Intuitive Surgical, Inc. · NASDAQ:ISRG
Intuitive Surgical — Investor Presentation (December 2018)
43 slides from Intuitive Surgical's investor presentation, December 2018
Slide 1: Quantifying the Impact
Quantifying the Impact Clinical economics references from leading thoracic surgeons
Slide 2: About clinical benefits and costs
HOME ← BACK FORWARD → COST METHODOLOGY About clinical benefits and costs From a hospital perspective, clinical benefits may result in the potential cost reductions noted below; however, these clinical benefits and costs may vary per hospital and be higher or lower than mentioned during this presenta
Slide 3: About clinical benefits and costs
HOME ← BACK FORWARD → COST METHODOLOGY About clinical benefits and costs When considering cost-effectiveness of an advanced technology like the da Vinci system, we recommend that hospitals perform a full cost-benefit analysis, considering not just the operating room costs but the costs associated wi
Slide 4: Lobectomy
HOME ← BACK FORWARD → COST METHODOLOGY Lobectomy Mark Dylewski, MD G. Kimble Jett, MD South Miami Hospital The Heart Hospital Baylor Plano Miami, FL Plano, TX Samuel Kim, MD Baiya Krishnadasan, MD Banner – University Medical Center Tucson St. Joseph Medical Center Tucson, AZ Towson, MD Dao Nguyen, M
Slide 5: Surgeon Profile
HOME ← BACK FORWARD → COST METHODOLOGY Surgeon Profile Mark Dylewski, MD South Miami Hospital Miami, FL Da Vinci System Training ® 2006 Residency University of California Medical Center, Davis (General) Albany Medical College, New York (General Surgery) Fellowship: Albany Medical College, New York (
Slide 6: Background Information
HOME ← BACK FORWARD → Background Information Published results of Mark Dylewski, MD vs. published results Dylewski, MR, Ohaeto, AC, Pereira, JF. (2011). Pulmonary Resection Using a Total Endoscopic Robotic Video-Assisted Approach. Seminars in thoracic and cardiovascular surgery. Study Design Outcome
Slide 7: Study Information
HOME ← BACK FORWARD → Study Information Lobectomy: published results for comparison with the published results of Mark Dylewski, MD Oh, D., Reddy, R., Gorrepati, M., Mehendale, S., & Reed, M. (2017). Robotic-Assisted, Video-Assisted Thoracoscopic and Open Lobectomy: Propensity-Matched Analysis of Re
Slide 8: Clinical Outcomes and Estimated Cost Savings
HOME ← BACK FORWARD → COST METHODOLOGY Clinical Outcomes and Estimated Cost Savings Published results of Mark Dylewski, MD vs. published results Length of Stay In-hospital Transfusions Conversions In-hospital Complications O.R. Time (days) (percentage) (percentage) (percentage) (minutes) 7.0 44.0 24
Slide 9: Surgeon Profile
HOME ← BACK FORWARD → COST METHODOLOGY Surgeon Profile G. Kimble Jett, MD The Heart Hospital Baylor Plano Plano, TX Da Vinci System Training ® 2011 IDN System Baylor Scott and White Health Residency Massachusetts General Hospital (General) Emory University (Thoracic) National Heart Institute, NIH (C
Slide 10: Background Information
HOME ← BACK FORWARD → Background Information Clinical Outcomes and Estimated Cost Savings G. Kimble Jett, MD: single-surgeon unpublished vs. published results Design Cost Methodology • Unmatched comparison of surgeon provided data (for da • Cost savings from da Vinci RAS vs. other modality = (∆ LOS
Slide 11: Study Information
HOME ← BACK FORWARD → Study Information Lobectomy: published results for comparison with surgeon’s unpublished experience Oh, D., Reddy, R., Gorrepati, M., Mehendale, S., & Reed, M. (2017). Robotic-Assisted, Video-Assisted Thoracoscopic and Open Lobectomy: Propensity-Matched Analysis of Recent Premi
Slide 12: Clinical Outcomes and Estimated Cost Savings
HOME ← BACK FORWARD → COST METHODOLOGY Clinical Outcomes and Estimated Cost Savings G. Kimble Jett, MD: single-surgeon unpublished vs. published results Length of Stay In-hospital In-hospital Complications O.R. Time (days) Transfusions (percentage) (minutes) (percentage) 7 44.0 248 235 6 38.7 167 2.
Slide 13: Surgeon Profile
HOME ← BACK FORWARD → COST METHODOLOGY Surgeon Profile Samuel Kim, MD Banner – University Medical Center Tucson Tucson, AZ Da Vinci System Training ® 2012 Residency Hospital of the University of Pennsylvania (General) Massachusetts General Hospital (Cardiothoracic) Memberships Cardiothoracic Surgery
Slide 14: Background Information
HOME ← BACK FORWARD → Background Information Samuel Kim, MD: A single surgeon's unpublished experience Design Cost Methodology • Surgeon provided data for all cohorts • Cost savings from da Vinci RAS vs. other modality = (∆ LOS days x LOS cost) + (∆ OR Time min x OR cost) + (∆ Transfusions% x Patien
Slide 15: Clinical Outcomes and Estimated Cost Savings
HOME ← BACK FORWARD → COST METHODOLOGY Clinical Outcomes and Estimated Cost Savings Samuel Kim, MD: a single surgeon’s unpublished experience Length of Stay Transfusions Conversions O.R. Time (days) (percentage) (percentage) (minutes) 7.0 205 6.8 5.0 138 4.6 106 3.2 2.0 1.0 0.0 N/A Cost $1,475 $1,11
Slide 16: Surgeon Profile
HOME ← BACK FORWARD → COST METHODOLOGY Surgeon Profile Baiya Krishnadasan, MD St. Joseph Medical Center Townson, MD Da Vinci System Training ® 2009 Residency University of Washington, Seattle (General) Research Fellowship, Cardiothoracic Surgery University of Washington, Seattle (Thoracic) Membershi
Slide 17: Background Information
HOME ← BACK FORWARD → Background Information Clinical Outcomes and Estimated Cost Savings Baiya Krishnadasan, MD: single-surgeon unpublished vs. published results Design Methodology • Unmatched comparison of surgeon provided data (for da Vinci • Cost savings from da Vinci RAS vs. other modality = (∆
Slide 18: Study Information
HOME ← BACK FORWARD → Study Information Lobectomy: published results for comparison with surgeon’s unpublished experience Oh, D., Reddy, R., Gorrepati, M., Mehendale, S., & Reed, M. (2017). Robotic-Assisted, Video-Assisted Thoracoscopic and Open Lobectomy: Propensity-Matched Analysis of Recent Premi
Slide 19: Clinical outcomes and estimated cost savings
HOME ← BACK FORWARD → COST METHODOLOGY Clinical outcomes and estimated cost savings Baiya Krishnadasan, MD: single-surgeon unpublished vs. published results Length of stay O.R. time In-hospital In-hospital (Mean days) (min) transfusions mortality (%) (%) 235 248 9.8 7.0 6.0 6.9 136 2.5 1.7 Dr.Baiya
Slide 20: Surgeon Profile
HOME ← BACK FORWARD → COST METHODOLOGY Surgeon Profile Dao Nguyen, MD, FACS University of Miami Miami, FL Da Vinci System Training ® 2012 Residency McGill University (General) McGill University (Cardiothoracic) Fellowship: MD Anderson Cancer Center Thoracic Oncology Memberships American Association
Slide 21: Background Information
HOME ← BACK FORWARD → Background Information Clinical Outcomes and Estimated Cost Savings Dao Nguyen, MD: single-surgeon unpublished vs. published results Design Cost Methodology • Unmatched comparison of surgeon provided data (for da • Cost savings from da Vinci RAS vs. other modality = (∆ LOS days
Slide 22: Study Information
HOME ← BACK FORWARD → Study Information Lobectomy: published results for comparison with surgeon’s unpublished experience Oh, D., Reddy, R., Gorrepati, M., Mehendale, S., & Reed, M. (2017). Robotic-Assisted, Video-Assisted Thoracoscopic and Open Lobectomy: Propensity-Matched Analysis of Recent Premi
Slide 23: Clinical Outcomes and Estimated Cost Savings
HOME ← BACK FORWARD → COST METHODOLOGY Clinical Outcomes and Estimated Cost Savings Dao Nguyen, MD, FACS: single-surgeon unpublished vs. published results Length of Stay In-hospital Transfusions In-hospital Complications O.R. Time (days) (percentage) (percentage) (minutes) 248 7.0 6.0 44.0 38.7 235
Slide 24: Surgeon Profile
HOME ← BACK FORWARD → COST METHODOLOGY Surgeon Profile Walter Scott, MD Albany Medical Center Albany, NY Da Vinci System Training ® 2002 Residency University of North Carolina, Chapel Hill (General) University of Utah (Cardiothoracic) Memberships Cardiothoracic Surgery Network (CTSNet) Eastern Cardi
Slide 25: Background Information
HOME ← BACK FORWARD → Background Information Clinical Outcomes and Estimated Cost Savings Walter Scott, MD: single-surgeon unpublished vs. published results Design Cost Methodology • Unmatched comparison of surgeon provided data (for da • Cost savings from da Vinci RAS vs. other modality = (∆ LOS da
Slide 26: Study Information
HOME ← BACK FORWARD → Study Information Lobectomy: published results for comparison with surgeon’s unpublished experience Oh, D., Reddy, R., Gorrepati, M., Mehendale, S., & Reed, M. (2017). Robotic-Assisted, Video-Assisted Thoracoscopic and Open Lobectomy: Propensity-Matched Analysis of Recent Premi
Slide 27: Clinical Outcomes and Estimated Cost Savings
HOME ← BACK FORWARD → COST METHODOLOGY Clinical Outcomes and Estimated Cost Savings Walter Scott, MD: single-surgeon unpublished vs. published results Length of Stay In-hospital Complications O.R. Time (days) (percentage) (minutes) 44.0 7.0 248 235 6.0 38.7 4.0 37.9 157 Cost $1,475 $23,322 $21 (per
Slide 28: Surgeon Profile
HOME ← BACK FORWARD → COST METHODOLOGY Surgeon Profile Roy Williams, MD Mount Sinai Medical Center Miami Beach, FL Da Vinci System Training ® 2002 Residency SUNY Health Science Center at Brooklyn (General) Fellowship: SUNY Health Science Center at Brooklyn (Thoracic) Memberships American College of
Slide 29: Background Information
HOME ← BACK FORWARD → Background Information Clinical Outcomes and Estimated Cost Savings Roy Williams, MD: single-surgeon unpublished vs. published results Design Cost Methodology • Unmatched comparison of surgeon provided data (for da • Cost savings from da Vinci RAS vs. other modality = (∆ LOS da
Slide 30: Study Information
HOME ← BACK FORWARD → Study Information Lobectomy: published results for comparison with surgeon’s unpublished experience Oh, D., Reddy, R., Gorrepati, M., Mehendale, S., & Reed, M. (2017). Robotic-Assisted, Video-Assisted Thoracoscopic and Open Lobectomy: Propensity-Matched Analysis of Recent Premi
Slide 31: Clinical Outcomes and Estimated Cost Savings
HOME ← BACK FORWARD → COST METHODOLOGY Clinical Outcomes and Estimated Cost Savings Roy Williams, MD: single-surgeon unpublished vs. published results Length of Stay Conversions In-hospital Complications O.R. Time (days) (percentage) (percentage) (minutes) 7.0 248 235 6.0 44.0 5.5 38.7 185 13.1 6.9
Slide 32: Surgeon Profile
HOME ← BACK FORWARD → COST METHODOLOGY Surgeon Profile James Wudel, MD Wake Forest Baptist Medical Center Winston-Salem, NC Da Vinci System Training ® 2011 Residency Vanderbilt University Medical Center (Internal Medicine) Vanderbilt University Medical Center (General) University of Michigan (Cardio
Slide 33: Background Information
HOME ← BACK FORWARD → Background Information Clinical Outcomes and Estimated Cost Savings James Wudel, MD: single-surgeon unpublished vs. published results Design Cost Methodology • Unmatched comparison of surgeon provided data (for da • Cost savings from da Vinci RAS vs. other modality = (∆ LOS day
Slide 34: Study Information
HOME ← BACK FORWARD → Study Information Lobectomy: published results for comparison with surgeon’s unpublished experience Oh, D., Reddy, R., Gorrepati, M., Mehendale, S., & Reed, M. (2017). Robotic-Assisted, Video-Assisted Thoracoscopic and Open Lobectomy: Propensity-Matched Analysis of Recent Premi
Slide 35: Clinical Outcomes and Estimated Cost Savings
HOME ← BACK FORWARD → COST METHODOLOGY Clinical Outcomes and Estimated Cost Savings James Wudel, MD: single-surgeon unpublished vs. published results Length of Stay In-hospital Transfusions Conversions In-hospital Complications (days) (percentage) (percentage) (percentage) 7.0 6.0 44.0 38.7 3.5 13.1
Slide 36: Cost References & Methodology
HOME ← BACK FORWARD → Cost References & Methodology Ref. Clinical Metric Resource(s) Published Value(s) Used Price Index Adjustment Calculation a. Length of stay Halpern NA, Pastores SM. Critical care $1,153/day From 2005 USD to 2018 USD, $1,153 ÷ 84.474 x 108.036 = medicine in the United States 200
Slide 37: Cost References & Methodology (cont'd)
HOME ← BACK FORWARD → Cost References & Methodology (cont’d) Ref. Clinical Metric Resource(s) Published Value(s) Used Price Index Adjustment Calculation f. Complications Cost of Complication = Multiplier x / reoperations MS-DRG Medicare Payment DRG multiplier Healy MA, Mullard AJ, Campbell DA, Multi
Slide 38: Cost References & Methodology (cont'd)
HOME ← BACK FORWARD → Cost References & Methodology (cont’d) Ref. Clinical Metric Resource(s) Published Value(s) Used Price Index Adjustment Calculation f. Complications Cost of Complication = Multiplier / reoperations x MS-DRG Medicare Payment (cont’d) MS-DRG Payments: Medicare Inpatient MS- Medica
Slide 39: Cost References & Methodology (cont'd)
HOME ← BACK FORWARD → Cost References & Methodology (cont’d) Ref. Clinical Metric Resource(s) Published Value(s) Used Price Index Adjustment Calculation g. Readmissions Healthcare Cost and Utilization MS- # of $ Cost per From 2014 USD to 2018 Weighted average of national (cont’d) Project (HCUP) by U
Slide 40: References
HOME ← BACK FORWARD → References 1. Dylewski MR, Ohaeto AC, Pereira JF. Pulmonary resection using a total endoscopic robotic video-assisted approach. Semin Thorac Cardiovasc Surg. 2011 Spring;23(1):36-42. doi: 10.1053/j.semtcvs.2011.01.005 2. Oh DS, et al. Robotic-Assisted, Video-Assisted Thoracosco
Slide 41: Important Safety Information
HOME ← BACK FORWARD → COST METHODOLOGY Important Safety Information Financial Disclosure Important Safety Information All surgeons represented in this document have received compensation Serious complications may occur in any surgery, including da Vinci® from Intuitive for consulting and/or educatio
Slide 42: Important Safety Information
HOME ← BACK FORWARD → COST METHODOLOGY Important Safety Information Da Vinci Xi® System Precaution Statement The demonstration of safety and effectiveness for the specific © 2018 Intuitive Surgical, Inc. All rights reserved. Product names procedure(s) discussed in this material was based on evaluati
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