Thread by @genghis_pon

[THREAD] Detailed thoughts on $TMDX below

- "Key Geographies" Supply-Driven TAM
- U.S. Supply-Driven TAM
- Demand for Organ Transplants (Lung/Heart/Liver)
- Larger donor list --> larger recipient list
- Quick revenue sizing based on current demand
- More positive catalysts

1/ Company-provided TAM from $TMDX's 10K of $8.02Bn for lung, heart and liver.

This is supply-driven i.e., sizing opp by unlocking utilization of previously unused organs.

"Key Geographies" per $TMDX include US, Canada, EU and Australia.

2/ We extrapolate $TMDX's TAM for U.S. by applying utilization assumptions from above to Company-provided U.S. figures.

We get U.S. TAM of approx $3.65Bn.

Important to know b/c a successful FDA panel will first benefit U.S. commercial efforts, then trickle over to int'l after.

3/ Both TAMs above are supply-driven, b/c they reflect newly-enabled procedures made possible by $TMDX :

i) lower ischemic time
ii) larger geographic reach
iii) organ viability assessment

Here's the kicker - how about demand? What if $TMDX unlocks supply but demand is limited?

4/ We pulled data from the Organ Procurement Transplant Network @UNOSNews
srtr.transplant.hrsa.gov/annual_reports…

After sifting, an easy proxy for demand is combo of:

1) # of patients in waitlist at end of the year i.e., backlog; and

2) patients added to waitlist each year...

5/ In theory, if $TMDX does its job right, the term waitlist should one day be eradicated.

The dream is everybody who needs a lung, heart or liver will be matched with a donor.

Assuming backlog is depleted, that leaves us with just new additions each year in steady-state.

6/ OPTN '19 Data ('20 figures N/A & would be outliers; lung transplants have yet to recover due to Covid)

Lung Backlog: 1,423
Lung Annual Addition to WL: 3,244

Heart Backlog: 4,167
Heart Annual Addition to WL: 3,387

Liver Backlog: 12,562
Liver Annual Addition to WL: 12,767

7/ Data above reveal that current U.S. demand is SMALLER than unlocked supply by $TMDX

Lung: potential supply 25.8K, but only 3.2K added to waitlist per year

Heart: potential supply 24.9K, but only 3.4K added to waitlist per year

What to make of this?...

8/ Per Dr. Schroder from Duke, seems that the size of the recipient list is a function of available organs.

Demand will grow with supply.

(🙌🏼 @a_p2014 for sending me link & @JonahLupton
for bringing to att'n)

9/ Per vid above, there are more liver transplants in U.S. than heart transplants, but more people die from cardiac problems.

Given 200-400K prospects; assume transplant 10% w/ midpoint at 30K a year, that is much higher than today (4K additions to WL for heart transplants).

10/ Thesis is that if donor list is enlarged, recipient list should grow with unlocked supply.

Even if we assume ceiling for number of procedures by using only current demand i.e., "annual additions to waitlist" for the 3 organs, $TMDX makes $900mm+ in sales ($45K/procedure).

11/ Clearly above numbers should take haircut factoring in competition from other warm perfusion players but $TMDX seems ahead of the game.

But wait, we haven't even baked in $TMDX's:
(i) International opp
(ii) Kidney OCS
(iii) Positive impact from OCS National Program

END/ Seems like an interesting year for $TMDX, starting with FDA Panel meeting for Heart on April 6th and then Liver in June/July '21

Please retweet and provide your thoughts on any of the above. Would love to get industry insights from anybody with sector knowledge. Thanks!