Thanks chagsy I’ll have a look at osprey. I’m looking for reasons not to hold Impedimed. So I’ll look for comparisons. cheers.

I had a little look at Osprey and my summary went a little down the rabbit hole: It is a device to try to limit the amount of contrast medium given during imaging of blood vessels during a procedure eg. Coronary angiogram +/- stenting by a cardiologist. Over the years the conundrum has been how to give this without hurting the kidneys too much. The history of contrast and acute kidney injury has lead to a) biochemical changes of the contrast b) different fashions for decreasing risk via other medicines/fluid administration. None of these have been really proven. So Osprey decides to objectify the amount given so that it is standardised rather than given as a dose by the operator themselves (eg. Vascular surgeon/cardiologist/radiologist) via a foot pedal.

There are a few fundamental differences I feel: And I like this thought process as it has made think a lot harder about what is truly a moat in early biotech. Obviously Osprey has the benefit of hindsight for its failures.

1. The device: Both are medical devices that have to be put through the FDA and registered for use. A cursory look through the patent protection for medical devices through Chat GPT says there is a lot of wiggle room. So both could technically be improved and re-patented by someone else. Creation of this device from engineering to completion is 1-2 years.
2. Measurable benefit from Device that is reproducible and able to be monetised: Does the device have the appropriate research behind it to actually create a meaningful difference to patient outcome (if it does another 2-3 years potentially of moat): I felt the Osprey research was inferior by a fair way made more difficult by the heterogenous nature of the outcome that could be confounded by a multitude of other causes of kidney injury.
3. Osprey: Has multiple small studies suggesting it decreases Acute kidney injury classified by AKIN (there are two ways to classify acute kidney injury, both have pro’s and con’s AKIN is one). But the studies are looking at heterogenous outcomes including cost. They are small studies none peer reviewed, statistically significant, but so many more confounders.
4. Impedimed: the one large study that is randomised and peer reviewed that shows a statistically significant difference for a very measurable outcome and less confounders.
5. Ease of implementation: Both very simple to use dont require much training.
6. Osprey: Sales techniques to lobby hospitals/Care networks (multiple hospitals under them) to show the benefit.
7. Impedimed: two fold approach lobby the care networks and also the very recent situation where it is written into the guidelines for NCCN based around the quality of its research. This speeds up the process with one care network and insurance company already writing it into their reimbursement.
8. When will they make money? How close to profitability is the company and how many more capital raises will they need.
9. Who is on the board? and what are their strengths and weaknesses and are they right for that specific time in the lifecycle of a biotech, this is my one big worry with impedimed that I am looking out for and would potentially sell if things turned here. I am still a little dirty that they announced a capital raise at the same time they had market sensitive information that the first insurance company was coming on board. Why they didn’t announce that first and then raise at a higher price I have no idea.
10. Other uses: Impedimed actually does have other uses for the same device: in cardiac and renal. This has been put on the back burner as it would require trials and money. But it does have other options.
11. The community support and awareness: for acute kidney injury caused by a bit of contrast vs lymphodaema a life altering morbidity due to breast cancer that will just always attract so much more community support and awareness.

Multiple other points for me to start thinking about in regards to small bio caps. Not sure how to rate each point for importance at this stage but has started the thought process. Thanks Chagsy.