1. November 4, 2014
CYBERONICS
INCORPORATED
CYBX/NASDAQ
Continuing Coverage: Cyberonics keeps their Nerve
Investment Rating: Market Perform
PRICE: $ 52.00 S&P 500: 2,012.10 DJIA: 17,383.84 RUSSELL 2000: 1,165.42
Need for replacement batteries generates recurring revenues
Focus on international markets offers huge growth potential
Commitment to R&D and technology innovation drive investment
strategy
Regulatory approval is necessary to offer new products and enter
new markets
Our 12‐month target price is $59.00
Valuation
EPS
P/E
CFPS
P/CFPS
2014 A
$ 2.00
26.0x
$ 1.98
26.2x
2015 E
$ 2.14
24.3x
$ 3.06
17.0x
2016 E
$ 2.55
20.4x
$ 3.15
16.5x
Market Capitalization Stock Data
Equity Market Cap (MM): $ 1,324.23 52‐Week Range: $46.23 ‐ $73.51
Enterprise Value (MM): $ 1,216.55 12‐Month Stock Performance: ‐9.49%
Shares Outstanding (MM): 25.47 Dividend Yield: Nil
Estimated Float (MM): 21.64 Book Value Per Share: $ 10.38
6‐Mo. Avg. Daily Volume: 162,759 Beta: 0.58
Company Quick View:
Cyberonics Inc. (CYBX) is a medical device technology company
headquartered in Houston, Texas. The Company manufactures and
markets the Vagus Nerve Stimulation Therapy System (VNS Therapy), an
FDA approved treatment for refractory epilepsy and treatment‐resistant
depression.
Company Website: http://www.cyberonics.com/
Analysts: Investment Research Manager:
Arpit Bhopalkar J. Brad Bauguss
Cheng Chen
Daniel Hall
Se Hwan Kim
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own primary research regarding any potential investment.
Wall Street's Farm Team
BURKENROADREPORTS
3. Cyberonics Incorporated (CYBX) BURKENROAD REPORTS (www.burkenroad.org) November 4, 2014
3
We believe Cyberonics is a good buyout candidate because of its extremely small debt and its
share price over the past few weeks has been stable. The company has a significant unused
debt capacity at the moment which can be used to finance a buyout. Furthermore, only small
amount of stocks are management owned and a large quantity of CYBX stock is floated in
market. The potential acquirer can buy the shares directly from the institutions.
Table 1: Historical Burkenroad Ratings and Prices
Date Rating Price*
11/21/13 Market Underperform $59.00
11/06/12 Market Perform $48.00
11/16/11 Market Outperform $40.00
11/29/10 Market Perform $32.17
12/03/09 Market Outperform $23.28
11/25/08 Market Outperform $18.57
*Price at time of report date
INVESTMENT THESIS
Cyberonics’ strong financial performance during fiscal year 2014 and high potential for future
growth form the basis for our expected target price of $59.00. According to our analysis and
research, we believe current growth will continue based on recurring sales and the increased
awareness of the Vagus Nerve Stimulation (VNS) Therapy within the medical community.
Additionally, the Company aims to diversify its product offerings by investing in research and
development (R&D) and looking for strategic acquisitions. Company growth strategy also
centers upon increasing sales internationally. Not all developments have been positive. Due to
a non‐reimbursement designation by the Center for Medicare and Medicaid (CMS), Cyberonics
has lost potential revenues from the use of VNS for depression treatment. Thus, we have not
included the market for depression treatment in our analysis.
Need for replacement batteries generates recurring revenues
Cyberonics’ recurring sales revenue is one of the major drivers of growth for the Company.
According to Cyberonics, around 70% of patients with VNS Therapy have replaced the device
battery. However, due to developing competition in the refractory epilepsy treatment market,
Cyberonics’ management forecasts that the replacement growth rate will stabilize in the mid‐
single digits for the foreseeable future. In addition to the U.S. market, sales from replacement
batteries are growing internationally. In contrast to the U.S. market, management expects the
international replacement market to grow, reaching the low to mid‐teens in 2015. With the
gradual growth in Cyberonics’ customer base, Cyberonics business model should produce both
stable revenue growth and increased profitability in mid‐term future.
4. Cyberonics Incorporated (CYBX) BURKENROAD REPORTS (www.burkenroad.org) November 4, 2014
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Increased Focus on international markets offers huge growth potential
Cyberonics sells products in 73 countries, implanting medical devices in over 70,000 patients to
date. In fact, the Company has almost doubled its international business over the last three
years, reaching $55 million in 2014. The Company expects its new production facility in Costa
Rica to be functional by December 2014, producing shipments to Europe and later to other
international markets. Cyberonics seeks to strengthen its foothold in Canada and Europe and
intends to expand its epilepsy business in Latin America (including Brazil), Russia, Australia and
Asia pacific region. Altogether, the Company expects its international business to grow around
mid to high teen percentage.
According the World Health Organization study on epilepsy, approximately 150,000 new
patients in western Europe are diagnosed with epilepsy every year. Therefore, patient growth
is promising in Cyberonics second largest market. In Japan, Cyberonics experienced an
estimated 20% growth in sales of the VNS Therapy implants during the first quarter of 2015.
Similarly, the Company expects 20% of year over year growth in Japan due to the increased
number of referrals by doctors. The Japanese market is strong with one million epileptic
individuals and 50,000 new cases occurring each year. For this reason, expansion plans for
Japan are underway and Cyberonics expects to have its first direct employee base in Japan in
the second quarter of fiscal 2015. Latin America is also a promising market for the Company
with the AspireSR generator reaching 35% increase in sales volumes. The successful launch of
Cyberonics' AspireSR generator in the United Kingdom and Germany is well in line with
management expectations.
Commitment to R&D and technology innovation to drive investment strategy
Cyberonics strives to maintain a leadership position in the VNS Therapy market. In order to
continue as the market leader, Cyberonics invests considerably in marketing and developing its
pipeline projects. Some of the future projects include ‐ next generation VNS Therapy System,
including generators which utilize cardiac and brain‐based seizure detection stimulation
paradigms, rechargeable battery technology, wireless communication technology, and
improved lead technology. The Company made quick progress in developing products in the
areas of external epilepsy monitoring, rechargeable battery technology, and the magnetic
resonance imaging (MRI) compatibility of its pulse generators. By improving current offerings,
Cyberonics is able to grow its average unit price and to encourage patient replacements.
Regulatory approval is necessary to offer new products and enter new markets
Decisions by regulating bodies continue to define the products Cyberonics can offer and which
markets the Company can enter. Recently, the Company received regulatory approval in
Europe for its new product, the ProGuradianRest. The product is an in‐home event tracking
and monitoring system designed to detect, record and notify medical services of seizures
accompanied by heart rate changes or movement. Following European regulatory approval,
Cyberonics filed for approval with the Food and Drug Administration in the U.S. and awaits
results.
11. Cyberonics Incorporated (CYBX) BURKENROAD REPORTS (www.burkenroad.org) November 4, 2014
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Table 2: Peer Comparison
Company Ticker
Market
Cap (in
billions)
P/E P/BV
EV/
EBITDA
D/E ROE
R&D
(% of
sales)
Medtronic MDT 63.69 21.99 3.2 11.14 66.5% 15.8% 8.69%
Greatbatch GB 1.09 23.34 1.84 10.14 32.99% 8.86% 8.14%
Masimo Corp. MASI 1.23 21 3.84 12.56 23.56% 19.94% 10.17%
NeuroSigma NSIG N/A N/A N/A N/A N/A N/A N/A
NeuroPace, Inc. N/A N/A N/A N/A N/A N/A N/A N/A
Peer Average ‐ 22.01 22.11 2.96 11.28 41.00% 14.86% 9.00%
Cyberonics CYBX 1.35 23.19 5.05 12.97 1.0% 23.94% 16.51%
Source: Yahoo Finance October 2, 2014
Research and development (R&D) spending is an important metric when studying the medical
device industry because the industry relies on innovation and new product development. This
metric is a strong indication of a company’s future performance. Cyberonics leads industry
spending on R&D with 16.51% compared to a peer average of 9%.
Medtronic (MDT/NYSE)
Medtronic is a global pharmaceutical corporation, headquartered in Minneapolis, Minnesota.
The company has a presence in more than 140 countries. Medtronic is among the largest
medical device manufacturers in the world with a market capitalization of $63.7 billion. The
company’s neuromodulation division manufactures and markets a deep brain stimulation
therapy. The therapy is based on a surgically implanted device that delivers electrical
stimulation to different parts of the brain to block harmful electrical activity. The device targets
the treatment for dystonia, essential tremor, chronic pain, obsessive compulsive disorder, and
Parkinson’s disease.
Greatbatch Inc. (GB/NYSE)
Greatbatch, Inc., headquartered in Frisco, Texas, designs and manufactures cardiac rhythm
management, neuromodulation, vascular access, and orthopedics treatment components. The
company does not compete with Cyberonics in epilepsy treatment. However, Greatbatch Inc.
is a producer of a variety of implantable medical devices and has a market capitalization most
similar to Cyberonics.
Masimo Corp. (MASI/ NASDAQ)
Masimo Corp., headquartered in Irvine, California, is a global medical technology company that
develops and manufactures innovative noninvasive patient monitoring technologies, including
medical devices and a wide array of sensors. The company’s core set of products include
Masimo SET, Masimo rainbow Pulse CO‐Oximetry and brain function monitoring technology.
These products are used to measure hemoglobin levels and assess respiration rates and brain
functioning, respectively. The company operates worldwide and has increased its revenues
four fold over the last five years.
16. Cyberonics Incorporated (CYBX) BURKENROAD REPORTS (www.burkenroad.org) November 4, 2014
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Table 4: Institutional Holdings Summary
Holder Name
Shares
Held
% O/S
Institution
Type
Renaissance Technologies, LLC 2,411,201 9.06
Hedge Fund
Manager
Vanguard Group, Inc. (The) 1,802,672 6.77
Investment
Advisor
Palo Alto Investors, LLC 1,715,430 6.44
Hedge Fund
Manager
Eagle Asset Management Inc 1,331,853 5.00
Investment
Advisor
BlackRock Fund Advisors 1,291,183 4.85
Investment
Advisor
Blair (William) & Company, L.L.C. 1,192,474 4.48
Investment
Advisor
RS Investment Management Co., LLC 1,023,829 3.85
Investment
Advisor
Brown Capital Management, Inc. 920,166 3.46
Investment
Advisor
Kalmar Investments Inc. 873,813 3.28
Investment
Advisor
BlackRock Institutional Trust Company, N.A. 837,824 3.14
Investment
Advisor
Source: Yahoo Finance October 15, 2014
As of October 2014, the top five insider holders were important members of the Company’s
management team. These five individuals owned 1.49% of shares outstanding, representing a
2.02% decrease from the previous year (see Table 5).
Table 5: Insider Holdings Summary
Holder Name
Shares
Held
% S/O
Recent
Change
Daniel Jeffrey Moore 155,569 0.58% (3,000)
David S. Wise 70,120 0.26% (2,000)
Gregory H. Browne 62,911 0.24% 0
Mark Verratti 54,663 0.21% 0
Bryan D. Olin 53,424 0.20% 0
Source: Yahoo Finance October 15, 2014
19. Cyberonics Incorporated (CYBX) BURKENROAD REPORTS (www.burkenroad.org) November 4, 2014
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Table 6: Current and Quick Ratio
Company Ticker Symbol Current Ratio Quick Ratio Debt/Equity
Medtronic MDT 3.82 3.48 66.5%
Volcano Corp. VOLC 4.00 3.26 134.2%
Greatbatch GB 3.96 2.43 33.0%
Masimo Corp. MASI 1.59 1.25 0.0%
Peer Average ‐ 3.34 2.61 58.4%
Cyberonics CYBX 8.91 8.13 0.0%
Source: Yahoo Finance July 31, 2014
FINANCIAL PERFORMANCE AND PROJECTIONS
Our $59.00 12‐month price target for Cyberonics, Inc. is derived from multiple assumptions
about the main revenue drivers of the Company including VNS Therapy pricing and unit sales.
Additionally, we made assumptions on how Cyberonics’ would handle important operating,
investing, and financing decisions in the near future. Forecasts and assumptions were derived
from the Company’s historical financial statements, industry metrics, and management
guidance supplied during our site visit.
Operating Assumptions
We considered several methodologies to forecast future revenues. We first considered a
regression model, but we could not find enough significant factors to proceed with a
regression. Thus, we decided on a price and quantity model that relied on historical financial
statements of the Company to determine appropriate growth rates for units sold and unit
prices. After reviewing the historical data, we used the previous two years’ average quarterly
compounded growth rates of 2.02% for VNS price growth and 0.63% for unit sales growth. Our
analysis revealed recurring sales from replacement devices as the main revenue growth
driver. Growth from recurring sales is expected to be between 11‐14% in the coming year,
according to Company management.
Investing & Financing Assumptions
Guidance from Cyberonics' management team was our main source for developing investing
and financing assumptions. According to management, the Company is actively pursuing
breakthrough developments in epilepsy and other medical conditions. Therefore, R&D
investment will remain around 15% of sales. The Company will implement its share
repurchase program buying $1 million in shares by April 2015. Also, Management suggests its
overall property plant and equipment expenditures would be around $10 million for the year
2015. Cyberonics has sufficient liquidity and capital resources to fund business activities for
the year 2015.
22. Cyberonics Incorporated (CYBX) BURKENROAD REPORTS (www.burkenroad.org) November 4, 2014
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ANOTHER WAY TO LOOK AT IT
ALTMAN Z‐SCORE
The Altman Z‐Score forecasts the likelihood that a company will go bankrupt within the next
two years. The Altman Z‐Score is a five factor model, which considers:
Working capital/total assets
Retained earnings/total assets
Earnings before interest and taxes/total assets
Market value equity/book value of total liabilities
Sales/total assets
According to Altman, a Z‐Score above 2.99 shows a company is within the safe zone in terms
of bankruptcy or financial distress. Z‐Scores below 1.80 show a company is within the distress
zone, which means the probability of bankruptcy within two years is high. The Z‐Score model
is accurate, with real world applications successfully predicting 72% of corporate bankruptcies
prior to a company’s actual Chapter 11 bankruptcy filings.
Table 7 shows that Cyberonics’ Z‐Scores have been consistently in the safe zone for the past
five years. Although Cyberonics fell within the distress zone in 2008, its Z‐Score steadily
improved over the following years, culminating with a score of 30 in 2014. Such high scores
can be attributed to Cyberonics’ debt free structure, and suggests that the Company has a
very low probability of bankruptcy based on its financial figures only.
Table 7: 10 Years Historical Altman Z‐Scores
Year Ending 2010 2011 2012 2013 2014
Z Score 8.36 18.25 24.74 23.80 30.23
Zone Safe Zone Safe Zone Safe Zone Safe Zone Safe Zone
Source: Bloomberg November 11, 2014
24. Cyberonics Incorporated (CYBX) BURKENROAD REPORTS (www.burkenroad.org) November 4, 2014
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WWBD?
What Would Ben (Graham) Do?
Mr. Ben Graham, the father of fundamental equity analysis, formulated an eight‐hurdle
analysis framework to identify stocks that are undervalued and exhibit high growth potential.
According to Graham, a company is attractive if it passes four of the eight criteria.
Although Cyberonics does not pass the first four hurdles, its passes the fifth, sixth, and
seventh hurdles because of solid debt to equity and current ratios and strong earnings
growth over the past five years. As shown in Figure 5, even though Cyberonics fails as a value
investment according to Ben Graham’s criteria, the Company does exhibit some positive
signs both in terms of price to earnings and low risk levels.
Figure 5: Ben Graham Dial
25. Cyberonics Incorporated (CYBX) BURKENROAD REPORTS (www.burkenroad.org) November 4, 2014
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Earnings per share (ttm) 2.20$ Price: 51.99$
Earnings to Price Yield 4.23%
10 Year Treasury (2X) 5.60%
P/E ratio as of 10/23/09 (53.1)
P/E ratio as of 10/29/10 (49.1)
P/E ratio as of 10/28/11 29.1
P/E ratio as of 10/26/12 32.8
P/E ratio as of 10/25/13 34.7
Current P/E Ratio 23.7
Dividends per share (ttm) ‐$ Price: 51.99$
Dividend Yield Nil
1/2 Yield on 10 Year Treasury 1.40%
Stock Price 51.99$
Book Value per share as of 10/24/14 10.00$
150% of book Value per share as of 10/24/14 15.00$
Interest‐bearing debt as of 10/24/14 ‐$
Book value as of 10/24/14 264,324$
Current assets as of 10/24/14 214,542$
Current liabilities as of 10/24/14 26,695$
Current ratio as of 10/24/14 8.0
EPS for year ended 10/25/13 1.67$
EPS for year ended 10/26/12 1.41$
EPS for year ended 10/28/11 1.02$
EPS for year ended 10/29/10 (0.56)$
EPS for year ended 10/23/09 0.74$
EPS for year ended 10/25/13 1.67$ 18%
EPS for year ended 10/26/12 1.41$ 38%
EPS for year ended 10/28/11 1.02$ ‐283%
EPS for year ended 10/29/10 (0.56)$ ‐176%
EPS for year ended 10/23/09 0.74$
Stock price data as of November 4, 2014
Yes
Yes
No
Hurdle # 7: Earnings Growth of 7% or Higher over past 5 years
Hurdle # 8: Stability in Growth of Earnings
CYBERONICS INC. (CYBX)
Ben Graham Analysis
Hurdle # 1: An Earnings to Price Yield of 2X the Yield on 10 Year Treasury
Hurdle # 2: A P/E Ratio Down to 1/2 of the Stocks Highest in 5 Yrs
No
No
Hurdle # 3: A Dividend Yield of 1/2 the Yield on 10 Year Treasury
Hurdle # 4: A Stock Price less than 1.5 BV
Hurdle # 5: Total Debt less than Book Value
Hurdle # 6: Current Ratio of Two or More
No
No
Yes
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Tulane University
Freeman School of Business
BURKENROAD REPORTS
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