Err...you know me, I try and stay on the conservative side...if the estimates are 32 million for the USA, I never take that, I'll always take a smaller subset...
But have a read of this one....The Arthritis Foundation of America is a very reputable source. I don't also need to re-introduce Dr D Felson, world Key Opinion Leader in the OA space.
----- Posted 11/July/2020 ------------------ THE NUMBERS ARE WRONG!
h no...what's this all about? What is Mozzarc on about now, is this something we all need to be concerned with?
Ok firstly apologies for the somewhat sensationalist header but trust me, when you are finished reading this post you will agree with me that this post DESERVED such a graphic title! I believe this post will be up there with some of the ones I have had the most joy in compiling and writing, it was a real discovery. Before I scare any of you too much with the title of this post, don't worry, this is a positive post! It contains good information about what we own...though it came to me as ashockwhen I saw it earlier last week.
Paradigmers, I have always been led to believe that OA is a massive problem and this post here tonight brings you nothing to refute this, what then is ol' Mozz harping on about?
Let me present the topics we shall cover tonight:
INTRODUCTION
Paradigmers the numbers are just not right, there is a mistake! Now before we get to that, the revised numbers aren't coming from me! They come from one of the most credible and Mozz trustworthy sources that I know of, which we will soon get to.
Ok here is the Mozz Money Line®: The number of people in the USA with OA is NOT 31 million! It's been revised.
MOZZ ! If you are going to post here that it is something dumb like 31.4 million instead of the previously thought 31 million, you are going to fall a few rungs down on my HC Best Poster's ladder list (or indeed right off the bloomin' ladder)...better yet I’m going to throw you intoPool-Chief’spool and I'm revoking your free drinks card and a couple of them fancy cucumber and salmon sandwiches (ooh don't they sound delightful with a glass of his medium shelf red wine) that I was going to shout you when we are next allowed to go to the pub (Yes I'm a Victorian!) that will be in 2025 at this rate.
Mozz falling off the esteemed HC poster's ladder of fame? Nahh not today at least - the number change is significant though...read on!
CURRENT NUMBERS
Paradigmers, it's not a secret that the current numbers of OA in the US arehuge...31 million is a large amount. Again, I'm not saying we are going to tackle each and every one of them. New guys, there are varying degrees of relief our drug delivers with the best stratum occurring in the 4 to 6 band on the scale of pain. However, all pain stratum experience pain relief with a high 90% of the cohort getting some relief...yes unfortunately there are a few that don't find any relief. Again this will come more to light with the much larger numbers in the Phase 3 with some 1150 candidates that starts at the end of this year.
WHO IS CAGR AND HOW IS HE RELATED TO US?
As a primer for where I'm going with this, CAGR simply stands for Compound Annual Growth Rate. Simply speaking it is a percentage measure of what the annual rate of return has to be to go from the beginning through to the end of a given time frame. Err Mozzie Speak? Well let's say we started in 2015 with I dunno...a price of 35 cents...hint hint...and today we ummm are at $3.16 ...well let's use a formula!...
CAGR formula
It looks complicated but we have all the data so let's feed it in:
V(t0) = Initial Price of share = $0.35 V(tn) = The end value = $3.16 tn- t0= The number of years over the period = 2020 - 2015 = 5
Chuck all that into the formula and you get:
Rightio...now my dad was a great Year 11/12 Chemistry and Biology Teacher and he was good at maths in the day, he always taught me to get the answer and plug it back into the question to double check....so let's do that...
Ok so that checks out...what this means that so far since inception (IPO), we have managed to achieve a more then decent 56% CAGR so far on our share price!
Paradigmers, finally when all is said and done, a good story must involve Growth! It's not enough to have good sales in the present moment, the market is always forward looking..forward thinking..forward anticipating. Yes things might be good now..but the market wants more...it wants to know that future prospects look good and that there are other dishes we can cook up later on.
WHAT IS THE FORECASTED GROWTH?
Of What? Our own SP? Mate I have no idea what it will in next month let alone further down the track, you tell me... perhaps my answer would be -A LOT!
But I can tell you what the annual CAGR rate is forecasted to be for OA.. 8.1%Now current inflation runs here in Aussie at about 2%...it's prob a fraction lower at the moment, and the longer term average is prob more closer than 3%...so let's call it 2.5%...this means if you, over the longer term, are achieving greater than 3% you are staying ahead of the curve. Your money is increasing in real terms. Paradigmers what we want is a business to invest in whereby our revenue will increase at a greater rate than just inflation otherwise in real terms we are going backwards.
Of course this will only be an issue if all we had was OA and once our revenue matures, which wouldn't be for a number of years. This may all be quite academic once we start other indications some time off in the future. A bit like a jet (No 'R' words here), we have a very steep initial trajectory of growth to come once we are approved.
The thing that excites me is that OA is big...MPS is significant...but think of all the future indications we might tackle....vast.
So why is OA growing at such a high rate, 8.1% is quite high? A few reasons:
1) Aging population with increased life expectancy
2) A more sedentary lifestyle, yes we are getting lazier with the advent of machinery to do a lot of the work for us and a lot of us are doing office jobs and not exercising as much...
SO WHAT IS WRONG?
I always thought OA was around 31 million in the USA...Well in 2015 the numbers were revised to "54.4 Million adults in the USA"1It's a massive number by any scale...by any measure. So what is the problem then , what numbers are wrong?
My dear reader. I give you just one number to digest 91.2
What?
There is a typo, right? I tell you my eyes popped out when I read it and I went and read the article not once but twice! It’s not just a musing...it’s not just a speculative paragraph in an offhand publication..this isn't some Back Alley operator that ain't so good with their numbers...guess what the source of this info is.....no really...try and guess...
Would you believe it’s a cited publication by Dr D Felson!?!
Dr Felson at the end of 2017 believes this number to be a MASSIVE 68% higher than previously thought....in other words some 91.2 Million! 91.2 million is almost 3 times what I thought the number of OA patients were in the US....that's astounding. Now Paradigmers, you know I love researching PAR and discovering more about the wonderful drug and the wonderful company that you and I own. When I get a fact from the Great Dr himself I trust it...but to read thisagainin a separate source adds more weight and this secondary source of info is also very well respected and a renowned source. The secondary source? The Arthritis Foundation of America....in fact, well let me not type it...let me show it to you2:
A secondary source for this incredulously huge number...
HOW? HOW DID THIS GO WRONG?
Even if you aren't great with numbers, you can see there is more than a simple difference between 31 million and some 91-92 million!!..it's a factor of 3!So just how could they get it so wrong at such scale? Here is the answer. Paradigmers, for years we have relied on the 31 million figure...A single survey, relies on a simple question, have you had doc diagnosed arthritis? "Half the true cases are missed".3
In the survey that was conducted over a large sample size of some 34,000 people, there were primarily three main questions. The first one was: "Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus or fibromyagia"? This was one of the primary flush out questions. If you were in pain, you had arthritis but you hadn't been doctor diagnosed...you were counted as a NO to arthritis. This survey has been the primary survey used to compile the NATIONAL figures for OA prevalence across the USA...it is how they came up with an estimated 31 million.
As a secondary flaw...a second question asked this: "The next questions refer to your joints. Please do not include the back or neck. During the past 30 days, have you had any symptoms of pain, aching, or stiffness in or around a joint?”. The flaw was the fact that there were some 2,242 men and some 2,294 women, totalling some 4,536 out of a total of 33,762 total respondents that responded "Yes" to the question of chronic joint symptoms BUT responded "NO" to the question of whether they had ever received a diagnosis of arthritis from a doctor. This means that some 13.4% of respondents were NOT included in the population and this contributed to the under reporting of figures at a national level.
Amazing.
"The change in number is most acute in the under 65 years of age". WHY? Because most people that were above the age of 65 and took the sample survey had indeed had Doc Diagnosed OA...it's the younger groups below this age that hadn't necessary gone to the doc before specifically to be diagnosed as having OA. They just had the symptoms ! So they weren't included in the Doc Diagnosed figures which paints the national picture.
QUESTION: For people aged 18 to 64...how many have OA...whether they know it or not, whether they have had a doc confirm it?
A) 1 in 30
B) 1 in 21?
C) 1 in 11
Yeah you know the answer ain't any of those...Paradigmers....it's a frightening 1 in 3!!!3...OA is not just an older person's affliction.
Want more? Yes here is another factoid- "By conservative estimates, between 2002-2014, almost two-thirds (64 percent) of adults with doctor-diagnosed arthritis were younger than 65 years old".4There are other studies that noted a marked increase in the rate of knee and hip replacements in the age group of 45-64 and this is also one of the groups where the numbers previously recorded are wrong. Not only that but OA of the knee featured heavily in the sample but for other joints not so much. In fact the nature of the survey led to this error.
The Survey simply asked if you have had doc diagnosed OA. It asksnothingof joints, ie to try and investigate if you just have OA of the shoulder...or in the wrist...etc...thus "resulting in the misclassification of nearly one-half and one-third of subjects" in the two age groups namely 45-64 and > 65 respectively. In other words "chronic joint symptoms have not been used in combination with doctor‐diagnosed arthritis to derive national estimates of arthritis prevalence".
YEAH KINDA NEED PROOF NOW
Mozz, this is kinda like going back to an unsolved murder, using a new tech like DNA matching and then finding out who dunnit years later. Jeepers, I reckon with this post I've earn't my Snoopy Dog with Magnifying glass Avatar. Ok great Mozz...hand me over the evidence.... Take a look at Reference 1...it's a bit of a read but you can just read the paragraph under the Results section...mind blowing.
IS THIS REALLY ALL THAT BIG?
Now I know some of you may think, C'mon Mozz mate...who really cares, it's all just estimates..30 mil...90 mil...whatever...I would refute this...it doesn't matter what we were going to attract in terms of future patients when the estimates were 31 mil...whatever that fig...be it a conservative 1 million...be it a more realistic 3 million...be it an optimistic 5 million...all of those numbers just tripled with the fact that the presence of OA is actually a lot more than first thought. This does not take into consideration any extra growth (CAGR)...or area..(UK..Europe...Japan...ROW).You decide how big this actually is.
A REVISED FORECAST
Mate, in all my calcs...I use conservative figs...I use a total OA pop of 31 million, I say that we could only ever treat 20% of them as they fall into the best iPPS treatable strata (though all strata would get some benefit from our drug and yes, there unfortunately may be up to 10 or 15% overall that get NO relief no matter what stratum of pain they are in).
My thinking, of this sub group we would only ever treat maybe 40% as they would have insurance or access to a Doc or be bothered to work out how to stop their pain in a safer and better way. So that's: 31,000,000 x 20% x 40% = 2.48 million...multiply this out by a conservative $2500 and we are in the Billions.
That's just for USA...that's just for OA.NOW you tell me that the underlying number is 90 ODD MILLION...that's a 3 x increase without me having to do anything ....We now go from around 7.4 Billion to 21 Billion? I'm not saying it's going to be next month or next year...it will take some time for this to play out...what I am saying is that the potential was big anyway...it's now somewhat bigger! With just a measly 20% royalty on a crazy 21 BILLION USD...for ONLY OA and ONLY USA? Mate...now tell me there isn't at least a decent chance of a very bright future.
Do two things for me:
1. Hold at least some shares for ten years...promise me...yes you can sell along the way...you can pay back your cost of capital..you can crystalise some profits and buy that RV, err upgrade your tent... yes yes Pool_Lord, update your Volvo (oh shaddap) ...but seriously, hold even just 5% of your holding forever, I really can't see you regretting it. (Not advice, you must plan and seek your own independent advice, I'm not licensed). Seriously, whatever you have as of this day...earmark 5% and say this is not moving...give it to your wife...give it to your sister, anyone you trust with your life...and throw away the key...write it in your will...put it in the safe...heck keep it in the beer freezer in the garage.
2. Vote No if we get a tiny take over deal for $2 Billion USD (That's just a random example, I think we'd have to say no at even 3 times this figure)(We want a Distribution Deal, NOT a Take Over deal). If this happens and we must band together. We will be throwing the baby out with the bathwater if we say yes at too low a price..we must protect the baby...
Don't do it...just hold on tight.
YOU LOOK LIKE YOU ARE NEW?
New guys, a warm welcome..I can easily and confidently say you are lucky to have discovered us. Feel free to post a little blurb about yourself and how you came across your investment in PAR in the following thread, started by the wonderfulPharmD, many thanks to him for initiating this one. Simply click on the link below:
AsFree2napmentioned recently, there will not only be new users reading about us but the prospects of large, and I mean VERY large Instos will and have started digging into us. They are coming Paradigmers...and when they get convinced...they will buy...you may not see many of these intra-day block trades...but be sure our volumes will go up...these guys are not like retail...they have teams of analysts, they will allocate much time and energy...they will buy up big before a lot of us even know it's happened. All of a sudden you will find the very nature of our register is different. Whether it be JP Morgan...Morgan Stanley..it might be Citi Group...it could be GS and so many other NY Bank of Mellon type institutions...there will be many with US heritage that will want a representation of us...and I'm not talking a few thousand shares here and there.
A lot will seriously start looking at us after 2 major events: 1) Upcoming EAP data release 2) Start of IND for OA
...it will be a wake up call for many.
If any one is reading this from any of those investment houses...there is so much to be learnt about the molecule called PPS!
New guys, what we have is not only compelling..it is in my humblest opinion, unique...rare...and its dam* hard to copy/replicate. A bit like that guy that stumbled over the Welcome Stranger nugget...it's been just under the surface...in front of humankind's noses for so long but no one has bothered pick it up or test it..trial it and run with it. We are that company...we are at the forefront in my views. Enjoy the run...it won't be over-night...but we are on an amazing path.
Oh I can't resist, here is the story, I'm sure there are at least 20% of you that don't know about it..specially the ones from O'seas may not...I'll keep it short, I promise!
THE 3 CENTIMETRE STORY
A massive find! I reckon the nugget of PAR is somewhat bigger... how many people in the world know about us right now....hardly a drop.
Anyway, new guys and others, I was stoked, stumbling across this David Felson read that was the backdrop for this post...I cannot get enough of him!
CONCLUSION
The ocean is vast...I take an Options Trading cruise once every two years, most likely I will not be able to go this year which I'm very cut about. I usually go alone, though the second time I took my eldest son and he loved it. (Not the Options seminar , the social scene and myriad of things you can do on a cruise!). Anyway when I have a rare free moment on ship I stare out my balcony and for tens of minutes there is nothing but water...for miles and miles and miles....This is the very same vastness of the sheer number of people we may just one day address.
Paradigmers do you know what you own....I say this from time to time...but sit back for a sec...think of just how many people are in pain whether it be to OA...MPS...Heart Failure...Torn ACL's or Ross River Fever..the list actually does go on...Yes excitingly for us the numbers have been revised by some very credible sources, I will perhaps continue to use the old conservative Mozz figs in my own personal calculations but at the back of my mind I can vaguely start to imagine just how vast the pain realm is ... I at least am starting to know what I truly own, do you?
DISCLAIMERS
Many large figures being thrown around here...must do your own research...our story looks promising but we know not of future hurdles and as others have commented, it most likely won't be a straight up path...there will be dips and bumps and we need to be patient...I reckon our CAGR for the SP has done well so far but I reckon there is more to come, but it is just my personal opinion finally.