Small-cap oncology system manufacturer Accuray (ARAY) reported a decent fiscal fourth quarter, but it’s hard to see much momentum in the business or any real sign that this company is becoming a more disruptive force within the radiation oncology market. Although I continue to give management high marks for improving the underlying efficiency of the business and cleaning up the balance sheet, I just don’t see signs that Accuray is really gaining on Varian (VAR) (or even Elekta (OTCPK:EKTAY)) in any meaningful way, and I don’t see anything on the horizon that would drive a sudden shift in sentiment among customers.
Valuation remains undemanding, and I still believe the acquisition of Accuray by a Chinese or Japanese company is conceivable, but med-tech stocks most often trade on the basis of revenue growth and it looks like Accuray has a long row to hoe to generate enough revenue growth to get investors excited about the shares.
Like Many Quarters, Some Good And Some Bad In Fiscal Q4
Accuray reported stronger than expected revenue in the fourth quarter, with 2% growth driving a 5% beat. Outperformance was driven entirely by the service business (up 15% and about 13% above expectations), with product revenue down 10% and in line with expectations.
Although a higher than expected mix of service revenue did compress gross margin somewhat (and service margin declined 160bp year over year), product margin improved nicely (up over 600bp on an adjusted basis), helped by a richer mix of CyberKnife systems. Adjusted EBITDA declined 25% in the quarter, while operating income rose 10% and the company posted a minor miss at the operating line, but a small beat at the EPS line.
Orders were once again a source of disappointment. Gross orders rose 12%, missing expectations by around 10% despite what management characterized as “strong performance” in CyberKnife and a 26% improvement in orders from Asia. Net order performance was far worse, up 2% and almost 25% short of expectations as the company saw a significant increase in order cancellations – something that had been running at a fairly slow and steady pace.
Characterizing the orders, Accuray management said that 20% were replacement orders, 20% were competitive take-aways in established vaults and 60% were in new vaults. Although the company appears to be winning more business than it loses upon replacements, the pace of replacement orders has still been weaker than expected a couple of years ago.
Looking Back, This Wasn’t An Especially Great Year
I believe this is a reasonable time to look back at the guidance management gave a year ago for this fiscal year and see how things stack up.
On the revenue line, management exceeded initial expectations by a couple of percentage points relative to the midpoint of guidance and managed to exceed the high end of the initial guidance range. This came about from better-than-expected service revenue performance, though, as product revenue growth of 2% came in below the 5% to 10% growth guidance, with weaker sales to China tagged as the primary culprit.
Management met the gross margin target, but missed the adjusted EBITDA guidance range of $25 million to $30 million by a wide margin ($17 million reported), with the company electing during the year to spend more on developing the business (particularly R&D).
Gross order growth of 2% also missed guidance of 5%.
Management provided guidance of 4% to 8% product revenue growth for this next fiscal year, and overall revenue growth of about 4% at the midpoint – a level of growth that frankly doesn’t compare all that favorably to Varian or Elekta for a company that is supposed to be a share-gainer. Management is also no longer giving order guidance. While management claims this is due in part to its decision to focus more resources and attention on driving multi-system orders, which will be more volatile, I don’t view less guidance as a net positive, particularly from a company that has struggled to hit its own targets. I’d also note that the EBITDA guidance provided for the year ahead is lower than where expectations were going into the quarter.
Where’s The Spark?
I’m finding it harder to sustain the argument that Accuray has enough upside to be worth further patience, as the company just isn’t making the expected progress. While regulatory issues have held back sales in China and management claims to be “continuing to make progress” on finding a Chinese JV partner, the execution on the opportunity in China just hasn’t been there.
Likewise with the overall execution on Accuray’s opportunities in the market. Accuray has been unable to convince clinicians that CyberKnife or the Tomo platform offer meaningful treatment/outcome advantages over rival systems (particularly Varian). What’s more, while Accuray’s partnership with RaySearch (OTCPK:RSLBF) has helped it improve an area that was significantly deficient compared to Varian and Elekta (treatment planning software), the company has struggled to make a compelling “here’s why you should go with us” case that resonates with hospital purchasing managers.
And now there’s the added news that the company’s CFO of roughly three years is leaving to join a private med-tech. There was no couching this decision in terms of wanting to relocate to a particular geographic area or wanting to get back to a particular industry segment (the med-tech in question is a urology company), and I think investors should ask why the CFO would want to leave if great things were just around the corner.
To be sure, I’m not saying that Accuray is hopeless or that it cannot/will not continue to show improving margins and some level of ongoing product growth. Radixact has seen decent commercial interest and I still believe the Onrad system has potential in markets like China and Japan. Along those lines, I could also see Accuray having some possible acquisition appeal to a Chinese or Japanese acquirer, and I think Accuray’s small size and insignificant market share would help the deal approval process.
After incorporating fourth quarter performance and guidance, I’m still looking for long-term revenue growth in the neighborhood of 3%. Although Elekta continues to struggle in the market, Varian seems to be benefitting the most from that. I do expect Accuray to be cash flow positive and generate better FCF margins in the coming years as the company slowly builds operating leverage on a growing revenue base. The biggest upside to those numbers, aside from some sort of unexpected shift among key opinion leaders that CyberKnife is must-have/must-use technology, would be more clarity in China and stronger sales execution in what should be a sizable long-term market opportunity for the company.
The Bottom Line
Accuray is not at all expensive, and I believe fair value remains between $4.50 and $5.50. Although announcing multiple multi-system wins could get some excitement back in the shares, as could the announcement of a meaningful partnership in China, the valuation argument is hampered by the reality that med-tech, and particularly small-cap med-tech, stock performance is typically driven by revenue growth and Accuray just isn’t likely to produce a lot of that. Consequently, investors need to at least appreciate the risk of this becoming/remaining a value trap and understand that it’s going to take time for the story to work.
Disclosure: I am/we are long ARAY.
I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article.