Orthofix Medical Inc. (OFIX) | Investment Case

1. Company Snapshot

1.a. Company Description

Orthofix Medical Inc.operates as a medical device and biologics company in the United States, Italy, Germany, France, the United Kingdom, Brazil, and internationally.It operates through two segments, Global Spine and Global Orthopedics.

The Global Spine segment manufactures, distributes, and provides support services for bone growth stimulator devices that enhance bone fusion, as well as used as a therapeutic treatment for non-spinal and appendicular fractures.This segment also designs, develops, and markets a portfolio of motion preservation and fixation implant products, which are used in surgical procedures of the spine; and a portfolio of products and tissue forms that allow physicians to treat a range of spinal and orthopedic conditions, as well as markets regenerative non-tissue biologic solutions derived from synthetic materials.The Global Orthopedics segment designs, develops, and markets orthopedic products that are used in fracture repair, deformity correction, and bone reconstruction procedures.

The company markets and distributes its products through direct sales representatives; independent distributors; and employed and independent sales representatives to physicians, hospitals, ambulatory surgery centers, integrated health delivery systems, and other purchasing organizations.The company was formerly known as Orthofix International N.V. and changed its name to Orthofix Medical Inc.in July 2018.

Orthofix Medical Inc.was founded in 1980 and is headquartered in Lewisville, Texas.

Show Full description

1.b. Last Insights on OFIX

Negative drivers behind Orthofix Medical Inc.'s recent performance include a disappointing Q4 earnings release, which missed estimates by $0.04 per share. The company's net sales growth of 8% on a reported and constant currency basis was overshadowed by a 12% decline in U.S. Spine Fixation net sales. Additionally, the company's recent conference participation and investor relations activities have been overshadowed by a shareholder litigation investigation, which may raise concerns about corporate governance and management's decision-making. Furthermore, the company's recent product clearance and CE Mark for the TrueLok Elevate Transverse Bone Transport System, while a positive development, may not have had a significant impact on the company's short-term performance.

1.c. Company Highlights

Last Price	15.9
Change Percentage	0.00%
Open	16.14
Previous Close	15.9
Market Cap ( Millions)	630
Volume	157848
Year High	20.48
Year Low	10.24
M A 50	15.15
M A 200	13.89

FCF Yield	-0.46%
Dividend Yield	0.00%
ROE	-25.59%
Debt / Equity	39.61%
Net Debt / EBIDTA	-1863.92%
Price To Book	1.43
Price Earnings Ratio	-5.31
Price To FCF	-217.12
Price To sales	0.77
EV / EBITDA	-123.04

2. Orthofix Delivers Strong Q3 with Revenue Growth and Margin Expansion

Orthofix reported total global net sales of $203.4 million, a 6% increase over the prior year, driven by strong performance in its U.S. Spine and Orthopedics segments. The company's Spine Fixation business saw an 8% year-over-year increase in net sales, fueled by the continued adoption of its 7D FLASH navigation system. Earnings per share (EPS) came in at $0.2, beating analyst estimates of $0.12. Gross margins are expected to be approximately 72% for the second half of the year, indicating a stable margin profile.

Publication Date: Nov -23

                                    📋 Highlights
                                    U.S. Spine Fixation Growth:
                                                Net sales increased 8% YoY with 10% procedural volume growth, driven by 7D FLASH adoption
Orthopedics Momentum:
                                                U.S. segment delivered 19% YoY growth, fifth consecutive quarter of double-digit gains
Distributor Transition Success:
                                                Top 30 U.S. distributors grew 25% YoY (Q3) and 33% TTM, validating commercial strategy
Bone Growth Therapies Performance:
                                                6% above-market growth via cross-selling and market leadership reinforcement
Financial Highlights:
                                                Total net sales reached $203.4M (+6% YoY), with 72% gross margin guidance for H2 2025

                                

Segment Performance

The U.S. Spine Fixation segment saw a 10% increase in procedural volume, with the company noting strong momentum across its spine portfolios. The Orthopedics business had a standout quarter, with U.S. Orthopedics growing 19%, driven by the successful global launch of TrueLok Elevate and supported by new product introductions. The Bone Growth Therapies team continued to excel, delivering above-market growth of 6% by leveraging cross-selling opportunities.

Guidance and Outlook

Orthofix expects a slight deceleration in revenue growth to about 4% in Q4, compared to 6% in Q3. The company remains confident in its ability to deliver strong operational and financial performance, supported by a robust innovation pipeline and consistent commercial execution. For 2026, analysts estimate revenue growth at 5.8%, which is slightly below the company's long-term financial targets of 6.5% to 7.5% CAGR.

Valuation

With a P/E Ratio of -5.09 and a P/S Ratio of 0.74, Orthofix's valuation appears reasonable, considering its revenue growth prospects. The company's EV/EBITDA ratio is -118.84, indicating that its enterprise value is not justified by its current EBITDA levels. However, this is likely due to the company's negative EBITDA. The ROE and ROIC are also negative, at -25.59% and -13.43%, respectively, highlighting the need for improvement in profitability.

Distribution and Product Pipeline

The company is consolidating its distribution partners to scale in the future, which involves replacing multiple distributors with a single partner in some areas, while adding new distributors to enter regions where it had a weak presence. Orthofix is also excited about the growing interest in its TrueLok Elevate product, with plans to participate in ongoing studies to validate its clinical benefits.

3. NewsRoom

Orthofix Medical Inc. (OFIX) Presents at UBS Global Healthcare Conference 2025 Transcript

Nov -11

Source: seekingalpha.com

Orthofix Medical Inc. (OFIX) Q3 2025 Earnings Call Prepared Remarks Transcript

Nov -04

Source: seekingalpha.com

Orthofix (OFIX) Beats Q3 Earnings and Revenue Estimates

Nov -04

Source: zacks.com

Orthofix Medical Inc. (NASDAQ:OFIX) Given Consensus Recommendation of “Moderate Buy” by Analysts

Oct -26

Source: defenseworld.net

Orthofix to Report Third Quarter 2025 Financial Results

Oct -14

Source: businesswire.com

FMS vs. OFIX: Which Stock Is the Better Value Option?

Oct -07

Source: zacks.com

ORTHOFIX ALERT: Bragar Eagel & Squire, P.C. is Investigating Orthofix Medical Inc. on Behalf of Long-Term Stockholders and Encourages Investors to Contact the Firm

Sep -04

Source: globenewswire.com

FMS vs. OFIX: Which Stock Should Value Investors Buy Now?

Aug -07

Source: zacks.com

4. Business Breakdown

4.a. Revenues by Country

4.b. Revenues by Segment

5. Expected revenues mid-term growth (5.69%)

6. Segments

Spinal Implants, Biologics, and Enabling Technologies

Expected Growth: 5.5%

Orthofix Medical Inc.'s 5.5% growth is driven by increasing demand for spinal implants, biologics, and enabling technologies. Key drivers include an aging population, rising prevalence of spinal disorders, and advancements in minimally invasive surgical procedures. Additionally, the company's focus on innovation, strategic partnerships, and expansion into emerging markets contribute to its growth momentum.

Bone Growth Therapies

Expected Growth: 5.8%

Orthofix Medical Inc.'s Bone Growth Therapies segment growth of 5.8% is driven by increasing demand for minimally invasive spine procedures, adoption of novel biologic solutions, and expansion into emerging markets. Additionally, strategic partnerships and investments in research and development are contributing to the segment's growth.

Global Orthopedics

Expected Growth: 6.2%

The 6.2% growth of Global Orthopedics from Orthofix Medical Inc. is driven by increasing demand for minimally invasive spine procedures, rising adoption of orthobiologics, and expanding presence in emerging markets. Additionally, advancements in 3D printing and robotic-assisted surgeries are contributing to the segment's growth.

7. Detailed Products

Bone Growth Therapies

Orthofix Medical Inc. offers a range of bone growth therapies, including bone growth stimulators and osteoinductive products, to enhance bone healing and fusion.

Biologics

Orthofix's biologics portfolio includes a range of products, including bone graft substitutes and osteoinductive products, designed to promote bone healing and tissue regeneration.

Internal Fixation

Orthofix's internal fixation products, including plates, screws, and rods, are designed to stabilize and support the spine and other bones during the healing process.

Orthobiologics

Orthofix's orthobiologics products, including bone graft substitutes and osteoinductive products, are designed to promote bone healing and tissue regeneration.

Spinal Implants

Orthofix's spinal implant products, including interbody devices and instrumentation, are designed to treat a range of spinal conditions, including degenerative disc disease and spinal deformities.

Surgical Instruments

Orthofix's surgical instruments, including surgical tools and implantable devices, are designed to support surgeons during orthopedic and spinal procedures.

8. Orthofix Medical Inc.'s Porter Forces

Forces Ranking

Threat Of Substitutes

Orthofix Medical Inc. operates in a highly competitive industry, and there are several substitutes available for its products. However, the company's focus on innovation and quality has helped it to maintain a competitive edge.

Bargaining Power Of Customers

Orthofix Medical Inc.'s customers are primarily healthcare professionals and hospitals, who have limited bargaining power due to the specialized nature of the company's products.

Bargaining Power Of Suppliers

Orthofix Medical Inc. relies on a few key suppliers for its raw materials, which gives them some bargaining power. However, the company's strong relationships with its suppliers help to mitigate this risk.

Threat Of New Entrants

The medical device industry is highly regulated, and there are significant barriers to entry. This makes it difficult for new entrants to compete with established players like Orthofix Medical Inc.

Intensity Of Rivalry

The medical device industry is highly competitive, with several established players competing for market share. Orthofix Medical Inc. faces intense competition from companies like Stryker, Johnson & Johnson, and Medtronic.

9. SWOT Analysis

10. Capital Structure

10.a. Balance Sheet

10.b. Weighted Average Cost of capital

	Value
Debt Weight	14.13%
Debt Cost	6.32%
Equity Weight	85.87%
Equity Cost	9.24%
WACC	8.83%
Leverage	16.46%

11. Quality Control: Orthofix Medical Inc. passed 3 out of 9 key points

Strong Liquidity

Low Debt

Strong Interest Coverage

Healthy Cash Flow

Operating Efficiency

Strong Return On Equity

Consistent Revenue Growth

Consistent Operating Cash Flow Growth

Margin Improvement

12.a Historical Valuation

12.b Price/Earnings Ratio

12.c Margin Valuation

12.d Peers Valuation

Peers Group Analysis

SI-BONE

A-Score: 4.7/10

Value: 7.0

Growth: 5.8

Quality: 5.6

Yield: 0.0

Momentum: 6.0

Volatility: 4.0

1-Year Total Return ->

AxoGen

A-Score: 4.0/10

Value: 2.6

Growth: 7.1

Quality: 3.9

Yield: 0.0

Momentum: 8.0

Volatility: 2.7

1-Year Total Return ->

Silk Road Medical

A-Score: 3.8/10

Value: 6.2

Growth: 5.6

Quality: 5.0

Yield: 0.0

Momentum: 5.0

Volatility: 1.0

1-Year Total Return ->

TELA Bio

A-Score: 3.3/10

Value: 7.8

Growth: 5.8

Quality: 3.6

Yield: 0.0

Momentum: 1.0

Volatility: 1.3

1-Year Total Return ->

Xtant Medical

A-Score: 3.0/10

Value: 6.2

Growth: 2.9

Quality: 3.9

Yield: 0.0

Momentum: 3.5

Volatility: 1.3

1-Year Total Return ->

Orthofix Medical

A-Score: 2.8/10

Value: 4.8

Growth: 1.3

Quality: 2.5

Yield: 0.0

Momentum: 3.0

Volatility: 5.0

1-Year Total Return ->

Peers Metrics

12.e Scoring ^Insights

12.f DCF ^BETA

Parameters

Short Term Growth

53.42%

Short term Time

10.0

Long-Term Growth

2.00%

WACC

8.83%

Orthofix Medical Inc. - US68752M1080

1. Company Snapshot

1.a. Company Description

1.b. Last Insights on OFIX

1.c. Company Highlights

Lower Growth

Cheaper

Stable Momentum

Earnings Miss

Revenues Beats

Earnings Beats

Revenues Miss

Strong Momentum

Fairly Valued

Less Volatile

Medium Volatility

Lower Quality

2. Orthofix Delivers Strong Q3 with Revenue Growth and Margin Expansion

Segment Performance

Guidance and Outlook

Valuation

Distribution and Product Pipeline

3. NewsRoom

4. Business Breakdown

4.a. Revenues by Country

4.b. Revenues by Segment

5. Expected revenues mid-term growth (5.69%)

6. Segments

Spinal Implants, Biologics, and Enabling Technologies

Expected Growth: 5.5%

Bone Growth Therapies

Expected Growth: 5.8%

Global Orthopedics

Expected Growth: 6.2%

7. Detailed Products

Bone Growth Therapies

Biologics

Internal Fixation

Orthobiologics

Spinal Implants

Surgical Instruments

8. Orthofix Medical Inc.'s Porter Forces

Forces Ranking

Threat Of Substitutes

Bargaining Power Of Customers

Bargaining Power Of Suppliers

Threat Of New Entrants

Intensity Of Rivalry

9. SWOT Analysis

Strength

Weaknesses

Opportunities

Threats

10. Capital Structure

10.a. Balance Sheet

10.b. Weighted Average Cost of capital

11. Quality Control: Orthofix Medical Inc. passed 3 out of 9 key points

12.a Historical Valuation

12.b Price/Earnings Ratio

12.c Margin Valuation

12.d Peers Valuation

Peers Group Analysis

Peers Metrics

12.e Scoring Insights

12.f DCF BETA

Parameters

Short Term Growth

Short term Time

Long-Term Growth

WACC

Target Price

15.9$

Current Price

15.9$

Potential

-0.00%

Expected Cash-Flows

12.e Scoring ^Insights

12.f DCF ^BETA