Piper sees finalized NCD as net negative for Silk Road, positive for InspireMD

Piper Sandler analyst Adam Maeder notes that CMS has published its final decision memo related to the carotid artery stenting NCD. In the document, it appears that CMS finalized all major discussion items essentially in-line with the July proposed memo and consistent with Piper’s/Street expectations. This includes the decision to expand CMS reimbursement coverage for TF-CAS into standard surgical risk patients and asymptomatic high-risk patients. In the firm’s view, the finalized NCD appears to be net negative for Silk Road Medical (SILK) and a clear positive for InspireMD (NSPR). For Silk Road Medical, Piper believes the updated NCD sets the stage for additional competitive pressure in the coming years-though market awareness might also benefit. For InspireMD, the NCD gives the firm better visibility into future standard risk reimbursement-though InspireMD will also need to garner standard risk approval from FDA. Piper remains Neutral rated on Silk Road Medical shares and Overweight rated on InspireMD, and thinks the latter’s shares should react favorably to the news. Conversely, Piper thinks the market is already more-or-less pricing in this NCD outcome for Silk Road Medical after pullback.