Consolidating both shares and strategy

Update | 12 May 2021

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Nexstim started 2021 on a positive footing with its Q121 business and clinical update highlighting incremental operational progress and a growing body of evidence in depression. The successful €6.4m (net) spring rights issue provides additional funds to support execution on the company’s 2020-24 corporate strategy, including funding further development of new accelerated iTBS treatment protocols. Resolutions at this week’s AGM authorised a 100 to 1 reverse share split to facilitate trading, positioning the company to continue to deliver on its goal of revenue growth and improved profitability, catalysed longer-term by a disruptive shift in depression treatment (and its delivery) with its accurately navigated SmartFocus transcranial magnetic stimulation (TMS) NBT technology. Updating our model for the raise and share consolidation results in a valuation of €49.4m or €7.44 per share (€6.84 fully diluted).

Year-end: December 31201920202021E2022E
Revenues (€m)
Adj. PBT (€m)(6.8)(4.2)(3.8)(1.4)
Net Income (€m)(6.8)(4.1)(3.8)(1.4)
EPS (€)(0.25)(0.02)(0.69)(0.21)
Cash* (€m)
EBITDA (€m)(6.0)(3.0)(3.3)(1.1)
Source: Trinity Delta. Note: *Our cash forecast assumes receipt of €10m in cumulative funding in FY21 and FY22
  • Best foot forward with new strategy Nexstim’s Q1 operational update confirmed the hire of two new sales personnel in the US, a record level of utilisation in the existing NBS (diagnostic) and NBT (therapeutic) system installed base, and several new system placements (four NBS, two NBT) in the US and Europe despite ongoing COVID-19 impacts. Increased utilisation should translate into growing high margin recurring revenues, a key element of the profitable growth strategy. At end-March 2021, 33 NBT systems had been placed worldwide (18 US; 15 Europe/RoW).
  • Progressing existing and new applications Increasing utilisation of the installed base should drive near-term organic growth, supported by wider NBS applications (including motor and language mapping as published in Cancers, January 2021), US reimbursement codes for presurgical mapping, and the growing patient registry evidence base for NBT in major depressive disorder (MDD). Over 200 completed NBT therapy sessions are targeted in 2021; latest data covering 159 US MDD patients shows 47.2% in remission and 76.1% achieving a clinical response, comparing favourably with historic TMS data. Further data is anticipated from pilot studies of accelerated iTBS protocols in pain and depression during 2021. Promising initial results from the severe depression pilot at Kuopio University Hospital support expansion into a broader trial programme (March 2021 Lighthouse).
  • Core valuation of €7.44/share Updating our model for the rights issue and 100-1 share consolidation (effective May 14 with a May 17-19 trading date dependent on their stock exchanges) results in an rNPV valuation of €49.4m (equivalent to €7.44 per share or €6.84 fully diluted). Ahead of further pilot study data, we conservatively assess that the iTBS protocol MDD opportunity could add €8.7m (€1.21/share) to our core valuation.


12 May 2021

Market Cap€36.0m
Enterprise Value€26.1m
Shares in issue663.6m
12 month range€0.05-0.10
Free float55%
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: Nexstim, Trinity Delta Note: Accounts produced according to Finnish GAAP. 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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