Foolish Forecast: Grab Intuitive Surgical While It's Cheap

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Intuitive Surgical (Nasdaq: ISRG) tends to inspire people. If it's not the promise of short hospital stays and fewer aches and pains after a small-incision robotic surgery, it's last quarter's results making fellow Fool Brian Orelli shout "Intuitive for president!"

But the stock has crashed hard in the past year. Is that the beginning of a long, hard winter, or an invitation to invest and frolic in green fields? Let's find out.

What Fools say
Here's how Intuitive Surgical's CAPS rating stacks up against some of its peers and competitors:

 

Market Cap (billions)

Trailing P/E Ratio

CAPS Rating

Intuitive Surgical

$3.91

19.7

****

Integra LifeSciences Holdings (Nasdaq: IART)

$0.79

50.4

****

CONMED (Nasdaq: CNMD)

$0.50

10.9

*

Accuray Incorporated (Nasdaq: ARAY)

$0.30

N/A

*****

Hansen Medical (Nasdaq: HNSN)

$0.13

N/A

****

Data taken from Motley Fool CAPS and Yahoo! Finance.

Please note that I'm using the phrase "peers and competitors" in a very broad manner here -- these companies work in minimally invasive surgery, but not necessarily with robotics. For more info, come back after the next table.

CAPS All-Star SwordAgain is overflowing with enthusiasm for this stock in this recent pitch: 

Analysts finally downgrading and lowering estimates, leading to an impression that they are giving up on high growth targets. This leaves room for upgrades and raising expectations. Channel checks indicate that hospitals still have credit for buying robotic systems. Projections are slightly reduced. Lowest P/E in a long while gives a great opportunity to buy.

Fellow All-Star StckPickr3000 is less optimistic: "Medical Equipment sector is just getting hammered right now. I think this sector will only truly recover when the entire market gets its legs back under itself."

What management does
This is about as close to the definition of a strong business as I've ever seen. I'll let you bask in the glory of Intuitive's numbers on your own. Meet you back here in a minute.

Margins

6/2007

9/2007

12/2007

3/2008

6/2008

9/2008

Gross

66.5%

67.6%

69.0%

69.3%

70.3%

70.9%

Operating

30.4%

32.2%

34.7%

35.5%

36.1%

36.4%

Net

20.6%

22.7%

24.1%

24.5%

24.7%

24.3%

FCF/Revenue

26.9%

25.7%

30.9%

27.7%

22.7%

21.4%

Growth (YOY)

6/2007

9/2007

12/2007

3/2008

6/2008

9/2008

Revenue

55.7%

57.7%

61.2%

64.7%

62.8%

59.0%

Earnings

(5.9%)

21.5%

100.6%

103.4%

95.1%

70.3%

All data courtesy of Capital IQ, a division of Standard & Poor's. Data reflects trailing-12-month performance for the quarters ended in the named months.

One Fool says
Intuitive Surgical's moat isn't just wide. It's filled with triflic acid and mutant carnivorous plesiosaurs, surrounded by electrified razor wire, and patrolled 24/7 by veterans of the French Foreign Legion. In other words, this business fears no competitor and has no peers. Intuitive has bought its fiercest rivals, and its money-making technology is guarded by layers of patent protection. If you're getting robotic surgery done, it's very likely performed with these da Vinci robots.

Now, Intuitive already released preliminary results, pointing to about 22% year-over-year sales growth overall but 45% higher sales of the disposable accessories you need to replace after each surgery; $82 million of the company's $232 million revenue came from these renewable sales in a Gillette-like "give away the handles and make a killing on the blades" business model. If it's good enough for Procter & Gamble (NYSE: PG), it's certainly good enough for a smallish-cap medical technology expert.

Sure, the economic crisis is forcing some hospitals to push back expensive upgrades like a million-dollar robotic surgeon. But the Greatest Generation is not getting any younger, and they will start asking for low-impact surgery that only Intuitive can deliver. Moreover, the vast majority of all da Vincis still move into American hospitals, leaving a massive global market nearly untapped.

Check out that diminutive P/E ratio above, and compare it to the surging growth rates. You're getting a massive deal here, Fool. Let the market panic while you consider buying Intuitive Surgical on the cheap.

Of course, when Intuitive Surgical officially releases earnings later this week, Brian Orelli will be back here with detailed coverage. Stay tuned.

Further robotic Foolery:

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Intuitive Surgical and Hansen Medical are Motley Fool Rule Breakers recommendations. Integra LifeSciences Holdings is a Stock Advisor selection. The Fool owns shares of Procter & Gamble. Try any of our Foolish newsletters today, free for 30 days. Or just sign up for a free CAPS account to perhaps find the identities of your fellow Fools who were quoted above. They might have more to tell you!

Fool contributor Anders Bylund is an Intuitive Surgical shareholder, but he holds no other position in any of the companies discussed here. OK, he does use a Gillette razor. Happy now? You can check out Anders' holdings if you like, and Foolish disclosure is the Punxsutawney Phil of financial forecasting.

Comments from our Foolish Readers

Help us keep this a respectfully Foolish area! This is a place for our readers to discuss, debate, and learn more about the Foolish investing topic you read about above. Help us keep it clean and safe. If you believe a comment is abusive or otherwise violates our Fool's Rules, please report it via the Report this Comment Report this Comment icon found on every comment.

  • Report this Comment On January 20, 2009, at 2:12 PM, PauvrePapillon wrote:

    If you’re contemplating a bet in the medical equipment space, why not first take at look at Accuray (ARAY)?

    When the market (correctly) understood that CyberKnife was a truly unique and revolutionary technology, investors bid Accuray’s post-IPO shares up to an intraday high of $31.09 (9 February 2007). As Varian and others made repeated claims, in numerous press releases, interviews and conference calls, that their gantry-mounted machines could do the same thing as the robotically controlled CyberKnife, Accuray’s market cap shrank even though its economic fundamentals actually improved.

    On 6 December 2008, Accuray, finally, fired back with the release of two animated videos that effectively demonstrate what CyberKnife is and why it is fundamentally different from gantry-mounted radiation sprayers. You can see them for yourself at http://www.accuray.com.

    Since then (as of close of market 16 January 2009) Accuray shares have gone up 31.5 percent. Varian’s shares have gone down 9.5 percent (in spite of a recent announcement that net orders are up 12 percent) and Tomo is down 29 percent while the NASDAQ is up 1.3 percent. (As we post this, all of those numbers are down but the trend is still in tact.)

    Are investors now beginning to rethink this space and conclude that Accuray really does have something?

    From Breakthroughs That Will Change Lives in 2009…

    “Cyberknife has the potential to replace surgery as the first form of treatment for cancer,” says Dr Nick Plowman, director of clinical oncology at St Bartholomew's Hospital.

    http://www.dailymail.co.uk/health/article-1106224/From-machi...

    And it’s just now being discovered by, and moving into, a huge market…

    See WSJ’s Is CyberKnife Ready for Prime Time in Prostate Cancer?

    http://blogs.wsj.com/health/2008/11/28/is-cyberknife-ready-f...

    And it’s making waves in Europe and Asia as well…

    From ABC News London…

    http://www.abcnews.go.com/Video/playerIndex?id=6549791

    And most CAPS players like it…

    http://caps.fool.com/Ticker/ARAY.aspx

    You might make double up or even triple up with ISRG but with Accuray you have a serious candidate for a multi-bagger in the making.

  • Report this Comment On January 20, 2009, at 6:43 PM, GoNuke wrote:

    Robotic surgery is cool. The big question is does it reduce costs. So far it only reduces the length of hospital stays. Each day spent in hospital is costed using fixed costs divided by room days. Robotic surgery saves no cash and doesn't reduce costs of surgery. The assumption must be that eventually da Vinci's progeny will reduce the real costs of surgery. Given that da Vinci's are about cost neutral in the US where medical costs are the highest in the world bodes ill for the da Vinci.

    The main reason to have one is to attract top-notch surgeons who are drawn to the technology.

    I'd like to see some evidence that hospitals still have access to credit. My information is that they don't. Given that da Vinci machines do not have a real positive NPV it is hard to see how a hospital can convince a lender that such equipment is a safe investment. It will not pay for itself -unless somehow it leads to drastic reductions in malpractice insurance premiums.

  • Report this Comment On January 21, 2009, at 4:33 PM, PauvrePapillon wrote:

    As the dust settles on The Coronation…

    ARAY up 31

    VAR down 12

    TOMO down 21

    NASDAQ flat

    Tracking from 6 December 2008 (the release date of Accuray’s animated technology differentiation videos) to close of market 21 January 2009.

    “I call upon all responsible, productive people to work hard and sacrifice so that we can redistribute their incomes to those who will never be able to find a decent job because they refuse to buy into bourgesoise middle class values like staying in school or learning a trade or finding a husband before starting a family but are, nevertheless, the Ones We Have Been Waiting For because they will get on a bus and go vote for me whenever and wherever I need to send them.”

    His Exalted Excellency Barack Hussein Obama (FIBPOTUS)

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11/23/2009 11:43 AM
PG $62.89 Up +1.09 +1.76%
The Procter & Gamb… CAPS Rating: *****
ARAY $5.63 Up +0.09 +1.62%
Accuray, Inc. CAPS Rating: ****
CNMD $21.93 Up +0.47 +2.19%
CONMED Corp CAPS Rating: **
HNSN $2.65 Down -0.05 -1.85%
Hansen Medical, In… CAPS Rating: ****
IART $32.59 Up +0.60 +1.88%
Integra LifeScienc… CAPS Rating: ***
ISRG $281.75 Up +5.31 +1.92%
Intuitive Surgical… CAPS Rating: ****

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