No. of Recommendations: 44
Hey Fools,

I had a chance to tour Abiomed's HQ last week and sit down with their head of IR for an hour. My goal is to post the entire conversation on this board for all to read, but that's going to take a day or two to complete.

In the meantime, here are a few key takeaways:

+Abiomed is pronounced Ah-be-O-med.

+Their MOAT is super wide for the following reason:
++There is no direct competition right now and getting a competing product to market would require a PMA (which is a more arduous process than a 510k approval). A potential competitor woud also have to get by the company's 310 patents and another 300+ that are pending.
++70% of surgeries involving an Impella pump have an Abiomed employee in the room while the procedure is taking place. This is either a sales rep (70-80 in the field) or, more likely, a clinician (250 in the field). After the surgery is over the employee says "hey doc, want to reorder?" This is a big reason why their reorder rate is 100%.
++The company follows up with every single patient in the hospital in person after surgery. Patient data is collected on 95% of cases and sent back to HQ for analysis. Their database now includes data from 70,000 cases and growing.
++Patients are monitored remotely by Abiomed's customer support staff in real time (the Impella sends data back to the company's HQ over the web).
++The company is super, super, super serious about training (their own staff as well as Impella users). Their new training center (they showed me around) is state of the art. They regularly bring in physicians to record videos on best practices and share them on the internet so that other physicians can see.

+The TAM continues to grow as new products/procedures/geographies come online. Market share right now is 9% in the U.S., 12% in Germany, and <1% in Japan. These numbers are likely high since they are constantly getting new approvals & clinical data that expands the number of use cases that could benefit from an Impella.

+Major focus right now is U.S., Germany, and Japan. Japan's three main heart associations (sort of like our on American Heart Association) approached Abiomed several years ago asking them to bring the device to market. Those three agencies lobbied the Japanese FDA to allow approval. Open heart surgery isn't an option in Japan, so they are super interested in the technology since it is minimally invasive.

+Impella already has regulatory thumbs up in China, India, Israel, and Europe. New countries will be opened up after reimbursement/commercial team is in place.

+The corporate culture is very Foolish. They invite several Impella patients to the HQ every year for a summer barbeque to tell their story. They even name conference rooms after former patients. The management team has a formal book club where they get together and discuss ideas that they have read about (CEO Michael Minogue's favorite business book is "Blueprint to a billion" by David Thomson)

Overall, I came away from the meeting very impressed.

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