Letter To Invuity Management

Includes: IVTY
by: longcastadvisers

Evidence suggests that Invuity's lighted surgical products are winning favor among doctors.

Management however is culpable for several failings on capital allocation and cash burn. These issues run deep and effect the company's culture and compensation.

Alternative and potentially higher return methods exist for delivering these products to market, in a more capital efficient manner. Above all, management needs to put the customers, not themselves, first.

This letter recently sent to the Board aims to encourage management to focus solely on long term capital allocation vs short term efforts that consistently fail.

Dear Chairman:

It is my belief that a product that solves a long-standing problem for its customers, sold at a reasonable price, and at a margin that generates profits for its manufacturer is generally a good starting point for a winning investment, especially when that investment can be purchased at a low multiple.

At ~2x sales, I believe Invuity has these initial ingredients, which is why I and my clients are holders of roughly 35,000 shares.

But good products alone are not enough to weigh the odds favorably for long term success. The investment world is littered with the detritus of mismanaged companies that HAD terrific products. Rather, long term investment success requires executives and managers who make sound capital allocation decisions to generate growth and cash flow, towards the eventual goal of self-funding operations.

I urge you strongly to read Amazon’s shareholder letter from 1997 to fully understand and internalize what it means to invest for the long term so you can reflect on the many ways Invuity can improve in this regard.

I am writing because I want our company to avoid the fate of detritus that plagues so many other promising small companies simply on account of poor decisions by its executives and managers. With your public equity returns down nearly 70% since the IPO concurrent with a nearly +70% return for the IHI Medical Device ETF, I am certainly not alone in my concerns.

Fortunately, I do not believe there are many issues that need resolving. Unfortunately, the issues seem to emanate from the core and culture of the wrong ways of doing business: Short term-ism, impatience, “Wall Street” pandering, and disregard for customers and shareholders concurrent with overly generous compensation for executives and directors.

This must change.

You and the Board and the Executives must engage your full facilities of good capital allocation. Reverse the trends of short-term decision making and focus instead on the long-term growth of the company, for benefit of the company’s customers first and foremost. When your customers knock down the doors to get your product, you, your employees and your shareholders will all benefit.

The issues I observe that lead me to write this letter all reflect an absence of clear, simple thinking on the long-term development of the company and its markets:

1. Location. The decision to locate product assembly in one of the highest-cost regions in one of the highest cost cities in the country is inexplicable. This is not a tech company vying for high skilled talent.
2. Executive comp. Phil is wildly overpaid, both in comparison to similarly sized companies in the same industry and on an absolute basis. A company this size should not be paying $1.5M to its CEO, nor should it be compensating its Directors as generously as it does. I’m sure you could point to many small successes that you believe justifies this compensation, but until Invuity is on a path towards funding its own growth, you are not successful.
3. Sales strategy. In the last year, and despite the company’s infancy, Invuity has had two different heads of sales and embarked on two different sales strategies. I appreciate that the new sales strategy is intended to create a more durable selling-culture for the company. But if this is true, why did the company initially pursue a strategy of stuffing channels through experienced mercenary hires? I imagine you were trying to show a “fast start”, which leads one to wonder, for whose benefit? It appears like a decision driven by short term-ism.
4. Guidance. Personally, I see no reason to provide guidance at all but I accept that those without imagination cling to “business as usual”. That you consistently miss your own guidance however … what is there to say about that?

Were these failings simply examples of growing pains, this letter would not be warranted, for the patient investor endures these knowing that smart, self-reflective and adaptable management turns early missteps into future strides. Unfortunately, our management appears to be missing opportunities to adapt and improve. Rather it seems intent on continuing to promote its decisions as sound despite ample evidence to the contrary.

I am a shareholder of this company because the product solves a long-standing problem. Doctors I’ve talked with who have used the product overwhelmingly approve. Those who haven’t overwhelmingly respond: “If it does what they say it can do, that would be amazing.” (The two criticisms I most often hear from customers of your lighted yankauers and bovies are that they are too expensive or that the disposability creates unnecessary waste.)

I am also attracted to the optionality in this investment. First, despite so-called “obvious problems” such as …

• The product is too expensive for cost conscious customers
• The equipment doesn’t have a CPT code so it is not reimbursable
• The environment is not ripe for hospitals to spend money on discretionary products

… you’ve grown sales from $7M / year in 2013 to $32M / year in 2016, or 65% CAGR, and over the same period, gross profits have grown 95% CAGR. Something is working.

Furthermore …

• If you can generate +70% gross profit margins in Potrero Hill, I imagine what you can generate assembling in a low cost region and when you actually achieve scale.
• If you’re doing 31k procedures / quarter selling an expensive item to just a few verticals, I imagine what you could be doing if you sought ubiquity, selling at a lower price but across many more procedures, and helping so many more patients as well.
• Finally, I consider what $30M in gross profits and a novel new product portfolio might be worth to a company with an existent sales force, run by a management focused on wise capital allocation.

In short, I own this because I look beyond yesterday’s and today’s poor decisions, with the expectation that in the future, better stewardship of capital – by you or someone else - will unlock the value.

At the current rate, a new capital raise will be required in 12-18 months. I simply want to ensure that the allocation of current and future capital is put to its best and highest use, through a reorientation of goals and expectations towards a more long term focus, a more customer-centric focus and bounded by patient and wise capital allocation.

Disclosure: I am/we are long IVTY. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it. I have no business relationship with any company whose stock is mentioned in this article.