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    Joseph Downing • Piper Sandler

    Joseph Downing is an Assistant Vice President of Equity Research at Piper Sandler, specializing in healthcare sector analysis with a focus on medical device companies such as Merit Medical Systems and Vapotherm. He has participated in earnings calls and published sector coverage, demonstrating skill in detailed financial analysis and communication with company leadership. Starting his career at Cantor Fitzgerald & Co. after graduating from Fordham University in 2020, Downing joined Piper Sandler as an equity research analyst in November 2021. He holds relevant securities credentials and is recognized for his rapid career progression and expertise within healthcare and medical technology equities.

    Joseph Downing's questions to Pulmonx Corp (LUNG) leadership

    Joseph Downing's questions to Pulmonx Corp (LUNG) leadership • Q1 2025

    Question

    Asked about the reasons for the perceived softness in Q1 U.S. revenue, the outlook for U.S. growth acceleration, and plans for expanding the therapy awareness specialist program.

    Answer

    Executives attributed the U.S. growth rate primarily to a very tough year-over-year comparison, not external factors like weather. They expect U.S. growth to accelerate in the second half of the year due to their strategic initiatives. They hope to expand the therapy awareness specialist program beyond the initial 7 territories if it proves effective.

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    Joseph Downing's questions to Pulmonx Corp (LUNG) leadership • Q4 2024

    Question

    Asked for details on factors affecting 2025 gross margin, the potential for long-term margin expansion, and the impact of the current flu/respiratory season on procedures.

    Answer

    The company expects the 74% gross margin to be influenced by geographic mix and trend up in H2. Long-term, they see headroom for margin expansion from higher production volumes absorbing overhead. They have not seen a significant negative impact from the flu season and noted it could be an opportunity for patient identification via LungTrax.

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    Joseph Downing's questions to Edap Tms SA (EDAP) leadership

    Joseph Downing's questions to Edap Tms SA (EDAP) leadership • Q4 2024

    Question

    Joseph Downing, on behalf of Jason Bednar from TD Cowen, asked for an assessment of the hospital capital equipment purchasing environment in early 2025 compared to 2024, specifically regarding sales cycles and decision-making processes. He also questioned whether the CMS reimbursement rate increase, effective January 1, has generated incremental interest from hospitals in adopting the Focal One system.

    Answer

    Executive Ryan Rhodes stated that while sales cycle times remain consistent, the company's pipeline is growing and its strategy has adapted to be more effective. He emphasized that Focal One is a "clinically necessary, strategic, revenue-enhancing service line" for hospitals' prostate cancer programs, which helps in sales discussions. Rhodes confirmed the 5.4% CMS reimbursement increase helps significantly in hospital pro forma analyses, strengthens the business case for adoption, and ultimately improves patient access to the technology, though the full impact will be seen over the year.

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    Joseph Downing's questions to Edap Tms SA (EDAP) leadership • Q2 2024

    Question

    Joseph Downing from Piper Sandler asked for details on the drivers needed to improve gross margins in the HIFU segment. He also requested more information on the BPH clinical trial's timeline and enrollment, and what key learnings from the endometriosis program could be applied to the BPH study's execution.

    Answer

    CFO Ken Mobeck attributed the Q2 gross margin pressure to product mix, the conversion of operating leases at lower final purchase prices, higher temporary vendor costs, and some probe costs. He stated that a new vendor and higher HIFU volumes in the second half should improve margins. CEO Ryan Rhodes explained the BPH study is a combined Phase I/II trial to define parameters and validate safety/effectiveness, with patient enrollment starting in September. Regarding the endometriosis study, Rhodes highlighted positive takeaways like proven lesion reduction and patient crossover from the sham arm, noting the team is preparing for further FDA discussions.

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