Minimally Invasive Devices Will Capture Expanding Sleep Market

Key Takeaways

• Genio's unique features and focused U.S. rollout strategy could enable rapid market share gains, higher utilization, and sustained margin expansion.
  
• Nyxoah is positioned to benefit from global OSA diagnosis trends and expanding patient eligibility, driving long-term revenue growth above market expectations.
  
• Heavy reliance on a single core product and uncertainties in regulatory, legal, and reimbursement processes create significant risks to sustained revenue growth and profitability.

Catalysts

A medical technology company, develops and commercializes solutions to treat obstructive sleep apnea (OSA).

• Analyst consensus sees FDA approval and initial U.S. launch as a meaningful revenue catalyst, but this view likely underestimates just how rapidly Genio's unique bilateral stimulation and favorable label differentiation (including non-contraindication for CCC and positional OSA) could allow Nyxoah to capture dominant share in high-volume implant centers, potentially accelerating top-line growth well beyond expectations over the next 18-24 months.
  
• While consensus expects strong U.S. commercial execution from the new sales team, the company's highly focused two-pronged rollout and innovative onboarding requirement-training only those physicians who bring a ready pipeline of eligible patients-could lead to both faster account activation and higher initial utilization rates, driving better-than-forecast operating leverage and gross margins as the commercial footprint scales.
  
• Nyxoah stands to disproportionately benefit from the dramatic global increase in OSA diagnoses, driven by an aging population and heightened public and policymaker focus on sleep health, positioning Genio for long-term revenue compounding far above market growth rates as new patient pools are unlocked.
  
• The rise of GLP-1 therapies is poised to expand the eligible Genio addressable market, as more high-BMI OSA patients are brought into Genio's proven efficacy range rather than excluded, setting up an inflection in patient volumes and revenue potential that is not yet recognized in the financials or consensus models.
  
• As minimally invasive, patient-friendly medical devices become the standard of care-and with Genio's single-incision, MRI-compatible design-Nyxoah could not only achieve higher price realization relative to CPAP alternatives but also command premium pricing in international markets, resulting in significant long-term margin and earnings expansion as adoption broadens.

Nyxoah Future Earnings and Revenue Growth

Assumptions

• This narrative explores a more optimistic perspective on Nyxoah compared to the consensus, based on a Fair Value that aligns with the bullish cohort of analysts.
• The bullish analysts are assuming Nyxoah's revenue will grow by 194.5% annually over the next 3 years.
• Even the bullish analysts are not forecasting that Nyxoah will become profitable in next 3 years. To represent the Analyst Price Target as a Future PE Valuation we will estimate Nyxoah's profit margin will increase from -1564.9% to the average BE Medical Equipment industry of 4.0% in 3 years.
• If Nyxoah's profit margin were to converge on the industry average, you could expect earnings to reach €5.1 million (and earnings per share of €0.11) by about August 2028, up from €-77.2 million today. The analysts are largely in agreement about this estimate.
• In order for the above numbers to justify the price target of the more bullish analyst cohort, the company would need to trade at a PE ratio of 201.2x on those 2028 earnings, up from -2.6x today. This future PE is greater than the current PE for the BE Medical Equipment industry at 38.9x.
• Analysts expect the number of shares outstanding to grow by 7.0% per year for the next 3 years.
• To value all of this in today's terms, we will use a discount rate of 6.99%, as per the Simply Wall St company report.

Nyxoah Future Earnings Per Share Growth

Risks

• Nyxoah faces high regulatory scrutiny and unpredictable approval timelines, especially for new indications like CCC, which could slow product launches and inflate development costs, negatively affecting its ability to expand revenue and compressing net margins in the long run.
  
• The company's dependence on a single core product, the Genio system, creates concentrated revenue risk; if Genio adoption slows due to emerging non-invasive technologies or unexpected clinical results in next-generation studies, future revenue growth may stall.
  
• Persistent and rising SG&A costs, along with high ongoing investments in R&D and legal expenses such as the current patent litigation with Inspire Medical, could outpace revenue gains and extend operating losses, thereby pressuring both net margins and earnings for several years.
  
• Intensifying competition from established medical device firms with deeper commercial infrastructure and more diversified portfolios may lead to pricing pressure, reduced market share, and difficulty maintaining premium pricing, all of which threaten long-term revenue and gross margin expansion.
  
• Extended and inconsistent timelines for value analysis committee and payor approvals, together with the risk of unfavorable coverage or pricing decisions due to global cost-containment trends, may delay U.S. and international commercialization, slowing revenue ramp and potentially restricting earnings growth.

Valuation

• The assumed bullish price target for Nyxoah is €18.6, which is the highest price target estimate amongst analysts. This valuation is based on what can be assumed as the expectations of Nyxoah's future earnings growth, profit margins and other risk factors from analysts on the bullish end of the spectrum.
  
• However, there is a degree of disagreement amongst analysts, with the most bullish reporting a price target of €18.6, and the most bearish reporting a price target of just €6.0.
  
• In order for you to agree with the bullish analysts, you'd need to believe that by 2028, revenues will be €126.0 million, earnings will come to €5.1 million, and it would be trading on a PE ratio of 201.2x, assuming you use a discount rate of 7.0%.
  
• Given the current share price of €5.44, the bullish analyst price target of €18.6 is 70.8% higher.
  
• We always encourage you to reach your own conclusions though. So sense check these analyst numbers against your own assumptions and expectations based on your understanding of the business and what you believe is probable.