Expanding IVF Access: Initiatives to Make Fertility Treatments More Accessible

US CLINICS INNOVATE TO BREAK FINANCIAL, GEOGRAPHICAL, AND EDUCATIONAL BARRIERS

This News Digest Story is paid featured content. The advertiser has had editorial input and control over its creation. However, the views and opinions expressed in this article do not necessarily represent the views of Inside Reproductive Health. The sponsorship of this content does not imply an endorsement by Inside Reproductive Health.

By Lisa Munger

As demand for fertility treatments surges and barriers persist, several leading fertility clinics and organizations in the U.S. are implementing innovative measures to make in-vitro fertilization (IVF) more accessible to a broader population. By working to address financial, geographical, and educational barriers, these organizations seek to ensure that more people can access the resources they need to expand their families.

CNY Fertility: Affordable and Accessible Care

William Kiltz, vice president of marketing and business development at CNY Fertility, said the company has emerged as a leader in making fertility treatments affordable and accessible.

Kiltz highlighted three primary mechanisms for expanding access: eliminating financial barriers, removing restrictive cutoffs based on age or health metrics and addressing geographical challenges.

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ORGANON IS COMMITTED TO HELPING ASPIRING PARENTS ON THEIR FERTILITY JOURNEY

Organon is proud to collaborate with the fertility community in championing care equity around the world and is committed to:

• Elevating fertility education and awareness

• Expanding resources and access to care

• Investing in innovative fertility solutions

Every journey to parenthood is unique, and Organon is here to empower aspiring parents every step of the way.

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He said CNY Fertility's pricing stands out in the industry, with treatments costing one-third of the national average.

“Where standard IVF treatments typically cost around $20,000, CNY Fertility offers similar services for $6,764,” Kiltz said. “This affordability and flexible financing options allow more families to access fertility care. The average household income of CNY’s patients is around $80,000, significantly lower than the typical $180,000 for IVF patients nationwide.”

CNY Fertility has developed a patient-friendly travel program that leverages telehealth and local medical facilities to address geographical barriers.

"Patients can receive treatment remotely for most of the process, only needing to visit our clinics for two days," Kiltz said. "We believe that access to the care needed to grow one’s family is a fundamental human right."

Inception Fertility: Advocating for Improved Insurance Coverage

Under the leadership of CEO TJ Farnsworth, Inception Fertility is also at the forefront of expanding IVF access. Inception focuses on increasing insurance coverage and educating insurance companies about comprehensive fertility care.

"Our top priority is to remove capacity constraints and advocate for expanded coverage," Farnsworth said. "We are dedicated to adapting to changes in the insurance landscape and increasing the number of employers offering fertility care benefits."

Inception Fertility offers solutions for patients facing financial barriers. Through BUNDL Fertility, patients can bundle multiple cycles at a discount, reducing the overall cost and increasing success rates. Additionally, the Wyatt Fertility Foundation provides financial assistance and funds research in infertility.

"We are excited to award five $15,000 grants for IVF, demonstrating our commitment to the future of fertility care," Farnsworth said.

Kindbody: Training and Expanding Access

Kindbody is tackling the issue of limited access through innovative training programs. Angie Beltsos, M.D., chief executive physician, emphasized the importance of increasing the number of qualified fertility specialists.

"Kindbody was founded to create health equity and make family-building more affordable," Beltsos said. "Our new KindInstitute will train board-certified OB/GYNs in reproductive endocrinology and infertility, significantly increasing the number of professionals available to provide care.

This training program, set to graduate its first cohort in 2024, seeks to address the shortage of fertility specialists and improve access for underserved communities. By equipping OB/GYNs to perform fertility-related procedures, Beltsos hopes to increase the monthly cases treated by 50% or more. Additionally, Kindbody is expanding its online offerings to provide convenient, remote patient consultations.

Organon: Cost-Saving Programs for Medications

Organon, a company with a portfolio that has a long history in fertility medications, focuses on reducing patients' costs, said Mike Pohleven, U.S. Fertility Business Unit lead, regarding the effect of Organon’s partnership with ReUnite Rx on expanding access to fertility care

“Our two most popular and utilized programs are the ReUnite Discount Program, which offers point-of-sale discounts for cash-paying customers without insurance benefits, and ReUnite Assist, which provides additional savings for uninsured, income-eligible patients.”

Going forward, Pohleven said the company’s development “will be based on market dynamics and events, so we are always aiming to meet the needs of aspiring parents.. Organon’s mission-critical NorthStar is to be ‘Here for Her Health.’ We continually look for ways to address women's unmet needs.”

Through ReUnite Rx, Organon provides access to several cost-savings programs, benefiting 50,000 eligible patients since 2018, he said.

This News Digest Story is paid featured content. The advertiser has had editorial input and control over its creation. However, the views and opinions expressed in this article do not necessarily represent the views of Inside Reproductive Health. The sponsorship of this content does not imply an endorsement by Inside Reproductive Health.

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All external links active as of 7/18/2024

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

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SREI Weighs Options to Deal with Fellowship Scarcity in REI

Taking fellowship training from three years to two, corporate-academic partnerships considered primary options

BY: LISA MUNGER

There are 49 accredited fellowship programs, as of the Accreditation Council for Graduate Medical Education's most recent data from the 2021-2022 academic year. ACGME assumed accreditation responsibilities for the first year in 2016 from the American Board of Obstetrics and Gynecology; 41 REI fellowships existed. 

As first reported by Inside Reproductive Health, the University of Miami/Jackson Health System Program and the University of Washington Program received ACGME approval in fall 2022, making them the latest programs to receive approval. 

Academic Years and New Programs Accredited By ACGME

2021-2022 University of Rochester

2020-2021 None

2019-2020 SUNY Downstate Health Sciences

2018-2019 None

Before the 2018-2019 academic year, all previously ABOG-accredited programs had to apply for accreditation with ACGME. Thus, in 2016-2018 all existing were re-approved.

What’s more, the National Resident Matching Program matched 49 out of 49 open fellowship positions in 2022. There were 78 individual applicants for REI fellowship program positions for the 2021-2022 academic year in the most recent available data.

The Pipeline for New Programs

ACGME cannot estimate new programs coming in the pipeline. 

“It depends on receiving and approving new program applications,” said Susan Holub, director of communications at ACGME. 

Currently, 49 fellowship programs exist, with 175 fellows, according to ACGME. 

How to Increase REI Fellowships: Challenges

One hurdle in establishing new REI Fellowships is finding qualified faculty. REI is a specialized field; a limited number of qualified physicians can teach in fellowship programs. Another barrier is finding a suitable location for the program. REI programs require access to a large number of patients, as well as state-of-the-art facilities—all costly prospects.

Ruben Alvero, M.D., past president of SREI, professor of Obstetrics and Gynecology at Stanford Medical School and division director of Reproductive Endocrinology and Infertility at the Lucille Packard Children’s Hospital told Inside Reproductive Health there are several impediments to establishing programs and in adding fellows. 

“It's onerous to establish new programs or fellows,” he said. The biggest stumbling blocks that exist are securing financing and in terms of the paperwork and the actual application itself.” 

Alvero said the cost of adding fellows is highly variable, as is the prospect of beginning a new fellowship program. Costs vary based on the geographic area, cost of living, demographics, facilities in place, availability of private partnerships and faculty recruitment needs; thus, no amalgamate data exist as these factors are unique to each case. 

Securing Accreditation: The Process

The process of starting an REI fellowship program is complex and requires a significant investment of time and resources. The first step is to obtain accreditation from the ACGME. A five-step journey is outlined on their website. 

This process involves submitting a detailed application with information about the program's curriculum, faculty and facilities. Once accreditation is granted, the program can begin recruiting fellows.

Step 1—Locate and Read Program Requirements and FAQs

Step 2—Locate and Save Review Committee Staff Contact Information

Step 3—Gather Information Needed to Prepare the Application

• Complete the specialty-specific application, which can be found on the Program Requirements and FAQs and Applications page of the REI specialty section of the ACGME website. 

• Provide a block diagram for each year of education in the program

• All Program Letters of Agreement for participating sites with required rotations

• Policies and procedures for resident/fellow clinical and educational work hours, including policies on moonlighting

• Policy for supervision of residents and fellows

• Establish competency-based goals and objectives for one educational experience at each educational level.

• Evaluation forms for residents/fellows, faculty, program assessors

• Semi-annual, summative and final evaluation forms

• Policy for resident/fellow and faculty member well-being 

Step 4—Initiate Application to ACGME’s Accreditation Data System

Step 5—Submit the Application

• A Letter of Notification (LoN) will be sent through ADS after the Review Committee reviews the application. 

• The LoN will detail the accreditation decision and any citations or areas for Improvement issued during the review.

• It can take four to 12 months following the submission of an application to undergo a review and receive an accreditation decision from the Review Committee. 

Viable Options for Expanding Fellows

Alvero said one option under discussion is possibly shortening the fellowship term from three years to two. However, given the rigor the programs require, this may not be an appealing choice. 

Alvero’s colleague and current president of the American Society for Reproductive Medicine, Michael A. Thomas, MD, told Inside Reproductive Health that though ASRM will look to SREI for guidance, as an REI specialist himself, moving from three years to two may be untenable. 

“In a short amount of time, it’s not just learning how to get the eggs and put the embryos back, but also learned understanding the physiology, understanding and contributing to the research,” said Thomas, professor and department chair of Obstetrics and Gynecology at the University of Cincinnati College of Medicine. “From what we know from a clinical standpoint, it takes longer than six months to contribute the research necessary to advance the field.” 

Alvero said that a second option is to secure public/private investments to support academic programs financially. 

One example is private funding from Shady Grove Fertility with publicly-held Walter Reed National Military Medical Center, intended to benefit military families. 

“The program at Shady Grove has fellows from Walter Reed from the National with support through NIH [fellowship program] so that there's a collaboration there,” he said. 

Alvero said he expects more of these collaborations to develop. 

In the interim, Thomas said he hopes more fellows will mean REI specialty services will be available to a broader audience and, promisingly, with insurance coverage to increase access to more marginalized populations. 

“The problem is you can’t just expand a program; they must be good programs. You want to make sure that you have fellows that are being trained rigorously and make sure that those fellows have the opportunity to go wherever they want [rather than limited by geography near major population centers.].”

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health.

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All external links active as of 6/8/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

Compared: Progyny, Kindbody, Carrot, and Maven as fertility benefit coverage increases 33% in two years

BY: RON SHINKMAN

According to a recently released survey by the International Foundation of Employee Benefit Plans, 40% of U.S. employers offered some form of fertility coverage last year. That’s up dramatically from 2020, when only 30% offered fertility benefits – a 33% jump in just two years. More employers now offer fertility benefits than financial assistance or paid leave for an adoption.

“We’ve been seeing family-friendly benefits like fertility coverage continue to grow as part of the larger trend of expanding work-life integration policies to be more inclusive of all employees,” said IFEBP Vice President of Content Julie Stich.  “Fertility benefits hold a high value by talent no matter their gender identity or relationship status. Providing these benefits helps nurture overall happiness and well-being.”

However, coverage can differ dramatically between employers. For example, among companies that offer fertility benefits, less than 35% cover egg harvesting or freezing services, and less than 45% cover fertility services that are not related to in vitro fertilization (IVF). There are numerous other variations along those lines.

Larger employers – those with more than a few hundred workers – often self-fund their employee medical costs and use a third-party administrator to handle claims (typically a subsidiary of a large health insurer). They may also outsource their benefits to major fertility platforms such as Progyny, Carrot or others in what are known as benefit “carveouts.” In those cases, the fertility firms usually act as a one-stop shop, offering benefits in line with the limits of coverage set by the employer, managing claims and collecting payments. Here is a breakdown of the four largest platforms:

Kindbody
Founded: 2018
Headquarters: New York City
Valuation: $1.8 billion
Locations: 27 Clinics in 21 cities in 15 states and the District of Columbia, Including New York City, Los Angeles, Atlanta and Houston
Senior Management: Gina Bartasi, Founder and Chairwoman; Angeline Beltsos, M.D., CEO, clinical operations; Annbeth Eschbach, CEO, corporate operations; Greg Poulos, President; Taryn Branca, Chief Revenue Officer
Major Employer Clients: Walmart, Lyft, Activision

Walmart, the nation’s largest company with more than 2.3 million employees, entered into a fertility benefits carveout with Kindbody last September.

“Our partnership with Walmart signals that fertility benefits have joined medical, dental, and vision as standard workplace benefits for leading employers,” said Bartasi when the deal was announced.

The pact with Walmart is an indication of how all-in-one fertility companies have grown in just a few years. Kindbody was founded only five years ago. That it was able to raise more than $281 million, according to Crunchbase, helped turbocharge its growth.

Although Kindbody does not post specifics regarding its benefits packages for employers, a recent webinar conducted by its senior management indicated that companies should curate a benefit that takes into account projected utilization by employees, medical and drug costs per cycle, and sources of direct and indirect savings.

Progyny
Founded: 2008
Headquarters: New York City
Enterprise Value: $2.7 billion
Coverage: It networks with 650 clinics and 950 physicians and clinicians
Leadership: David Schlanger, Executive Chairman; Peter Anevski, CEO; Michael Sturmer, President; Mark Livingston, Chief Financial Officer; Jennifer Bealer, General Counsel
Major Employer Clients: Detroit Pistons (NBA Team and its employees); Children’s Hospital Association

Progyny is the elder statesman of the group with its founding in 2008. Its 2022 revenue of nearly $787 million was 57% higher than 2021’s. It works with 370 corporate clients nationwide representing some 5.4 million employees, although the company has been mostly tight-lipped about its clientele. Unlike the other companies, it does not post the names and logos of its major corporate clients on its website. And the employer pacts it has announced – with an NBA team and a healthcare trade association – likely only cover a few hundred employees apiece.

Progyny and Maven were the only companies to respond to a request seeking comment for this article prior to publication. According to Progyny spokesperson Alexis Ford, the company assigns each patient an advocate “to better understand their Progyny benefit, their deductible, co-insurance, etc., since this is dependent on each employer’s health plan. The patient care advocate also provides unlimited education and is the patient’s go-to resource during the entire journey.”

Ford provided a single detail regarding Progyny’s carveouts: 90% of employers working with the company also offer their workers ProgynyRX, which includes medication coverage, next-day deliveries and access to support from pharmacists and other medication clinicians.

According to Holly Hutchison, co-owner of Reproductive Health Center in Tucson, Ariz, a carveout firm such as Progyny offers a “smart cycle.” That is specifically an egg retrieval and transfer along with anesthesia, laboratory and monitoring services. “Employers choose how many cycles they want to include in coverage, from one to five cycles,” she said.

According to Progyny’s website, an IVF procedure where one embryo is implanted and rest are tested and/or frozen represents three-quarters of a cycle. An intrauterine insemination represents one-quarter of a cycle. Egg freezing is half a cycle. A reciprocal IVF procedure involving a same-sex couple is 1.25 cycles, while a surrogacy IVF is 1.5 cycles.

Carrot Fertility
Founded: 2016
Headquarters: Menlo, Park, Calif.
Valuation: $500 million (estimated)
Locations: NA
Leadership: Tammy Sun, Founder and CEO; Ashima Ahmad, M.D., Co-Founder and Chief Medical Officer; Tim Kelly, Chief Commercial Officer; Brooke Quinn, Chief Customer Officer
Major Employer Clients: Zoom; Clif Bar; Lucid Motors (luxury electric automaker)

Carrot Fertility has raised more than $114 million since its founding, according to Crunchbase. Its $500 million valuation is an estimate made by Inside Reproductive Health based on available revenue data and multipliers for the healthcare industry.

Carrot Fertility did not respond to a request seeking comment about their company’s differentiation in the fertility space.

Maven Clinic
Headquarters: New York City
Founded: 2014
Valuation: $1.35 billion
Locations: NA
Leadership: Katherine Ryder, Founder and CEO; Kalliope White, Chief of Staff
Major Employer Clients: Snap, Bumble, Sanofi, Booz Allen Hamilton

A Maven spokesperson said the company offers “typical” carveouts, but did not provide specifics. 

Maven has raised more than $292 million since its founding, according to Crunchbase.

Carveouts Provide More Guidance Than Traditional Insurance Companies

Despite the dramatic increase in fertility benefits from employers, there are still no standardized guidelines mandated by nationwide governmental bodies such as the U.S. Department of Health and Human Services. As a result, fertility benefits and carveout structures vary from company to company.

“The coverage will vary depending on the employer and which fertility benefit management group they choose,” said Hutchison. State mandates on fertility benefits also play a role, she added. Hutchison estimated that about 45% of its patients currently have some form of insurance coverage. “They all have co-payments and deductibles and out of pocket amounts that apply prior to the coverage kicking in,” she added.

David Stern, the chief executive officer of Boston IVF – which operates 18 fertility clinics in six states – observed that most employees receive minimal guidance regarding their fertility benefits.

“You might have fertility coverage and IVF coverage, but the employee is told by their insurer ‘you’ve got to figure out yourself,’” he said. That puts enrollees at risk of using up their benefits on unneeded testing and procedures before they even start IVF, Stern added.

By contrast, carveouts can provide direction to health plan enrollees. According to Stern, one of the most important parts of a carveout is that fertility platform companies can provide care managers “who will talk to you about what the process is and what it looks like.” Boston IVF is a network provider for several major fertility benefits companies , including Progyny, Maven, Carrot and Stork Club Fertility, according to Stern.
 

Controlling Unexpected Costs

Stern noted that many platforms also emphasize “centers of excellence” models where they only refer patients to clinics with the highest standards and outcomes. This not only helps with success rates, but can also protect the employer, which may rely on rigorous standards to avoid multiple births. A triplet birth, even if all are healthy, can cost a self-insured company more than seven times the cost of a single birth, Stern said. As a result, he observed that many carveout arrangements specify only one embryo transfer at a time may be attempted for an IVF or similar procedure. Currently, about 95% of Boston IVF’s procedures are comprised of only a single transfer, according to Stern.

Whether employers offer carveouts or not, most coverage Stern sees from companies is minimal.

“You can go to a doctor and you can be seen by a specialist, but they don’t pay for medication or treatment,” he said.

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

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All external links active as of 4/20/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

Natera revenue over $800 million, net loss almost $600 million for 2022

BY: NATASHA SPENCER

On 28th February 2023, the US clinical genetic testing company released its full-year financial results for 2022, which include information on milestones achieved in 2022 and early 2023 and its financial statements. 

Net loss increase

Natera’s net loss increased to over half a billion dollars, reaching $547.8 million for the full year in 2022, compared to a net loss of $471.7 million in 2021 and 229.7 million in 2020. On the newly-released earnings call, a spokesperson for Natera told Inside Reproductive Health: “The company reiterated its goal of hitting a cash flow breakeven quarter in 2024.”

Despite these losses, Natera reported cash reserves, cash equivalents, short-term investments and restricted cash totaling approximately $898.4 million at the end of 2022, compared to $914.5 million at the end of 2021. 

As of 31st December 2022, the company had a total outstanding debt balance of $362 million. The amount comprises $80.4 million including accrued interest from its credit line with investment bank, UBS, along with a gross outstanding balance of $287.5 million under its seven-year convertible senior notes, which it received in April 2020. 

Total revenue projections

In 2023, Natera’s total revenue guidance is between $980 million- $1 billion. If Natera reaches this projected revenue, it is expected to reduce cash burn—the rate a company loses money—by approximately $150 million in 2023. 

“Our guidance for 2023 reflects our expectations for robust top-line growth as we reduce operating expenses and continue to position the company for ongoing success,” said Natera’s CEO, Steve Chapman. The company’s increased operating expenses were primarily due to growing its headcount, it reports, to support new product offerings.

Natera’s total operating expenses increased by 16.7% in 2022 year-on-year, amid its changing product portfolio, increased labor, and overhead costs. In 2023, Natera will focus on lowering these total operating expenses to achieve its projected targets.

The company anticipates its 2023 gross margin to be approximately 41% to 44% of revenues. Natera’s selling, general and administrative costs are estimated to reach approximately $510-$540 million in 2023; research and development (R&D) costs are projected at $325-$345 million, and net cash consumption is expected to be between $300-$325 million.

Revenue is up, gross profit margin is down

Speaking to Inside Reproductive Health, Natera provided information on the company’s revenue breakdown. Natera generated total revenues over the last three years of $820.2 million in 2022, $625.5 million in 2021, and $391.0 million in 2020.

The company’s gross profit equaled $364.0 million in 2022, $307.1 million in 2021, and $187.4 million in 2020, representing a gross margin of 44.4%, 49.1%, and 48%, respectively. While Natera’s gross revenue and gross profit are up, the company’s gross margin has dropped by 4.7% year-on-year.  

In 2022, medical device provider for women’s healthcare, Cooper Surgical, also saw a drop in its gross margin, decreasing from 67% in the fiscal year 2021 to 65% in 2022. The company stated that this was driven mainly by currency. 

It was also a similar story at science and technology company Merck, which saw its gross margin decline from 72.0% in 2021 to 70.6% in 2022. Merck said this decrease is primarily due to higher amortization of intangible assets, along with increased sales of the oral antiviral medicine Lagevrio and revenue from third-party manufacturing arrangements, both of which have lower gross margins.

Natera cited its changing product mix, increased labor, and overhead costs as the primary reasons behind its lower margins in 2022. Volume growth and customer support drove these, as well as one-time revenue of £28.6 million recognized from its Qiagen arrangement in 2021. Natera saw a year-over-year volume improvement of 31.6% in 2022, the company’s spokesperson shares.

No fertility services breakdown

When asked, Natera was unable to detail how much of the revenue and net income comes from fertility-related services. “We don’t break out revenues or other financials by product,” Natera’s spokesperson confirmed. 

Currently, the company’s fertility-related product portfolio includes Spectrum, a preimplantation genetic test, Anora, a miscarriage test, and Horizon, a carrier screening test. 

New board member 

Natera announced that Ruth E. Williams-Brinkley is joining its board of directors, growing its total board members to ten, effective in the position from 2nd March 2023.

As the current president of Kaiser Permanente Health Plan of the Mid-Atlantic States (KPMAS), a position Williams-Brinkley will continue to hold, the healthcare executive oversees the company’s care delivery and health plan operations.

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

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All external links active as of 3/9/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

After End of Ferring License Deal, INVO Bioscience Moves to Acquire Fertility Practices

BY: RON SHINKMAN

In a bid to gain traction with its intravaginal device for IVF patients, INVO Bioscience has modified its business strategy to focus on acquiring freestanding fertility practices.

For the first nine months of 2022, INVO reported a loss of $8.1 million on revenue of $544,000. By contrast, the company lost $6.8 million on revenue of $1.1 million during the first nine months of 2021.

INVO has had to refocus its business strategy after a distribution deal with Ferring Pharmaceuticals ended in late 2021. Ferring had issues convincing physicians at busy practices to bring its products on board, INVO Chief Executive Officer, Steve Shum, said in an interview with Inside Reproductive Health.

“For a medical practice operator that is generally running at 100% of capacity or close to it, the idea of bringing in a completely new treatment methodology leads to the question ‘why? Why do it if nothing is broken?’” Shum said.

Nevertheless, soon after the Ferring pact began in 2019, it immediately became one of INVO’s leading sources of revenue. In the last year of the agreement, $3.6 million of INVO’s $4.1 million in revenue came from Ferring’s licensing fees. 

By comparison, INVO reported revenue of just $544,054 for the first nine months of 2022. Nearly $395,000 of that revenue came from INVO’s branded clinics in Georgia, Alabama and Monterrey, Mexico, which are operated in joint venture with existing fertility practices. Less than $150,000 was derived from direct product sales. 

“We see quite a few smaller practices that have one to two or maybe three physician operators, and we think that's the right sort of size practice for us to entertain potential acquisitions,” Shum said. 

The Sarasota, Fla.-based INVO is close to completing its first acquisition, which involves what Shum described as a “great practice” in an area of the U.S. he declined to disclose. 

“It’s been around for quite a while, it does good business and it’s nicely profitable,” Shum said. “It has a good reputation in the area, which is important. So, we’re excited about it.” He later added that he hoped to announce specifics of the acquisition when the company releases 2022 year-end earnings, likely sometime next month.

Shum discussed the new strategy during the company’s third-quarter earnings call in November, and suggested there may be as many 100 clinics nationwide with annual revenue of $1.5 million to $6 million that could be purchase targets.

John Heerdink, managing partner of Vista Partners, a San Francisco-based investment management firm, noted during the earnings call that “If you tucked in one, two or three of these (practices), you would reach breakeven (or) profitability very quickly.”

A Ferring spokesperson did not respond to a request seeking comment on the agreement’s end. Shum said that the company looked for similar distribution deals with other firms, but that there has not been any success as of yet.

Shum noted that the cash-pay policies of many fertility practices and the INVO product may be at odds. According to INVO, the average cycle with its product runs $5,000 to $8,000, versus $12,000 to $15,000 for a traditional round of IVF, although both have similar chances for success. Although the lower cost may be attractive to clients, selling it to clinicians who rely almost exclusively on cash-paying patients bred a fear they may “cannibalize” their own revenue streams, Shum said.

By acquiring its own practices, INVO is able to provide its products to patients directly. Shum noted INVO would also provide administrative and other forms of support to the practices it intends to acquire. It plans to keep the practicing physicians and other staff in place.

INVO has plans to open as many as 20 joint venture clinics in the U.S., with plans to open new sites in Tampa and Kansas City soon. It is also offering its products in Malaysia and Spain, with plans pending to enter the Chinese and Indonesian markets.

Shum did not immediately respond to a follow up request to describe how the acquisition strategy will be funded. Shum noted that the company has identified and executed a letter of intent for specific funding to close the acquisition, but has not released any other details.

INVO has raised $1.025 million since late 2022 for general business purposes, according to recent filings with the Securities and Exchange Commission. That came from the issuance of $500,000 in debentures, $275,000 in unsecured convertible notes and even $250,000 chipped in by Shum and Andrea Goran, the company’s chief financial officer, along with the latter’s colleagues. 

Regardless, the practice acquisitions will be a linchpin of INVO’s business moving forward. “We’re definitely going to work to try to find additional acquisitions this year and beyond, so it will become an ongoing part of our strategy,” Shum said. “But I would say right now we have a very intense focus on completing this first (transaction).”

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

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All external links active as of 3/2/23.

External links are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by Fertility Bridge or Inside Reproductive Health of any of the products, services or opinions of the corporation or organization or individual. Neither Fertility Bridge nor Inside Reproductive Health bears responsibility for the accuracy, legality or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content.

Profit Down for 11 of 12 Publicly Traded Fertility Companies

This News Digest Brought to You by
BUNDL

BY: RACHEL LELAND

At least 12 publicly traded companies have multi-million dollar divisions, or their entire corporate focus, in the reproductive health space. 

The companies have different fiscal years. Some ended their 2022 fiscal year last summer. Most will not until the end of March 2023. In their most recent quarterly or annual reports, only one company, Jinxin Fertility Group which owns HRC Fertility, reported a gain in net profit. Inside Reproductive Health indicates the reporting periods below.

Jinxin Fertility Group
According to Jinxin Fertility Group’s half-year earnings report, the company experienced a 27.8% increase in gross profit, jumping from ¥363.2 million in June 2021 to ¥464.3 million the same month in 2022. In the same period, the company’s total revenue climbed from ¥859.3 million to ¥1.1 billion, a jump of 32.5%. The Group’s net profit bumped from ¥162.6 million to ¥187.6 million, a 15.4% climb. Jinxin Fertility Group is listed on The Stock Exchange of Hong Kong Limited. 

Femasys
Femasys’ third-quarter report shows that the company’s gross sales jumped 24.7% from $105,403 to $131,451 from Q320, largely due to the increase in U.S. FemVue sales. The report flagged the company’s YoY revenue up 28.89% from $269,580 to $347,460. Their income statement reports an $8.5 million net loss for the first three fiscal quarters of 2022. Femasys is listed on the NASDAQ.

Cryoport 
According to Cryoport’s third-quarter report, revenue from the company’s reproductive medicine  increased to $7.6 million, a gain of 15% or $1.0 million compared to the same period in 2021. The report noted that the increase was driven by strong demand for the company’s CryoStork solutions as well as new international fertility clinic partnerships. YoY net loss attributable to common stockholders was $33.9 million, or $0.69 per share, for the nine-month period ending in September 2022. Cryoport is listed on the NASDAQ.

Hamilton Thorne 
According to Hamilton Thorne’s third-quarter report, YoY gross profit increased a total of 11.8% from $18.2 to $20.4 million. Year over year sales increased 14% to $41.8 million. Hamilton Thorne’s net income dropped 41.8% from $1.6 million to $930,000. Hamilton Thorne is publicly traded on the Toronto Venture Exchange.

Monash IVF
Monash IVF’s group revenue grew 4.7% from AU$183.6 million to AU$192.3 million. 26,22236,200 Their net profit for fiscal year 2022, which ended June 30 of the same year, decreased from 2021’s AU$36.2 million to $26.2 million, a drop of 27.6%. Monash IVF is publicly traded on the Australian Securities Exchange. 

Natera
According to Natera’s third-quarter report, gross profit for the third quarter in 2022 and 2021 were $94.1 million and $76.7 million, respectively, representing a gross margin of 44.7% and 48.5%, respectively. The company’s total revenue climbed from $452.4 million in 2021 to $602.9 million, a 33.2% increase. Natera reported a net loss for the third quarter of 2022 of $121.5 million, or ($1.25) per diluted share, compared to a net loss of $151.3 million, or ($1.63) per diluted share, for the same period in 2021.

EMD Serono
Merck KGaA is publicly traded on the Frankfurt Stock Exchange and the Xetra Stock Exchange.In the United States and Canada, Merck operates as EMD Serono in the healthcare business. According to Merck’s third quarter report, fertility sales grew 6.2% from €1.003 billion to €1.066 billion. The company’s healthcare specific income loss was substantial, dropping to € –133 million from € 129 million in 2021.

Organon
According to Organon’s third quarter report, the company’s gross profit in 2022 of $991 million was close to last year’s gross profit of $986 million. Total net revenues were $1,537 million for the third quarter of 2022, a decrease of 4% as-reported and an increase of 3% excluding the impact of foreign currency, compared with the third quarter of 2021. Net income from continuing operations for the third quarter of 2022 was $227 million, or $0.89 per diluted share, compared with $323 million, or $1.27 per diluted share, in the third quarter of 2021. According to the report, Follistim AQ (follitropin beta injection), increased 2% ex-FX in the third quarter of 2022, and ganirelix acetate injection increased 52% ex-FX. Organon is publicly traded on the New York Stock Exchange. 

INVO Bioscience 
According to INVO Bioscience’s third-quarter earnings report, revenue decreased by more than 87% following the termination of the company’s license with Ferring Pharmaceuticals on January 31, 2022. Gross profit for the YoY third quarter also dropped by 36% from $198,456 to $126,205. In the third quarter, INVO had a net loss of $2.5 million. INVO Bioscience is listed on the NASDAQ.

Cooper Surgical
In its fourth quarterly report, CooperSurgical, a subsidiary of CooperCompanies, saw revenue up 35% to $277.1 million. YoY gross profit for the entire CooperCompanies climbed from $1.95 billion to $2.14 billion, 9.4%. All in all, CooperCompanies’ net income fell by 86.9% from $2.94 billion to $385 million. Cooper Companies is traded on the New York Stock Exchange. 

Myovant Sciences
In its third-quarter earnings report, Myovant Sciences showed its cumulative total revenue for 2022 reached $321.5 million surpassing the previous year’s total of $173.4 million by 85%. Net loss for the Q3 2022 was $57.6 million compared to $63.4 million for the same period a year ago. Myovant Sciences is traded on the New York Stock Exchange. 

Progyny
In its third-quarter report, Progyny, reported a 53% year-over-year growth increase to $572.5 million from $373 million. The company’s gross profit was $122.8 million, an increase of 41% from the $87 million reported in 2021. Finally, net income was $26.9 million, a decrease of 46.8% from last year’s $50.6 million. Progyny is listed on the NASDAQ.

Pete Anevski, Chief Executive Officer at Progyny attributes the biggest driver of demand for fertility benefits to need and increased interest among millennials, the largest demographic in today’s workforce.

“Traditional insurance plans attempt to control the cost of care by restricting utilization with dollar maximums, step therapies, prior authorizations, and treatment exclusions. Their approach results in low live-birth rates and high-cost, high-risk pregnancies and multiple births, which negatively impact employers and their members,” Anevski said. 

The themes reported in this publication are those of the news. They do not reflect the views of Inside Reproductive Health, nor of the Advertiser

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