CEO RK's Performance

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i have heard and agree with all of the point you make and more. I believe there is a different business model that would work for all constituents, physicians, the company, and most important the patients. One example, applicable in a large group,practice or academic center is to model it after the infusion center/pheresis center model. Infusions themselves are a low margin service based business but have become very profitable as the number of biological agents requiring infusions has driven demand. I know in some practices the practice purchases the agents and marks them up to,generate additional income but I believe this model can be adapted. The opportunity for PTNS is only going to increase with the ever increasing awareness of cognitive impairment associated with the use of anticholinergic medications for the treatment of urinary incontinence. Why the company has not leveraged this into their marketing message is a mystery to me and a disservice to the salesforce. Clinical understanding and appreciation of the risks associated with pharmacotherapy for urinary incontinence is evolving and creating an immense opportunity for PTNS, it is incumbent upon this mgmt team to monetize this opportunity they have been given
 






anonymous said:
i have heard and agree with all of the point you make and more. I believe there is a different business model that would work for all constituents, physicians, the company, and most important the patients. One example, applicable in a large group,practice or academic center is to model it after the infusion center/pheresis center model. Infusions themselves are a low margin service based business but have become very profitable as the number of biological agents requiring infusions has driven demand. I know in some practices the practice purchases the agents and marks them up to,generate additional income but I believe this model can be adapted. The opportunity for PTNS is only going to increase with the ever increasing awareness of cognitive impairment associated with the use of anticholinergic medications for the treatment of urinary incontinence. Why the company has not leveraged this into their marketing message is a mystery to me and a disservice to the salesforce. Clinical understanding and appreciation of the risks associated with pharmacotherapy for urinary incontinence is evolving and creating an immense opportunity for PTNS, it is incumbent upon this mgmt team to monetize this opportunity they have been given
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Hey Doc, I can see you are not a business man, probably a good thing.

The infusion center/pheresis center model would not work here. For UPC, the amount of reimbursement for the treatment is capped by the 3rd parties. You can put any business model you want into place, but the reimbursement amount, at around $125 to $130 per treatment from Medicare will not change. Out of this amount you have to pay $65 for the lead set and your other expenses. That does not leave much behind to entice many doctors to put up with the hassles or to try to work around the space constraints for this TRx.

OAB is a huge market, yet the revenue the company generates in relationship with the market size is miniscule, and has been for a long time now. UPC is not a blockbuster TRx. Smart investors have this figured out, and you see that reflected in the share price.

Sorry to break the bad news to you.
 






  • no, it is not bad news at all. I am quite familiar with the infusion center business model, and they originally came to exist for some of the same reasons that PTNS has not achieved commercial success. In the case of infusions in the physicians office you tied up a room for a prolonged period of time compared to an office visit, it was nursing intensive, starting an IV, accessing a portacath/Hickman, required fixed cost consumables of IV tubing, flush etc all reimbursed under a fixed payment. The economics "worked" once efficiency and throughput increased. What do you feel the company could/should do to monetize this opportunity?
 






I was a sales rep for this company for a long time and got out because the management could not see the writing on the wall. The fee for service model at the office level is not going to be successful as stated in other posts for a number of reasons. (not profitable enough, space, etc) I got tired of spinning my wheels trying to get offices going, only to have them stop after a few patients.
I tried to push for Physical Therapists to do PTNS. Why? They have the space and are willing to do procedures for $65 profit. Patients are accustom to going to PT every week or more and it's less threating to the patient. All I got back from senior mgt was that it's not reimbursable at that level and would not be a good fit. REALLY!!!! PTNS was not reimbursable by docs either a few years ago, change it!!! Look forward!!!! PT's are doing acupuncture, using lasers, ultrasound and many other medical devises, they can do PTNS if trained. Even a sales rep can do it!!!!! This treatment belongs in physical therapy!!!!!
 






Ex rep. Thank you for your response. I appreciate your insight.. Was it this mgmt team that pushed back against your suggestions or the prior team? I agree with you that the foundation of the business model can not be based on office based practices adopting and integrating PTNS into their practice. As demonstrated to this point that is good for the business as it exists today, not the potential of the business. Analogous to your PT based model is to utilize existing underutilized resources/infrastructure along the lines of the infusion/dialysis model where a single caregiver, a NP or PA can administer tx to multiple puts in parallel not in series. In your experience with the company did you call on any of the large incontinence centers whose practice and business model is focused on incontinence care? Thank you
 


































































What may make this interesting is that one of the board members who appears to see the issues with current mgmt owns 8% of the company while RK despite a generous, very generous compensation pkg own minimal equity in the company
 


















Last year's stock performance was not much good either, unless you a negative 80% plus percent stock return good!

This is the second year in a row we are onto lousy performance provided by RK
 












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