Elekta Ab Class B · OMXSTO:EKTA_B
Elekta Ab Class B — ASTRO 2011
45 slides from Elekta Ab Class B's conference presentation, October 2011
Slide 1: Elekta: Growth through innovation
Elekta Growth through innovation ASTRO, October, 2011 Tomas Puusepp President and CEO ASTRO 2011 - Growth through innovation 13.00 Innovation ● Growth ● Outlook Tomas Puusepp, President and CEO 13.20 Elekta Brachytherapy Solutions Jos Lamers, EVP Elekta Brachytherapy Solutions 13:40 Q&A 13.50 Elekta
Slide 2: Elekta – stronger than ever
Elekta – stronger than ever Every year… Elekta Neuroscience • Close to 1,000,000 patients receive treatment with radiation therapy and radiosurgery equipment from Elekta Elekta Oncology • Whereof 60,000 patients undergo Gamma Knife® surgery Every day… Elekta Software • 100,000 patients receive diagn
Slide 3: Growth Strategy
Growth Strategy Innovation Emerging markets Elekta positioned to capture accelerated growth 2011 – Focus on delivering value with solutions - 2010 ”From machine 1st priority Accelerate growth to systems” – from systems to solutions - 2005 • Grow share in established markets with leading extended ”Pe
Slide 4: Elekta positioned to capture accelerated growth
Elekta positioned to capture accelerated growth 2011 – Focus on delivering value with solutions - 2010 ”From machine 2nd priority Grow the margin and establish to systems” industry leading efficiency - 2005 • Invest part of EBIT to accelerate growth ”Perfecting the • Full system portfolio machine” t
Slide 5: Growth through innovation
Growth through innovation Drivers • Technical innovations – IMRT, IGRT, VMAT, etc. • Demonstrate value – Proving and communicating value of treatments – Patients having increased interest/influence • Specialization – Multifunctionality – Disease-specific treatments Increased R&D for state-of-the-art
Slide 6: Innovation through collaboration
Innovation through collaboration Examples of R&D collaborations Elekta International IMRT consortium Elekta Synergy® Research Group Elekta Spine consortium Leksell Gamma Knife® Society Elekta Lung Research Group Example: Elekta Lung Research Group • Multinational group of five centers – Led by Inga
Slide 7: Healthcare spend drives number of linacs
Healthcare spend drives number of linacs Healthcare spend per capita and installed linacs per million inhabitants USD and units installed USA Ireland Denmark Linacs Sweden1 Norway per million people Japan Australia Switzerland Taiwan Germany Netherlands 1 Belgium Austria Established Market UK France
Slide 8: Elekta - pioneer and partner in cancer care
Elekta - pioneer and partner in cancer care Elekta CompactTM Leksell Gamma Knife ® MOSAIQ® RTP PerfexionTM AgilityTM Clarity® Auto Scan IdentifyTM Lung Research Group Spine Research Group Innovation is a key contributor to Elekta’s growth strategy Market characteristics and growth drivers Establishe
Slide 9: Strong performance in emerging markets
Strong performance in emerging markets Market share 40-50% 40% 25-30% 45-50% Strong underlying demand trends • As life expectancies rise globally, the number of cancer patients will increase • Improved survival rates create additional demand • Radiation therapy remains significantly cheaper than che
Slide 10: Nucletron - important step in Elekta's growth
Lack of capacity Large regional differences in availability of cancer care NORTH AMERICA Installed base: 3,700 No. of persons/linac ASIA PACIFIC USA: 84,000 Installed base: 2,900 No. of persons/linac: 1,246,000 EUROPE Installed base: 2,500 No. of persons/linac Germany: 171,000 Scandinavia: 135,000 B
Slide 11: Outlook: Regional outlook
Outlook Regional outlook North and South America • Stable demand in North America • Strong growth prospects in South America Europe, Middle East and Africa • Stable growth in most established markets • Some uncertainty of government healthcare spending in PIGS • High demand in emerging markets Asia
Slide 12: Record-high order backlog; Guidance for fiscal year 2011/12
Record-high order backlog • Backlog increased to SEK 8,843 M • Continued good visibility of sales and earnings • Healthy backlog development for Leksell Gamma Knife® and linacs Guidance for fiscal year 2011/12 • Net sales is expected to grow by more than 10% in local currency • Operating profit in S
Slide 13: Elekta Brachytherapy Solutions
Strengthened position in global radiotherapy Market share Trend Varian 45% Elekta 35% Accuray 9% Siemens 9% Others 2% Note: Order intake. Sources – company reports Elekta Brachytherapy Solutions Adding to growth and profitability Jos Lamers EVP Brachytherapy Solutions 13
Slide 14: World leader in brachytherapy
Nucletron today World leader in brachytherapy • Unmatched global leadership in brachytherapy – Presence in >100 countries – 3,000 clinics worldwide using Nucletron products – 60% worldwide market share • Strong R&D focus ~11% of revenues invested in 2010 • Strong growth in 2010 (currency adjusted):
Slide 15: Brachytherapy market and usage
Brachytherapy market and usage Brachytherapy Use of brachy in cancer share of RT market treatment 2010 1) Other 8% Brachytherapy Eye 3% Gynecology 10% Head & neck 2% Esophagus 2% Breast 12% 47% Other RT 90% Prostate 26% (1) GEC ESTRO Patterns of Care study. Relates to all brachytherapy including HDR
Slide 16: Truly global business and no.1 in most markets
Truly global business and no.1 in most markets Market positions North and South America Europe and MEA Asia Pacific Share of sales 2010: 32% Share of sales 2010: 44% Share of sales 2010: 24% Japan No.1 US No.1 Europe No. 1: • Germany China No.1 • Italy • Spain • France India No.1 • CEE2) LatAm1) No.
Slide 17: Nucletron within the Elekta group
Nucletron within the Elekta group Four drivers to further accelerate growth 4. Driving awareness of brachytherapy 3. Expanding geographically 2. Developing body sites 1. Exploiting the installed base 1. Exploiting the installed base Cross-selling opportunities Afterloader upgrade No. of customers: 5
Slide 18: Innovation and product development; Developing new body sites
1. Innovation and product development Vaginal CT/MR Oncentra® Brachy Prostate Solution MultiChannel Applicator 2. Developing new body sites Example: rectal Market opportunity: Nucletron’s rectal applicator • Colorectal cancer incidence: 3rd most frequent cancer in the EU and US 1) 10–15cm: upper 1/3
Slide 19: Strengthened presence together with Elekta
3. Strengthened presence together with Elekta Increased presence and share of direct sales: • Higher focus on growth • Enables increased services revenues • Broader and more attractive customer offering Example, services revenue 2010: Distributors Direct sales Services Products 22% Increase direct s
Slide 20: Driving awareness of brachytherapy
4. Driving awareness of brachytherapy Decision Makers, Policy Makers, KOLs Health Care Providers, Referring Patients, Patient Associations Physicians Source: Company information. Customers and patients will benefit from improved service offerings and reduced treatment times • No 1. in brachytherapy
Slide 21: Elekta Neuroscience
Elekta Neuroscience Åsa Hedin Executive Vice President Elekta Neuroscience Elekta Neuroscience World-leading solutions for treatment and localization of brain disorders 21
Slide 22: Leksell Gamma Knife - the most established technology
Leksell Gamma Knife® - the most established technology …and still gaining Cumulative number of patients treated 600 000 • Almost 300 Leksell Gamma Knife® 500 000 systems in use 400 000 • More than 600,000 patients treated to date (2010) 300 000 • More than 3,000 publications on 200 000 Gamma Knife®
Slide 23: Opportunities for Leksell Gamma Knife
Opportunities for Leksell Gamma Knife® US centers (in 2009) by number of craniotomies1 annually 137 114 163 96 68 24 40 No SRS 106 88 111 15 Non-LGK, SRS only 31 16 Both LGK and 34 non-LGK SRS 6 18 17 4 19 13 LGK only 3 19 8 6 1-50 51-100 101-200 201-350 >350 1 Based on Medicare data; multiplied by
Slide 24: Treated with Leksell Gamma Knife
Treated with Leksell Gamma Knife® Malignant tumors 44% Benign tumors 35% Vascular disorders 12% Functional disorders 8% Ocular 1% Over 600,000 patients treated - expanding by 60,000 annually Brain metastases are becoming increasingly common • Brain metastases occur in 20-40% of cancer patients(1), a
Slide 25: Gamma Knife surgery and brain metastases
Gamma Knife® surgery and brain metastases • #1 indication for Gamma Knife surgery • >200,000 patients treated to date • Well documented in literature • Indication-specific FDA clearance • Superior for multiple brain metastases – Precision and accuracy – Minimal dose to healthy tissue – Workflow effi
Slide 26: Gamma Knife radiosurgery – a flexible tool
Gamma Knife radiosurgery – a flexible tool in the brain metastases armamentarium …alone • Avoid postponing …in …boost • Proven to improve or pausing chemo combination after survival (level 1 for as with WBRT with chemo WBRT single metastases) Gamma Knife radiosurgery …to …salvage • Decrease risk of
Slide 27: Scientific literature supports spine radiosurgery
Scientific literature supports spine radiosurgery • The incidence and prevalence of spinal metastases occur in 30-50% of all cancer patients 1) • Literature review including 5,000 patients gives strong recommendation that radiosurgery should be considered over conventional radiotherapy 2) 1) Harel R
Slide 28: Elekta Oncology: Growth Through Innovation
Elekta Oncology Growth Through Innovation Dee Mathieson Senior Vice President Oncology Business Line Management Cancer incidence is growing Cancer incidence, world Most frequent cancers, world Million 25 Breast Prostate 20 21,4 Lung 19,1 Colorectum 16,9 Cervix uteri 15 15,0 Stomach 13,3 12,7 Liver 1
Slide 29: Elekta research groups
Elekta research groups Helping to improve clinical outcomes • Delivers “Evidence Based Medicine” • Managed and supported by MOSAIQ • Incorporates continuous quality improvement and decision support Data feedback, outcomes reporting, quality assurance Screening & diagnostics Treatment planning Active
Slide 30: Example 1: Lung cancer
Example 1: Lung cancer Incidence and mortality Challenge world, million 2,9 Reach target while minimizing impact on surrounding tissue 1,7 1,5 Mortality Constantly moving Incidence Decrease high mortality rate 2010 2030E Source: Globocan 2008 Elekta Lung Research Group • Pooled clinical data from >
Slide 31: Example 2: Prostate – most frequent male cancer
Example 2: Prostate – most frequent male cancer Incidence and mortality Challenge world, million 1,7 Motion management Accuracy and dose control 0,9 Mortality Incidence Survival rates are 0,5 high 0,3 2010 2030E Source: Globocan 2008 Intra-fraction Motion Management External monitoring systems Respo
Slide 32: Clarity Autoscan - motion management
Clarity Autoscan - motion management • 4D • No dose • Non-invasive • Continuous anatomy tracking – As opposed to marker tracking Example 3: Nasopharynx Incidence and mortality Challenge world, thousands Motion management Anatomical figure – from tip of nose Dose control into thorax and accuracy Dose
Slide 33: Nasopharyngeal cancer research group; Safety by design
Elekta Nasopharyngeal cancer research group • Established 2011 • Data available on well over 1,000 patients • Participating Trans-Asian institutions 1. National University Cancer Institute, Singapore 2. National Taiwan University 3. Tuen Mun Hospital, Hong Kong 4. Cancer Institute and Hospital of th
Slide 34: Identify; Agility – the specification
Identify™ Verification of complete Patient, position set-up prior to treatment and accessories • Right patient • Right location • Right set-up This feature is in research and is not for sale or distribution. AgilityTM – the specification • Largest high resolution field size – 40x40cm – Shorter treat
Slide 35: Agility – Clinical benefits
AgilityTM – Clinical benefits • Wide clearance – Patient comfort – Oblique techniques; breast, head & neck • Extremely low leakage – minimise unwanted dose; paediatric , secondary cancers • Very tight penumbra for accurate dose delivery – Critical structure avoidance; prostate, NPC • Highest speeds,
Slide 36: Elekta Software - our focus
Elekta Software - our focus Every treatment requires and generates thousands of data parameters Elekta’s oncology software designed to: • Provide ease of use, increased safety and support for decision making • Treatment planning and treatment management • Store patient-specific data – learn and eval
Slide 37: Elekta software - leading market positions
Elekta software - leading market positions Market share North America Europe Asia Pacific OIS: 61%, #1 OIS: 64%, #1 OIS: 44%, #2 TPS: 16%, #3 TPS: 48%, #1 TPS: 41%, #1 Proton Therapy Global OIS: 80%, #1 TPS: 50%, #1 Note: Market share installed base 2011, including Oncentra Supports the entire chain
Slide 38: Elekta Software Strategies
Elekta Software Strategies • Utilize world-leading competence within OIS and TPS to protect and drive growth within existing installed base and gain market share • Drive development towards disease specific needs while enhancing tools to support standardization and clinical evidence • Increase pace
Slide 39: Driving the technological development
Driving the technological development Workflow automation • Workflow Manager in MOSAIQ® • IQ Scripts • Designed to customize workflow and automate a multitude of tasks • Drives Standardization and gathering of clinical evidence • Stickiness within installed base! Driving the technological developmen
Slide 40: Monaco future releases
Monaco future releases Monaco® 3.0 - released July 2011 Monaco® with VMAT • Dynamic Conformal Arc Planning • APEX micro MLC (Stereotactic planning) Monaco® 3.1 - December 2011 • Bias Dose Planning (Composite Planning) • Multiple Rotation Arc Beams • Multiple Arc VMAT for Elekta linacs Monaco® 3.2 -
Slide 41: MOSAIQ RTP – introducing first two modules
MOSAIQ® RTP – introducing first two modules • Plan and dose review capabilities Evaluate • First step in bringing classic TPS features into OIS • Successfully passed IHE-RO Connectathon for Dose Display • Stereotactic localization distributed in MOSAIQ® Locate • Used clinically in Stereotactic Radio
Slide 42: Medical device outlook; Market dynamics
Medical device outlook North America • New product launches − Safety, clinical efficacy, efficiency • Aging population − 40 million, > 65 in 2010, growing to 72 million in 2030 • Admissions and procedural volume pressures − Persistent unemployment impacts provider revenues • Affordable Care Act − Un
Slide 43: Elekta North America going forward
Elekta North America going forward… Installed base • Enhance service excellence: – Most recent MDBUYLINE report ranks Elekta #1 • Provide advanced solutions: – Streamlined workflow = higher efficiency – Advanced treatments = higher effectiveness • Increase consulting solutions: – Meaningful use – Pr
Slide 44: Elekta is gaining market share; Performance FY11
Elekta is gaining market share Linac share - installed base Linac share – new orders (FY10/11) (FY10/11) Management Analysis Siemens 4% Siemens Elekta Tomo/ 10% 11% Accuray 3% Elekta Tomo/ 7% 19% Accuray Varian 74% Varian 72% Elekta’s installed base, age 70 60 50 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 1
Slide 45: Concluding Remarks
Concluding Remarks Tomas Puusepp President and CEO Growth Strategy Innovation Emerging markets 45