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No Need to Brace Yourself Clear Aligner Market Primer Life Science Tools & Diagnostics 21 October 2019 Equity Research Americas

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No Need to Brace Yourself Clear Aligner Market Primer Life Science Tools & Diagnostics 21 October 2019 Equity Research Americas This is an updated version of the document published earlier today to incorporate takeaways from our Bull/Bear Lunch. No Need to Brace Yourself Clear Aligner Market Primer Life Science Tools & Diagnostics 21 October 2019 Equity Research Americas Erin Wright Research Analyst (212) 538-4080 [email protected] Katie Tryhane Haley Christofides Matthew Urbik Research Analyst Research Analyst Research Analyst (212) 325-2713 (212) 325-3720 (212) 325-2152 [email protected] [email protected] [email protected] DISCLOSURE APPENDIX AT THE BACK OF THIS REPORT CONTAINS IMPORTANT DISCLOSURES, ANALYST CERTIFICATIONS, LEGAL ENTITY DISCLOSURE AND THE STATUS OF NON-US ANALYSTS. US Disclosure: Credit Suisse does and seeks to do business with companies covered in its research reports. As a result, investors should be aware that the Firm may have a conflict of interest that could affect the objectivity of this report. Investors should consider this report as only a single factor in making their investment decision. Align Technology – Bull/Bear Scenarios Controversy Bull Case Bear Case Average Selling Price . Mix Shift to Accelerate Volume Growth: As ALGN . LT ASP Pressure: ASPs expected to continue to broadens its focus to a broader customer base, volume compress in 2019, with limited visibility on longer term What do ASP pressures mean for ALGN’s LT growth should offset an inherently compressed ASP; pricing power potential, with competitors in the wings revenue growth? Opportunity for non-price discount promotions Doctor-Directed Competition . Well Ahead of Competition: It is well ahead in terms . New Competitors: Doctors with established of innovation, with the ability to address an increasingly manufacturer relationships may opt to try out or fully How much of a concern are newer doctor-directed greater portion of a vastly underpenetrated market switch to newer doctor-directed product offerings product launches in the clear aligner market? DTC Competition . Safer/Effective Alternatives will Prevail: Regulators . Customers to Seek Cheaper Option: Competitors and/or doctors will deter DTC utilization through (e.g. SDC) take share in a lower tier market given more Will consumers choose doctor-directed offerings education and/or proposals/lobbying for safer options cost-effective/convenient (e.g. no doctor visits) given DTC options in the market? Intellectual Property . Continuously Innovating: Proven ability to continue . Losing Competitive Edge: As patent protection innovation with recent product launches (mandibular expires, competitors will utilize the basis of ALGN’s Can ALGN maintain its market leading position as advancement), staying well ahead of competition technology to advance products, potentially taking share its IP goes off patent? Clear Aligner Adoption . Largely Underpenetrated Market: Over time, clear . Limited Utilization: Doctors continue to prefer more aligners will become the standard of care, displacing traditional methods, with concern over clear aligner Will clear aligners achieve meaningful adoption traditional brackets & wires, while also driving broader capabilities and safety longer term given limited adoption thus far? overall utilization China (NT Dynamics) . Strong Market Positioning: Remains the premium . Weaker Economic Growth: Slowing broader economic brand of choice in China and remains one of the Top 2 growth in China may impact ALGN’s sales opportunity Will ALGN be able to sustain the same level of major players, contributing to high barriers of entry robust growth in China going forward? Valuation . Buy the Pullback: ALGN’s shares have fallen 36% . Premium Valuation: Despite recent valuation since its most recent high on May 16, and its still robust compression, ALGN still trades well above other Dental What is the right valuation for ALGN? growth prospects continue to warrant a higher multiple and Med Tech industry constituents Other Factors / Macro . Continued Favorable Macro Environment . Economic Downturn Reduces Demand . DSO Penetration . Increased Marketing Expense Required . Global Expansion . Global Trade Dynamics 2 SmileDirectClub – Bull/Bear Scenarios Controversy Bull Case Bear Case Teledentistry Model . Remote Monitoring is Sufficient: Doctors may . LT ASP Pressure: Without regularly scheduled in- effectively gauge a client’s suitability for clear aligner person visits, a patient is susceptible to higher risk of Is remote monitoring sufficient when providing treatment and appropriately monitor treatment remotely inappropriate malocclusion treatment orthodontic treatment? Efficacy . Efficacy Demonstrated: SDC’s clear aligners have . Safety/Efficacy Concerns: There is no public data received FDA 510(k) approval, indicating that it has demonstrating efficacy, particularly of its nighttime Do SDC’s clear aligner work properly to straighten a sufficiently demonstrated efficacy via tests/data analysis aligners, and customer complaints apparent patient’s teeth? Competition . Barriers to Entry: SDC has inherent advantages in a . Some Competitors Making Headway: Competition vertically integrated end-to-end process, supporting unit apparent in the market, potentially offering a With new DTC start-ups, will SDC be able to economics, where start-ups are likely significantly more distraction; CandidCo seems to be making strides maintain its robust growth? unprofitable SmilePay Financing . Supporting Conversion: SmilePay reduces conversion . Unproven Track Record: SmilePay is a fairly new friction, supporting growth; Moreover, implicit price offering with an unproven track record on bad debt As a captive offering, is SmilePay financing too concessions are already modeled into expectations management; 100% acceptance rate/no credit check risky? Litigation / Regulatory . Success as a Disruptor: As a disruptor, combative . Scrutiny Drives Volatility: Regardless of whether efforts from practitioners are unsurprising, and SDC has SDC squashes exclusive regulatory efforts, these Will SDC be able to effectively combat efforts by successfully fended off local/state dental boards for four dynamics will continue to drive intra-quarter volatility local/state dental boards? years Mgmt/Ownership Structure . Still Meaningful Stake: Insiders still have massive voting . Voting Power: Key management profited from power; Meaningful experience in disruptive models SDC’s IPO and have retained voting power (87% How committed is SDC’s management team? ownership stake) Valuation . Share Deterioration Egregious: With shares down over . Still More Room for Deterioration: Valuation still 60% since IPO, it is now trading below competitor ALGN does not fully reflect investment risks What is the right valuation for SDC? despite faster growth prospects Other Factors . Continued Favorable Macro Environment . Economic Downturn Reduces Demand . SmileShop Footprint Relationships (e.g. CVS, WBA) . Increased Marketing Expense Required . Global Expansion . Customer Complaints / Clinical Limitations 3 Clear Aligner Bull/Bear Key Metrics ALGN Takeaways • While over half of investors are Bullish on the Doctor Directed Market, investors remained Mixed-to-Bearish on their outlook of ALGN • Most Meaningful Long Term Opportunity for ALGN: Teen Market; Global Expansion • Least Relevant Long Term Opportunity: Adult, DTC Channel • Top Risk Factors for ALGN: ASP Compression, DTC Competition • Least Relevant Risk Factors: Management, DSO Penetration • Top Potential Competitors for ALGN: DTC Competitors, 3M’s Clarity Aligners, Straumann’s Clear Correct SDC Takeaways • While investors are fairly Mixed on the Direct to Consumer Market, investors remained Mixed-to-Bearish on their outlook of SDC • Most Meaningful Long Term Opportunity for ALGN: Underpenetrated Market; Incremental Retail Relationships • Least Relevant Long Term Opportunity: Innovation; SmilePay • Top Risk Factors for ALGN: Regulatory Environment; Concerns Around Efficacy • Least Relevant Risk Factors: International Expansion; Rapid SmileShop Footprint Expansion View on ALGN View on Dr. Directed Market View on SDC View on DTC Market Terminal View Bearish 6% 12% Bullish Bullish Bullish 24% 24% 24% Bearish 29% Bearish Bearish 41% 29% Neutral 29% Bullish 59% Neutral Neutral 35% Neutral 41% 47% 4 Source: Credit Suisse, n=20 Clear Aligner Bull/Bear Key Metrics ALGN: What Describes Your Thoughts on the Overall, XRAY was viewed as best positioned to outperform the Evolving Clear Aligner Competitive Landscape? group, followed by ALGN, NVST, SDC, HSIC, and PDCO (NT Negative) Will have a meaningful XRAY 2.2 Best Positioned (Neutral) Room negative impact to for several players ALGN's grow th in the market - trajectory NT ALGN 3.0 Should not derail 14% ALGN's grow th trajectory NVST 36% 3.0 SDC 3.3 (LT Negative) Will HSIC 3.8 have a meaningful negative impact to ALGN's grow th trajectory LT PDCO 5.2 50% 0.0 1.0 2.0 3.0 4.0 5.0 6.0 ALGN: What Would Make You More SDC: What Would Make You More Positive/Negative? Positive/Negative? More Positive More Negative More Positive More Negative International Expansion DTC Penetration Increases Positive Regulatory Dynamics Further Negative Regulatory Headlines Continued Execution Traditional Orthodontia More Aggressive Execution ALGN Performs Better than Expected Regulatory Changes Further ASP Compression Volume Growth Slows China Improves Guidance Revision Efficacy Issues Strong Q3/Q4 Positive Competitive Product Reviews Bad Reviews of Competitor 5 Source: Credit Suisse, n=20 Competitive Landscape (DTC vs. Doctor-Directed)
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