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Establishment Labs Holdings Inc (ESTA)
NASDAQ:ESTA
Top Page
Establishment Labs Holdings
(NASDAQ:ESTA)
57Neutral
Positive Factors
Market Expansion
The US launch of Motiva is ahead of schedule, with rapid account sign-ups and encouraging monthly order rates.
Safety Profile
ESTA released 5-year US Motiva PMA data, confirming the best-in-class safety profile already established by the 2-, 3-, and 4-year results.
Sales Performance
There is potential for US sales to exceed $6MM, which is above the initial guidance.
Negative Factors
Competitive Comparison
Longer-term follow-up data produced by competitors make for a better comparison to ESTA's latest results.
Establishment Labs Holdings (ESTA) vs. S&P 500 (SPY)
Market Cap
$1.18B
Dividend YieldN/A
Average Volume (3M)582.34K
Price to Earnings (P/E)―
Beta (1Y)1.43
Revenue Growth0.53%
EPS Growth2.23%
CountryUS
Employees1,018
SectorHealthcare
Sector Strength62
IndustryMedical - Devices
Share Statistics
EPS (TTM)-2.98
Shares Outstanding28,845,814
10 Day Avg. Volume334,264
30 Day Avg. Volume582,340
Financial Highlights & Ratios
PEG RatioN/A
Price to Book (P/B)N/A
Price to Sales (P/S)6.89
Price to Cash Flow (P/CF)-13.80
P/FCF Ratio0.00
Enterprise Value/Market CapN/A
Enterprise Value/RevenueN/A
Enterprise Value/Gross ProfitN/A
Enterprise Value/EbitdaN/A
Forecast
1Y Price Target
$59.17Price Target Upside42.27% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering6
Establishment Labs Holdings Business Overview & Revenue Model
Company DescriptionEstablishment Labs Holdings Inc. is a global medical technology company that operates in the medical aesthetics sector, primarily focusing on the development, manufacturing, and marketing of advanced breast implants. The company's flagship product is the Motiva Implants, which are known for their innovative design and technology aimed at improving patient outcomes and satisfaction. Establishment Labs is committed to enhancing the safety and aesthetics of breast implant procedures, leveraging cutting-edge research and development to offer high-quality medical solutions.
How the Company Makes MoneyEstablishment Labs makes money primarily through the sale of its Motiva Implants, which are distributed to plastic surgeons and healthcare facilities worldwide. The company generates revenue by marketing and selling these implants directly or through a network of distributors in various international markets. A significant portion of its earnings is derived from regions where there is a high demand for cosmetic surgery, such as Latin America, Europe, and Asia. Establishment Labs also invests in research and development to innovate and expand its product offerings, which can lead to increased sales and market share. Strategic partnerships and collaborations with healthcare providers and industry experts further enhance its market presence and contribute to revenue growth.
Establishment Labs Holdings Financial Statement Overview
Summary
Establishment Labs Holdings faces ongoing financial challenges with consistent operational losses and negative cash flows. While there is stability in revenue and gross margins, profitability remains a concern. The balance sheet shows improvements in equity, but high leverage poses risks. Continuous efforts to manage cash flows and reduce losses are critical for future financial health.Income Statement
The company's revenue growth has been relatively flat with minor increases over recent years, showing a slight increase of 0.53% from 2023 to 2024. Despite steady gross profit margins averaging around 66%, net margins are severely negative due to consistent losses, with the 2024 net profit margin at -50.94%. The EBIT and EBITDA margins are also negative, reflecting ongoing operational challenges.45
Neutral
Balance Sheet
The company's balance sheet shows high leverage with a debt-to-equity ratio of 0.08 in 2024, indicating a low level of debt relative to equity. However, the company has a positive equity ratio of 15.30%. Despite a significant rise in stockholders' equity from previous negative values, ongoing losses affect return on equity.40
Negative
Cash Flow
The cash flow statement indicates difficulties in generating positive cash flow, with negative free cash flow growth and substantial operating cash outflows. The operating cash flow to net income ratio is negative, reflecting the challenges in covering net losses. However, there was some improvement in free cash flow in 2024 compared to 2023.38
Negative
| Breakdown | ||||
| Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 | Dec 2020 |
|---|---|---|---|---|
| Income Statement | Total Revenue | |||
| 166.03M | 165.15M | 161.70M | 126.68M | 84.68M | Gross Profit |
| 109.53M | 106.98M | 106.59M | 85.40M | 52.50M | EBIT |
| -49.99M | -65.03M | -39.66M | -25.14M | -27.92M | EBITDA |
| -56.22M | -58.31M | -56.90M | -26.54M | -24.93M | Net Income Common Stockholders |
| -84.60M | -78.50M | -75.21M | -41.14M | -38.12M |
| Balance Sheet | Cash, Cash Equivalents and Short-Term Investments | |||
| 90.35M | 40.03M | 66.36M | 53.41M | 84.52M | Total Assets |
| 346.83M | 268.64M | 211.06M | 139.53M | 156.39M | Total Debt |
| 4.20M | 192.22M | 178.66M | 53.81M | 51.76M | Net Debt |
| -86.14M | 152.19M | 112.31M | 391.00K | -32.77M | Total Liabilities |
| 293.74M | 250.25M | 219.25M | 88.79M | 81.43M | Stockholders Equity |
| 53.09M | 18.39M | -8.19M | 50.74M | 74.96M |
| Cash Flow | Free Cash Flow | |||
| -64.63M | -113.06M | -86.43M | -34.26M | -16.42M | Operating Cash Flow |
| -58.52M | -88.51M | -52.17M | -27.53M | -12.51M | Investing Cash Flow |
| -15.61M | -24.55M | -34.79M | -7.16M | -5.56M | Financing Cash Flow |
| 125.89M | 86.23M | 100.25M | 4.05M | 64.67M |
Establishment Labs Holdings Technical Analysis
Positive
41.59
Price Trends
36.68
Positive
39.77
Positive
41.64
Negative
Market Momentum
0.84
Positive
52.99
Neutral
63.54
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For ESTA, the sentiment is Positive. The current price of 41.59 is above the 20-day moving average (MA) of 39.47, above the 50-day MA of 36.68, and below the 200-day MA of 41.64, indicating a neutral trend. The MACD of 0.84 indicates Positive momentum. The RSI at 52.99 is Neutral, neither overbought nor oversold. The STOCH value of 63.54 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for ESTA.
Establishment Labs Holdings Risk Analysis
Establishment Labs Holdings disclosed 62 risk factors in its most recent earnings report. Establishment Labs Holdings reported the most risks in the “Legal & Regulatory” category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Establishment Labs Holdings Peers Comparison
Overall Rating
UnderperformOutperform
Sector (48)
Financial Indicators
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
66 Neutral | $1.12B | 86.38 | 3.42% | ― | 14.88% | -86.70% | |
61 Neutral | $1.15B | ― | -12.08% | ― | 3.85% | -339.15% | |
57 Neutral | $1.18B | ― | -236.67% | ― | 0.53% | 2.23% | |
54 Neutral | $1.11B | ― | -3.87% | ― | -17.42% | 70.55% | |
52 Neutral | $1.22B | ― | -8.54% | ― | 11.65% | 11.33% | |
48 Neutral | $6.86B | 1.11 | -50.22% | 2.47% | 16.71% | 1.53% |
* Healthcare Sector Average
Performance Comparison
ESTA
Establishment Labs Holdings
41.59
-11.20
-21.22%
OPK
Opko Health
1.65
0.30
22.22%
PCRX
Pacira Pharmaceuticals
24.89
-4.12
-14.20%
INVA
Innoviva
18.07
3.26
22.01%
NEO
NeoGenomics
9.42
-5.45
-36.65%
Establishment Labs Holdings Earnings Call Summary
Earnings Call Date: Feb 26, 2025 | % Change Since: 15.34% | Next Earnings Date: May 12, 2025
Earnings Call Sentiment Positive
The earnings call presented strong highlights, particularly around the successful US launch and operational efficiency improvements, which were offset by challenges in global demand, particularly in Latin America, and high cash usage due to US market investments.Highlights
Strong US Launch
US sales totaled $3.3 million in the first two months of the launch, exceeding expectations. Over 650 accounts have been fully onboarded with 450 placing orders, and 88% reordering.
Revenue Growth
Fourth-quarter revenue increased by 41% year-over-year to $44.5 million. Full-year sales were $166 million, with a forecast of 25% growth over 2024.
Operational Efficiency
Operating expenses reduced by $12.5 million in 2024 compared to 2023. EBITDA loss improved to $13.1 million from $17.4 million last year.
Expansion in Europe
Acquired distributor in Benelux to leverage infrastructure and achieve synergies. European distribution center in Antwerp is set for expansion.
Positive Gross Margin Trends
Gross profit improved to 68.5% of revenue compared to 65.2% last year, driven by higher production volumes and lower manufacturing costs.
Innovative Product Line
Strong interest in Motiva and new products like Mia and Preservé expected to drive growth. Mia Femtech and Preservé are anticipated to expand the market.
Lowlights
Uneven Global Demand
Global demand outside the US remains uneven, with significant weakness in Latin America and meaningful declines in some EMEA countries.
Cash Usage
High cash usage in Q4 and expected in Q1 due to investments in US commercial efforts and inventory to support US launch.
Latin America Weakness
Revenues in Latin America were flat, indicating stabilization but no growth. Continued weakness in this region offset other strengths.
Uncertain Regulatory Timelines
Future growth partially dependent on US FDA approvals for new products, with timelines extending to 2026 and beyond for some indications.
Company Guidance
During Establishment Labs' fourth-quarter 2024 earnings call, the company provided guidance for 2025, projecting revenue between $205 million and $210 million, representing a 23% to 26% growth over 2024. The company highlighted a strong start in the U.S. market, with $3.3 million in sales in the first two months of its launch and an expectation of generating $5.5 million in sales for the first quarter of 2025. Establishment Labs plans to achieve its first positive EBITDA quarter in 2025, driven by U.S. sales growth and operational efficiencies. The company also noted that global demand outside the U.S. remains uneven, with mid-single-digit growth expected in EMEA and APAC regions, while Latin America is expected to remain flat. Establishment Labs aims for a gradual return to growth in these markets and has set a target of $35 million in U.S. revenue for 2025. Additionally, the company discussed its ongoing efforts to manage operating expenses, with a focus on achieving EBITDA positivity in the latter half of 2025 and cash flow breakeven by 2026.Establishment Labs Holdings Corporate Events
Business Operations and StrategyFinancial Disclosures
Establishment Labs Forecasts Strong 2025 Revenue Growth
Positive
Jan 16, 2025
In a presentation at the J.P. Morgan Healthcare Conference on January 15, 2025, Establishment Labs announced updated financial guidance for 2025, forecasting revenue between $205 million and $210 million. The company expects international sales to contribute $170 million to $175 million and U.S. sales to contribute $35 million. Establishment Labs aims to achieve positive adjusted EBITDA in 2025 and expects to realize positive cash flow by 2026, indicating a positive trend in its financial performance.
Executive/Board ChangesFinancial Disclosures
Establishment Labs CEO Retirement and Revenue Growth
Positive
Jan 13, 2025
Juan José Chacón-Quirós, CEO of Establishment Labs, announced his retirement effective March 1, 2025, while continuing as a board member and advisor. Peter Caldini, the current President, will serve as Interim CEO. Establishment Labs also shared preliminary unaudited fourth quarter revenue figures which align with recent guidance, showcasing the company’s continued growth and market presence in the breast aesthetics industry.
Glossary
OutperformA stock rated as "Outperform" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests that the stock is likely to deliver higher returns compared to the average returns of other stocks in the same sector or market index. Investors might consider this stock a good buying opportunity.
NeutralA stock rated as "Neutral" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly attractive nor unattractive for investment. Investors may consider holding onto the stock, as it is not expected to either significantly outperform or underperform the market.
UnderperformA stock rated as "Underperform" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests that the stock may deliver lower returns compared to the average returns of other stocks in the same sector or market index. Investors might consider selling the stock or avoiding it as an investment.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.