Stenocare – real growth now and profits around the Corner
THE BIG PICTURE:
All you need to know in relation to Stenocare and the TO1 warrant with exercise 6-19 December 2023
LATEST UPDATE
Record sales in 2023 and break-even in 2024:
For 4 years, Stenocare has been working hard to reach and exceed the sales volumes of 2018 and 2019, its first two years of successful operation. This goal is now in hand.
IMPORTANT INFORMATION ABOUT 2023:
With the announcement of sales in Q3-2023 of 2.3mdkk, combined with preliminary guidance for Q4-23 of 1.7mDKK, STENOCARE is on track to all times high actual gross sales in 2023 of around 6.5mdkk. This is up from practically no sales in 2020 and very limited net sales in 2021 and 2022.
Detailed information about 2023 click here
OUTLOOK FOR 2024:
While 2023 has shown success in Denmark in terms of sales volume, leading to all time high actual sales, it is equally important to point out that sales are expected to reach 15mDKK in 2024 (+/-20%) leading to projected break-even by end 2024.
Detailed Outlook for 2024 click here
CEO of Stenocare, Thomas Skovlund Schnegelsberg comments:
“We planned 2023 to be the year of sales growth and it is rewarding to see that we are reaching more and more patients each quarter. We have managed to leverage that we have 10 products approved for sales. Denmark is our home market and clearly our largest market, but it is important to remember, that we have entered several of our markets very recently and the related potential is ready to be turned into business in 2024. This is a strong platform for our growth in the coming years.”
Strong Patient Growth in Denmark
The number of patients continued to grow strongly during Q3-23 for STENOCARE A/S (“STENOCARE” or “the Company”) which resulted in actual sales of DKK 2.3m. The reported net sales amounted to DKK 0.2m but included a large product return from Norway of DKK 2.1m, which we consider as a one-of occasion. Adjusted for the product return, EBITDA amounted to DKK -1.7m, the best in a quarter since Q1-19 and we estimate STENOCARE to reach break-even by the end of 2024. With estimated net sales of DKK 66.6m by 2026, and with an applied P/S multiple of 5x, a potential present value per share of DKK 9.4 (10.2) is derived in a Base scenario
STENOCARE Q3-23: 2023-11-14
Motivated net present value of stock: DKK 9.4/share (Base scenario)
SUMMARY
The following is a summary of the 7 elements that describe the Stenocare business and equity story.
💚 The opportunity (1-2):
Stenocare provides prescription based medical cannabis that can enhance the quality of life for millions of patients suffering from severe and chronic illnesses, alleviating their pain, and offering comfort to their loved ones. This is relevant for 100’s of millions of patients in the world and Stenocare has built the assets needed to convert this opportunity into a highly scalable, profitable and market leading business.
💪🏼 The business case (3-6):
Founded in 2017 and listed in 2018, the Stenocare core business (sales of imported products under own brand) is once again scaling (+200% YoY growth in actual sales after correction of returned goods). This is due – primarily – to its #1 position in the Danish home market as well as early growth in other Stenocare markets with a portfolio of 10 licensed products currently being sold in 4 markets (Denmark, Norway, the UK and Australia) and additional 5-6 products coming on stream in Denmark, Sweden, Australia and Germany. Breakeven are due by 2024 and financial goals are once again highly ambitious. In addition, Stenocare is getting ready to bring its own world class cultivation facility into the supply chain along with other strategic initiatives, such as introduction of game-changing, next generation oil-products based upon an exclusive, patented technology and improvement of distribution power through introduction of on-line clinics.
💎 The investment case (7):
Stenocare has a limited need for additional working capital due to the expected growth in sales. In short, potential is high and given the nature of and growth in the current business, risk is about scaling what works. Stenocare intends to refinance its existing (remaining) debt of about 7,5mdkk as part of the upcoming TO1 exercise (terms to be announced).
PRESENTATION
… of the 7 elements that describe the Stenocare business and investment case.
Click below to read each point.
ELABORATION
… of the 7 elements that describe the Stenocare business and investment case.
Click below to read each point.
The industry is ready to unlock its potential (elaboration of #1)
The growing sales run rate in 2023 leads to a healthy business (elaboration of #2-7)
What is the situation in each market (elaboration of element #4 and 5)
Taking medical cannabis to the next level (elaboration of #2, 4 and 6)
Stenocare’s world class cultivation facility (elaboration of #2, 3, 4 and 6)
PRESENTATION:
The following is a presentation of the 7 elements that describe the Stenocare business and equity story.
1: The POTENTIAL
1a) Global potential: It is estimated, that as many as 1 in 10 adult individuals are newly diagnosed with chronic pain each year.
1b) Validated potential: Increasingly, pharma grade medical cannabis is being recognized as a valuable alternative to opioids and other non-natural medical treatments for chronic pain. Studies are being conducted worldwide to provide medical evidence of the benefits experienced by patients.
1c) Addressable potential: Stenocare is dedicated to be(come) an international leader in the ongoing maturing of this emerging 2.1bn Euro market (European market size by 2027 according to Prohibition Partners). Growth is already underway, break-even is around the corner and the potential is almost unlimited.
2: The ASSETS
Cornerstones are in place. Stenocare’s highly experienced team has successfully built four categories of strategic assets in support of its ability to scale:
1. Regulatory assets: Proven ability to obtain regulatory approval for Stenocare oil-products. Stenocare is a first mover in Denmark, Norway and Sweden and currently offer 10 products for sale in 5 national markets, due to grow in 2023 and 2024.
2. Supply chain assets: Close relationship with strategic, pharma grade supplier and preparing to seek license to sell and export products from Stenocare’s own world class cultivation facility.
3. Commercial assets: Pharma-grade distribution infrastructure and sales in place in 5 of 6 markets and is on track to reach as many as 10 countries by 2025.
4. Partnership assets: Unique and patent protected, pharma grade oil technology from a pharma product developer, for precise dosage and absorption, is under development and on track for release in 2024.
3: The JOURNEY TO DATE (’SO FAR’)
When progress was delayed on the way, endurance is a winning formula. Stenocare has developed a strong ability to execute with focus upon pharma grade medical cannabis oil in chosen markets.
3a) Hype and turbulence (2018-2022): Stenocare’s IPO in 2018 was Europe’s first medical cannabis listing. The listing was very successful with its shares soaring beyond 50dkk/share and quarterly profits occurring after just 2 quarters of operations.
Since then, the industry has gone through a classic hype cycle with initial euphoria being replaced by failure of many (most) contenders, pursuing pure volume strategies. Now after significant delays, from which all contenders, including Stenocare have suffered, the dust is settling.
Stenocare was shook by malpractice and discontinuation of its sole supplier in 2019 and sales dropped (close to) zero in the second half of 2019, and stayed at modest levels through 2020 and 2021. New suppliers were brought in place (from Canada, Germany and Australia) and new markets were introduced, leading to sales in 2022 largely driven by a major initial order to the Norwegian market in Q4-22. Unfortunately, for political reasons, sales to Norwegian patients were not realized and for that reason these products expired and were returned to Stenocare in Q3-23.
3b) Real growth (2023): Real growth in sales volume and patients emerged in 2023, driven by the Danish home market and 2 new products approved for sales. As a result, sales volumes in Denmark are yet again approaching those of 2019 although slower than expected due to longer product approval/licensing cycles of the Danish Medicines Agency which have delayed the introduction of Stenocare’s third and most important product.
3c) Full circle (2024-2025): Since 2018, Stenocare has invested around 60mdkk in building its own world-class pharma-grade cultivation facility that is on track to become the backbone of the Stenocare supply chain.
Once fully on-stream and licensed this will provide a unique source of added profitability and scalability.
4: The BUSINESS TODAY (THE ‘NOW’)
Profits around the corner. Stenocare is growing consistently (quarter over quarter) in 2023 and is ready for ‘primetime’ in 2024.
4a) Leadership in the Nordics: Stenocare is the only licensed supplier that has sold full spectrum oil-based products in Denmark, Sweden and Norway.
Stenocare is winning market shares and breakeven is imminent in Denmark subject to its third and final product approval, which is delayed, but expected soon.
Sweden and Norway are markets with large potential. However, as these markets are not legalized (so-called magistral markets), they are expected to scale at a lower pace during 2024 and 2025.
4b) Wider international presence: Stenocare also actively operating in England (UK), Australia and Germany (Q4-23) all of which are larger markets with multiple vendors.
4c) Multiple strategic initiatives are taking shape, “behind the scenes”: These include own production, new and highly advanced pharma-grade products, on-line clinics, education of doctors and initiatives to expand from 6 to 10 countries by 2025.
5: The FINANCIAL GOALS
Grow big on own steam. STENOCARE aims to build a profitable and highly scalable business towards international market leadership.
5a) Immediate (current fiscal year, 2023): Guidance for gross sales of 6,5mdkk corresponding to 170% YoY growth in gross sales (after retrospective correction for products sold primarily in Norway in 2022 and returned thereafter).
Approaching profitable core business (defined as Stenocare branded import/export business, counting all cost apart from cultivation facility) through receipt of license for 3rd and most important product in Denmark. Business still sensitive to regulatory delays.
5b) Intermediary (2024/2025): +100% YoY growth (green bar on figure). Core business to be profitable during 2024. Overall break-even by end of 2024. Final timing still subject to receipt of licenses as expected.
6: The OPERATIONAL PLAN AND PRIORITIES
Focus upon Execution and Innovation towards strong international market leadership. The growth towards and beyond profitability is executed on three parallel tracks
6a). Build market penetration at home and beyond: Building a highly profitable home market (Denmark) and seeding/growing international (existing and new) markets.
6b). Improve offering and competitiveness: Adding innovative initiatives that improve quality of care and competitiveness (a: pharma-grade oils with unique benefits for patients, b: on-line clinic that increases accessibility, c: other strategic initiatives, not yet announced.
6c) Vertical integration across the value chain: Activation of own world class cultivation facility with production of pharma grade medical cannabis products.
7: The EQUITY STORY:
Ready, set, go. Uniquely, STENOCARE is a high-potential, largely proven and already scaling business case with profits in sight and limited funding needs.
7a) Value for money: High Potential and low risk (favourable P/R ratio) is a durable formula for success. The high potential and ambition level is described above. Risk is relatively low due to high intrinsic value (real growth and all building blocks for profitable growth being in place).
Despite progress, etc., the Stenocare stock is trading at all time low relative to its prior peak of >50dkk/share (early days while listed on Spotlight Stock market).
7b) Limited needs: To date, a total of almost 100mdkk has been invested in Stenocare. Due to the cash at hand in combination with improving cash-flows from sales, Stenocare has limited needs of approx. 3 mdkk for additional working capital ahead of the anticipated break-even by end of 2024.
Refinancing of debt and exercise of warrants (TO1 in December 2023 and TO2 in May 2024) are points of focus.
7c: Potential news-flow: While patience is always a virtue, Stenocare’s many value and growth triggers are indicators for a strong and steady news-flow in coming months and quarters. These may include but are not necessarily limited to:
- 3rd product to be approved in Denmark
- Sales initiatives in from 5 international markets
- Launch of additional markets
- Launch of online clinic in the UK
- Introduction of next generation products
- Export from own cultivation facility
ELABORATION:
The following is an elaboration of the 7 elements that describe the Stenocare business and equity story.
The medical cannabis industry is ready to unlock its potential (element #1):
Millions of pain-patients deserve a quality-of-life improving alternative to opioids etc. due to heavy and often debilitating side-effects and issues with addiction. Medical cannabis is a natural (non-chemical) substance known and increasingly recognized for its ability to address chronical pain among other things without major side-effects and with limited risk of addiction. With the wave of legalization of medical cannabis across Europe seen during the last 5-7 years, a new industry with an obviously huge potential has emerged. Different countries in Europe and beyond have adopted different procedures for approval of products with Denmark being probably the strictest of all. Other barriers are doctors’ lack of knowledge and general stigma. But time is a “healing factor” and the potential is unchanged. According to industry analyst (Prohibition Partners) the European marked will grow from Euro 500 mill today towards Euro 2.1 billion in 2027. A large part of the potential relates to conversion from unregulated and privately funded self-medication to regulated prescription with an element public payment in full or in part. For example, +1.4 mill UK patients are self-medicating with illegal cannabis, and they would value receiving treatment from a trained doctor with a quality product controlled by and partially paid for by the health authorities. In summary, it is an emerging industry that is not yet in full contact with its potential. Nonetheless, the benefits for companies who manage to overcome the barriers are significant. Stenocare is such a company.
The growing sales run rate in 2023 leads to a healthy business (element #2-7):
Strong foundation: Stenocare has successfully managed to benefit from its first-mover advantage by having 10 prescription-based products approved for sale in 6 markets with individual regulatory regimes, market maturity, distribution infrastructure and degree of stigma. This makes Stenocare unique.
The lesson of 2022: However, launching in several markets while also seeking to expand in the Danish home market is no simple task. This has become apparent in several ways. While the potential in each market is unquestionable, it is clear that the path through policy makers/regulators/medical agencies, distributors, doctors and through to patients in need should never be underestimated. Seeding each market was a high priority from the beginning of 2022, onwards. While results and real growth are/is indeed already visible in 2023, the fruits from most of these activities are due to be harvested in 2024 and onwards.
Development in gross sales: In essence, Stenocare sells to distributors in the respective markets. Distributors sells to pharmacies for delivery to patients. In new markets where sell-through to patients is not secured, Stenocare is exposed to the risk that products expire and that distributors return these to Stenocare. Gross sales is total sales adjusted for returned products retrospectively in the period when products were sold. Stenocare was hit by this in Q3-23 as the first major shipment to Norway in Q4-22 was unable to reach patients while the products were still valid. This was caused by local management at the pain centers holding back on budget for treatment with all types of medical cannabis products (ie. not only Stenocare products), resulting that product expired and were returned in Q3-23.
Outlook 2023: Sales have started in 5 of 6 markets awaiting approval of new products in Sweden and with Germany as the latest new market coming on stream in Q4-2023 as announced on October 30, 2023. Sales in the Danish market is the primary driver behind the strong growth quarterly sales in 2023 to the right with Q3-23 representing the largest gross sales to date.
Essentially, Stenocare’s sales run-rate, can be illustrated as Last 12 Months (LtM) gross sales and Quarterly LtM growth Year over Year adjusted for returns.
As can be seen to the right, the trend was flat during 2021, 2022 and into 2023. Then in the most recent quarters LtM sales grew remarkably to 6,5mDKK in Q3-23 by more than 600% YoY relative to LtM in Q3-22.
Development in retail sales: Moving from ‘virgin sales’ in new markets with a higher risk of returns, ref. above, Stenocare is maturing into more established relationships (especially in Denmark and Australia) with end-to-end sell through. As can be seen in the illustration to the right, these numbers have been growing at a fast pace in 2023, which serves as an important indicator of sharply reduced risk of products delivered not being sold before expiry going forward.
Outlook beyond: Thanks to this current development and a very promising outlook for 2024 across all 6 markets, Stenocare is on track to become a healthy business reaching break-even by end 2024. Please see the description of each of the 6 markets below.
What is the situation in each market (element #4-5):
The 6 markets addressed by Stenocare are all different, yet can be defined and described in three categories:
Home market: Denmark, legalized
Near markets: Sweden and Norway, not yet legalized, i.e. magistral market.
Other markets: United Kingdom and Australia. LATEST: Germany. All legalized and competitive. More markets in the pipeline. Stenocare has a proven record of entering new markets and also works as a first mover in early-stage legalization. The company is working on several new markets which offer the potential to position Stenocare as the first approved supplier of medical cannabis.
Denmark
The company has the only two medical cannabis oil products that have been approved for the Danish Pilot Programme. Latest health data confirm that Stenocare’s oil products have increased gradually and as per Q3-23 aggregate Stenocare sales have exceeded oil products sold magistrally (outside the Pilot Programme). Stenocare is far into the regulatory approval process with the Danish Medicine Agency to have the third major volume product approved. This is expected within 4-6 months. With this product, the company will have a full product-line to serve most Danish patients.
Sweden
Sweden has no legal framework for medical cannabis. Stenocare was successful in having initial approval for treatment of selected patients based upon magistral prescription during 2020. Currently, sales are pending and the company is now working with new specialist doctors and treatment areas which – along with the availability of quality products are keys to growth in sales. Stenocare is far into the regulatory approval process with the Swedish Medicine Agency to have three new oil products approved, and there is a group of target patients waiting to begin treatment within 4-6 months.
Norway
Medical cannabis laws in Norway are like those in Sweden. In Norway, Stenocare supplies full spectrum medical cannabis oil products with a full product-line available at Norwegian pharmacies, which is valued by patients. Stenocare is actively developing a framework for doctors’ training/knowledge. Given that both Sweden and Norway are markets without legalization, Stenocare has gone through similar market adoption processes starting with initial success, then delays in sales due to local management at the pain centers holding back on budget for treatment and resulting returns of products and then (soon) real acceleration based upon a cleared path to patients and doctors.
United Kingdom
Stenocare has a product line of three oil products in the UK, a competitive market where the total cost of treatment is a barrier for many patients. Addressing this barrier, Stenocare has created an Online Clinic IT-platform, that offers value to both patients and doctors: a) Doctors receive a complete clinic setup with booking, video consultation, payment, and journal system. The doctor will use the platform free of charge. The doctor can therefore reach more patients regardless of patients’ location, and the total cost of a consultation will be lower, b) Patients will have easier access to doctors – as the online clinic allow them to see the doctor from the comfort of their homes. Also, the cost of the consultation can potentially be lower – which will enable more patients to afford the treatment. This will enable the treatment of more patients and grow the sales run rate of Stenocare products.
Australia
The company has had a medical cannabis oil product approved for sales since last year and seen a healthy growth in patients and sales. The Australian market is evolving both on the regulatory front and on patients’ treatment. Stenocare is working to expand both partnerships to reach more patients and launch a new oil product to offer patients more choice. This is expected to happen during Q1 2024.
Germany
Stenocare is entering Germany with a medical cannabis oil product that is covered by health insurance. Competition is significant with many international suppliers working to establish a market presence in the largest market, that is expected to grow from Euro 350 mill to Euro 1 bill during the next five years. Stenocare is partnering with a local pharma partner to launch the first branded product in October 2023, which will not only generate short term sales, it will also serve as a first market penetration and brand building ahead of the planned, introduction of next generation oil products. This is expected to position Stenocare as industry leader for a new product line that can target pain management more effectively. The product development is currently ongoing, and it is the ambition to have a next generation product candidate ready for regulatory approval within 12 months.
Taking medical cannabis to the next level (element #2, 4 and 6):
As mentioned, Stenocare has invested in developing a new product line that is based on a patented oil technology. The company holds the worldwide exclusivity to use this patent for cannabis, that is branded “ASTRUM oil”. This will revolutionize the dosing delivery of medical cannabis to patients and solve the general challenge with securing uniform uptake of the cannabis in the blood of patients. With pharmacokinetic studies on dogs, Stenocare has documented that the oil technology has the potential to significantly improve the effect of the treatment. The company will use this technology in a new product line that is currently being developed with an external contract partner. The ambition is to have the first product candidate ready for regulatory approval within 12 months, i.e. by end of 2024. Stenocare expects that this new product-line will position the company as a first mover of next generation medical cannabis oil products, that offer doctors and patients better predictability of dosage delivery and bioavailable in the body (i.e. treatment effect).
Stenocare’s world class cultivation facility coming into play (element #2, 3, 4 and 6):
Stenocare has two pillars that form its supply chain strategy.
The first pillar is supply partnerships with pharma-grade suppliers of medical cannabis products, that are Stenocare branded in several markets.
The second pillar is Stenocare’s Danish cultivation facility, that is an indoor state-of-art facility where Stenocare is developing unique cultivars (ie. plant strains) that supplement the products from the first pillar. This will enable Stenocare to serve its markets and patients with more choice from a larger productline, and scaled-up supply capacity to match actual demand in the market.
This model also effectively allows Stenocare to start low and then scale the volume needed as the new markets develop.
