Resmed q1 2012 ir presentations 1

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Resmed q1 2012 ir presentations 1

  1. 1. Global Leaders in Sleep and Respiratory Medicine Investor Relations Update Q1 20121 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  2. 2. Forward Looking Statements Statements contained in this release that are not historical facts are “forward-looking” statements as contemplated by the Private Securities Litigation Reform Act of 1995.These forward-looking statements, including statements regarding the Company’s future revenue, earnings or expenses, new product development, and new markets for the Companys products are subject to risks and uncertainties, which could cause actual results to materially differ from those projected or implied in the forward looking statements. Additional risks and uncertainties are discussed in the Companys Annual Report on Form 10- K for its most recent fiscal year and in other reports the Company files with the U.S. Securities & Exchange Commission. Those reports are available on the Companys Web site.2 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  3. 3. Global Leader in SDB and Respiratory Medicine Global leading developer, manufacturer and distributor of medical devices to treat sleep-disordered breathing and other respiratory conditions.3 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  4. 4. What We Do • Improve quality of life for people with sleep-disordered breathing or respiratory failure through: – Innovative products and technology • Raise the benchmark for effective diagnosis, therapy, patient comfort and compliance. – Education, awareness, screening • Help the medical community and public to understand sleep-disordered breathing. • Provide tools to identify people at risk. – Ventilation solutions • Provide temporary or long-term ventilatory assistance. – Monitoring systems • Ensure therapy meets clinical requirements.4 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  5. 5. Market Opportunities Market Size – 20% sleep apnea in the adult population. 13% Mild; 7% Moderate to Severe 7% 13% 2002 Young T, Peppard E, and Gottlieb D. Epidemiology of obstructive sleep apnea: a population health perspective. Am J Respir Crit Care Med 2002; 165:1217-12395 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  6. 6. What is Sleep-Disordered Breathing? • Abnormal respiration during sleep (e.g. snoring, apneas, reduced airflow). • Most prevalent is obstructive sleep apnea – a collapse of the upper airway despite ongoing breathing efforts. • Other types include central sleep apnea characterized by the lack of breathing effort and mixed apneas (combination of obstructive and central sleep apnea). Healthy upper airway Partially obstructed upper airway Obstructed upper airway6 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  7. 7. Visible and Hidden Impacts of Sleep-Disordered Breathing SDB Externally Internally • Choking arousals • Hypoxemia • Fragmented sleep • Hypercapnia • Nocturia • Sympathetic activation • Unrefreshed on wakening • Endothelial dysfunction • Morning headaches • Metabolic dysregulation • Impaired concentration • Hypertension • Daytime sleepiness • Arrhythmias • Myocardial infarction • Stroke7 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  8. 8. Sleep Apnea is Prevalent in Patients with Other Serious Conditions Logan et al. Drug-Resistant Hypertension 83% J. Hypertension 2001 O’Keefe and Patterson. Obesity 77% Obes Surgery 2004 Oldenburg et al, Congestive Heart Failure 76% Eur J Heart Failure, 2007 Type 2 Diabetes 72%* Einhorn et al. Endocrine Prac 2007 Pacemakers 59% Garrigue et al. Circulation 2007 Atrial Fibrillation 49% Gami et al. Circulation 2004 All Hypertension 37% Sjostrom et al. Thorax 2002 Coronary Artery Disease 30% Schafer et al. Cardiology 1999 * Apnea-Hypopnea Index ≥ 58 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  9. 9. Links Between OSA and Chronic Disease FIGURE Possible mechanistic links between obstructive sleep apnea, obesity, metabolic syndrome, and type 2 diabetes Obstructive Sleep Apnea Type 2 Diabetes Sleep Fragmentation / Intermittent Hypoxia Sleep Deprivation Obesity Oxidative Stress Neurohormonal Changes Insulin Resistance Inflammation Syndrome Metabolic Hypertension DyslipidemiaReproduced with permission from Tasali E, p MSM, 2008. Obstructive sleep apnea and metabolic syndrome: Alterations in glucosemetabolism and inflammation. Proc AM Thorax Soc. 5:207-217 (2008). Official journal of the American Thoracic Society. Copyright ©American Thoracic Society.9 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  10. 10. Our Five Strategic Initiatives 1. Sleep-disordered breathing (SDB) and its association with and impact on cardiovascular and cerebrovascular diseases. 2. SDB and its association with and impact on type 2 diabetes mellitus. 3. SDB and its association with and impact on peri- operative risk. 4. SDB and its association with and impact on occupational health and safety. 5. Ventilatory support with respect to chronic obstructive pulmonary disease (overlap syndrome) and neuromuscular disease.10 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  11. 11. Company Reorganization – May 2011 • Reorganized certain business units and management responsibilities to more effectively align activities with strategic goals. • Provide innovative solutions with scale and efficiency. • Improve our ability to deliver and result in more effective investment initiatives. • Focus on key drivers for future growth. • Newly-created respiratory care strategic business unit will also focus on chronic obstructive pulmonary disease. • Newly-created strategic business unit, ResMed Ventures and Initiatives, will focus on opportunities in disease states related to sleep-disordered breathing and other market opportunities tied to our key strategic initiatives.11 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  12. 12. Our Commitment to Ventilation Developing innovative and effective mechanical ventilation solutions to improve the quality of life for patients and providing assistance to care-givers. We provide: Mechanical ventilation for congenital defects, illness, trauma, obesity, cardiac arrest, neuromuscular disease, pulmonary disease and sometimes sepsis and shock. Non-invasive ventilation solutions with the best-in-class leak algorithms to support temporary or long-term ventilation. Invasive ventilation solutions for dependant patients with value or leak ventilators providing both pressure and volume ventilation.12 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  13. 13. Gründler GmbH Acquisition • Integrates innovator of medical humidification products into respiratory care business unit. • Supplies humidification for neo-natal/pediatric, non-invasive pressure support and intensive care unit ventilators. • Enables ResMed to provide a system to sell into the home and hospital markets. • Allows ResMed to build expertise and competitive position in humidification. • Leverages humidification technology between ventilation and obstructive sleep apnea.13 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  14. 14. CareFusion and ResMed Partner in Ventilation • Exclusive five-year distribution agreement for ventilation products. – Hospitals, long-term acute care facilities and skilled nursing facilities. • Initial focus - launch of the Stellar 100 and related products. – Stellar provides a perfect solution for CareFusion to enter the fast- growing non-invasive pressure support ventilation market with ResMed’s unique performance, size and mobility features that solve patient/ventilator synchrony and leak compensation problems. – Competitive price differentiation. • Non-invasive ventilation is the largest and fastest-growing segment in America’s sub-acute ventilation market.14 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  15. 15. BiancaMed Acquisition • First acquisition to become part of ResMed’s newly-created Ventures and Initiatives unit. • ResMed has been an investor since 2003. • BiancaMed is a leading Irish medical technology company. • Developed an innovative, accurate, convenient, non-contact device to monitor sleep and breathing in the home and hospital. • Developing technology for several medical and consumer applications. – Potential future applications in chronic diseases such as heart failure and chronic obstructive pulmonary disease. • Enhances commitment to innovation in sleep and respiratory medicine and the related co-morbidities by commercializing products incorporating novel technologies.15 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  16. 16. OSA and Cardiovascular Disease16 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  17. 17. Why Sleep Apnea and Cardiovascular Disease? • Sleep apnea is highly prevalent in cardiovascular disease patients1. – 30% to 80% of patients for common CVD states. • Obstructive sleep apnea increases risk of incident heart failure2. – Men ages 40-70 with AHI >30 were 68% more likely to develop heart disease than those with AHI <5. • Sleep apnea can cause changes in blood vessel function that reduces blood supply to the heart in people who are otherwise healthy3. • Benefits of CPAP treatment: – Continuous positive airway pressure treatment reverses blood vessel abnormalities. – Sleep apnea therapy lowers blood pressure4. • 4mm Hg to 10mm Hg reduction with CPAP therapy .1 Logan et al. J. Hypertension 2001; Schafer et al. Cardiology 1999 – Sleep apnea therapy improves cardiovascular health5.2 Gottlieb et al, Circulation July 20103 Hypertension: Journal of the American Heart Association July 2010 • Left ventricular ejection fraction, six-minute walk, VO2 max, afterload, BNP.4 Becker et al. Circulation 20035 Kaneko et al. NEJM 2003, Maisel et al. UCSD VA Hospital – Case Study Data (2002), Teschler et al. AJRCCM 2001 17 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  18. 18. SERVE-HF Clinical Trial • Aim: Demonstrate that adaptive servo-ventilation therapy over two years can improve morbidity and mortality in patients with predominant central sleep apnea and heart failure. • Design: randomized controlled trial with @1200 evaluable subjects. − Control arm - optimal medical care. − Active arm - optimal medical care plus ASV. • Status: Actively enrolling in Europe. • Progress: Currently enrolled over 800 patients in 60 centers. • Main Sub-study: Demonstrate that ASV therapy improves heart failure outcomes such as left ventricular ejection fraction and quality of life metrics (n=300).18 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  19. 19. OSA and Diabetes19 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  20. 20. Type 2 Diabetes & OSA Clinical Connections • 72% of patients with type 2 diabetes suffer from obstructive sleep apnea (OSA)1. – 86% of obese diabetics have OSA. • OSA may have a causal role in the development of diabetes2. • OSA is associated with insulin resistance (independent of obesity)3. • Obese patients with sleep apnea are more insulin resistant than patients with simple obesity4. • 30% of patients presenting to a sleep clinic have 1 Einhorn et al. Endocr Pract 2007 2 Reichmuth et al. Am J Respir Crit Care Med 2005 impaired glucose tolerance or diabetes, of which 3 Ip et al Am J Respir Crit Care Med 2002, Punjabi et al. Am J Respir Crit Care Med 2002 40% are undiagnosed5. 4 Tassone et al. Clin Endocrinol 2003 5 Meslier et al. Eur Respir J 200320 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  21. 21. OSA and Obesity21 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  22. 22. Obesity Trends* Among U.S. Adults(*BMI 30, or about 30 lbs. overweight for 5’4” person) 1990 2000 2010 No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30% 22 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  23. 23. Global Obesity Forecast • In 2008, 9.8 percent of the world’s male population were obese, as were 13.8 percent of women. In 1980, these rates were 4.8 percent and 7.9 percent1. • The World Health Organization predicts there will be 2.3 billion overweight adults in the world by 2015 and more than 700 million of them will be obese.1 Majid Ezzati, MD et al, of the Imperial College of London 23 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  24. 24. Peri-operative Risk24 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  25. 25. Sleep Apnea Epidemic = Peri-operative Risk • More than 40+ million US adults suffer from sleep-disordered breathing1. – More than 85% remain undiagnosed2. • Increase in prevalence of obesity has led to increase in obstructive sleep apnea3. • High prevalence of undiagnosed obstructive sleep apnea in the surgical patient population (24%)4.1 Young et al. J Am Med Ass 20042 Young et al. Sleep 19973 Newman et al. Arch Intern Med 20054 Chung et al. Anesthesiology 2007 25 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  26. 26. Sleep-Disordered Breathing and Occupational Health and Safety26 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  27. 27. Transportation Agencies Recognize Link between Sleep-Disordered Breathing and Accidents • US – In October 2009, the National Transportation Safety Board wrote to the US Coast Guard and Federal Motor Carrier Safety Administration recommending screening of all ship pilots, bus and truck drivers for sleep apnea. – US Federal Motor Carrier Safety Administration meeting December 2011 to discuss its medical review board’s recommendations on sleep apnea. • UK – Truck driver with undiagnosed sleep apnea killed a 26-year old driver. – Coroner in the case and father of dead man call for UK professional drivers to be tested.27 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  28. 28. Health Plan and Disability Cost Benefits of OSA Treatment Waste Management’s Experience % Reduction 0% • All Medical Costs Short-term disability Short-term disability Short-term disability 37% reduction in total medical costs for those treated in 1st year. -10% absences leaves costs • 79% reduction in short-term -20% disability costs for those treated -30% in 1st year. -40% • 72% reduction in short-term disability days absent in 1st year. -50% • 52% reduction of employees with -60% a short-term disability leave in 1st -70% year. -80%Commercial motor vehicle operators with obstructive sleep apnea andtreated with positive airway pressure therapy (N=156)Hoffman, et al., Journal of Occupational & Environmental Medicine, vol. -90%52, no. 5 (2010) -100% 28 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  29. 29. Health Plan and Disability Cost Benefits of OSA Treatment % Reduction Schneider Trucking’s Experience 0% Total Medical Costs Accidents Hospital Admissions • Results 12 months post-CPAP -10% treatment1. – 57.4% reduction in total medical -20% expenses = $6,456/year. -30% – 91% reduction in hospital admissions. -40% – Does not include savings from accidents. -50% • Results from original 6-month -60% follow up study. – Improved retention by 229%. -70% – 73% reduction in accidents. -80%1Berger, et al., CHEST 2006 -90% -100%29 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  30. 30. Superior Product Innovation30 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  31. 31. New Mask Offerings Considered Best in Class Quattro™ FX Mirage™ FX Swift™ FX “The FX Trilogy”31 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  32. 32. S9™ Series Delivers More Comfort, More Compliance, More Connectivity High $ VPAP™ Adapt Bi-Level PRICE Med $ Premium Segment - Elite Low $ Value Segment – Escape FEATURES • Climate control • Climate control • Ultra quiet Easy-Breathe • Simple menu settings • Wireless monitoring • Wireless monitoring • Easy-Breathe waveform makes • Seamless integration with © ResMed 2006 • Sleep quality indicator • Sleep quality indicator breathing more comfortable optional H5i™ heated humidifier • Comprehensive data • Simple menu settings with Climate Control (AHI tracking, mouth • Seamless integration with • Enhanced Vsync™ technology leak, central sleep optional H5i™ heated provides superior apnea detection) humidifier with Climate patient–ventilator synchrony Control32 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  33. 33. Skinit • Skins allow a patient to fit the device into their lifestyle. • Skins present an opportunity for cash revenue for HMEs. • Personalization has been immensely successful across multiple industries. • Personalization will lowering the emotional barriers to accepting therapy, which will drive therapy adherence. Therapy adherence drives customer revenue and patient health. • Skins create a unique way to reconnect with patients who have abandoned therapy and potentially bring them back in to using a device.33 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  34. 34. Stellar™ 100 – Easy Access to Quality Therapy • Feature-rich, premium non- invasive ventilator that can also be used invasively. • Light, compact and portable. • Packed with exciting innovative features. • Improved leak management system (VSync), which makes breathing more natural for the patient.34 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  35. 35. Financial Results35 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  36. 36. 67th Consecutive Quarter of Revenue Growth Q1 2012 Revenue $314.8M +12% (Constant Currency) (+8%) $50.5M Net Income -11% $0.33 EPS -8%36 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  37. 37. Sales by Region & Product Q1 2012 Masks & Flow Generators Accessories 54% 46% Americas Europe 36% 54% Asia-Pacific 10%37 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  38. 38. Annual Revenue Performance 15% 5YR CAGR 1,400,000 1,200,000 1,000,000 800,000US$ 000 600,000 400,000 200,000 - 2006 2007 2008 2009 2010 2011 Net revenues38 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  39. 39. Net Income Growth 21% 5YR CAGR 250,000 20.0% 18.0% 200,000 16.0% 150,000 US$ 000 % of Revenue 14.0% 100,000 12.0% 50,000 10.0% - 8.0% 2006 2007 * 2008 2009 2010 2011 Net Income Net Income as % of Revenue * 2007 Net Income excludes the impact of a voluntary product recall expense of $59.7 million, $41.8 million net of tax.39 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  40. 40. Sustained EPS Growth 20% 5YR CAGR $1.60 $1.44 $1.40 $1.23 $1.20 $1.00 $0.95 $0.80 $0.69 $0.70 $0.58 $0.60 $0.40 $0.20 $0.00 2006 2007* 2008 2009 2010 2011 * 2007 EPS excludes the impact of a voluntary product recall expense of $59.7 million, $41.8 million net of tax.40 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  41. 41. Balance Sheet USD 000 Sep-11 Jun-11 Cash/ Marketable Securities 610,063 735,267 Accounts Receivable 251,103 274,352 Inventory 187,950 200,777 Other Current Assets 93,683 82,056 PP&E 432,687 462,107 Patents/ Goodw ill 331,628 283,398 Other Assets 28,178 30,965 TOTAL ASSETS 1,935,292 2,068,922 Accounts Payable 46,688 55,194 Accruals 103,274 103,787 Incom e Taxes Payable 33,262 7,988 Current portion, long term debt 4,095 163 Deferred Revenue 58,897 62,362 Long Term Debt 130,000 100,000 Deferred Incom e Tax 10,058 8,691 TOTAL LIABILITIES 386,274 338,185 Com m on Stock 815,765 799,068 Retained Earnings 1,162,380 1,111,862 Treasury Stock -629,338 -504,625 Other Com p Gain (Loss) 200,211 324,432 STOCKHOLDERS EQUITY 1,549,018 1,730,73741 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine
  42. 42. • Global leader in sleep medicine. – Committed to increasing education and awareness of sleep-disordered breathing. – Complete solutions from screening to support and monitoring. • Advancing ventilation for respiratory care. – Creating new benchmarks in ventilation to meet the challenges of respiratory care. – Innovative homecare solutions to improve quality of life. • Trusted track record, poised for greater success. – Strong leadership and globally-diversified team of over 3,300 personnel with diverse expertise. – Continuous innovation and investment in research and product development. – Ongoing journey of growth, leadership and excellence. – Strong balance sheet.42 © ResMed Q1 2012 Global leaders in sleep and respiratory medicine

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