Daily Brief Health Care: Establishment Labs Holdings In, Certara , Cencora , D.Western Therapeutics Institute Inc., Monash Ivf, SIGA Technologies and more

• Establishment Labs is a Costa Rican company known for manufacturing and selling breast implants, with their Motiva implant gaining market share from competitors.
• The stock price of ESTA has recently dropped significantly due to a weak Q3 and lowered guidance, presenting an opportunity for investors to get into the dominant player in the breast augmentation market at a discounted price.
• With Motiva having a low rupture rate and no cases of associated cancers, analysts value ESTA at approximately $100 a share on a DCF basis, making it a compelling investment opportunity for potential growth.

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• This is our first report on Certara, a renowned biosimulation player.
• The company recently released its Fourth Quarter 2023 Earnings.
• In terms of performance, the company reported revenue growth of 6% for the year, in line with their guidance from August 2023.

• Cencora announced during its First Quarter 2024 Earnings, a year-over-year increase in revenue of 15% to over $72 billion, with adjusted earnings per share also increasing year-over-year by 21%.
• Recognizing the strong first quarter performance, the company has raised its full-year guidance for fiscal 2024.
• The company’s performance was fueled by the execution of commercial partnerships and strategic positioning, with teams prioritizing customer-centricity and enhancing service provision.

• Major milestones with high expectations coming in the next 2-3 years: 1) Phase IIb US trials for H-1337 as “first choice as a second-line Glaucoma drug” for patients who do not respond to PGs
•  2) 2024 application/approval and 2025 launch of DW- 1002 in Japan, 2023 application and 2024 approval/launch in China, as well as orphan drug designation for combination formula MembraneBlue-DualⓇ (DW-1002 + trypan blue) in the US
• 3) in Japan, start P2 clinical trials in 2024, P3 trials in late 2025 though 2026, and normal schedule application for approval for regenerative cell-therapy DWR-2206 in 2027

• Monash Ivf (MVF AU) delivered a strong result in H1FY24, with revenue growth of 22% YoY to A$126M and underlying NPAT growth of 19% YoY to A$15M.
• The company has guided for FY24 underlying NPAT of A$29–30M compared to A$25.5M in the prior comparative period (excluding contribution from the Fertility North acquisition).
• Secular industry tailwinds, consistent market share gain, and strong new patient registrations provide a sustainable growth trajectory for Monash IVF.  

SIGA Technologies has delivered its best top-line performance in the last five years, supported by a late surge in TPOXX deliveries across both domestic and international markets. FY23 product revenues grew 50.8% to $130.7m, driven by Q423 BARDA deliveries and international orders, resulting in overall revenues increasing to $139.9m (+26.3% y-o-y). Barring packaging-related bottlenecks, which delayed some deliveries to Q124, there could have been incremental upside to meet our $172.6m revenue estimate. The strong cash flow generation and healthy balance sheet (year-end net cash balance of $150.1m) was reflected in the company’s declaration of a special cash dividend of $0.6/share ($42.7m total; >60% payout ratio). Given sales visibility on further BARDA stockpile replenishments and increasing international market traction, we expect FY24 to be another strong year. We revise our FY24 estimates and now expect PEP and pediatric launches in 2026 (2025 previously), resulting in our valuation adjusting to $16.51/share (versus $17.24/share previously).