Forum Topics 4DX 4DX Webinare

Pinned straw:

Added 3 months ago

Below are my notes and comment from webinar:

CT:VQ™ market is around 1m scans a year in the US and a value of around $1b.

Superior technology to the current radiopharma procedures in:

  • No contrast agents – ie either radioactive dust or injectables into bloodstream
  • Clearer image
  • More accessible with 14,500 existing scanners in US
  • Better workflow
  • Better patient experience
  • Lower cost.


Questions: Costs and Sales pricing:

Was cagey, but said expected $600 per procedure, about the same as their LVAS product and it costs about $4 each (said this with a straight face). Said a share of this will need to go to the hospitals. $300m of sales would be just the beginning

(Importantly said this was the first time 4DX was selling a product that was a replacement product, not something new). Said product was ready for rollout.

Conversion to paying customers:

Had never given a free trial for any 4DX product where the practice did not end up paying.

Medicaid Reimbursement:  Said confident will have by the end of the year.

VA and DoD progress: said had a team in Washington. Spoke of the value of their XV LVAS product and gave example of DoD burns pit scans versus a biopsy. Their existing scan cost around $1k (?) versus $30k for a biopsy.

Asked about PME partnerships: refused to comment, but did say product was technically compatible

CME approvals; Said focus of on the US where 40% of the market and 50% of the profits are.

It is interesting the changes in Department of Health and Human Services (Robert Kennedy) and how the US healthcare landscape is changing. Today announcement from PNV in response to New York Times press speculation. It would seem PNV is on the right side of the muted changes with a low cost product. Similarly the same thing seems to apply with 4DX and their offerings. (Contrast this with BOT and its old school management whose major skills and experience appear to be in rorting the US insurance and government reimbursement system. And just how they appear to have come unstuck, for that and other reasons.

Andreas was his in a black T shirt and looking his usual disheveled self. His demeanor was slightly more upbeat than his previous webinars over the years and he took questions. He said that he and his team will working around the clock to make this work.  Looks good to me and I think you can be reasonably sure Andreas is working for you the shareholder and will not be spending his evenings rooting whores and snorting lines of cocaine.   Share price is off post his presentation, so f&%$ed if I know what I got wrong. 

mikebrisy
Added 3 months ago

@Scoonie just adding to your straw, I got "my BA" to do an analysis of the transcript and compare it with the ASX release and then to pulll out new disclosures in the presentation. Below is the complete "dump", but some great nuggets in there.

Before getting into this detail, Andreas highlighted how unusual it was for the FDA to approve the 501 without first sending back any questions during the review process. He linked this to the statiscal analysis presented, and this really does look like a gamechanger.

On commercial execution, the fact that it can be integrated on existing PACS systems behind the existing PACS layer, allowing the CT:VQ to be viewed consistent with the basic CT, means that they have really thought about the user and ease of deployment. This is great news.

As to your comment on SP movement today, expect volatility. The SP has already gone up 40%+ following the FDA approval announcement and +240% since Sam H tipped in a few millions. This is valued at over 25x revenue, so it is going to be volatile. I couldn't get more yesterday at $0.65, and I am happy to wait for it to come back. I would like a larger position now that I understand it better, because I think we will see rapid adoption. Afterall, this is a tech that is not adding something new, but effectively replaces a much more expensive technology.

So let's imagine just on the application of replacing nuclear medicine with a global market size of $2.6bn. If the $600 per scan cost is $4, they share $200 with the hospital, and $200 with their distributor, and end up with only $100-200 themselves, Then that's an effective TAM of $430m, of which about $200m is in the US.

So let's base valuation on the US bsuiness, which will be there short term focus. If they can get rapid penetration of 10-20% of the market over 3-5 years, then that's $20-40m revenue in 3 - 5 years, from $5m in FY25. So that's anywhere from 35% to 100% revenue growth p.a. over the next few years, with little need to do much to their cost base. So, the building blocks are there to value this. I'll come back to this later, but hopefully we can see from these numbers that I won't be chasing the SP up at $0.80!

OK, now the detailed analysis of the webinar - some good nuggets in there which will help developing some valuation scenarios.

Additional Insights from the Webinar (Not in ASX Release)

???? Summary of New Insights

The ASX release framed CT:VQ™ as a historic FDA clearance with billion-dollar market potential. The webinar went further, giving investors a roadmap for execution:

  1. FDA win was unusually clean – no questions, evidence above standard.
  2. Commercial detail: price ~$600–650/scan, cost ~$4, margin strategy, early hospital targets.
  3. Reimbursement: aiming for Medicare approval in 2025 (fastest ever for 4DX).
  4. VA/DoD strategy: pilots + leadership engagement, strong economic argument, Philips channel.
  5. Adoption case: replacement product, minimal training barrier, leapfrog over outdated tech.
  6. Partnerships: Philips confirmed, PME hinted.
  7. Strategic focus: US first, later global.


1. FDA Process & Strength of Evidence

  • Andreas Fouras stressed how unusual it was for FDA to approve without sending back any questions, due to the overwhelming strength of 4DMedical’s data package.
  • Detailed discussion of reader study stats (Kendall’s Tau >0.7, exceeding FDA’s “very strong” standard) and superiority claims (absence of contrast artifacts, lower noise, better correlation with physiology).

→ New detail: ASX noted validation but did not highlight the “no FDA queries” milestone or superiority vs equivalence.

2. Commercialisation Readiness

  • Product is fully ready for rollout – FDA clearance was the last regulatory step.
  • Sales targeting: hospitals with high nuclear VQ volumes already identified, e.g. UC San Diego (PE focus) and Cleveland Clinic (COPD).
  • Expectation of rapid contracting in 2025, leveraging conferences (Chest, RSNA).

→ New detail: Specific target hospitals and tactical commercialisation timeline absent from ASX.

3. Pricing, Revenue & Economics

  • Expected price point: ~US$600–650 per scan, in line with CT-LVAS.
  • Delivery cost to 4DMedical: ~US$4 per scan, leaving ample margin to share with hospitals/partners.
  • Highlighted potential for subscription vs pay-per-use models.
  • Reinforced that every pilot historically converted into a paying contract.

→ New detail: None of this pricing or cost detail appeared in ASX.

4. Reimbursement Outlook

  • Confident Medicare reimbursement in 2025, expecting shortest lag ever between FDA clearance and reimbursement for a 4DX product.
  • Based on lessons from XV and CT-LVAS reimbursement pathways.

→ New detail: ASX did not mention reimbursement timelines.

5. Veterans Affairs (VA) & Department of Defense (DoD)

  • Dual strategy:
  • Bottom-up pilots with VA regional hospital networks (VISNs).
  • Top-down engagement with DC leadership.
  • Burn pit study showed 98% agreement with biopsy; cost saving: biopsy ~$30,000 vs CT:VQ ~$1,000.
  • VA budget recently increased under current US administration, supportive for adoption.

→ New detail: Cost-saving rationale, burn pit data, and strategic lobbying not disclosed in ASX.

6. Partnerships

  • Philips: confirmed as a likely sales partner into VA, already engaging doctors.
  • Pro Medicus (PME): acknowledged technical compatibility and ongoing support, but no public detail yet.

→ New detail: ASX mentioned neither Philips VA role nor PME integration.

7. Barriers to Adoption

  • For two-thirds of US market still on planar imaging, no reason not to leapfrog nuclear 3D and go straight to CT:VQ.
  • Usual frictions: contracting, IT integration – but mitigated by Philips’ larger salesforce.
  • First time 4DMedical can pitch a direct replacement product rather than a “new tech” sale.
  • On a question on trial periods and pilots: “We’ve never done a pilot that doesn’t converted into a paying customer.” Andreas believes the evidence shows that all they have to do is get the prodict into the hands of doctors for them to use with patients, and then “they will demand it.”

→ New detail: Positioning CT:VQ as a replacement product (not an add-on) was absent from ASX.

8. International Expansion

  • CEO clarified US is ~40–45% of global sales and >50% of profits.
  • Global rollout planned later, but ROI dictates focus on US first.

→ New detail: ASX mentioned global opportunity, but not the explicit capital allocation priority.


DIsc: Held

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