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IXICO+
Forging a new frontier
With a new CEO at the helm (effective February 2017) IXICO is poised to enter its next
phase as a public business. The AIM-listed business has established itself as a medical
imaging data analytics specialist and trusted partner to the Pharma/Biotech and CRO
industries, having supported global clinical trials and collected clinical data from over
400 hospitals globally. With its proprietary, integrated and scalable digital platform and
deep understanding of clinically relevant data science in dementia and other
neurological disease, we see IXICO as well-placed to benefit from a number of structural
tailwinds as the pharmaceutical industry looks to leverage digital technologies to
revolutionise the way medical care is delivered. The roll-out of its proprietary Assessa®
PML platform with partner Biogen generates scope for a step-up in top-line growth over
the next 12 to 18 months, and underscores IXICO’s ability to convert a clinical research
project into a commercial-scale platform, in our view. Together with a revitalised focus
on commercialisation and profitability, we are excited by the potential for accelerating
momentum in this innovative specialist digital health company. House Stock.
Strong underlying demand factors: IXICO benefits from a number of favourable demand
factors, not least the increasing prevalence of neurological disorders (i.e.
Alzheimer’s/dementia, Parkinson’s and Multiple Sclerosis), which is under-pinned by an
aging population, and an increasing appetite for integrated digital healthcare platforms for
partners in a number of sectors (Pharma, CROs, technology).
Double-digit growth and path to profitability: We see double digit top-line growth from
FY17 and a clear path to profitability under-pinned by the momentum in IXICO’s existing
platform. Our fundamental DCF valuation suggests a fair value of c.45p/share. We assume
a c.11% CAGR to FY2026F and profitability by FY2020/21F, and use a discount rate of
c.13%, reflecting both the relatively low-risk profile of the business, offset by the illiquidity
of the listing and the lack of visibility on contract timings. As at 30th
September 2016 IXICO
had cash of £3.1m. House stock.
Equities Research Initiation of coverage 26th April 2017
House stock Current price 30.0p Healthcare UK
FTSE AIM All-Share
Reuters/Bloomberg IXI
Shares in Issue (m) 27.1
Market Cap (£m) 6.8
Net Cash (£m) 3.2
Enterprise Value (£m) 3.6
Next update
1H 2017 results May 2017
Performance 1M 3M 12M
Absolute (%) 25.0 (17.2) (22.9)
Rel Index (%) 24.4 (20.0) (39.1)
Relative to FTSE All Share
+ Non-Independent Marketing Communication: This is non-independent research. The analyst who has prepared this report is aware that Shore Capital Stockbrokers Limited and/or another member of the Shore Capital group has a relationship with the company covered in this report and/or a conflict of interest which may impair the objectivity of the research. Accordingly, the report has not been prepared in accordance with legal requirements designed to promote the independence of investment research and is not subject to any prohibition on dealing ahead of the dissemination of investment research. Shore Capital and Corporate is nominated adviser to IXICO and Shore Capital Stockbrokers is broker. In line with our conflicts of interest policy we do not have recommendations on House Stocks
Research analyst(s)
Tara Raveendran
0207647 8142
tara.raveendran@shorecap.co.uk
Adam Barker
0151 600 3707
adam.barker@shorecap.co.uk
Results and Forecasts
Year to
September
Revenue
(£m)
EBIT
(£m)
Net
Income
(£m)
Adj EPS
(p)
Net debt
(£m)
EV/Sales
(x)
EV/EBITDA
(x)
PER
(x)
DPS
(p)
Div
Yield
(%)
2014A 3.4 (2.6) (2.5) (9.0) (3.3) 2.0 (2.7) (2.8) 0.0 0.0
2015A 3.1 (1.4) (1.4) (6.3) (1.9) 2.2 (4.8) (4.0) 0.0 0.0
2016A 3.1 (2.8) (2.9) (6.3) (3.2) 2.2 (2.4) (3.9) 0.0 0.0
2017F 3.5 (1.8) (1.8) (7.7) (2.1) 1.9 (4.2) (3.3) 0.0 0.0
2018F 3.9 (1.1) (1.1) (4.6) (1.2) 1.7 (7.3) (5.5) 0.0 0.0
2019F 4.4 (0.6) (0.6) (2.4) (0.7) 1.5 (15.0) (10.5) 0.0 0.0
Source: Company Data; Shore Capital Markets
Disclosures of potential conflicts of interest as required by regulatory bodies are shown on page 26
26th April 2017 IXICO+
2
Table of Contents
Investment summary 3
Catalysts 4
Financing history 4
Valuation 5
Risks 10
Neurological diseases; an unmet need 11
IXICO - Overview 12
Moving up the value chain 18
Optionality from research collaborations 19
Forecasts 20
Management 23
Appendix 1 – CT Imaging Market 24
Abbreviations 25
26th April 2017 IXICO+
3
Investment summary IXICO is an established and trusted development partner to the Pharma/Biotech and
contract research organisation (CRO) industries. Its artificial intelligence (“deep learning”)
data analytics capabilities, based on the LEAP (Learning Embeddings for Atlas
Propagation) technology, are reinforced by its extensive in-house knowledge database
around clinically-relevant data science in dementia and other brain-related neurological
diseases. We anticipate double-digit top-line growth going forward, with the company
exposed to a number of fundamental growth trends such as the increasing prevalence of
dementia/neurological disease and the broader use of imaging and advanced data analysis
in drug development and post marketing drug safety surveillance. Furthermore, we see
future opportunities for growth from the adoption of new technologies (i.e. PET imaging,
advanced MRI methods and the use of wearable biosensors) in drug development,
treatment and management of neurodegenerative diseases.
IXICO was founded in 2003 by researchers from three leading UK universities and became
a public company through the reverse takeover of AIM-listed Phytopharm in 2013. Since
listing IXICO has successfully focussed on (i) investing in its core product offering (i.e.
TrialTrackerTM
and Assessa®), (ii) broadening its therapeutics focus beyond Alzheimer’s
(now c.60% of revenues versus >90% on admission to AIM), and (iii) identifying and
integrating strategic M&A targets (i.e the August 2015 acquisition of Optimal Medicine,
which added supportive “real-world” data collection and analytics capabilities). Its three
largest shareholders are Invesco Asset Management (23%), IP Group (21%) and
Touchstone Innovations (13%).
Its proprietary patent-protected technology forms the core of both its clinical trial services
product TrialTrackerTM
and its decision support platform Assessa® and is endorsed by
enduring industry relationships. For a company of its size IXICO has an impressive track
record of working with established players, having deals with around nine (from seven at
the time of admission to AIM in 2013) of the top 20 global Pharma companies by R&D
spend, including Biogen^ (BIIB, NR CNP at $289.9) and J&J^ (JNJ, NR CNP at $123.3)
and five of the top ten contract research organisations (CROs). We see IXICO as well
placed to become the “go-to” partner in the brain health field, given its deep understanding
of the Pharma ecosystem (from both a regulatory and a drug
development/commercialisation perspective) and its established reputation as a trusted
partner to large Pharma, Biotech and CROs.
Furthermore we believe that IXICO should be able to leverage its data analytics platform
across all stages of drug development, from early studies through to post-marketing
applications. We see the Assessa® PML platform developed in partnership with Biogen as
a key validator of this strategy and look to the commercial roll-out to reinforce our
forecasts.
We believe a discounted cash flow (DCF) methodology is most appropriate to value IXICO.
Our forecasts assume a step-up in growth to c.13% during FY2018-20F (incl), supported
by existing contracts (including Assessa® PML with Biogen) and a return to c.10-11%
long-term top-line growth over the period to FY2026F, in line with the historic top-line
growth. Our c.45p fair value is based on a WACC of c.13% and a long-term growth rate of
2.5%. IXICO had cash of £3.1m as of 30th
September 2016.
IXICO is a pioneer in digital brain
health, with a specialist focus on
neurological disease
Significant progress since listing
Platform endorsed by
partnerships
Digital platform applicable across
all stages of drug development
Fundamental DCF-derived fair
value of c.45p/share
26th April 2017 IXICO+
4
Catalysts Aside from the scheduled financials, we anticipate continued focus on IXICO’s ability to win
new contracts in a broad range of neurological diseases, but we acknowledge the limited
visibility to predict the timings of these.
We would look for updates from the existing (disclosed) partnerships over the next 12-18
months, including:
Start of Oxford Biomedica’s^ (OXB, NR CNP at 472p) P2a study of OXB-102 in
Parkinson’s (first patient dosed 2017F)
Beta pilot of Assessa® PML with partner Biogen (2017F)
Production phase of Assessa® PML with partner Biogen (2017/8F)
Further contract announcements demonstrating continued diversification of revenues,
such as the recent (March 2017) $1.5m contract with a top 10 pharmaceutical
company for a Phase 2b trial of Progressive Supranuclear Palsy (“PSP”)
Financing history With net cash of c.£3.1m as of 30th September 2016, following the successful £2.7m
equity placing in November 2015, in the absence of further corporate (M&A) activity, and
based on our fairly conservative operating expense projections, we do not anticipate any
immediate capital need.
We forecast c.£20m cumulative revenue/other income (i.e. from grants and R&D credits)
generation from FY2016A through to breakeven, which we forecast in FY2020/21F. Our
forecasts are discussed in more detail later in this report.
Since incorporation in 2003 and prior to admission on AIM (2013), IXICO raised c.£4.5m of
investment in the form of equity and loan notes and had been awarded grant funding
totalling £3m and >£17m in contract value from customers, principally large Pharma.
Following admission to AIM in 2013, IXICO has largely funded itself via contract revenue (it
has announced around £13m from a number of contracts) and research grants (c.£3m
from various funding bodies including Innovate UK), with the exception of the £2.7m equity
raise in 2015, which was in conjunction with the £1.5m acquisition of the private UK-based
web health company Optimal Medicine.
In the absence of further
corporate (M&A) activity, we do
not foresee an immediate cash
need
26th April 2017 IXICO+
5
Valuation Typically we use a blended methodology based on a fundamental discounted cash flow
(DCF) analysis together with a peer multiple. However, finding a direct peer for IXICO is
difficult, given its unique and specialist services offering, in our view. Hence, we have
based our fundamental valuation on a traditional DCF.
We have also included an analysis of two discrete listed peer groups (smaller listed peers
in the parallel “Cognitive Testing” market and healthcare data analytics companies) for
discussion purposes.
Fundamental valuation analysis
We have used a discounted cash flow (DCF) methodology to derive a value of around 45p
per share, corresponding to an enterprise value of £12m, including the c.£2m forecast
year-end 2017 cash.
We believe early-stage venture investments should use a discount rate of c.30% to reflect
the relatively high risk profile, while a lower discount rate (c.8-10%) is more appropriate for
mature companies.
We have used a discount rate of c.13%, reflecting both IXICO’s established track-record as
a partner to industry and also the limited visibility on future contracts/pipeline longer-term
together with the illiquidity in the shares.
Our forecasts assume a step-up in growth over FY2017-18F, with the roll-out of the
Assessa® PML platform with Biogen over the next 12 to 18 months. Beyond FY2026F we
forecast top-line growth to normalise to c.10-11%, consistent with the historical growth
rates for this business and underpinned by opportunities to (i) expand service within
existing contracts and (ii) drive accelerated adoption of services within new
clients/contracts. We anticipate sustainable profitability by FY2020/21F, with increasing
leverage inherent in the business model driving an improved gross margin over the
forecast period, together with a disciplined approach to investment to support growth.
Figure 1: DCF valuation (pence/share) – sensitivity to growth rate and discount rate
g/discount rate 11.3% 12.1% 12.9% 13.7% 14.5%
1.0% 54.4 47.6 41.9 37.0 32.9
1.5% 55.8 48.7 42.7 37.7 33.5
2.0% 57.5 49.9 43.7 38.5 34.1
2.5% 59.3 51.3 44.8 39.3 34.7
3.0% 61.3 52.8 45.9 40.2 35.4
3.5% 63.6 54.6 47.2 41.2 36.2
4.0% 66.2 56.5 48.6 42.3 37.0
Source: Shore Capital Markets
Our DCF-derived valuation is
based on a discount rate of
c.13%
26th April 2017 IXICO+
6
Relative valuation analysis
Finding a direct peer for IXICO is difficult, in our view, given its unique offering. We see the
larger contract research organisations (CROs) – such as Parexel^ (PRXL, NR CNP at
$62.8) and Icon^ (ICLR, NR CNP at $78.5) as partners more than peers, with IXICO’s
specialist offering more complementary (and higher margin) than traditional CRO services.
We point to a number of recent deals in which CROs and large diversified healthcare
companies have partnered with specialist data analytics firms to augment their own
offerings. In this context we believe that partnering with large CRO’s/industry partners
could significantly enhance IXICO’s reach and capabilities to compete for larger contracts.
We also highlight a number of deals between larger technology players (e.g. IBM, Dell) and
specialist imaging analytics companies, which reinforces the opportunity, in our view, and
highlights a universe of non-traditional partners. Medical images are one of the largest and
fastest growing sources of data in the healthcare industry, accounting for an estimated
90% of all medical data according to IBM. However a number of challenges remain:1
Immense volume of data – specialists are often overwhelmed with the volume of
imaging data – with some hospital emergency rooms managing up to 100k images per
day.
Most analysis still manual – the portfolio of tools available to clinicians to extract
actionable data from images remains limited, requiring most analysis to be done
manually.
Image data remains disparate – integrated data sets (ie medical records, lab tests,
genomics) are of increasing value to decision makers however with the existing
platforms medical imaging remains largely disconnected from mainstream health
information, reinforcing the broader opportunity for proprietary imaging analytics
platforms, in our view.
Figure 2: Specialist analytics platforms in demand
Date Acquirer Target Scope Details
Dec 2016 BioTelemetry Telcare Medical Supply (P) Acquisition ($7m upfront)
DA-cleared remote diabetes management platform
Jun-2016 Philips NV PathXL (P) Acquisition Proprietary image analysis & tissue pathology software focused around cancer
May- 2016 BioTelemetry VirtualScopics Acquisition ($16m)
Specialist imaging capabilities
Apr- 2016 Bioclinica ArisGlobal (P) Collaboration Pioneer in safety and pharmacovigilance space
Nov-2015 Dell Zebra Medical Vision (P) Partnership Imaging analytics and research platform
Nov-2015 Dell MphRx (P) Partnership Analytics software providing operational analytics
Aug- 2015 IBM-Watson Merge Healthcare Acquisition
($1bn)
Platform offers software solutions (on-premise & cloud-based) to
integrate medical images with the IT infrastructure hospitals
Jul-2015 HP Inovalon Partnership Offers cloud-based data analytics and data-driven intervention
platforms.
P – private Source: Shore Capital Markets
1 IBM press release “Watson to Gain Ability to “see” with planned $1bn acquisition of Merge
Healthcare” (August 2015)
Finding a direct peer for IXICO is
challenging
Large technology companies are
non-traditional partners but
demonstrate an increasing
interest in healthcare analytics
26th April 2017 IXICO+
7
The most closely related larger CRO in terms of service offering is the PE-owned
Bioclinica, a specialty clinical trial services and technology provider, with expertise in
medical imaging.
Cinven acquired the specialist CRO in August 2016 for $1.3bn from another PE firm, JLL
Partners, which bought the company in 2013 for an equity value of $123m. Since that time
Bioclinica has been engaged in a number of deals, including with consulting firm Kinapse
(May 2015) and Compass Research (July 2016), which provides Bioclinica with access to
c.180k elderly residents in a retirement community in Florida who could contribute to
research into Alzheimer’s and dementia amongst others.
We have also included two discrete listed peer groups – peers in the parallel “Cognitive
Testing” market and specialised data analytics firms, for comparative purposes.
Cognitive testing peers
As a UK-based peer, also listed on AIM, we have included Cambridge Cognition^
(COG LN, NR CNP at 112p) in our analysis. However, we note that its product offering
is quite different - Cambridge Cognition markets a suite of computer-based cognitive
assessments and does not offer any specialised digital data analysis technology
platform or services as IXICO does.
Cogstate^ (CGS, NR CNP at AUD $0.92) is an Australian-listed cognitive testing
business. Like IXICO it started with a focus on Alzheimer’s disease but is now focused
on expanding to a broader range of indications including assessing cognitive decline in
cancer patients.
Healthcare data analytics peers
Medidata^ (MDO, NR, CNP) is a US-based global SaaS (Software as a Service)
company that specialises in developing cloud-based data analytics platforms for use in
clinical trials.
Brain Resource Ltd (BRC, NR, CNP) is an Australian-listed company that has a
comprehensive database of standardised brain training and assessment protocols
together with a predictive analytics platform that it uses to develop products for the
healthcare sector.
We also highlight a number of emerging digital neuroscience and “deep learning/AI”
companies, the majority of which are unquoted and relatively nascent in terms of the
technology, but which are developing highly specialised and complementary platforms,
highlighting the growth opportunity in this market, in our view.
BlackFynn Inc^ (private) is a US company focused on developing its BlackFynn Data
Science Platform™ (allows for the integration of multiple complex neuroscience data
inputs).
CorTech Labs^ (private) is a US company whose proprietary NeuroQuant® platform
measures volumes of neurological structures from brain MRI scans. NeuroQuant® is
marketed directly by CorTech and also through distribution agreements with Philips^
(PHIA, NR CNP at EUR 31.49) and Invivo^ (NVIV, NR, CNP at $3.96).
Privately held Bioclinica a leader
in medical imaging
Growing universe of smaller
private competitors underscores
growth opportunity
26th April 2017 IXICO+
8
BrainReader^ (private) – this Denmark-based company has developed the FDA-
cleared NeuroreaderTM
, a volumetric (i.e. MRI) brain assessment software tool for
healthcare professionals.
ADMdx^ (private) is a US company that provides neuroimaging studies and data
analysis to pharma partners, with a particular focus on CNS disorders, but also has
developed diagnostic software for Alzheimer’s and other dementias.
In contrast to many of these start-ups, IXICO has been revenue generating for many years,
and has a proven track record with Pharma, hence we believe that it is well-positioned to
capitalise on and leverage its established data analytics platform.
Figure 3: Analytics and “deep learning” in Healthcare - Selected Start-ups
Source: CB Insights
With its double-digit (+10% p.a.) top-line growth, and attractive margins, supported by
services/volume-driven operating leverage and justified by its proprietary technology
platforms as well as a breadth of services compared with other listed cognitive testing and
data analytics peers, this would suggest at least a sector multiple is appropriate in our
view.
Double-digit top-line growth,
operating leverage and breadth of
service justify a sector multiple, in
our view
26th April 2017 IXICO+
9
Figure 4: IXICO - peer group analysis
Source: Bloomberg (prices as of 24th April 2017), Shore Capital Markets
Figure 5: IXICO profitability relative to peers
Source: Shore Capital Markets
Mkt Cap EV/Sales EV/EBITDA PE Stock Performance
Ticker Company Name Currency Price (LC, m) Curr Fwd Curr Fwd Curr PE Fwd PE 1Yr YTD 1 Mos
COG LN Equity CAMBRIDGE COGNITION GBp 113.5 23 2.6 2.1 40.5 18.3 49.3 22.3 177% 64% 47%
BRC AU Equity BRAIN RESOURCE LTD AUD 0.08 13 na na na na na na -45% -20% -11%
CGS AU Equity COGSTATE LTD AUD 0.92 104 2.3 1.8 26.5 10.1 51.1 18.0 42% -24% -10%
IXI LN Equity IXICO PLC GBp 31 8 na na na na na na -25% -3% 15%
MDSO US Equity MEDIDATA SOLUTIONS USD 63 3,670 6.2 5.2 25.5 20.6 50.6 41.4 34% 27% 13%
The higher margins at peers reflect the pure play software licensing model (i.e. BRC and COG) and/or greater proportion of revenues being derived from data analytics (i.e. MDSO). We forecast gross margins at IXICO of c.60% longer term, with the combined specialist services and opportunity to expand its commercial data analytics capabilities and for deploying a software licensing model offering access to a proprietary technology platform justifying a price premium in our view. This compares with gross margins of 30-40% at the larger US-listed CROs (Icon and Parexel).
26th April 2017 IXICO+
10
Risks Commercial/execution risk
IXICO’s commercial strategy is based on winning new contracts with Pharma partners, and
hence there is some degree of commercial execution risk, in our view. We believe that
IXICO’s impressive track record of securing partnerships (with the company having worked
with nine of the top 20 Pharma by R&D spend to date), and reputation as a thought leader
in the emerging field of brain health, should offer some reassurance that the company can
continue to sign contracts in the future.
Key customer risk
Historically IXICO’s sales pipeline has been lumpy, a reflection of both the long sales
cycles (2-3 years) of its contracts and the size of each contract relative to revenues on a
group basis. We are encouraged by recent contract wins, with management working to
diversify and grow the customer and revenue base. These efforts are evidenced in the
reduction of key customer risk, in our view, with the three largest clients in FY2016
representing 14%, 14% and 11% of revenues, which compares favourably with 35%, 17%
and 13% in FY2015.
Technology risk
IXICO operates in a rapidly evolving field. Rapidly evolving technology (e.g. blood-based
diagnostic tests for neurodegenerative diseases) could render the IXICO platform
redundant, or in a worst case obsolete. We note that IXICO’s reputation as an innovative
data-led business reduces this risk to some degree. The TrialTracker™ and Assessa®
platforms are constantly being updated to account for new data inputs, and we see this
data-driven progression as an attractive opportunity longer term (e.g new/more data
improves predictive algorithms).
Financing risk
IXICO had cash of £3.1m as of 30th September 2016. In the absence of further contract
wins, and based on our fairly conservative operating expense projections, and that the
research collaborations remain funded, either through grants or partner support, we do not
anticipate any immediate capital need. We acknowledge that management retains the
flexibility to reduce opex further if necessary, but would view this as being at the expense
of future growth.
Adoption of IXICO’s products and
services key to securing future
value
Recent contract wins have
diversified and grown the
customer base, reducing the key
customer risk
Continued innovation and focus
on data analytics reduce
redundancy risk
Based on IXICO’s current cash
position and our conservative
forecasts, in the absence of M&A
we do not foresee any immediate
cash need
26th April 2017 IXICO+
11
Neurological diseases; an unmet need The most common neurological diseases cost the c.$800bn in 2015 globally
2, with
Alzheimer’s and other dementias costing c.$240bn3 in the US alone, and this is expected
to grow as the elderly population almost doubles every 20 years. Hence there is increasing
appreciation for the need for early and effective diagnosis and treatment (i.e. disease-
modifying).
Historically reliant on a combination of clinical symptoms, patient history and traditional
cognitive/behavioural assessments, clinical studies of neurodegenerative disease are
increasingly incorporating a range of imaging and other biomarkers. As quantitative
markers neuroimaging endpoints offer the opportunity to (i) better understand the treatment
effect and demonstrate quantitative evidence of disease slowing, (ii) monitor the safety of
potential therapies and (iii) identify those patients most likely to benefit from treatment (i.e
as a companion product).
In a clinical trial setting, the types of neuroimaging most commonly used as biomarkers of
neurodegeneration and dementia include magnetic resonance imaging (MRI) and
radionucleotide imaging (i.e positron emission tomography (PET)) with novel tracers.
MRI is the most widely used neuroimaging technique to measure anatomical changes
and neurodegeneration in vivo. More advanced structural MRI methods (DWI/DTI,
MRS and perfusion imaging) can be used to measure neuronal damage, and
functional MRI can be used to measure brain function.
PET imaging uses radio-labelled ligands (“tracers”) to measure perfusion, metabolic
and neurochemical processes in vivo. Multiple tracers have been used in studies of
dementia including: fluorodeoxyglucose (FDG), which measures brain glucose
metabolism, tracers that look at brain protein deposits (e.g. amyloid, tau) and tracers
that look at neurotransmitters (e.g. dopamine, acetylcholine).
Figure 6: Commonly used neuroimaging biomarkers
Disease Biomarker Methodology
Alzheimer’s Brain atrophy/function
Amyloid/tau/glucose
ARIA 1& 2 (safety)
MRI
PET
MRI
Parkinson’s
Huntington’s
Multiple Sclerosis
Brain atrophy/function
Cerebral perfusion
MRI
PET
ALS Brain atrophy/function MRI
HAND Brain atrophy MRI
Prion diseases Brain atrophy
Cerebral perfusion
MRI
PET
Source: Shore Capital Markets
2 Alzheimer’s Disease International
3 Borenstein et al, (“The burden or neurological disease in the US”; Annals of Neurology, April 2017)
Increasing dementia prevalence a
global issue
Neuroimaging biomarkers
increasingly relevant in clinical
trial settings
26th April 2017 IXICO+
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IXICO - Overview IXICO provides services and technology to help industry partners collect, manage and
analyse brain imaging endpoints for neurodegenerative diseases. Its integrated
product/service offering encompasses the entire drug development lifecycle – from early
research and clinical trials through to post-marketing surveillance, and generates revenues
through two complementary streams.
Clinical trial technologies and services comprise revenues tied to its clinical
trials offering (i.e. TrialTracker™/Assessa® platforms and the associated
supporting services). This is the more established business, and historically
represented the principal source (>95%) of revenues. The business typically
involves contracts of c.3-5 years in length and totalling c.£3-5m in value over the
contract life. We are encouraged by recent contract wins, such as the recent
(March 2017) imaging analysis contract in a P2b trial of progressive supranuclear
palsy, which highlights IXICO’s ability to secure further contracts in new
therapeutic areas with both existing and new clients. This underpins our
confidence in the longer-term double digit top-line growth.
Commercial collaborations – Assessa® PML. The flagship collaboration with
Biogen typifies the potential in this newer business (“Commercial collaboration” in
Figure 8 below), in our view. In this structure the Pharma/Biotech partner makes a
financial contribution towards developing the platform and IXICO receives
milestones and longer-term recurring services/usage fees on an ongoing basis.
While relatively modest at present, with the single Biogen collaboration in pilot
phase in FY2017F, as discussed later in this report, we see commercial
collaborations as a source of potential future upside, which is not reflected in our
current valuation.
Figure 7: Realising Value – IXICO offers an integrated technology solution through all stages of development
Source: Company Data
IXICO – providing clinical trial
data analytics evaluation and
analysis in neurodegeneration
26th April 2017 IXICO+
13
Existing contracts and relationships
IXICO has an impressive track record of drug development partnerships, including deals
with nine of the top 20 global Pharma by R&D spend. We see this as IXICO’s core offering,
a stable base business that is growing at double digits, well ahead of the c.5-6% overall
market growth rate, which reflects market share gains as well as expansion into other (i.e
beyond Alzheimer’s) disease areas.
Figure 8: IXICO - disclosed contracs since becoming public
Date Indication Partner Scope Details
May 2014 Huntington's Pharma A Technology & Services MRI imaging techniques
May 2014 Huntington's Pharma A Technology & Services MRI imaging techniques
November 2014 Huntington's Pharma A & B Technology & Services Enhancement of an existing contract
December 2014 Cancer Pharma C Technology & Services Contract to support P1/2 study
April 2015 Huntington’s Pharma D Technology & Services Advanced MRI imaging techniques
and clinical trial endpoints
June 2015 Cancer
Neurodegen. disease
Pharma C & E Technology & Services Alliance projects with VirtualScopics
August 2015 Alzheimer's Pharma F Technology & Services Contract to support P1/2 study
August 2015 Not disclosed Pharma G* Technology & Services Seven year $1m p.a. contract
October 2015 Multiple Sclerosis Biogen Commercial collaboration Assessa® PML – clinical deployment
January 2016 Alzheimer’s Pharma F (x2), H & C Technology & Services Four contracts worth £3m in total
April 2016 Parkinson's Oxford Biomedica Technology & Services Five year contract supporting OXB-
102 P2 study
October 2016 Supranuclear Palsy Pharma I Technology & Services $1.2m contract to support P2a study
(US/EU)
March 2017 Supranuclear Palsy Pharma E Technology & Services $1.5m contract to support P2b study
*based on our analysis of ongoing Alzheimer’s trials we believe the partner is JNJ Source: Company Data; Shore Capital Markets
IXICO has a broad research and
commercial presence in the
clinical trial imaging data analytics
market
26th April 2017 IXICO+
14
Figure 9: IXICO has worked with nine of the top-20 Pharma (by R&D spend)
Company R&D Spend (€bn)
Novartis
9.0
Roche
8.6
Johnson and Johnson
8.3
Pfizer
7.0
Merck US
6.4
Bristol-Myers Squibb
5.3
Sanofi
5.2
AstraZeneca
5.2
Bayer
4.4
GlaxoSmithKline
4.2
AbbVie 3.9
Eli Lilly
3.7
Amgen 3.6
Celgene
3.4
Boehringer
3.0
Gilead
2.8
Takeda
2.6
Allergan
2.5
Biogen
1.8
Novo Nordisk
1.7
Source: Evaluate Pharma, Shore Capital Markets
26th April 2017 IXICO+
15
We highlight the momentum in the commercial strategy with recent contracts:
Global P2/3 neurodegeneration study (August 2015): IXICO was awarded a c.$7m
contract for use of its TrialTrackerTM
and Assessa® platforms in a long-term global
P2/3 trial. The contract is for a minimum of seven years ($1m/year), with the potential
to increase in scope.
Based on our analysis of clinicaltrials.gov we believe the contract to be related to the
study of JNJ’s BACE-inhibitor JNJ5481911 in patients at risk of developing
Alzheimer’s.
Development of Assessa® PML (October 2015): IXICO signed a commercial
collaboration agreement with a leading Pharma company (which has since been
disclosed as Biogen) to develop an adapted version of Assessa® to help in monitoring
and managing patients who were at high risk of developing PML, a rare and potentially
fatal side effect of some market-leading Alzheimer’s therapies (including Biogen’s
Tysabri). This project is discussed further in the next section “An evolving strategy -
moving up the value chain”.
Expanding portfolio in rare diseases (October 2016/March 2017): Most recently
IXICO announced two contracts in disease areas beyond Alzheimer’s, including (i) a
$1.5m contract with a top-15 global Pharma company for use of its TrialTracker™ and
Assessa® platforms in studying the rare neurodegenerative disease progressive
supranuclear palsy (PSP) in October 2016, and (ii) a separate $1.5m contract (March
2017) with an existing customer for use of its clinical trial services in a P2b PSP trial.
With an early focus on Alzheimer’s, this therapeutic area remains important but represents
a decreasing percentage (now c.60% from c.90% in 2013) of overall revenues as
management has worked earnestly to diversify its revenue base and expertise to other
serious medical conditions that include a component of neurodegeneration at an early
stage (i.e. Parkinson’s and multiple sclerosis).
IXICO is accelerating growth by
expanding into new CNS
therapeutic areas
Recent contracts highlight breadth
of therapeutic expertise in
neurological disease
CENTRAL
NERVOUS
SYSTEM
PARKINSON’S
DISEASE
ALZHEIMER’S
DISEASE
HUNTINGDON’S
DISEASE
PSYCHOSIS
MULTIPLE
SCLEROSIS
PROGRESSIVE
SUPRANUCLEAR
PALSY
26th April 2017 IXICO+
16
IXICO product and technology summary
IXICO’s proprietary digital platforms, TrialTrackerTM
and Assessa®, have been used in
global clinical trials across around 400 hospitals, and remain the company’s lead products.
In addition, IXICO acquired Optimal Medicine (August 2015), and with it “real-world” data
collection technologies to enable future product development, which we discuss below.
TrialTracker™ is a data/image management and analysis tool and is the most
established of the portfolio. It is a web-based system which allows researchers to track
and analyse images, and is predominantly used by Pharma/Biotech clients in a clinical
trial setting. IXICO has continued to develop and expand the platform in terms of its
features and functionality to manage image data, including improving the way the data
is transferred electronically, privacy-protected (i.e. anonymised), quality-controlled,
queried, analysed and reported. More recently, IXICO has been responding to interest
from the pharmaceutical industry to leverage the platform to enable data collection and
analysis from wearable biosensors.
The 2014 licensing agreement with VirtualScopics offers strong validation of the high
quality service offering, in our view, with the US partner citing “faster turnaround times”
as a key differentiator.
IXICO has a number of ongoing contracts, including one with a Pharma partner in a
large P3 Alzheimer’s trial and a second in Parkinson’s with Oxford Biomedica.
Figure 10: IXICO's proprietary digital platform - TrialTracker™
Source: IXICO
26th April 2017 IXICO+
17
Assessa® offers a digital diagnostic methodology based on analysis of images
generated from MRI scans. Assessa® incorporates both the core TrialTracker™
platform and LEAP (Learning Embeddings for Atlas Propagation), a proprietary
algorithm which compares patient-specific data to a reference database of multiple
age-matched reference images. Assessa® was CE marked as a medical device in
Europe and Canada in 2013.
Figure 11: Assessa®
Source: IXICO
MyBrainBook® is a mobile (web app) technology in development for dementia
patients and their support network. The technology is designed to be incorporated into
their daily routine, enabling the customisation of treatment and tracking of outcomes.
The project was a result of collaboration between IXICO, the NHS Mental Health
Trusts, the Health Innovation Network, community care providers and other third
sector partners.
Mehealth® offers a suite of web-based digital healthcare technologies for use in
clinical decision support. The current portfolio is focused on ADHD and behavioural
health. The platform integrates online patient portals that allow patients to keep real-
time records between consultations, and allow health professionals to collect and
analyse these data, with the aim of ultimately optimising/customising treatments.
Assessa® is unique in its ability to
provide a prediction of clinical
decline personalised for an
individual patient based on a
combination of imaging and
clinical tests
“Real-world” data collection
technologies – enhancing
proprietary product development
capabilities.
26th April 2017 IXICO+
18
Moving up the value chain IXICO is seeking to position itself as a leading “digital brain health” company. Its core
product and services offering is built on the application of its expertise, based on its
proprietary image-analysis platform (based on the patented LEAP technology) and in-
house knowledge (backed by clinical data collected from over 400 hospitals globally). The
company’s strategy is to develop these core offerings further to support every stage of drug
development and develop post marketing digital companion products for dementia and
other neurodegenerative conditions.
We note that IXICO’s clinical focus is predominantly dementia (particularly Alzheimer’s and
Huntington’s disease), but more broadly it is succeeding in leveraging its offering for other
neurodegenerative diseases, and other central nervous system (CNS) conditions in which
there is some manifestation of the disease in the brain (such as MS and Huntington’s
disease).
Case study: leveraging core expertise in multiple sclerosis
We point to the Assessa® PML platform developed in collaboration with partner Biogen as
a case study to the opportunity for value creation at IXICO.
In this example, IXICO was able to capitalise on an initial contract for the use of
TrialTracker™ in monitoring the safety of an immunotherapy in Alzheimer’s disease. From
this base IXICO was subsequently able to win a second contract for a commercial pilot and
ultimately secure a commercial collaboration contract for a “digital companion product” for
use alongside Biogen’s Tysabri.
We see the Biogen contract for the Assessa® PML platform, which was developed in
collaboration between the partners in response to specific identified need, as a prototype
for future deals of this nature. Under the commercial collaboration deal Biogen made a
financial contribution towards the development of the platform, with an expectation that the
partner will make an ongoing contribution.
IXICO – working to become a
leading digital brain health
company
Commercial collaboration with
Biogen a key validator
26th April 2017 IXICO+
19
Optionality from research collaborations In addition to the established clinical trial imaging business, IXICO has a broadly self-
funding (through grants and partner funding) R&D collaboration platform. We see this as
upside, allowing IXICO to continue to build its reputation as a leader in the broader digital
health field, while engaging with established players in a more strategic sense.
Cygnus Project – real-world data analytics: Cygnus is a two-year project,
sponsored by IXICO and funded by Innovate UK, that aims to evaluate the feasibility of
web-based mobile and wearable technologies in collecting data from patients and their
carers. In June 2016 Cygnus joined the Dementias Platform UK (DPUK), a high profile
collaboration that includes leading academic centres as well as companies like GSK,
AstraZeneca and JNJ.
AMYPAD – data modelling initiative: The Amyloid Imaging to Prevent Alzheimer’s
Disease (AMYPAD) project is a private-public collaboration investigating the use of
amyloid brain scans to improve the diagnosis and management of Alzheimer’s
disease. IXICO’s TrialTracker™ and Assessa® platforms form a central part of this
five-year project, acting as the data collection/analysis interface to collect and manage
c.6k images and scans from a Europe-wide database of c.24k patients.
RoadMap – wearables & digital disease modelling: A consortium of Pharma and
academic centres, that seeks to investigate the use of digital technology platforms as
tools in data aggregation and analysis.
Figure 12: IXICO research collaborations - Past & Present
Date Indication Partner Scope/Comment
2010 Neurodegenerative FDA Critical Path To improve efficiency of neurodegenerative disease development process
October 2012 Alzheimer’s’ ADNI*
Ongoing longitudinal study with USC
June 2014 Imaging VirtualScopics Alliance Commercial and operational alliance for clinical trial support
June 2014 Multiple MRC Dementia Platform(UK)/UKDP Investigating causes of dementia across Alzheimer’s, Parkinson’s and motor neurone disease.
June 2014 Psychosis PSYSCAN Diagnosis and prognosis of patents at risk for psychotic illness
January 2015 Alzheimer’s EPAD 5yr programme for prevention of Alzheimer’s disease
May 2015 Dementia Cygnus – real world study 2yr real-world data collection inc wearables, web-based and mobile technologies
May 2015 Vascular disease Innovate UK 2yr project quantifying vascular disease burden in CNS
March 2016 Dementia SENSE-Cog 5yr project looking at sensory, cognitive and mental impairments in the elderly
April 2016 Parkinson's Parkinson's UK/CPP Establishing best practice for clinical trial planning,
August 2016 Alzheimer's Deep and Frequent Phenotyping Study Identification of biomarkers for early Alzheimer’s diagnosis
October 2016 Alzheimer's AMYPAD/IMI 5yr project investigating utility of amyloid brain scans
November 2016 Alzheimer’s ROADMAP Ongoing real-world study assessing wearable biosensors
* ADNI - Alzheimer’s Disease Neuroimaging Initiative Source: IXICO, Shore Capital Markets
Leveraging its grant-funded
collaborations and building its
reputation as a thought leader in
digital health in the
study/management/treatment of
brain disease
26th April 2017 IXICO+
20
Forecasts We forecast a c.12-13% growth per annum from FY2018F to FY2020F, underpinned by
contracted revenues over FY2017-2019F and conservatively assuming around four to five
new contract wins in the Clinical Trials Technology & Services business over the forecast
window. We assume modest c.5% growth in annual contract size, with the typical duration
remaining around three years.
We conservatively assume that growth normalises over FY2020F to FY2025F to a more
conservative c.10% p.a. We see significant upside to our revenue forecasts if IXICO is able
to secure more than our c.1 contract p.a. forecast, the Biogen-collaboration progresses
faster than anticipated, further expansion in the MS therapeutics area or IXICO is able to
secure another strategic commercial collaboration (i.e. either similar to the Assessa® PML
or as part of its wearables initiative).
We highlight recent contract wins as evidence of momentum in this business.
March 2017: IXICO signed a $1.5m contract for its imaging clinical trial technology with
an existing top-ten Pharma customer. The contract is for the supply of services to a
P2b trial in progressive supranuclear palsy (PSP).
October 2016: IXICO secured a $1.2m contract to support a P2a study in progressive
supranuclear palsy (PSP) in the US and EU.
April 2016: Five-year contract with Oxford Biomedica to support development of
OXB102 in Parkinson’s disease.
August 2015: IXICO announced its largest ever clinical trial contract for a Phase 2/3
study in Alzheimer’s disease ($1m p.a. over seven years).
Contract wins in diseases beyond the core Alzheimer’s expertise, including the contracts
for Parkinson’s with Oxford Biomedica and Huntington’s disease, reduces the reliance on
existing customers (i.e. key customer risk) and demonstrates IXICO’s ability to expand
beyond its legacy offering in dementia/Alzheimer’s. Furthermore, these multi-year contracts
also improve visibility of IXICO’s future revenue streams, which should offer some comfort
to investors.
We forecast a modest c.2-3% CAGR in other operating income (grants and R&D credits) to
FY2026F, which is able to cover c.50% of the R&D spend over the period. Together with
the revenue generated from existing and future contracts, in the absence of M&A, we do
not foresee an immediate need for IXICO to raise additional capital. We forecast a
cumulative net cash burn of c.£2.4m through to breakeven, which our model suggests is in
FY2020F.
We look to the new CEO to drive an increasing focus on leveraging the existing capabilities
and momentum of the business to deliver double-digit growth, and target breakeven and
sustainable profitability over the medium term. Under new leadership we anticipate a new
focus on the balance between investment and profitability and would expect the focus to be
further streamlined internally, supporting those R&D ventures and commercial
collaborations that complement the company’s growth ambitions.
Near-term forecasts supported by
existing contracts
Upside longer-term from more
contracts, faster progress of the
Biogen collaboration and/or new
collaborations
Recent contract wins evidence of
momentum and improve earnings
visibility
FY2017F underpinned by visible
contracted revenues
26th April 2017 IXICO+
21
Figure 13: IXICO - Summary P&L
Source: Company Data; Shore Capital Markets
Figure 14: IXICO – Forecasts under-pinned by existing contracts
Source: IXICO, Shore Capital Markets
(GBP, '000) - YE 30 Sep 2015A 2016A 2017F 2018F 2019F 2020F 2021F 2022F 2023F 2024F 2025F
Summary P&L
Revenues 3,115 3,111 3,466 3,912 4,436 5,033 5,617 6,243 6,911 7,618 8,362
% YoY -0.1% 11.4% 12.9% 13.4% 13.5% 11.6% 11.2% 10.7% 10.2% 9.8%
Cost of Sales (1,323) (1,680) (1,733) (1,799) (1,952) (2,114) (2,303) (2,497) (2,764) (3,047) (3,345)
Gross Profit 1,792 1,431 1,733 2,112 2,484 2,919 3,314 3,746 4,146 4,571 5,017
% Margin 57.5% 46.0% 50.0% 54.0% 56.0% 58.0% 59.0% 60.0% 60.0% 60.0% 60.0%
Other Income (incl collaboration income) 1,067 752 620 770 770 770 770 620 620 620 620
Operating Costs (4,253) (5,053) (4,144) (3,950) (3,806) (3,757) (3,768) (3,799) (3,820) (3,845) (3,871)
EBIT (1,394) (2,870) (1,791) (1,068) (552) (68) 315 567 946 1,346 1,766
% Margin na na na na na na 6% 9% 14% 18% 21%
Net Financial Income (inc FX) 1 (65) 0 0 0 0 0 0 0 2 7
Profit Before Tax (1,393) (2,935) (1,791) (1,068) (552) (68) 315 567 946 1,349 1,773
Tax 199 750 0 0 0 0 (63) (113) (189) (270) (355)
% effective tax rate na na 0% 0% 0% 0% 20% 20% 20% 20% 20%
Net Income (1,194) (2,935) (1,791) (1,068) (552) (68) 315 567 946 1,349 1,773
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2016A 2017F 2018F 2019F 2020F 2021F 2022F 2023F 2024F 2025F
Gro
up
Re
ve
nu
es (
£m
)
% o
f to
tal re
ve
nu
es
o/w unallocated (%) o/w from existing contracts (%) Group Revenues (£mn)
26th April 2017 IXICO+
22
Figure 15: IXICO - Summary cash flow and balance sheet
Source: IXICO, Shore Capital Markets
(GBP, '000) - YE 30 Sep 2015A 2016A 2017F 2018F 2019F 2020F 2021F 2022F 2023F 2024F 2025F
Summary Cash Flow
Net Income (1,194) (2,119) (1,791) (1,068) (552) (68) 252 454 757 1,079 1,419
+ Depreciation & Amortisaton 49 55 194 142 106 79 61 48 38 31 26
+ Other adjustments 298 565 562 0 0 0 0 0 0 (2) (7)
+ Change in working capital (469) (36) (5) (6) (7) (8) (8) (8) (9) (10) (10)
Cash Flow from Operations (1,316) (1,535) (1,040) (932) (454) 4 305 493 786 1,098 1,427
Purchase (Sale) of PPE (45) (24) (21) (20) (19) (18) (16) (16) (15) (14) (13)
Purchase (Sale) of Intangible Assets 0 0 0 0 0 0 0 0 0 0 0
Other financial (incl millestones) 1 99 0 0 0 0 0 0 0 2 7
Cash Flow from Investing (44) 75 (21) (20) (19) (18) (16) (16) (15) (11) (6)
Capital changes 0 2,706 0 0 0 0 0 0 0 0 0
Debt changes 0 0 0 0 0 0 0 0 0 0 0
Other financial 0 0 0 0 0 0 0 0 0 0 0
Cash Flow from financing 0 2,706 0 0 0 0 0 0 0 0 0
Increase (Decrease) in Cash (1,360) 1,246 (1,061) (952) (472) (14) 289 477 771 1,087 1,422
Closing Cash 1,934 3,120 2,059 1,108 635 622 910 1,388 2,159 3,246 4,667
(Cash Burn) (1,315) (1,436) (1,040) (932) (454) 4 305 493 786 1,100 1,434
Summary Balance Sheet
Cash equivalents & PPE 1,934 3,120 2,059 1,108 635 622 910 1,388 2,159 3,246 4,667
PPE 116 88 83 78 73 69 65 61 57 54 50
Intangible Assets 300 559 391 274 192 134 94 66 46 32 23
Goodwill 0 0 0 0 0 0 0 0 0 0 0
Other Assets 1,889 1,915 1,507 1,701 1,929 2,189 2,443 2,715 3,006 3,313 3,637
Total Assets 4,239 5,682 4,041 3,161 2,829 3,013 3,512 4,229 5,268 6,645 8,377
ST Debt 0 0 0 0 0 0 0 0 0 0 0
LT Debt 0 0 0 0 0 0 0 0 0 0 0
Other Liabilities 1,530 1,423 1,572 1,760 1,981 2,233 2,479 2,743 3,024 3,322 3,636
Total Liabilities 1,530 1,597 1,746 1,934 2,155 2,407 2,653 2,917 3,198 3,496 3,810
Share Capital 84,333 87,141 87,141 87,141 87,141 87,141 87,141 87,141 87,141 87,141 87,141
Total Equity 2,709 4,085 2,294 1,226 674 607 859 1,312 2,069 3,148 4,567
26th April 2017 IXICO+
23
Management Charles Spicer (Chairman) – Having previously been an advisor on corporate strategy to
the Board, Mr Spicer joined the Board of IXICO in July 2013. Prior to IXICO he served as
Chief Executive of MDY Healthcare plc^ (MDY, NR, CNP), a strategic healthcare investor,
and was head of Healthcare Corporate Finance at Numis^ (NUM, NR, CNP) (2003-2006)
and Nomura^ (8604, NR, CNP) (1998-2003). Mr Spicer is currently Non-Executive of
Realm Therapeutics^ (RLM, NR, CNP) (formerly Puricore), Creo Medical^ (private, NR,
CNP) and 11 Health Technologies Limited^ (private, NR, CNP).
Giulio Cerroni (CEO) – Mr Cerroni was appointed CEO in February 2017 and has 30
years of experience in the life sciences and diagnostics sectors. He was previously
Managing Director of the Genomics division of LGC group^ (private, NR, CNP). Before
joining LGC Mr Cerroni held a number of leadership roles in Thermo Fisher Scientific^
(TMO, NR, CNP), including Global Vice President & General Manager Anatomical
Pathology operations, and Managing Director of Thermo’s Abgene business. He has held
roles at Anachem^ (private, NR, CNP) (2000-2005) and ICN Biomedicals^ (private, NR,
CNP) (1996-1999). Mr Cerroni was also European Business Development Manager at Du
Pont, where he spent 14 years commercialising new technologies and services for Pharma
drug screening programmes. He holds a BSc in Environmental Science from Cardiff
University and an MBA from the University of Warwick Business School.
Professor Derek Hill (Executive Director) – Professor Hill is the founder and former CEO
of IXICO and now serves on the board as an Executive director. He has 25 years of
experience in medical imaging science and has authored more than 80 journal papers. In
addition, he has served on the scientific advisory board for several pharmaceutical
companies and is a member of the MRI Core of the Alzheimer’s disease Neuroimaging
initiative (ADNI). Professor Hill holds a PhD in medical image analysis from Guy’s and St
Thomas’ Hospitals, University of London, an MSc in Medical Physics from the University of
Surrey and a BSc in Physics from Imperial College.
Susan Lowther (CFO/Company Secretary) – Mrs Lowther joined IXICO as CFO in
October 2014. Prior to this she was CFO at Novacyt^ (ALNOV, NR, CNP) and also CFO of
Lab21 Group prior to its acquisition by Novacyt. Mrs Lowther has also held the position of
CFO at BioWisdom (until its acquisition by Instem) and RiboTargets (prior to its acquisition
by Vernalis+ (VER, House stock at 20.5p). She has also held senior financial management
roles at Lonza^ (LONN, NR, CNP), Celltech (now UCB) and Monsanto^ (MON, NR, CNP).
26th April 2017 IXICO+
24
Appendix 1 – CT Imaging Market The global clinical trials (CT) imaging market is expected to reach c.$1bn (+6% CAGR) by
2020F4. Growth is supported by the increasing prevalence of neurological diseases
(including Alzheimer’s, Parkinson’s and dementia) due to the global ageing population
and increasing awareness of health care costs of neurological diseases. The US
represents the largest market by geography, with Pharma accounting for the largest
proportion of the end user market.
Figure 16: Global clinical trial imaging market by geography
Source: Shore Capital Markets, MarketsandMarktets Analysis
4 MarketsandMarkets
Imaging endpoints provide a number of benefits over traditional cognitive/functional imaging endpoints in dementia and other brain diseases:
Assessing potential disease-modifying effects and differentiating these from symptomatic effects that do not impact underlying pathology
Often less variable and thus necessitate smaller sample sizes
Can be used to assess and monitor safety
26th April 2017 IXICO+
25
Abbreviations BACE – Beta-secretase
CNS – central nervous system
CRO – contract research organisation
DTI – diffusion tensor imaging
DWI – diffusion weighted imaging
FDG - fluorodeoxyglucose
MRI – magnetic resonance imaging
MRS – magnetic resonance spectroscopy
MS – multiple sclerosis
PET- positron emission tomography
PML - Progressive multifocal leukoencephalopathy
PSP – progressive supranuclear palsy
26th April 2017 IXICO+
26
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Ixico+ 1,2,3,4 This note is initiation of coverage
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26th April 2017 IXICO+
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