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![Page 1: ZOLL Medical Corporation - 旭化成株式会社 · ZOLL Medical 1 ZOLL Medical Corporation The Global Leader in Resuscitation March 11, 2015](https://reader031.fdocuments.net/reader031/viewer/2022021702/5cd4a7c588c993ec188cf16a/html5/thumbnails/1.jpg)
1ZOLL Medical
ZOLL Medical CorporationThe Global Leader in ResuscitationMarch 11, 2015
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2ZOLL Medical
Agenda• Basic Mission• History/Background• Main Business Discussion• Longer Term Plans• Summary
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3ZOLL Medical
Agenda• Basic Mission• History/Background• Main Business Discussion• Longer Term Plans• Summary
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4ZOLL Medical
Delivering Life-saving Technology ZOLL helps health care professionals, emergency responders, and non-medically trained rescuers save many thousands of lives each year with products that deliver superior clinical performance.
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5ZOLL Medical
(F)
ZOLL Revenue (March Year-End)
Ten Year CAGR16%
Achieved #1 share position in all four businesses
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6ZOLL Medical
Basic Definitions
TREATMENT Emergency defibrillationCatheterization procedure to reopen block vessel
TERMS Sudden cardiac arrest (SCA) Acute myocardial infarction (AMI)
SEVERITY Death if not immediately treated Injury or death over a number of hours
CAUSE
CARDIACARREST occurs when the heart malfunctions and stops beating unexpectedly due to fibrillation.
Cardiac arrest is an “ELECTRICAL”
problem.
A heart attack is a “CIRCULATION”
problem.
A HEART ATTACK occurs when blood flow in an artery to the heart is blocked.
CARDIAC ARREST? HEART ATTACK?
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7ZOLL Medical
Basic Definitions
WEIGHT 5-10 kg <2 kg .07 kg
Types of Defibrillators
WHEN USED Emergency During recovery period
After long term risk is established
DURATION OF USE During emergency 1-6 Months Many years
CUSTOMERSHospitals, ambulances, fire departments, the public
Cardiologists Electrophysiologists
EXTERNAL WEARABLE INTERNAL
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8ZOLL Medical
Basic DefinitionsTime to defibrillation is critical for cardiac arrest
Provides blood flow to maintain brain and heart until defibrillator arrives
Cardiopulmonary resuscitation (CPR) can change survival rates
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9ZOLL Medical
The Problem
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10ZOLL Medical
1% 7%
31%
42%
92%
Survival Rates Can Dramatically Improve
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11ZOLL Medical
The Chain of Survival
*
* Advanced cardiac life support
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12ZOLL Medical
Only ZOLL Addresses Every Link in the Chain
RescueNet ePCR** Electronic patient care reporting
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13ZOLL Medical
Agenda• Basic Mission• History/Background• Main Business Discussion• Longer Term Plans• Summary
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14ZOLL Medical
Paul M. Zoll, MD
Father of Modern Electrophysiology
Paul M. Zoll, Physician Co-founder• Professor of
Medicine at Harvard Medical School
• Lasker Award in Medicine
• American Heart Association Lifetime Achievement Award
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15ZOLL Medical
1950-1980Clinical Foundation
First external defibrillation, first implanted pacemaker, first cardiac rate monitor, first external pacer
ZOLL Medical Over the Years
1980’s Commercialization
ZOLL founded in Massachusetts, NTP1000, PD1200, uniform operating system, multi-function electrodes
1990’sInvestment
Smallest full-featured defibrillator, LifeCor,ZOLL Data Systems, superior defibrillator waveform
2000’s Integration
AEDs, AutoPulse, fluid resuscitation, temperature management, LifeVest
2010’s Expansion
International build out, new clinical indications, rapid salesforce expansion, joined Asahi Kasei Group
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16ZOLL Medical
DIRECT OPERATIONS
MANUFACTURING
ZOLL DISTRIBUTION
DEDICATED PERSONNEL
SUB/REP OFFICE
Canada
New Zealand
Australia
Singapore
JordanIndia
Russia
JapanS Korea
Taiwan
China
Malaysia
Italy
SwitzerlandFrance
UKGermany
Austria
Netherlands
Panama
Puerto Rico
FinlandSweden
Pakistan
Spain
Brazil
Argentina
PhilippinesVietnam
Indonesia
Chelmsford
San Jose
PittsburghBroomfield
HEADQUARTERS
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17ZOLL Medical
Agenda• Basic Mission• History/Background• Main Business Discussion• Longer Term Plans• Summary
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18ZOLL Medical
Four Main Businesses1. Defibrillation/CPR – Worldwide
Hospital/ambulance/fire/public resuscitation from SCA
2. Data – US/GermanySoftware to run emergency services (ambulance/fire)
3. LifeVest – US/Germany/JapanWearable defibrillator for patients at high risk of SCA
4. Temperature Management – WorldwideCooling/warming of patients/ post SCA/fever
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19ZOLL Medical
Defibrillation/CPR BusinessZOLL Progress• #1 in U.S. hospital• #1 in U.S. EMS• #2 in world public access defibrillation • Rapid traction outside United States
(23% YTD ’14 Growth)• Japan is key to attaining #1 position
Competitor Highlights• Philips restructuring and regulatory issues• Physio concentrating on automated CPR• Expect competition from China
Market
Others
PhysioControl
Philips
ZOLL
5YR CAGR FORECAST8%
2014 World Market $1.7B
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20ZOLL Medical
Data BusinessZOLL Progress• Transition to Software as a Service (SaaS)• International market is big opportunity
– ZOLL has German product• Community paramedicine/
distributed health– ZOLL product launching now
Competitor Highlights• Most competitors are small,
single product– Only ZOLL competes across all categories
ZOLL
TriTech
Other
ImageTrend
5YR CAGR FORECAST8%
2014 US Market $110M
Market
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21ZOLL Medical
LifeVest BusinessZOLL Progress• Protection from high temporary risk
– >200,000 patients protected so far– US penetration <20% of patients
• U.S. field sales force >400– Platform for other products
• Japan just started– Reimbursement < price– >125 patients protected
Competitor Highlights– ZOLL is not aware of any competing product in development– “Doing Nothing” is still our main competitor
U.S.
Germany
Rest of World
Japan
5YR CAGR FORECAST25%
World Market Potential>$2B
Market
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22ZOLL Medical
Temperature Management BusinessZOLL Progress• Targeted temperature management (TTM)
Trial has created a headwind for SCA– “Doing Nothing” is an option
• Recent InnerCool purchase makesZOLL only intravascular player
• Gross margin is up to 58%– Potential for high 60s
• Clinical trials ongoing for AMI– Potential for >$1B market
Competitor Highlights• Bard is strong but facing same TTM issues
ZOLL
Other
Bard
5YR CAGR FORECAST >10%
Current Indications Only
World Market Potential>$300M
Market
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23ZOLL Medical
Multiple Business Models Provide Strength
Business Structure ApproximateRecurring Revenue
Operating MarginPotential
Defib/CPR Capital Equipment 15% Mid Teens
Data License Plus Ongoing Maintenance 30% Low 20s
LifeVest Rental w/ Services 50% Mid 20s
Temperature Management Razor/Razor Blade 70% Mid to High Teens
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24ZOLL Medical
Different Medical SystemsDefib/CPR Data LifeVest Temp
United States Capital CapitalRental to Patient
Covered by Insurance(45% Government)
Operating Expenses
Germany Same Same Same SmallReimbursement
Japan Same N/A
Rental to HospitalReimbursement to
Hospital(100% Government)
Decision Pending
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25ZOLL Medical
International Growth Investments• Japan
– 61 ZOLL employees, ~$10M 2014 forecast revenue– Defibrillators, Automated CPR, LifeVest approved– Post SCA indication for temperature management
pending approval– >$100M revenue target in 5 years
• International LifeVest expansion– France and India next targets– China approval still pending
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26ZOLL Medical
Agenda• Basic Mission• History/Background• Main Business Discussion• Longer Term Plans• Summary
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27ZOLL Medical
ZOLL’s Longer Term Plan• Achieve revenue > $2B by 2020
• ZOLL internal plans even more aggressive• Broaden focus beyond resuscitation to:
Acute Critical Care • M&A will be necessary
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28ZOLL Medical
Acute Critical Care
• Medical equipment/devices/tools/software/IT/services which are necessary for:a) therapy/treatment of patients facing acute critical conditions, or,b) diagnostics to predict such conditions, or,c) preventing such patients from escalation to acute conditions.
• Products must contribute to an increase in cost effectiveness.
Definition
AMI, Stroke, Trauma, Respiratory Arrest, Cardiogenic Shock…
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29ZOLL Medical
M&A Strategy
Data• Links between each business• Links between areas of care
Early detection/ intervention to acute cardiac diseases
• LifeVest• Mobile cardiac telemetry
Resuscitation Focus
• Defibrillation/ monitoring
• CPR support• Airway maintenance
Cooling Focus• IVTM• Surface/other techs
• Pre‐hospitaltemperature management
5th /6th Division• Established business model
• No/few short‐term synergies with existing Divisions but
expect mid/long term synergies
Acute Critical Care
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30ZOLL Medical
Recent M&A ActivityBusiness What it Adds
Philips InnerCool • Consolidates IVTM Patent Position• OEM Surface Product
IMPACTInstrumentation
• Portable/Emergency/Military Ventilators• Platform to Combine with Defib/CPR
Advanced Circulatory Systems, Inc.
• Intrathoracic Pressure Regulation Technology
• ResQPOD Adds to ZOLL’s CPR Product Portfolio
• ResQPOD Pump
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31ZOLL Medical
ResQCPR SystemResQPOD ResQPUMP ResQCPR System - PMA P110024
Approved March 6, 2015
Single use, disposable enhances circulation
Reusable device performs active compression decompression CPR. Optimizes CPR using a suction cup to pull up on the chest.
Survival Endpoints S-CPR(Control)
ACD-CPR + ITD
(Intervention)
ACD-CPR + ITD Difference P value
Survival to hospital discharge 10% 12% 20% ↑ 0.12
MRS ≤ 3* 6% 9% 53% ↑ 0.019
Survival to 1 year 6% 9% 50% ↑ 0.030
PIVOTAL STUDY: Rescue Trial(Aufderheide et al. Lancet 2011)
*Study primary endpoint
FDA Indication for Use (IFU):
The ResQCPR system is intended for use as a CPR adjunct to improve the likelihood of survival in adult patients with non-traumatic cardiac arrest.
+ =
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32ZOLL Medical
Agenda• Basic Mission• History/Background• Main Business Discussion• Longer Term Plans• Summary
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33ZOLL Medical
ZOLL as Part of Asahi Kasei
* Includes equivalent backlog
Twelve Months Prior to Asahi Kasei Acquisition
Last Twelve Months
RevenueRevenue
67% Growth*
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34ZOLL Medical
Asahi Kasei – ZOLL synergies• Asahi Kasei has allowed ZOLL to invest
to achieve faster growth• ZOLL’s planning horizon expanded to five years• Asahi Kasei is asking ZOLL to move beyond
resuscitation • Asahi Kasei technologies now being explored for
ZOLL products• Fit and motivation from ZOLL perspective has
been very good
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35ZOLL Medical
ZOLL Summary• Both revenues and profits growing
aggressively• Much opportunity still available for
existing businesses• New businesses are being explored to
expand ZOLL’s domain