# Envizion Medical Financial Model Medical device company providing a real-time navigation system (ENvue) to guide feeding tube placement and prevent dangerous lung misplacements. - Canonical: https://finamodel.com/startups/envizion-medical - Excel download: https://finamodel.com/startup-models/envizion-medical.xlsx - Category: Health-tech - Model type: SaaS ARR / Valuation - Funding round: Series A - Funding: $18M - Founded: 2020 - Geography: Israel HQ (R&D), US commercial presence (national sales team). FDA 510(k) cleared Feb 2019 [DECK, slide 8]. - Customer: B2B2C ## About the company Envizion Medical provides ENvue, a real-time navigation system for feeding-tube placement designed to prevent dangerous lung misplacements. It gives hospitals a safer, more certain workflow for a common clinical procedure. The navigation unit is expected to be placed or loaned to hospitals, with recurring revenue generated by single-use feeding tubes billed monthly. A national agreement with a major private healthcare system supports the installed-base commercial strategy. The model should forecast hospitals onboarded, units placed, tube procedures per hospital, consumable price, and reorder cadence. Device placement cost, manufacturing, sales, regulatory, and hospital implementation costs should remain separate from recurring consumable margin. ## What's included - 5-year monthly revenue build with stage-appropriate growth assumptions - Full P&L, headcount plan, and operating-expense schedule - Cash-flow statement, runway, and burn-rate tracking - Valuation via exit multiple with a DCF cross-check - Returns analysis with MOIC and IRR - Unit economics including CAC, LTV, payback, and cohort retention ## Product & value proposition - Product: ENvue system - a nasoenteric feeding tube embedded with a localization sensor tracked by an external navigation unit, providing real-time visualization of tube position during placement. - Value prop: Eliminates risk of lung misplacement (4–5% of all placements worldwide) without needing post-placement X-ray. Enables early enteral feeding within 24–48 hours for critically ill patients, reducing ICU stay, disease severity, and complications. - Pipeline: Preterm infant application; navigation guided by X-Ray images. - FDA 510(k) cleared February 2019. Clinical trial at Cleveland Clinic and St. Vincent's: 58 placements, zero lung misplacements. ## Market - TAM: $1.6B for nasoenteric feeding tubes globally. Note: OCR reads "$1,6B" (European notation) = $1.6B USD. - Volume: ~25M nasoenteric tubes/year worldwide; ~7.3M/year in the US. - CAGR: 5.9%. - Regional share (% of market / CAGR): North America 33.7% / 5.0%; Europe 30.0% / 5.5%; Asia Pacific 26.1% / 7.4%; Latin America 6.2% / 6.8%; Middle East & Africa 26.1% / 7.4%. Note: percentages sum > 100% - likely share of total tube volume by region. - Key competitors: Abbott, Boston Scientific, Cook Medical, Danone, Cardinal Health, Avanos, Nestlé Health Science, Bard, Fresenius. - COVID-19 cited as additional market opportunity (ICU/ventilated patients). ## Revenue model - Monthly recurring revenue model. Tubes are single-use consumables - hospital pays per-tube used, billed monthly. - The ENvue system (navigation unit) is presumed to be placed/loaned at hospital; recurring revenue comes from tube consumable orders. - ASP / contract structure: Nationwide agreement signed with 2nd-largest private healthcare system in the US (150 hospitals) - implies institutional/GPO contracting. - Manufacturing capabilities mentioned - Israel-based production assumed. ## Traction & metrics - US commercial launch: January 2020. - Installed at 7 hospitals in the US as of deck date (post-Jan '20) with over 2,000 successful placements. - Nationwide agreement signed with 2nd-largest private US healthcare system (150 hospitals). - Multiple hospitals on monthly recurring orders. - "Thousands of procedures successfully performed with zero lung placements". - Clinical trial (pre-commercial): 58 placements at Cleveland Clinic and St. Vincent's, zero lung misplacements. ## Unit economics - Cost savings cited qualitatively: FDA-cleared technology "demonstrated to save lives and reduce costs". No quantified hospital cost-savings data in deck. ## Competition / moat - Current gold standard for verifying tube placement is X-Ray - performed after placement (reactive, not real-time), with growing concerns over cost and radiation exposure. - ENvue provides real-time guidance during placement - a differentiated approach. - Strong IP portfolio mentioned; no patent count or expiry disclosed. - FDA 510(k) clearance (Feb 2019) is a regulatory moat for US market entry. - Team has prior exits in adjacent navigation/medical device space: superDimension (acquired by Covidien $330M), Corpak MedSystem (acquired by Avanos $174M), Simbionix (acquired by 3DS), Sync-Rx (acquired by Volcano Corp.). ## Team & funding ask / use of funds - Doron Besser, MD - Co-Founder, President & CEO (Sunlight Medical, superDimension, Angioslide) - Shay Tsuker - Co-Founder & CFO (Bank Leumi Investment Group, Psagot Investment / Apax Partners) - Gabriel Portnoy - COO (IDF Brigadier General, Intelligence Corps) - Fred Reuning - VP Clinical Marketing (Novartis, Smiths Medical, Vascular Solutions, Nestlé Medical Devices) - Joe Kroll - National Sales Director (Corpak MedSystem / Avanos) - Robert McVey - VP Market Development (Corpak MedSystem / Avanos) - Guy Ben-Ezra - VP R&D (Orsan Medical, Deepbreeze, MTRE Advanced Technologies) - Ran Cohen - CTO (Simbionix, SuperDimension, Sync-Rx, Volcano Corp.) - Clay Anselmo - VP RA/QA (Alcon, Gambro, Reglera / Dohmen Life Sciences) - Anat Hofshi, PhD - Director Clinical Affairs (B.G Guard, Carmel StemSense) - Total raised: $16.7M. Investor: Swing Medical. ## Recommended financial model - **Archetype + why:** MedTech consumable revenue model (hospital-installed-base + per-procedure recurring revenue). The business follows a classic razor/blade (or "capital equipment + consumable") pattern: navigate unit placed at hospitals, recurring tube orders billed monthly. Revenue scales with (a) number of hospitals/units installed and (b) procedures per hospital per month. A 3-statement operating model built around these two drivers is the right structure. - **Forecast horizon & granularity:** 5-year monthly model (Years 1–2 monthly for cash burn visibility, Years 3–5 annual for strategic view). Given early commercial stage (launched Jan 2020), monthly granularity for the first 2 years is critical - runway and MRR ramp are the key management metrics. - **Key drivers & assumptions:** - *Installed hospital base (end of period):* 7 hospitals at model start. Ramp rate: +5–15 hospitals/month as national sales team activates 150-hospital agreement; ramp S-curve with 18-month full penetration lag. - *Procedures per hospital per month:* ~50–150 procedures/month/hospital based on ICU/surgical ward volume norms for a mid-size US hospital; use 80 as base case. - *Revenue per tube (ASP):* $150–$250/tube based on comparable single-use navigation consumables (Corpak/Avanos pricing tier); use $200 base. - *Navigation unit (capital equipment):* Placed/loaned at no upfront charge (common MedTech go-to-market for consumable pull-through); cost capitalized and amortized over contract life. - *Cost of goods sold (COGS):* 30–40% of tube ASP; navigation unit COGS ~$5,000–$15,000/unit based on sensor/HW complexity. - *Gross margin:* 60–70% blended (consumable-heavy businesses in this category run 65–75% at scale; apply lower margin early due to manufacturing scale-up). - *Sales force headcount:* National Sales Director + VP Market Development confirmed; ramp to 10–20 field reps over 3 years; $150K OTE each. - *R&D spend:* Israel-based team; ~$2–4M/year for pipeline (preterm infant, X-Ray navigation products). - *Market CAGR:* 5.9%. - *COVID-19 uplift:* Modest positive; ICU capacity surge 2020 provides incremental demand; not modelled as a separate driver - captured in procedure volume ramp. - *Total raised to date:* $16.7M. Opening cash balance based on burn rate implied by team size. - **Scenarios (Base / Bull / Bear - which variables flex):** - *Base:* Hospital ramp follows nationwide agreement at moderate pace (150 hospitals over 24 months); 80 procedures/hospital/month; ASP $200. - *Bull:* Rapid hospital activation (150 hospitals in 12 months); 130 procedures/month; ASP holds at $220 (pricing power from zero-lung-misplacement outcomes data). - *Bear:* Slow hospital buy-in (60 hospitals over 24 months); 50 procedures/month; ASP pressure to $170 from GPO negotiation; pipeline launch delayed. - **Required sheets / outputs:** 1. Assumptions dashboard (all drivers in one place, clearly tagged) 2. Revenue build: Installed hospital base → procedures/month → MRR → ARR 3. P&L (Income Statement): Revenue, COGS, Gross Profit, OpEx by category (S&M, R&D, G&A), EBITDA, Net Income 4. Cash Flow Statement: Operating cash flow, capex (navigation units placed), financing 5. Balance Sheet 6. Headcount plan (Israel R&D + US commercial) 7. Runway tracker (months of cash at current burn - critical given early stage) 8. Scenario toggle (Base / Bull / Bear) 9. KPI summary: MRR, installed base, procedures/month, gross margin %, cash runway ## Frequently asked questions ### Is the Envizion Medical financial model free? Yes. The Envizion Medical model is a free Excel download with live formulas. ### Can I change the assumptions? Yes. The workbook is editable and its live formulas recalculate when assumptions change.