Forum Topics CGS CGS CEO Interview

Pinned straw:

Added 2 months ago

I really enjoyed today's chat with Cogstate's Brad O'Connor (not Cooper!! as I mistakenly said.. ugh)

The recording in on the Meetings page and the transcript is here: Cogstate Transcript.pdf

A couple of things that stood out to me:

  • I REALLY liked the assertion that they are staying focused on their core competency -- a narrow but deep moat, as Brad put it. Doing too much, too soon is just too often a capital killing move for small caps.
  • It's clear that their offering is gaining increasing awareness and adoption by the big firms. As i say all the time, the social proof element is super critical for disruptors to properly exploit the opportunity in front of them.
  • It was really interesting to hear him say that the R&D phase is actually still critical, if even dominant relative to the challenge of scaling (not that they are ignoring that at all). His reference to AI here seemed grounded and reasonable, and the partnerships being leveraged here made a lot of sense.
  • Brad essentially spelled out what we investors should focus on -- the lead indicator of contract wins. Which, i suppose, it's somewhat obvious, but reading between the lines I wonder if he was essentially saying "we're expecting to win a bunch of work in the coming period"
  • I thought his comments on takeovers, the company's initial listing and their increased IR efforts were all rather candid and reasonable. Most often you get more generic responses to those kinds of questions.
  • The developing operating leverage is hard to miss, and testament to how well they are scaling. In fact, it is remarkable that their revenue has grown to the degree it has while they actually cut staff -- and significantly so.
  • This wasnt discussed, but a PE of 37 actually doesnt seem too excessive at all *if* they can indeed double their revenues in the coming years and sustain (or even extend) their margins.


Also, big shout out to @mushroompanda who's question Brad called "remarkably insightful". Looks like you've got a job offer out that one too!


Anyway, here's the AI summary of the meeting:

  • What Cogstate does (problem → solution)
  • Core problem in CNS trials: highly subjective clinician-administered cognitive endpoints at global scale create noise that can mask drug signal. Cogstate’s mission is signal over noise.
  • Solutions span: validated digital cognitive tests, trial design expertise, investigator training/certification, algorithmic data monitoring, human review of recorded assessments, and robust stats/reporting—all to reduce error.
  • Economics of “getting endpoints right”
  • A single Phase 3 Alzheimer’s trial can cost ~US$1B; Cogstate’s endpoint quality services are ~US$30–40m, a small fraction of total but critical to success and regulatory acceptance.
  • AI & the next phase of clinical trials
  • Trials are changing fast (1–3 years, conservatively “3–5”). Cogstate is applying small, purpose-built models over proprietary data rather than relying on generic LLMs.
  • New AI model (shipping “next month”) flags assessment-administration errors from audio recordings, moving human review from ~60 minutes to ~10 minutes—and ultimately to full automation and 100% review coverage. North Star: real-time prevention and, longer-term, AI avatar administration (multilingual, consistent, error-free).
  • Efficiency evidence: headcount down from ~200 to ~160 since COVID while revenue climbed from ~US$30m to ~US$50m, due to automation and data-analytics leverage.
  • Build vs partner (tech strategy)
  • Two years ago Cogstate shifted from fully in-house dev to a hybrid model with global engineering partner UST (~30k engineers). They run 12-week innovation cycles, tapping UST’s AI/data leaders, while Cogstate focuses on proprietary datasets and domain problems. Deliverables include avatar patients/caregivers for training/certification and internal productivity tools (e.g., AI-drafted RFI/RFP responses).
  • Medidata partnership (scale unlock)
  • Medidata is the dominant eClinical/EDC platform (acquired by Dassault Systèmes in 2019, ~US$5B deal). Historically light in CNS due to service intensity needed. Cogstate wraps CNS services around Medidata’s platform so Medidata can push into CNS; Cogstate gains reach and scale. Expect impact to show more in FY26 than FY25. Shareholder day (Nov 7, Melbourne) will feature Medidata’s COO Joe Schmidt and an ex-Lilly exec to discuss the partnership.
  • Financial profile & capital allocation (as discussed)
  • Recent year revenue ~US$50m; indicative margins: ~60% gross, ~30% EBITDA, ~25% EBIT. Cash ~US$36m at 30 June; ~US$5m buyback in the last 12 months. Board challenges management to speed up R&D, but management prefers rapid, measured experiments with customer validation.
  • Targets/aspirations: lift license revenue from ~24% to ~30% (supporting ~65% gross margin), drive operating leverage to potentially ~40% EBITDA at scale; path to US$100m revenue with better opex leverage.
  • Bookings vs revenue (key metric)
  • Sales contracts (bookings) are the lead indicator. FY22 bookings were US$82m vs ~US$40m revenue; but in FY23–FY25, total bookings were below revenue. Management aims to reverse this in FY26 (back to bookings > revenue) as growth re-accelerates.
  • Revenue lumpiness
  • Mix shift in FY25 toward more, smaller, diverse studies (faster revenue recognition) made results less lumpy; however, lumpiness may return in FY26 with visibility on larger Phase 3 Alzheimer’s programs.
  • Competition
  • Two main head-to-head players in CNS trial endpoints/services: Sign Health and Clario (both PE-owned, broader offerings, larger scale). Cogstate is the smaller, deeper specialist (“inch wide, mile deep”). Potential IPOs for peers depend on market windows.
  • Geography & APAC strategy
  • Majority of customers/revenue from US and Europe. Growing interest in APAC, particularly China (drug discovery, out-licensing post-Phase 2). Cogstate assessing whether to expand boots on the ground in the region.
  • Consumer/GP product (status)
  • Prior primary-care push with a partner (ACI) did not gain traction (Alzheimer’s prescribing is specialist-led). Cogstate re-acquired the IP (no cash returned; fewer future payments owed). Options under review: direct-to-consumer assessments, or a white-label with large payers/associations (e.g., Kaiser, Alzheimer’s Association) where Cogstate offers tools (possibly free) in exchange for dataset access to power insights and prevention—still undecided.
  • Alzheimer’s pipeline direction
  • Expect shift from treating dementia patients to pre-dementia populations (e.g., 50-somethings with risk markers), moving the system from sick-care to health-care (prevention & early management). Near-term data readouts could reshape AD R&D for the better.
  • Q&A highlights
  • Michael #1 (lumpiness trend & Medidata): Brad said FY25 looked less lumpy due to more small/varied studies; lumpiness could return in FY26 with larger trials; reiterated need to grow bookings and broaden indications beyond AD.
  • Michael #2 (Roche “TRAVELER” pre-screening): Brad called it “remarkably insightful”, confirmed Cogstate’s digital assessments are being used alongside blood biomarkers to identify community patients for future AD trials; joked Michael could “hit me up if you’re looking for a job.”
  • IR activity: Cogstate admits it had been “a bit st**” at IR; now stepping up because the business is at a scale where wider communication makes sense. Shareholder Day Nov 7 flagged.
  • Takeover chatter: On a past approach, there was diligence and a price but it wasn’t announcement-ready; acquirer ultimately did not proceed; disclosure came after market talk. On Medidata (hypothetical) acquiring Cogstate: board is open to value-creating M&A, but the company is not run for sale and is focused on capturing upcoming growth.
  • What to watch (management’s own list)
  • Bookings growth (sales contracts > revenue again in FY26).
  • Early Medidata contribution through FY26–FY28 (share gains).
  • Progress to US$100m revenue with license-mix expansion and margin uplift (opex leverage).
  • AD trial landscape and movement toward pre-dementia populations.


mushroompanda
Added 2 months ago

The more I think about this one, the better it looks.

They've been running into the headwind of a lack of new Phase 3 Alzhemier's Disease (AD) trial starts for the past two years. Mainly from large pharma companies switching focus to getting approvals over designing new trials. All the while the company delivered record revenue, profits and a maiden dividend. The company has done this by broadening its offerings into non-AD work, and its partnership with Medidata.

607a1caec71455e4d467d84d7aba237de9578e.png

Brad spelled out in no uncertain terms that this trend will reverse in FY26 due to their visibility of the AD trial pipeline. That's the type of lumpiness I can get on board with! One phase 3 win will underwrite growth for the next few years. Multiples, and strong growth will be all but assured.

Trailing EV/E is 21.8, or if you're an annualisoooooor like me and double the 2H FY25 it comes down to 17.7. Not expensive at all for a company that's growing well, with a new partnership that's only just underway and with a strong headwind that's about to reverse.

Like I mentioned in an earlier post on this thread - Roche is kicking off 3x Phase 3 AD trials in the next 6-12 months. And they've hired Cogstate to help recruit these patients, as confirmed in the interview. Winning one or more of these is where the near-term opportunity lies for Cogstate.

31

Slew
Added 2 months ago

I finally watched the Cogstate meeting over the weekend. I’ll admit, when I first saw the “enthusiastic” straws about it, I was a bit uneasy — I’m naturally sceptical, and sometimes I feel the straw collective can get a little self-reinforcing in its positivity. (On that note, I always appreciate when someone jumps in with an opposing view.)

After watching, I think the positive straws are warranted. Brad was noticeably more upbeat than in the last meeting. He came across as balanced and genuinely optimistic in his responses. And although he said several times, “You won’t like the answers,” actually I do— it’s not often a CEO openly admits when they don’t know something or when they were off track. So, it wasn’t just an "optimistic sell" story from Brad, IMO.

@mushroompanda your chart above is a great visual for showing the change in revenue mix.

Big thanks to @Strawman for hosting the meeting, and mushroompanda for your insights and sharing them — I hadn’t picked up on that, much appreciated.

I’ll be attending the investor day if anyone else is going.

held

24

mushroompanda
Added 2 months ago

Thanks @Slew.

To avoid confusion I should clarify the graph I posted was a contracts win (opposed to revenue) graph. It’s a leading indicator of revenue in future years, and shows a dearth of large AD trial starts in the last couple of years.

15
mushroompanda
Added 2 months ago

Great interview as always @Strawman , I really enjoyed this one.

I’ll let you guys in on why I asked the question about the Roche study pre-screening (TRAVELLER) potential patients for future Alzheimer’s Disease (AD) Phase 3 trials.

Brad confirmed Cogstate’s involvement on TRAVELLER. The observant investors may have already picked this up, since CGS’s proprietary “International Shopping List Test” is listed as an endpoint on clinicaltrials.gov.

Roche is running two Phase 3 AD trials with the drug Trontinemab - TRONTIER 1 and 2 - scheduled to begin on 2025-10-27 and run for three years. As of now, there’s nothing explicitly linking Cogstate to these trials.

Roche also plans to run a third Phase 3 AD trial targeting pre-clinical AD patients. These are individuals not yet showing cognitive symptoms but considered at risk of developing AD. The goal is to see if Trontinemab can be used preventatively.

While Brad appreciated my question, he was very careful in answering it and essentially batted it away to line leg (cricket analogy for deflecting). To me, that speaks volumes.

29

Strawman
Added 2 months ago

Very interesting @mushroompanda, and great sleuthing!

20

nerdag
Added 2 months ago

@mushroompanda, this conundrum is why I have stayed out of Cogstate. They are at the mercy of the pharma companies.

It should be irrelevant what the outcomes of the trials are, because Cogstate clips the ticket for each trial they are commissioned to run.

More trials = more revenue.

IMO, if the trial endpoints for a drug that hasn't yet been proven to work for AD has moved to can it prevent dementia, it's a big yellow flag that pharma is aware that these aren't the miracle drugs for Alzheimer's dementia that we hoped they would be.

Moving the goalposts to trials looking at preventing dementia is tantamount to admitting that clearing beta amyloid alone is insufficient.

The question is when pharma will decide the investment is a sunk cost and cut losses in the absence of a major breakthrough. It's happened before in neuroscience; look at schizophrenia and the collapse of investment in the dopamine hypothesis and abandonment of research funding circa 25 years ago - it's only just started to accelerate again in the last 3-4 years with muscarinic receptor agonists getting legs.

The investment case can and does collapse, although with the TAM of any breakthrough miracle drug, I suspect MAbs for Alzheimer's Dementia will be given a bit more rope than for other areas of neuroscience.

The point remains that Cogstate can't control if or when pharma decides to draw a line in the sand.

Too hard IMO.

23