Intuitive Surgical (ISRG) is scheduled to report the results of its first fiscal quarter after the market close on April 18, with a conference call scheduled for 4:30 pm EDT. What to watch:
1. PROCEDURAL GROWTH: Along with its fourth quarter report out in late January, Intuitive Surgical initiated its fiscal year 2019 procedure growth view, expecting 13%-17% growth. Intuitive said it expects 2019 procedure growth to continue to be driven by U.S. general surgery and procedures outside of the United States, where they are still in the early stages of adoption.
2. GROWTH PROSPECTS: With its report last quarter, Intuitive management said they expect similar seasonal timing of procedures in 2019 as in previous years, with Q1 being the seasonally weakest quarter as patient deductibles are reset. Intuitive Surgical CEO Gary Guthart added, "Mature procedure growth in the United States including prostatectomy and hysterectomy was solid again in 2018, though we expect slowing in these mature procedures going forward in some countries." After Intuitive's, Q4 report, Stifel analyst Rick Wise said the robotic surgery maker's Q4 results were "as advertised," calling the company's more-intense-than anticipated 2019 operating expense growth guidance the biggest incremental update on the company's earnings conference call. The higher spending, potentially over multiple years, will require some "digestion" by the market, but this aggressive investment is "offensive" in nature and affirms the still largely untapped opportunity ahead, Wise tells investors. Given the operating expenditures spending guidance, Wise lowered his 2019 and 2020 EPS estimates and cut his price target on the stock to $570 from $600. While noting that the company does not provide specific EPS guidance, Wise added that based on his systems sales projections, management's provided procedure growth guidance would suggest a 2019 EPS range of $11.54-$11.83. He kept a Buy rating on Intuitive Surgical shares.
3. EXPANSION EFFORTS: In early March, Intuitive purchased a "three-decade-old building about two blocks from its headquarters on Kifer Road in Sunnyvale," according to the Mercury News. "Our business has grown significantly over the past several years, necessitating expansion in locations worldwide, including Sunnyvale," said Peper Long, a spokeswoman for Intuitive Surgical, according to the Mercury News. On a more international scale, Intuitive Surgical CEO said during a recent CNBC interview that it was excited about its expansion in China. In an interview on CNBC's Mad Money, Intuitive Surgical CEO Gary Guthart said, "I think we are quite well positioned... We are very interested in helping the Chinese healthcare market, but right now we are supply-constrained... We are excited about our expansion in China and expect to make a difference there."
4. FDA COMMENTS ON SURGICAL ROBOTICS: Noting that it "takes women's health issues very seriously," the FDA issued a safety communication stating that "since robotically-assisted surgical devices became available in the U.S., robotically-assisted surgical procedures were widely adopted because they may allow for quicker recovery and could improve surgical precision. However, the FDA is concerned that health care providers and patients may not be aware that the safety and effectiveness of these devices have not been established for use in mastectomy procedures or the prevention or treatment of cancer. Patients and health care providers should also be aware that the FDA encourages health care providers who use robotically-assisted surgical devices to have specialized training and practice in their use. To date, the FDA has not granted marketing authorization for any robotically-assisted surgical device for use in the United States for the prevention or treatment of cancer, including breast cancer. The labeling for robotically-assisted surgical devices that are legally marketed in the United States includes statements that cancer treatment outcomes using the device have not been evaluated by the FDA." BC Capital analyst Brandon Henry noted that the FDA issued a safety communication regarding the use of robotics in cancer-related women's health surgeries, which he believes could put some incremental pressure on part of Intuitive Surgical's U.S. business with gynecologists, particularly the cancer-related hysterectomy portion. While he said the potential impact should be manageable, Henry thinks it is prudent to model a decline in Intuitive's U.S. cancer-related hysterectomies business in 2019, the analyst stated. He maintained a Sector Perform rating on Intuitive Surgical shares.