Admirable execution on 2021 strategic goals

Update | 12 January 2022

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2021 was an operationally successful year, with Nexstim achieving several strategic objectives as it works towards delivering higher revenues and improved profitability. Key 2021 goals met include reaching a MDD (major depressive disorder) patient data registry of >200 completed treatment sessions and securing the first partners, in Finland and the US, under plans to develop a deeper partnership business model for its NBT therapy business. 2022 should see further demonstration of strategic execution, with FY21 results (February 28) revealing the extent of financial progress, and results in H222 from the pilot study of accelerated treatment protocols in major depression could open a new inpatient market for Nexstim. Ahead of FY21 results and this pilot data we maintain our €59.1m (€8.84 per share) valuation.

Year-end: December 31201920202021E2022E
Revenues (€m)
Adj. PBT (€m)(6.8)(4.2)(3.9)(1.3)
Net Income (€m)(6.8)(4.1)(3.8)(1.3)
EPS (€)(0.25)(0.02)(0.71)(0.19)
Cash* (€m)
EBITDA (€m)(6.0)(3.0)(3.4)(1.1)
Source: Trinity Delta. Note: *Our cash forecast assumes receipt of €4m in additional funding in FY22
  • Maintaining growth momentum    Despite ongoing COVID impact, sales of new NBS (diagnostic) and NBT (therapy) systems remain healthy, with six NBS and eight NBT delivered during 9M21. At end-Q321, 44 NBT systems have been placed (19 US; 25 Europe/RoW); 190+ institutions have NBS systems. Existing customer demand for system upgrades and rising utilisation should boost recurring revenues, contributing to profitable growth. More customers seeking to use Nexstim’s TMS system in both diagnostic and therapeutic applications create a platform opportunity.
  • Positioning NBT as the TMS system of choice    Latest registry data on the first 208 US MDD patients continue to outperform historic TMS data, with remission of 50.2% and 76.0% achieving a clinical response. Further accelerated iTBS protocol data building on initial results from the Kuopio University Hospital pilot study in depression is expected in H222. This data will be central to positioning NBT in the delivery of emerging accelerated therapy protocols in severe depression, which require highly accurate navigation, and enabling access to a new in-patient market.
  • Embarking on deeper relationships    First NBT partnerships have been secured with private Finnish psychiatry centre Recuror and California-based PNC Management Services, a support services provider to Piedmont Neuroscience Center. The former will broaden availability of personalised TMS therapy in Finland’s private sector. The latter includes a c €0.5m investment in a minority ownership stake, sale of one NBT system, and access to anonymised data that will contribute to the patient registry.
  • Core valuation of €8.84/share   Ahead of FY21 results and further pilot study data in depression we continue to value Nexstim at €59.1m (equivalent to €8.84/share or €8.13 fully diluted) using a DCF-based rNPV model. Continued successful execution on strategic priorities could materially increase this.


12 January 2022

Market Cap€30.6m
Enterprise Value€28.3m
Shares in issue6.69m
12 month range€3.41-9.63
Free float65.6%
Primary exchangeHelsinki
Other exchangesStockholm
Corporate clientYes

Company description

Nexstim is a targeted neuro-modulation company that has developed a proprietary navigated rTMS platform for use in diagnostics (NBS) and therapeutics (NBT). NBS is used in planning brain surgery while NBT is focused on depression and chronic pain. FDA approval for depression was given in 2017, and the focus is on commercial roll out in the US, Europe and Asia.


Lala Gregorek
+44 (0) 20 3637 5043

Franc Gregori
+44 (0) 20 3637 5041

Exhibit 1: Summary of financials
Source: Company, Trinity Delta Note: The accounts are produced according to Finnish GAAP. The short-term debt in FY22e is indicative of our view of the company’s funding requirement. Sales forecasts do not include any contribution from indications yet to be approved. Historic EPS, DPS and Average no. of shares have been adjusted to reflect the 100:1 share consolidation in May 2021.


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