Titan Medical Inc (TMDIF)

[QuidWilson]

Urosurg - you make some excellent points. I am in Healthcare Supply Chain (11 years) and I have to adjust one notion - the ancillary costs for robotic surgery are necessarily higher than most lap procedures. Having been around for so long, there are dozens of lap disposables suppliers and they sell dirt cheap. With their monopoly, intuitive has never once had to negotiate disposables, scopes or repair prices and have kept them high by dictum. When you add up the use cost per instrument arm, specialized drapes, specialized insufflation trocars, specialized scope warmers, specialized staple loads, cords etc... it quickly becomes very expensive for one procedure. And payors do not directly reimburse for disposables expense, so you eat that out of your contribution margin. Based on an analysis we did, any additional reimbursement for a robotic procedure was cancelled out by the high marginal supply expense. Every health system has different payor agreements but for us, robot procedures are not generally profitable (except cardiac).