Thanks for bringing Axonics to the board. I am a Colon & Rectal surgeon who has implanted hundreds of sacral nerve stimulators. I echo many of the points made by Endoscopist. I am not willing to buy Axonics without a few more quarters of data for the following reasons:
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This is not a greenfield market. It is underserved but not greenfield. Medtronic is the first mover and technology leader in this market. Axonics will have to take market share from Medtronic which has a huge advantage of in place sales team.
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I have reviewed the Axonics literature. I do not see a compelling technical advantage in the Axonics product. The main difference in the Axonics and Medtronic products relate to rechargeable generator vs battery with 5-10 year life. The Axonics product is only rechargeable generator which means the implantable battery is slightly smaller but requires recharging every 1-2 weeks for the life of the product; whereas, the Medtronic product is traditional battery which requires no upkeep but lasts 5-10 years. In the cardiac pacemaker space, both battery options have been available for many years and non rechargeable is the overwhelming patient choice due to lack of upkeep.
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I do not see much advantage in a smaller battery. The battery is implanted in upper buttock/lower back so it is in a nonpressure bearing area with little cosmetic implication.
I hope both the Axonics and Medtronic succeed since this is an underserved area of medicine! As an investor, I am concerned this is ultimately a winner takes most field with Medtronic having a large advantage.
Hope this perspective helps,
Chris