despite the company’s claims to the contrary, Medicare provides only partial reimbursement to centers and that private payors offer none, forcing centers to eat the cost; 3) that alternatives are radically cheaper, whether NRP which is perhaps a mere 3 to 5% of the cost of an OCS case, or a tsunami of new entrants with cheaper, alternative perfusion/storage devices; and 4) that they plan to imminently sharply reduce or entirely eliminate their usage – within the next few months or quarters – or have already done so. We begin with a surgeon who highlighted a recent Duke University study that showed their contribution margin dropped by an astounding 60% per transplant case when they used TransMedics. The surgeon indicated “Waleed and his people got so angry at the Duke guy for bringing it up” and that Duke had to sharply reduce their usage “because they were taking such a bath.”",
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      "text": "TransMedics angry at cost analysis; Duke had to reduce device usage. “Waleed and his people got so angry at the Duke guy for bringing it up... they dropped their volume by 20% because they were taking such a bath.” – Prominent surgeon",
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      "text": "Duke study showed 60% reduction in contribution margin per case when using TransMedics. “I talked to the Duke guys... The contribution margin was something in the 40-cent range for the cases you use TransMedics on.” – Prominent surgeon",
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      "text": "\"The contribution margin was something in the 40-cent range for the cases you use TransMedics on.\" — Prominent surgeon, Director of leading academic transplant center; \"Waleed and his people got so angry at the Duke guy for bringing it up. I know for a fact that the Duke guys were on target to do a huge percentage of their liver transplants using TransMedics in a given year but they dropped their volume by 20% because they were taking such a bath.\" — Prominent surgeon, Director of leading academic transplant center",
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      "text": "Source: Scorpion Capital consultation calls with experts",
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